On April 2, 2019, the U.S. Food and Drug Administration (FDA) proposed revising the fluoride standard for bottled water to not exceed 0.7 milligrams per liter (mg/L). If finalized, the proposed rule would amend the allowable levels of fluoride in domestically packaged and imported bottled water to which fluoride is added by the manufacturer vs. naturally occurring fluoride levels found in source water. This proposal is based on findings from evolving research on optimal concentrations of fluoride that balances fluoride’s benefits in preventing tooth decay with its risk of causing dental fluorosis-a condition most often characterized by white patches on teeth. This level would ensure consistency with the U.S. Public Health Service’s (PHS) updated recommendation for the optimal fluoride concentration for community water systems (CWS) to prevent tooth decay.

It is also hoped this rule will provide clarity to consumers regarding fluoride levels. In 2015, PHS updated and replaced its 1962 Drinking Water Standards related to CWS fluoridation and recommended an optimal fluoride concentration of 0.7 mg/L. Interested parties may comment on the proposed rule electronically by visiting HERE and placing FDA-2018-N-1815 in the search box. The current enforceable drinking water standard for fluoride is 4.0 mg/L. This is the maximum amount that is allowed in water from public water systems. It is set to meet the current public health goal for protection against increased risk of crippling skeletal fluorosis-a condition characterized by pain and tenderness of the major joints. EPA also has a non-enforceable secondary standard for fluoride of 2.0 mg/L, which is recommended to protect children against the tooth discoloration and/or pitting.