Fluoride

FL: Fluoride Exposure in the US (2010)

Fluoride Exposure in the United States

• Assessment
  What are the estimates of fluoride exposure in US children?

  • Conclusion

    Research on fluoride exposure in US children is limited. While estimates of exposure from local tap water sources are available from a federal census, this information is incomplete. Additionally, because there are multiple pathways of fluoride exposure (e.g., supplementation, food, soil, etc.), individual levels of exposure can vary widely.

    One study of moderate quality concludes that infants in areas where tap water is adequately fluoridated may be at an increased risk of over-exposure because of multiple fluoride sources (e.g., fluoridated drinking water, infant formula, other beverages and foods). However, uncertainty in the estimates limits the findings.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What are estimates of fluoride exposure in US children?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bader JD, Rozier RG, Lohr KN, Frame PS. Physicians’ roles in preventing dental caries in preschool children: A summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med. 2004; 26(4): 315-325. 
      • Bassin EB, Mittleman MA, Wypij D, Joshipura K, Douglass CW. Problems in exposure assessment of fluoride in drinking water. J Public Health Dent. 2004 Winter; 64 (1): 45-49. 
      • dela Cruz GG, Rozier RG, Bawden JW. Fluoride concentration in dentin of exfoliated primary teeth as a biomarker for cumulative fluoride exposure. Caries Res. 2008; 42(6): 419-428.
      • Erdal S, Buchanan SN. A quantitative look at fluorosis, fluoride exposure, and intake in children using a health risk assessment approach. Environ Health Perspect. 2005 Jan; 113 (1): 111-117. 
      • Griffin SO, Gooch BF, Lockwood SA, Tomar SL. Quantifying the diffused benefit from water fluoridation in the United States. Community Dent Oral Epidemiol. 2001 Apr; 29 (2): 120-129.
      • Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA. Medication use among children less than 12 years of age in the United States: Results from the Slone Survey. Pediatrics. 2009; 124(2): 446-454.
  • Search Plan and Results: FL: Fluoride Exposure 2010