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A proposed bill would ban fluoride in drinking water, data shows areas with more fluoride in water have better dental health

The camera looks over an adult's shoulder as they rinse a toothbrush in a sink. To the right of the sink, toothpaste lies on the counter and a toothbrush rests in a glass.
Tima Miroshnichenko
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Oklahoma's third-graders have fewer dental problems in areas with more fluoride in drinking water.

An Oklahoma lawmaker has introduced a bill that would prohibit any public water supply in Oklahoma from adding fluoride to its drinking water.

Senate Bill 165, authored by Sen. Nathan Dahm, R-Broken Arrow, says banning fluoride is “immediately necessary for the preservation of the public peace, health or safety.”

The Oklahoma State Department of Health recommends “all applicable public water systems in Oklahoma be fluoridated to the optimal level for oral health.” Studies showthat fluoride in water helps kids avoid cavities as their permanent teeth develop, and it may slow tooth decay in adults as well.

But too much fluoride can cause cosmetic issues with teeth, like little white spots. In extreme cases, it can weaken bones. But those problems start to occur at higher concentrations than those found in Oklahoma public water supplies.

“If individuals want to use fluoride there are ways they can access it,” Sen. Dahm wrote in a Facebook post. “But the entire population shouldn’t be forced into it.”

Even with access to fluoride in mouthwash and toothpaste, fluoride in drinking water may give kids’ teeth a boost. When comparing public water fluoridation data with the Oklahoma State Department of Health’s data on dental problems in third-graders, Oklahoma’s kids tend to have fewer dental problems in areas with more fluoride in their drinking water.

Things like parental income, diet and accessibility of dental care could also factor into that tendency, but every 0.1 mg/L increase in fluoride concentration corresponded with a 7% decrease in third-graders with dental problems.

How much fluoride is in your water supply?

Fluoride is a form of fluorine, which is the thirteenth most abundant element in the Earth’s crust. Because of this, many public water supplies across Oklahoma report natural fluoride in their drinking water. Across the state’s non-fluoridated public water supplies, natural fluoride concentrations range from 0.01 mg/L in Haskell to 0.59 mg/L in Elk City.

In the United States, 0.7 milligrams of fluoride per liter of water is the recommended sweet spot for maximizing dental benefits without risking any negative effects. For reference, a grain of sand weighs about 1 milligram. The Environmental Protection Agency enforces a maximum limit of 4 milligrams of fluoride per liter, since that’s the concentration where fluoride can become a problem.

Nowata was the first community in Oklahoma to add fluoride to its water supply in 1951. In 2012, the State Department of Health introduced a Community Water Fluoridation Plan to provide information for communities considering water fluoridation.

Public water supplies that want to add fluoride must have their plans approved by the Oklahoma Department of Environmental Quality, which then monitors fluoride levels.

Fluoridated water supplies in Oklahoma range from 0.6 mg/L in Dover and Prague to 3.35 mg/L in Bluejacket.

The map below shows how much fluoride the average public water user gets in each Oklahoma county. This data comes from the CDC’s My Water’s Fluoride tool, which you can use to look up a specific water supply.

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Corrected: May 3, 2023 at 1:12 PM CDT
This article originally listed fluoride concentrations in micrograms rather than milligrams. Those units of concentration have been corrected. KOSU regrets the error.
Graycen Wheeler is a reporter covering water issues at KOSU as a corps member with Report for America.
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