- The U.S. Public Health Service should continue to recommend the use of fluoride to
prevent dental caries.
The U.S. Public Health Service should continue to support optimal fluoridation of
drinking water. Currently, the optimal level for water fluoridation is between 0.7 - 1.2
parts per minion, depending on mean daily air temperature for a geographic area.
The U.S. Public Health Service should sponsor a scientific conference(s) to recommend
both the optimal level of total fluoride exposure from all sources combined (including
drinking water) and the appropriate usage of fluoride containing dental products in order
to achieve the benefits of reduced dental caries and to minimize the occurrence of dental
The U.S. Environmental Protection Agency should review its regulations concerning
naturally occurring fluoride in drinking water based on the outcome of the scientific
conference(s) recommended above and based on this report.
In accordance with prudent health practice of using no more than the amount necessary to
achieve a desired effect, health professionals and the public should avoid excessive and
inappropriate fluoride exposure. For example, health professionals should prescribe
fluoride dietary supplements only when the fluoride level of the home water supply is
known to be deficient. Parents should educate young children to minimize swallowing of
fluoridated toothpaste and to use only small amounts of toothpaste on the brush.
The U.S. Food and Drug should review the labeling required for toothpaste and other
fluoride containing products to ensure that the public has adequate knowledge to make
informed decisions about their use, especially for young children (those under
Manufacturers of toothpaste should be encouraged to make the fluoride levels in their
products easily known. Manufacturers should determine whether toothpaste can be dispensed
in a dose limited container for use by children. Manufacturers of dental products should
explore whether the levels of fluoride can be reduced while preserving clinical
State health and drinking water programs should keep physicians, dentists, pharmacists,
physician extenders, and communities informed about the fluoridation status of drinking
water. This information will enable residents and health professionals to determine the
need for water fluoridation or for supplemental forms of fluoride.
Communities with high natural fluoride levels in the public drinking water supply should
comply with EPA regulations as mandated by the Safe Drinking Water Act. The current
primary and secondary maximum contaminant levels are 4 and 2 parts per million,
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An action plan to implement research and policy recommendations should be developed.
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