Updated fluoride safety guidelines released by EFSA

The European Food Safety Authority (EFSA) has published new guidelines regarding fluoride intake, reassessing the potential risks associated with fluoride found in drinking water, food, fluoridated table salt, and dental care products. This update reflects the latest scientific research and establishes safe intake levels for all age groups. The outcomes of public consultations on the draft risk assessment and protocol related to fluoride, conducted in recent years, are also available as part of the scientific opinion, reflecting the commitment to transparency and public engagement in health-related matters.  

Fluoride is a naturally occurring element known for its ability to prevent tooth decay. While only a handful of EU member states fluoridate public drinking water, approximately 90% of toothpaste sold in the region contains fluoride. The EFSA report emphasizes that proper use of fluoridated dental products—specifically applying them to the surface of teeth without ingestion—does not contribute significantly to fluoride exposure.  

According to Susanne Hougaard Bennekou, Chair of EFSA's Scientific Committee, the assessment indicates that current fluoride levels in drinking water do not pose health risks for most age groups. "Total fluoride exposure generally remains below the new safe and tolerable upper intake levels," she stated. However, exceptions exist for children aged 4 to 8 years. The report notes that, in rare cases, these children may experience mild dental fluorosis—characterized by tooth discoloration—if they ingest fluoridated dental products excessively.  

The European Commission requested this comprehensive review following emerging studies suggesting potential links between fluoride exposure and adverse effects on children's developing nervous systems. The assessment involved a thorough examination of over 20,000 scientific papers, focusing on both human and animal studies.  

For individuals aged 9 years and older, including pregnant women, EFSA has set a safe intake level at 3.3 mg/day. This guideline considers potential impacts on the developing central nervous system, particularly during pregnancy, and is based on the legal fluoride limit of 1.5 mg/L in EU drinking water. Notably, most European countries report fluoride concentrations well below this legal threshold, typically less than 0.3 mg/L.  

For younger children, the findings emphasize the risk of dental fluorosis as the most sensitive health effect. Consequently, the tolerable upper intake levels have been defined as follows: 1 mg/day for infants (0-12 months), 1.6 mg/day for toddlers (1-3 years), and 2 mg/day for children aged 4-8 years. These limits are primarily derived from the risk of dental fluorosis while also safeguarding against other potential adverse effects.  

Given the evidence linking fluoride to possible developmental issues in fetuses, further research is recommended to address existing data gaps. The European Commission may consider revising the current legal limit for fluoride in drinking water based on EFSA's findings to enhance consumer safety.    

Source:  

EFSA