On January 7, the U.S. Department of Health and Human Services announced the first reduction in the recommended level of fluoride in drinking water in 50 years, lowering the recommended level to 0.7 parts per million. This decision is prompted in part by recent data noting an increase in the level of fluorosis, a form of enamel damage and tooth discoloration due to too much fluoride. The National Health and Nutrition Examination Survey found that in 2004, 41 percent of children ages 12 to 15 have some level of fluorosis.
Many attribute the rise in fluorosis to increasing use of multiple products containing fluoride, such as toothpaste and fluoride-containing mouthwash. The addition of fluoride in drinking water has been controversial since its inception in 1962, when the decision was described as a step toward Communism. Few countries outside of the US add fluoride to drinking water.
Several articles about the new recommendations stress the importance of giving children under 6 no more than a pea sized amount of toothpaste and make sure they spit it out after brushing. Toothpaste with fluoride is not recommended for children under 2.
Schubert Center Faculty Associate James Lalumandier, DDS, MPH teaches at the School of Dental Medicine. He works with the Health Smiles Sealant program to provide sealants and oral health care to children in the Cleveland Metropolitan School District. In October 2010, he gave a talk as part of the Schubert Center’s Conversations on Children in Research, Policy and Practice on how the program has increased sealant rates to 80% of all third graders in the district.