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Amount of Fluoride Should Be Listed on Bottled Waters

Read the label to see if water contains fluoride.

More Americans are turning to bottled water as their source for H2O, but they may be turning their backs on an important element that protects teeth -- fluoride.

"Some brands contain no fluoride, some have fluoride naturally and some companies add fluoride to the water," says Mary Starsiak, D.D.S., a general dentist who practices on Chicago's Northwest Side. "Few brands provide information to the consumer on fluoride content."

Current U.S. Food and Drug Administration regulations do not require bottled water companies to list fluoride content unless fluoride has been added to the water. In these cases, the label must only note that fluoride is present in the water; however, the amount of fluoride added is not listed.

"The problem is that some patients who have switched to bottled water may not be getting the fluoride they need," says Dr. Starsiak. "Some parents mistakenly believe that they can give their children bottled waters because they are healthier, not realizing they are not getting the fluoride that children need to create strong enamel and fight tooth decay."

Dentists typically conduct screenings to determine the amount of fluoride their patients receive and the sources of the fluoride. "However, bottled water can be a problem because we don't know how much fluoride is in the water, which makes it difficult for dentists to counsel patients who are at high risk for caries," says Dr. Starsiak. "Consumers would benefit from more information about the fluoride content of bottled waters."

Ironically, says Dr. Startiak, the FDA requires that toothpaste tubes contain a warning that children are at risk of dental fluorosis if they consume too much toothpaste, although the level of how much toothpaste is not mentioned. Fluorosis can cause small discolorations to develop of teeth but has no other known detrimental effects.

"The fluoride content of bottled water will become more of an issue in the future because more and more people are buying it," says Dr. Starsiak. Indeed, the Beverage Marketing Corp. reported that consumption of bottled water in the United States had more than doubled between 1986 and 1996, from 4.5 to 11 gallons per person.

However, she says, the problem would be solved if all companies would list the fluoride content on their packaging. "There needs to be a uniform system of listing the amount of fluoride on the bottle so that consumers know exactly how much fluoride they are getting," concludes Dr. Starsiak. "I believe the consumer has the right to know."

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