How Many PPM Is A Safe Amount For Fluoride In Water?

A closer look at the link between fluoride in the water & health issues


Walk down the self-care aisle of any grocery store and you will find an array of toothpaste and mouthwash that promise to do everything except make you taller. Use this one to get whiter teeth and another one to help sensitive teeth. What do most of these products have in common? They contain fluoride.

Fluoride is a naturally occurring chemical substance found in minor quantities throughout the air, in water, soil, plants, animals, in toothpaste, many city water supplies, soft drinks, and at the dentist. The effort to ramp up fluoride in the United States began as early as the 1930s in an attempt to prevent dental caries through the addition of fluoride to the public water supply. By 1951, water fluoridation was the official policy of the U.S. Public Health Service with fluoridated water reaching 50 million people in the United States by 1961.

However, findings from research are prompting local policy makers to rethink their public health policy on supporting fluoridation of the water supply since the “safe rate” for fluoride has been lowered in 2015 due to an array of serious health issues that have surfaced in connection with new fluoride facts. The discussion on lowering the fluoride levels in water has long been a topic of contentious research. Even as early as 1992, Burt argued in “The Changing Patterns of Systemic Fluoride Intake” that the United states needed “a downward revision in the schedule for fluoride supplementation” as well as education on the potential for the damaging health effects brought on by too much fluoride (p 1).

In 1961, investigations into the safety of fluoride in the United States found “no clinically significant, adverse, physiological, or functional effects, with the exception of dental fluorosis, are to be anticipated in persons whose water supply contains fluoride in the concentration of 8 ppm ” (Azar, et al, 1961). In other words, the United States’ early findings supported nearly double the safe amount of 4 ppm now recorded by professionals in other global communities as the ceiling for safe water fluoridation levels. This would be fine if the adverse effects of over-fluoridation were benign. However, that’s not the case.

Chronic fluoride intoxication, known as fluoride toxicity, begins with a mottling of tooth enamel and an elevation of bone density, called osteosclerosis. This effect has been seen throughout communities where the domestic water supply was composed of fluoride in concentrations of over four parts per million (1-5). Moreover, fluoride is a recognized developmental neurotoxin, and not an essential trace element required for the development of healthy teeth and bones (Karimzade, Aghaei & Mahvi, 2014). Additional and very recent studies have linked exposure to fluoridated water during childhood “with impaired attention and cognitive and intellectual functioning” that manifests in children and adults as ADD/ADHD (Karimzade, Aghaei & Mahvi, 2014; Malin & Till, 2015). Both prenatal and postnatal exposure to fluoride have been linked to adverse effects of neurodevelopment (Malin & Till, 2015). Knowing this, you might begin to wonder why it’s being touted as so necessary to the public health and ask yourself, “Is fluoride safe?” This is a legitimate concern, and one whose full merits have yet to be addressed. Seen as a “fringe issue,” the concerns about fluoride are gaining momentum as the link to hypothyroid, the condition of underactive thyroid, begin to surface in connection to fluoride in our water sources.

A 2012 Water District 17 meeting in Austin illustrated one of the most alarming aspects of such discussions regarding fluoride. Texas dentist Mark Peppard, designating himself as a “referral base for M. D. Anderson,” recounted that he receives patients suffering from oral, head, and neck cancers and the primary intervention he offers is to put them in bed “every single night” with a fluoride tray containing “at least 5,000 ppm of topical application.” Relying on the most convenient fallback of professionals, defaulting to the literature supported by their local association without regards to blatant errors in past judgment regarding the safety of fluoride, dentists like Dr. Peppard often disregard the consequences of such treatments that extend beyond the teeth and adversely affect entire system. Without the input of such lofty professional opinions the damaging effect of fluoride may have been removed from Austin’s water supply. However, the input of one local dentist, spouting statistics offered as well by the ADA that often are proven incorrect in a few year’s time, was enough to keep fluoride in Austin’s water supply.

On a more troubling note, the clear data from a plethora of global research becomes a little fuzzier when filtered through the lens of the United States, the local governments, The American Dental Association, and your friendly local dentist advocating childhood fluoride treatments at every teeth cleaning. The ADA asserts that “community water fluoridation is the adjustment of the natural fluoride concentration in water up to the level recommended for optimal dental health” in a range of 0.7 to 1.2 ppm, ranking well above levels at which thyroid function is found to deteriorate (2005). In research citing over 128 “reliable sources,” the ADA’s definitively titled “Fluoride Facts” pamphlet confirmed in 2005 that up to 1.22 ppm was a completely safe concentration of fluoride in the water (2005). This information has been found to be not only incorrect based on recent studies, but also advocating what are now regarded as dangerously high levels of fluoride.

More recent research from the Journal of Epidemiology & Community Health asserts that water fluoridation above 4 ppm is linked to “30 per cent higher than expected rates of underactive thyroid” (Peckham, Lowrey & Spencer, 2015). Looking at the prevalence of underactive thyroid diagnoses for 2012-2013, data from over 7935 general practices was compiled to measure the risk. In England currently, roughly 6 million people live in communities that have added fluoridation in their water supply of up to 1 mg fluoride.

The researchers added the additional data comprised of a secondary analysis that compared the areas of the West Midlands, which has fluoridated drinking water, and Greater Manchester, which does not. A clear association between rates of underactive thyroid and levels of fluoride in the drinking water was discovered.

While these are purely observations, they did not cover accounting for other sources of fluoride, such as those found in dental products, in our food, and in drinks. These products are part of the systemic changes that Burt’s findings cite. The research from the Journal of Epidemiology & Community Health concluded that “consideration needs to be given to reducing fluoride exposure, and public dental health interventions should stop [those] reliant on ingested fluoride and switch to topical fluoride-based and non-fluoride-based interventions” (Peckham, Lowrey & Spencer, 2015, p 5).

What do all the numbers and the research show? The takeaway from the fluoride debate is that the “powers that be,” acting as governmental parenting and healthcare advocates for an uninformed population seem very comfortable using the police powers of the states to overmedicate their populations, creating grievous health concerns for many that will never be answered for or alleviated. Using the executive actions of government bodies, unilateral decisions to add fluoride to the drinking water is deemed in the best interest of their populations. When their error came to light through additional new research regarding the safety and efficacy of the fluoride levels, the levels were downgraded. A small parcel of states still hold out against the addition of fluoride into their drinking water (see below the communities that have rejected fluoride). With more than just the teeth at risk, it seems prudent to treat just the individuals who might need additional fluoride rather than potentially poisoning a large segment of the population.



Compiled by Fluoride Action Network

Community / Country
Sullivan, Missouri
Palatka, Florida
Oneida, New York
Clarksburg, West Virginia
Carl Junction, MIssouri
Bennington, Vermont
Montello, Wisconsin
Brackenridge Borough, Pennsylvania
Boynton Beach, Florida
Doomadgee, Australia
Schuylkill Haven, Pennsylvania
Ford City, Pennsylvania
La Prairie, Quebec, Canada
Warwick, Queensland, Australia
Stanthorpe, Queensland, Australia
Allora, Queensland, Australia
Yangan, Queensland, Australia
Preston, Georgia
Weston, Georgia
Southampton and parts of Hampshire County, UK
Richmond, Quebec, Canada
Waynesville, Missouri
Montrose, Colorodo
Bucks County, Pennsylvania
Camden, Tennessee
Oberon, New South Wales, Australia
Boyne, Michigan
Buffalo, Missouri
Bolton, England
Hernando County, Florida
Wellington, Florida
Amherst County, Virginia
Wood Village, Oregon
Huntsville, Ontario, Canada
Lake of Bays, Ontario, Canada
Atwood, Tennessee
Hoopa Valley (Humboldt County), California
Byron Shire (NSW), Australia
Cotati (Sonoma County), California
Forsyth, Missouri
Muskoka, Ontario, Canada
Davis, California
Tottenham, Ontario, Canada
Columbia, Tennessee
Woodland, Washington state
Mount Isa, Queensland, Australia
Parkland, Washington
Hamilton, New Zealand
Portland, Oregon
Rockhampton, Queensland, Australia
Kenton, Tennessee
Southwest Harbor, Maine
Innisfail, Queensland, Australia
Whitsunday Regional Council, Queensland, Australia
Au Gres, Michigan
Charters Towers, Queensland, Australia
Tyrone, Pennsylvania
Lebanon, Tennessee
Cloncurry, Queensland, Australia
Olivehurst, California
Plumas Lake, California

(affected by decision of the Olivehurt Public Utility)

Smithville, Missouri
St. Croix Falls, Wisconsin
Balsam Lake, Wisconsin
Pine Island, Florida
Kirkland Lake, Ontario, Canada
Milton, Florida
Bradford, Vermont
Romulus, New York
Pulaski, New York
Wichita, Kansas
Harvard, Nebraska
Crescent City, California
Lake View, Iowa
Cassadaga, New York
Santa Fe, New Mexico
Argos, Indiana
Bassett, Nebraska
Palisades, Colorado
Pevely, Missouri
Lakeville, Indiana
North Liberty, Indiana
Walkerton, Indiana
Okotoks, Alberta, Canada
Albuquerque, New Mexico
West Manheim, Pennsylvania
Bourbon, Indiana
Bolivar, Missouri
Myerstown, Pennsylvania
Hartland Township, Michigan
Grantsburg, Wisconsin
Lake Cowichan, British Columbia, Canada
Williams Lake, British Columbia, Canada
Palmer, Alaska
Lawrenceburg, Tennessee
Palmer, Alaska
Welsh, Louisiana
Spencer, Indiana /BPP Water
College Station, Texas
Hohenwald, Tennessee
Pottstown, Pennsylvania
Spring Hill, Tennessee
Fairbanks, Alaska
Naples Village, New York
Mount Clemens, Michigan
Holmen, Wisconsin
Lago Vista, Texas
Mechanicsville, Iowa
Marcellus, Michigan
Independence, Virginia
Yellow Springs, Ohio
Schuylkill Haven, Pennsylvania
Sparta, North Carolina
Tellico, Tennessee
O’Fallon, Missouri
Red Bay, Alabama
Napa, California
Sandpoint, Idaho
Selmer, Tennessee
Crete, Nebraska
Dakota City, Nebraska
Franklin County, Nebraska
Norfolk, Nebraska
Wahoo, Nebraska
Schuylkill Haven Borough, Pennsylvania
Xenia, Ohio
Beacon, New York
Amery, Wisconsin

(Decision reversed in 2010)

Wisner, Nebraska
Yutan, Nebraska
Humboldt, Kansas
Wakefield, Nebraska
Thunder Bay, Ontario, Canada
Plainfield, Vermont (voted to remove fluoride) 
Chippewa Falls, Wisconsin (for the 2nd time) 
Skagit County, Washington
Big Canoe, Georgia
Jackman, Maine
Moose River, Maine
Corning, New York
Ainsworth, Nebraska
Aurora, Nebraska
Battle Creek, Nebraska
Bayard, Nebraska
Beatrice, Nebraska
Bridgeport, Nebraska
Broken Bow, Nebraska
Cambridge, Nebraska
Central City, Nebraska
Chadron, Nebraska
Cozad, Nebraska
Crawford, Nebraska
David City, Nebraska
Eagle, Nebraska
Friend, Nebraska
Geneva, Nebraska
Gothenburg, Nebraska
Grand Island, Nebraska
Grant, Nebraska
Hastings, Nebraska
Hebron, Nebraska
Imperial, Nebraska
Kimball, Nebraska
Lexington, Nebraska
Madison, Nebraska
Milford, Nebraska
Mitchell, Nebraska
North Platte, Nebraska
Ord, Nebraska
Pawnee City, Nebraska
Pierce, Nebraska
Plainview, Nebraska
Ravenna, Nebraska
Schuyler, Nebraska
Scottsbluff, Nebraska
Shelton, Nebraska
Sidney, Nebraska
St. Paul, Nebraska
Stanton, Nebraska
Stromsburg, Nebraska
Sutherland, Nebraska
Sutton, Nebraska
Tekamah, Nebraska
Valentine, Nebraska
Weeping Water, Nebraska
Wilber, Nebraska
Wood River, Nebraska
Wymore, Nebraska
York, Nebraska
Prairie du Chien, Wisconsin
Hyndburn, Lancashire, England
Pendle, Lancashire, England
Alamo Heights, Texas
Elba, New York
Littleton, Massachusetts
Yarmouth, Massachusetts
Poughkeepsie, New York
Manila, Humboldt County, Calfornia
Lewisburg, Tennessee
Elgin City Council, Texas
Juneau, Alaska
O’Connor UD, Sparta, White County, Georgia
Quebeck Walling UD, Sparta, White County, Georgia
Cobleskill Village, Schoharie County, New York

(Decision reversed in 2009)

Marshall County BUP#1, Lewisburg, Marshall County, Georgia
LaGuardo UD, Lebanon, Wilson County, Georgia
Conewango Township, Pennsylvania
Glade Township, Pennsylvania
Mead Township, Pennsylvania
Pleasant Township, Pennsylvania
Big Creek Utility District, Grundy County, Georgia
Cagle-Fredonia Utility District, Big Creek, Sequatchie, Georgia
Altoona, Pennsylvania
Beach Haven, New Jersey
Sulphur Rock, Arkansas
Mt Desert Water District, Maine
East Montgomery, Tennessee
Martin County, Florida
Juneau, Alaska
Central Bridge Water District, New York
Ashland, Oregon

(Decision reversed in 2008)

Lenapah, Oklahoma
Page, Arizona
Lincoln, Maine
Lafayette, Tennessee
Bellingham, Washington State
Springfield, Ohio
Xenia, Ohio
Tooele, Utah
Mammoth Lakes, California
Homer, New York
Hood River, Oregon
Neosho, Missouri
Pagosa Springs, Colorado
Snohomish, Washington State
Lancaster, Ohio
Hutchinson, Kansas
Clarksdale, Mississippi
Milton, Washington State
Telluride, Colorado
Sumner, Washington State
South Blount Water District, Tennessee
Chippewa Falls, Wisconsin

(Rejected again in 2009)

Honolulu, Hawaii
Lancaster, Ohio
Sequim, Washington State
York, Nebraska
Columbiana, Alabama
Canton, New York
Shaler, Pennsylvania
Billings, Montana
Kalispell, Montana
Washoe County, Nevada
Methuen, Massachusetts
Redding, California
Watsonville, California
Texarkana, Arkansas
Ashdown, Arkansas
Oneida, New York
Franklin, North Carolina
Plainville, Massachusetts
Monroe, Louisiana
Colorado Springs, Colorado
Kennewick, Washington
Bennington, Vermont
Lanai, Hawaii
Erie, Colorado NOTE: FAN was informed in Jan 2013 that Erie is fluoridating. We do not know when the reversal took place.
Modesto, California
Worcester, Massachusetts
Flagstaff, Arizona
Sutherlin, Oregon
White Salmon, Washington
Goldendale, Washington
Bishopville, South Carolina
Harper, Kansas
Brewster, Massachusetts
McPherson, Kansas
Norridgewock, Maine
Blue River, Wisconsin
Willamina, Oregon
Ithaca, New York
Spokane, Washington
Brattleboro, Vermont
East Wenatchee, Washington
Shawano, Wisconsin
Nibly City, Utah
Hyrum City, Utah
Providence City, Utah
Smithfield City, Utah
Logan City, Utah
River Heights, Utah
Pequannock, New Jersey
Ozark, Missouri
Wooster, Ohio
Woodside, California
Ste. Genevieve, Missouri
Winfield, Kansas
Wilmington, Massachusetts
Santa Barbara, California
Johnstown, New York
Wichita, Kansas
Boca Raton, Florida
El Carjon, California
Helix Water District, California
Lakeside Water District, California
Hutchinson, Kansas
Riverview Water District, California
La Mesa, California
Santa Cruz, California
Olympia, Washington
Bremerton, Washington
Seward, Nebraska
Whitehorse, Yukon Territory, Canada
Grand Island, Nebraska
Norfolk, Nebraska
North Platte, Nebraska
Washington, Missouri
Kitmat, British Columbia, Canada
Hot Springs, Arkansas
Ridgefield, Oregon
Largo, Florida
Clearwater, Florida
North Redington Beach, Florida
Amsterdam, New York
Suisun City, California
Yardley, Pennsylvania
Village of Orfordville, Wisconsin
Western Nassau County, New York
Gothenberg, Nebraska
Bloomer, Wisconsin
Kodiak, Alaska
Carle Place, New York
Winter Springs, Florida
Pasco, Florida
York, Pennsylvania
Thurmont, Maryland
Albany, New York
Middletown, Maryland
Barnstable (Cape Cod), Massachusetts
Wagoner, Oklahoma
Redwood Valley, California
Los Altos Hills (Purissima) California
Campbell River, British Columbia, Canada
Port Hardy, British Columbia, Canada
Squamish, British Columbia, Canada
Fort Smith, Arkansas
Milltown, Wisconsin
Bellingham, Washington
Comox/Courtenay, British Columbia, Canada
Palm Beach County, Florida

Note: Parts of the county are fluoridated

Ketchikan, Alaska
Suffolk County, New York
Davis, California
Morgan Hill, California



Azar Ha, Nucho Ck, Bayyuk Si, Bayyuk Wb. “Skeletal Sclerosis Due to Chronic Fluoride Intoxication: Cases from an Endemic Area of Fluorosis in the Region of the Persian Gulf.” Ann Intern Med. 1961;55:193-200. doi:10.7326/0003-4819-55-2-193

BMJ. “Water fluoridation in England linked to higher rates of underactive thyroid.” ScienceDaily. ScienceDaily, 24 February 2015. <>.

Burt, B. A. (1992). “The changing patterns of systemic fluoride intake.” Journal of Dental Research, 71(5), 1228-1237.

Hanes, M., & Jones, M. (n.d.). Fluoride Action Network. Retrieved June 20, 2015, from

Isah, H. A., Mohammed, U. A., & Mohammed, A. A. (2014). Environmental distribution of fluoride in drinking waters of Kaltungo area, North-Eastern Nigeria. American Journal of Environmental Protection, 3(6-2), 19-24.

Karimzade, S., Aghaei, M., & Mahvi, A. H. (2014). Investigation of intelligence quotient in 9–12-year-old children exposed to high-and low-drinking water fluoride in west Azerbaijan province, Iran. Fluoride, 47(1), 9-14.

Malin, A. J., & Till, C. (2015). Exposure to fluoridated water and attention deficit hyperactivity disorder prevalence among children and adolescents in the United States: an ecological association. Environmental Health, 14(1), 17.

McGinley, J., & Stoufflet, N. (2005). Fluoridation Facts. Retrieved June 20, 2015, from Center/FIles/fluoridation_facts.ashx

Peckham, Lowery & Spencer. “Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water.” Journal of Epidemiology & Community Health, February 2015 DOI: 10.1136/jech-2014-204971









No Comments Yet.

Leave a comment

You must be Logged in to post a comment.

Removable Dental Veneers Online

Now Accepting New Clients

Special Pricing - Limited Time Only

  1. Order online below and receive your impression system
  2. Make impressions and send them to our design lab
  3. Our lab makes your veneers & sends them to you
  4. You now have a set of custom veneers Lab Direct™
  5. Each set of veneers are custom made for you
Brighter Image Lab Accepted New Client

YES, I'm asking to be an accepted new client for Press-On Veneers today from just $795!

I understand that the full price for Press On Veneers™ is $1989, and would like to take advantage of the 60% limited time special discounted pricing and only pay $795 per arch plus $46 for the 3-way express shipping. That's it, Nothing More. No Hidden Charges. I understand that each set of veneers are custom made for me and that accepting new clients is limited. I have assessed my own smile, and I believe I'm the ideal type of client for Press On Veneers™. By ordering, I confirm I am fully committed to the process and I understand that any payment is non-cancelable and non-refundable and I confirm I have read and agree to all of the terms & conditions.

Your Customized Veneers are Made with the Highest Quality Materials & Digital Craftsmanship:

  • 3D Digital Impression Scanning
  • Micron 4x Contouring
  • Pearl Polish
  • HD Digital Detailing
  • Sure Fit Seal

Our #1 Seller > $1295 for Both Arches ($647/arch) - Limited Time Offer - Prices Increase In 5 Days

30 Day Standard Processing - Learn more about 14 day processing at checkout

Smile Assurance Plus - 3 Year Coverage

Add-On Option - Because we know your smile is so important, we want to help you protect it. Get peace of mind knowing your investment is protected. 2 Year Warranty - $149

Now offering payment by eCheck
Help Us Fight Fraud