How much fluoride is too much?
The U.S. Environmental Protection Agency (EPA) has set a Maximum Contaminant Level for fluoride of 4.0 mg/L for drinking water for public water systems. This means that some people who regularly consume water above this level can experience bone disease. EPA has also set a secondary standard of 2.0 mg/L. Children who regularly consume water above this level may experience dental fluorosis, ranging from white flecks in the mildest forms to brown stains and pitting in the most severe forms. EPA recommends that children under nine years old not consume water with fluoride concentrations higher than 2.0 mg/L on a regular basis. Your dentist can help you decide how much fluoride you and your family need.
Prescribing fluoride supplements isn’t always a simple matter. Fluoride in drinking water, other beverages, and toothpaste can push intake above therapeutic levels and cause fluorosis. New guidelines from the American Dental Association and American Academy of Pediatrics help you decide when and how much supplementation your patients need.
