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Is Fluoride in Our Drinking Water Safe?

2025/4/15
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Chasing Life

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克里斯汀·蒂尔博士
播音员
主持著名true crime播客《Crime Junkie》的播音员和创始人。
玛格丽塔·丰塔纳博士
罗伯特·F·肯尼迪小
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罗伯特·F·肯尼迪小:我认为在饮用水中添加氟化物没有意义。大量的证据表明氟化物有害,犹他州率先禁止在饮用水中添加氟化物,我对此感到非常自豪,并希望其他州也能效仿。 克里斯汀·蒂尔博士:越来越多的证据表明,长期接触氟化物会对骨骼、甲状腺和大脑功能造成损害,尤其是在发育早期。我的研究发现,孕妇孕期接触高水平氟化物与孩子智商降低之间存在关联。 玛格丽塔·丰塔纳博士:氟化物是预防龋齿的一种重要工具,尤其是在医疗资源匮乏的地区。氟化物通过增强牙齿再矿化过程来对抗酸的侵蚀,从而预防龋齿。 播音员:关于饮用水中氟化物的安全性存在争议。一方面,氟化物有助于预防龋齿,但其益处随着牙科保健的改善而降低。另一方面,新兴研究表明,高剂量氟化物可能对健康有害,包括神经毒性和骨骼氟中毒。剂量决定毒性,我们需要权衡氟化物对健康的益处和危害。美国环保署将审查氟化物对饮用水健康风险的科学信息,其他国家也采取了不同的方法来预防龋齿,例如定期氟化物漱口或在牛奶中添加氟化物。

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When something's made for you, it simply fits. You feel special. That's the sensation of a Sleep Number smart bed. You'll sleep comfortably, hot or cold, soft or firm, because it's personalized, scientifically made for you. Sleep Number smart beds learn how you sleep and provide personalized insights to help you sleep better. Why choose a Sleep Number smart bed? So you can choose your ideal comfort on either side.

And now, for a limited time, Sleep Number smart beds start at $8.49. Prices higher in Alaska and Hawaii, exclusively at a Sleep Number store near you. See store or sleepnumber.com for details. Welcome to Paging Dr. Gupta. Thanks for joining us. This week, we're going to take a closer look at an issue that has been making a lot of headlines lately. It makes no sense to have fluoride in our water. The evidence against fluoride is overwhelming.

And I'm very, very proud of this state for being the first state to ban it. And I hope many more will come.

That was the head of the Department of Health and Human Services, Robert F. Kennedy Jr., talking about Utah recently became the first state in the nation to ban fluoride in public drinking water, a practice known as fluoridation. Now, typically on Tuesdays, we take your questions, but this week we're going to address a topic that's been getting a lot of questions, and that includes from our podcast producer, Sophia Sanchez.

Hey Sanjay, yes, I've definitely been wondering about this topic myself. I've even been asked a few questions from my family about what exactly the concern is over fluoride. So what exactly is the concern over fluoride? Alright Sophia, let's start with the basics first of all. Fluoride is a naturally occurring mineral that you can find in plants, soil, certain foods, and obviously water.

It is great for strengthening our teeth. I'm going to come back to that point. But remember, fluoride can help strengthen your teeth, and that's why it's been added to toothpaste and tap water for around eight decades now.

If you do the math, about 70% of Americans on community water systems, that's about 209 million people, have fluoridated drinking water in the United States. And the CDC credits fluoridated water for a 25% reduction in cavities in children. But here's the issue. There is an emerging body of science that does raise some concerns about health issues associated with fluoride.

We now have a growing body of evidence linking systemic fluoride exposure with detrimental effects on bone strength, thyroid function, and brain function, particularly when there is high exposure in early development. So that's Dr. Christine Till, a clinical neuropsychologist and professor of psychology at York University in Canada.

She leads a lab that specifically investigates fluoride neurotoxicity. And what her research has found is a link between higher levels of maternal fluoride exposure during pregnancy and subsequently lower IQ scores in kids in Canada. Okay, I want to repeat that.

Her research found a link between higher levels of maternal fluoride exposure during pregnancy and subsequently lower IQ scores in those kids in Canada. Now, a report released last summer from the National Toxicology Program, part of the NIH, came to a similar conclusion. So,

So you have that research in Canada, and then you have sort of validation of that research from the National Institutes of Health here in the United States. Now, to be fair, there is some criticism of this research. For example, like the American Dental Association, they released a statement pointing out that the research largely used data from areas outside of the United States. Why is that important?

Many of those areas outside of the United States had fluoride levels that are higher than what we see typically in the United States. And I want to emphasize this point because something that I repeat often on this podcast is this idea that the dose makes the poison.

Just about anything in high enough doses can be problematic. So the dose makes the poison. You've got to pay attention to exactly how much fluoride we're talking about. It is true that exposure to too much fluoride can lead to negative side effects. I think that's what all this research is showing. Too much fluoride over the course of several years can lead to something known as skeletal fluorosis. That's a condition that causes weaker bones and joint pain. It can

It can also lead to cosmetic problems like flecks of white on your tooth enamel. You may have seen this before. And then obviously the concerns about neurotoxicity. But the question that remains, going back to this idea that the dose makes the poison, how much is too much?

And where does this all leave us? What are the risks also of removing fluoride from our drinking water? We want to discuss this issue from two lenses. First of all, what is the harm? And also, what is the benefit nowadays in 2025? And we'll dig into that right after the break.

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These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. All right, there goes the pager and more comments from my producer, Sofia Sanchez. Okay, so Sanjay, if there's early research to suggest that fluoride, in large quantities of course, could be harmful, should I be worried about my drinking water? Do the risks outweigh the rewards here?

Yeah, so that's the question, Sophia. That is a fair question, and I think that's what a lot of people are wondering. Proponents of fluoridation will argue, look, it's an important tool when it comes to fighting cavities. In fact, if you look at what public health experts say about this, they will call it, quote, one of the single most effective public health measures to prevent tooth decay overall in the nation. That's what the American Dental Association said. Specifically what fluoride does is it helps every time you eat something with sugars, right?

the microorganisms that are in your mouth that are completely normal, they metabolize that sugar and they produce acids that damage your tooth.

Over time, that becomes a cavity. If you lose more minerals in your tooth, then you gain. And we gain minerals through our saliva. Saliva is a wonderful fluid that we have in our mouth, very important for our health of our tissues in our mouth, our teeth, etc. But many times the calcium and the phosphate and the saliva is just not enough with the diets that we have.

So fluoride makes this process of minerals coming back into the tooth, which we call remineralization, much more effective. And without fluoride, really, the levels of tooth decay that we would have would be significantly higher. That's Dr. Margarita Fontana. She's a dentist. She leads the University of Michigan's Global Initiatives Program in Oral and Craniofacial Health.

She's one of the many medical professionals who are weighing in on this and who believe fluoridation is crucial to fighting cavities, especially in underserved communities where access to dental care is limited. There is a nuance here. Emerging research finds that while fluoridation does prevent cavities, it may not help nowadays as much as we originally thought. A report last fall from the Cochrane Collaboration, that's an independent group that analyzes the existing scientific body of research and

they found only a slight benefit to adding fluoride to tap water. In their conclusion, fluoridation was most effective before 1975. Why is that? Because fewer children had access to dental care before that, and fluoridated toothpaste was not as commonly used.

As we've improved dental care, as we've got more fluoridated toothpaste out there, the incremental benefit of fluoridating your water has gone down. These days, the report said, fluoridation may decrease tooth decay in baby teeth slightly. Slightly was their word. Thank you, Sanjay. I'm learning that this is complicated, but I'm still wondering, how feasible is it to take fluoride out of our drinking water?

So that's the next question, right? And it's a question I think many public health officials and political leaders are considering right now. There has been defluoridation efforts in other countries around the world. And as we just mentioned at the top of the podcast, Utah is the first state in the nation to do that here. Now, again, about 70% of Americans are on community water systems, over 200 million people. They have fluoridated drinking water.

Adding fluoride to public water systems is something that is typically up to local, city, and county governments. So, for example, some communities like Portland, Oregon, they don't fluoridate their water.

But that at the same time doesn't mean the federal government can't have some influence over what local governments do. Just this month, the EPA, the Environmental Protection Agency, announced that they will review scientific information on, quote, the potential health risks of fluoride in drinking water. And that's obviously something we're going to pay close attention to.

It is the EPA's role to set the limits on what is allowed in water and make recommendations under the Safe Drinking Water Act. Again, this gets back to that idea, the dose makes the poison. It's the EPA's role to set the limits on what is allowed in water, and that goes for fluoride as well. Now, in other parts of the world,

Some countries have taken different steps to prevent cavities. Take Iceland, for example. The water is not fluoridated there. Schoolchildren take twice-monthly fluoride rinses. In some parts of the UK, for example, schools add fluoride to milk.

The good news is, across the board, I'm talking worldwide, tooth decay has decreased since the 1970s. Now, here in the United States, if you're in a city or state where there is no fluoride in the water, like Utah, which we mentioned before, it may be worth taking extra steps to take care of your and your children's oral health. You know the basic recommendations, brush your teeth with fluoridated toothpaste, fluoride toothpaste, floss daily, see a dentist at least once a year, you've heard all that,

For kids, though, fluoride sealants or varnish may also be appropriate to prevent dental cavities. That's something to think about, especially in places where water is not fluoridated. Ask your dentist about this. At the end of the day, I think one thing we can all agree on is that we want to make it easier for our kids and future generations to have happy and healthy smiles, right? So, look, whenever you think about these issues, you should ask yourselves this.

What is the benefit? And we know there is a benefit, but the benefit to fluoridating water has gone down over time as dental care has improved, as fluoridated toothpaste has become more of a thing.

Second question, what is the harm? That's a little bit more complicated, but keep in mind that the dose makes the poison. Anything at too high a dose can potentially be harmful. In many countries around the world where you see this data linking potentially fluoridated water to neurotoxicity, they may have had higher levels, higher doses, if you will, of fluoride in the drinking water.

Look, it's a complicated issue. There's a lot of nuance here, but we really wanted to address this, and I hope that helps you. Remember, we're always hoping to get a call from you. Leave us a message with your health question, 470-396-0832. And as always, thanks for listening. I really enjoy being here. I hope you do as well.

Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sophia Sanchez, and Kira Dering.

Andrea Cain is our medical writer. Our senior producer is Dan Bloom. Amanda Seeley is our showrunner. Dan DeZula is our technical director. And the executive producer of CNN Audio is Steve Liktai. With support from Jameis Andrest, John D'Onora, Haley Thomas, Alex Manasseri, Robert Mathers, Lainey Steinhardt, Nicole Pesereau, and Lisa Namarow.

Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Wendy Brundage.

When something's made for you, it simply fits. You feel special. That's the sensation of a Sleep Number smart bed. You'll sleep comfortably, hot or cold, soft or firm, because it's personalized, scientifically made for you. Sleep Number smart beds learn how you sleep and provide personalized insights to help you sleep better. Why choose a Sleep Number smart bed? So you can choose your ideal comfort on either side.

And now, for a limited time, Sleep Number smart beds start at $849. Prices higher in Alaska and Hawaii. Exclusively at a Sleep Number store near you. See store or sleepnumber.com for details.

This week on The Assignment with me, Adi Kornish. People often say these models suffer hallucinations. They make stuff up. Well, actually, they're designed to make things up, right? We want them to tell us something that we don't know. The CEO of Microsoft AI, Mustafa Suleiman, on the next era of the tech industry and about what it means to hold on to your values when the industry is moving faster than the rules meant to govern it.

Listen to The Assignment with me, Audie Cornish, streaming now on your favorite podcast app.