Water Fluoridation Facts

The Pinellas County Board of County Commissioners approved adding fluoride to the water system on Nov. 29, 2012. It was implemented on March 1, 2013.

Our first priority is public health. We comply with the U.S. Environmental Protection Agency’s (EPA) standard for fluoride in drinking water. Pinellas County’s fluoride level is well below EPA’s Maximum Contaminant Level (MCL) of 4.0 parts per million (ppm) and the EPA’s Secondary MCL of 2 ppm.

The community drinking water will have a fluoride level of 0.7 ppm based on a new recommendation from the U.S. Department of Health and Human Services. This puts our water at the minimum of the 0.7 to 1.2 ppm range recommended for dental health. Pinellas County will make revisions as needed for further developments in drinking water fluoridation regulations.

Frequently Asked Questions

Is water fluoridation safe?

Fluoride is safe when used properly. More than 50 years of evidence from 162 million Americans and 60 other countries shows fluoridated water can reduce or reverse tooth decay. Drinking fluoridated water at the optimal level has been scientifically proven to be not toxic and effective.

What level of fluoride is added to my water?

Natural fluoride levels in Pinellas County water currently range from an average of 0.15-0.50 ppm*. Water fluoridation will adjust the natural fluoride concentration in Pinellas County’s drinking water to 0.7 ppm.
* parts per million, ppm, is equivalent to one cent in $10,000

What are the benefits to water fluoridation?

Health experts say water fluoridation is the most effective public health method to improve oral health. Water fluoridation strengthens tooth enamel, protects a baby’s first teeth, and improves the dental health for the entire community in a cost-effective way.

Who benefits from water fluoridation?

The entire community benefits from water fluoridation regardless of a person’s age, income, level of education or ability to get dental care. A 0.7 ppm fluoride concentration can reduce the number of cavities in children’s baby teeth by as much as 60% and reduce adult tooth decay by nearly 35%.

What does water fluoridation cost?

Adding fluoride to the drinking water will cost Pinellas County approximately $130,000 a year. This will be absorbed into annual operating costs.

Should my child continue taking fluoride supplements?

The Florida Department of Health recommends that prescription dietary fluoride supplements should not be given to any child who lives or goes to school in a fluoridated water community. However, you should consult the pediatrician or dentist who prescribed the supplement before making any decisions.

Is fluoride considered a nutrient?

Fluoride is listed by the Institute of Medicine’s Food & Nutrition Board as a micronutrient. It is also included on the Dietary Reference Intake Table for phosphorus, calcium, magnesium, vitamin D and fluoride.

Should my family continue brushing with fluoride toothpaste?

Yes. Fluoridated water is part of a total oral health program and you can get more protection by using a fluoride toothpaste. You should make sure young children do not swallow toothpaste.

Is fluoride safe for my pets?

Fluoride is safe for pets, including aquatic life. Fluoridated water may even benefit their dental health.

Will a water softener affect the fluoride levels in my home's tap water?

Water softeners or carbon filters will not remove fluoride from the drinking water entering your home. However, a standard reverse osmosis unit can significantly reduce the fluoride content. Consult with the filtration system manufacturer for more information.

Why did the Pinellas County Board of County Commissioners decide to fluoridate the county's public water supply?

The Pinellas County Board of County Commissioners decided to fluoridate the county’s water supply based on overwhelming information that fluoride is beneficial and not harmful to the dental health of most people.

The board used data and recommendations from the Centers for Disease Control, EPA, American Medical Association (AMA), American Dental Association (ADA), U.S. Surgeon General, Florida Health Department and the County Health Department. The Pinellas County Board of County Commissioners acted with a thorough review and based on the data, felt that there was a health benefit associated with fluoridation of the public water supply.

Who is affected by the addition of fluoride?

This affects all Pinellas County water customers, as well as Clearwater, Pinellas Park, Safety Harbor and Tarpon Springs.

Does fluoridated water increase the lead levels in children?

Studies that have shown elevated lead levels in children living in fluoridated water areas have been reviewed by appropriate health agencies. In most cases, they do not meet strict scientific research guidelines. They also do not show a “cause and effect” relationship between fluoride and elevated lead levels in children.

Does fluoridated water affect the plumbing in my home?

There is no known adverse impact on home plumbing. Some believe that fluorosilicic acid lowers pH and enhances corrosivity. The amount of fluoride added will not significantly impact pH in the source water used by Pinellas County. Additionally, pH is carefully monitored and adjusted to optimal levels at the distribution system entry points.

Does the water softening process affect the concentration of fluoride in my drinking water?

Fluoride in drinking water is not typically removed by water softeners. However, reverse osmosis and activated alumina filtration may significantly reduce fluoride ions in drinking water. Consult with a water filtration company for more information.

What is fluorosis and when does it occur?

Dental fluorosis occurs when high amounts of fluoride is ingested in early childhood while tooth enamel is forming. Enamel forms on permanent teeth other than wisdom teeth from about the time of birth until the age of five. Fluorosis changes the teeth’s appearance, and can’t develop once tooth enamel is formed even if excessive fluoride is ingested. This means older children and adults are not at risk for dental fluorosis. Teeth that have erupted are also not at risk for dental fluorosis (American Dental Association. Fluoridation Facts 1999).

Is it true that over time fluoride provided through water fluoridation accumulates in the body, causing adverse bone health affects like skeletal fluorosis?

After drinking a glass of fluoridated water, the majority of the fluoride is absorbed into the blood stream. The fluoride levels quickly reach a peak concentration and then rapidly decline, usually within three to six hours. During this time, fluoride is absorbed by hard tissue like bones and teeth and is removed by the kidneys. More fluoride is retained in younger bones than in the bones of older adults.

According to generally-accepted scientific knowledge, optimally fluoridated water does not have an adverse effect on bone health. Evidence of advanced skeletal fluorosis, or crippling skeletal fluorosis, “was not seen in communities in the United States where water supplies contained up to 20 ppm (natural levels of fluoride).” Crippling skeletal fluorosis is extremely rare in the United States and is not associated with optimally fluoridated water (American Dental Association. Fluoridation Facts 1999).

Are we at risk of consuming too much fluoride through foods, beverages and water?

The total intake of fluoride from air, water and food in an optimally fluoridated community in the United States does not pose significant health risks.

Children living in a community with water fluoridation get a portion of their daily fluoride intake from fluoridated water and a portion from dietary sources. You must consume one liter of water fluoridated at 1 part per million (1 ppm) to receive 1 milligram (1 mg) of fluoride. On average, children under six years old would consume less than 0.5 mg of fluoride a day from drinking optimally fluoridated water (at 1 ppm).

Studies have shown that fluoride intake from foods, beverages and water has remained relatively constant for over half a century and is not likely to be associated with an increase in dental fluorosis. Dental decay has decreased because children today are being exposed to fluoride from a wider variety of sources than decades ago (American Dental Association. Fluoridation Facts 1999).

Can I remove the fluoride from my home drinking water?

Fluoride may be removed from water by some home water treatment systems. Although each type reduces fluoride to some extent, some units may reduce fluoride by greater than 95%. You should consult with home treatment system providers for information on system efficiency.

Who supports water fluoridation?

Virtually all major national and international health, service and professional organizations endorse or support water fluoridation, including:

  • American Dental Association.
  • American Medical Association.
  • American Academy of Pediatrics.
  • American Academy of Pediatric Dentistry.
  • U.S. Public Health Service.
  • United States Center for Disease Control and Prevention.
  • World Health Organization.
  • National Academy of Sciences.
  • American Water Works Association.
  • Florida Department of Health.

Are there health studies on the chemicals used in water fluoridation?

The claim is sometimes made that no health studies exist on the silicofluoride chemicals used in water fluoridation. The scientific community does not study health effects of concentrated chemicals put into water. The health effects of the treated water are studied like what chemicals like fluoride ion, silicates, or the hydrogen ion become when added to water.

Thousands of studies over 50 years have analyzed fluoride’s health effects. These studies have found fluoride to be safe and effective in reducing tooth decay. The EPA has not set any maximum contaminant level for the silicates, as there are no health concerns for the low concentrations found in drinking water.

Where can I find out more about water fluoridation?