Fluoride in Drinking Water

Experts recommend drinking fluoridated water to help prevent tooth decay, but questions still remain about fluoride's role in bone health. Many communities in the United States add fluoride to their drinking water to prevent tooth decay in children. Some scientists have raised concerns about fluoridation's relationship with osteoporosis, a disease that gradually weakens the bones and increases the chance of fractures.

The Paradox of Fluoride and Bone Density

Fluoride has been shown to increase the number of cells that build bone. From the 1950s through the 1980s, sodium fluoride was often suggested as a treatment for osteoporosis. However, in the 1980s, Mayo Clinic researchers discovered, during controlled trials involving postmenopausal women, that fluoride increased bone mineral density but also increased the incidence of fractures, especially in the lower extremities. Research since then has been conflicting, so fluoride therapy for osteoporosis is controversial.

A Look at the Research

Just a sampling of the literature on fluoride and bone health shows conflicting results.

The Need for More Research

The Oregon research is part of a larger study evaluating associations between broken bones and different factors that might increase or decrease fracture risk. Such studies help researchers formulate hypotheses, but this type of study cannot prove a cause-and-effect relationship. To prove that, scientists would have to take 2 similar communities, fluoridate one, and follow both for 25-30 years.

Ways to Prevent Bone Loss

Regardless of their positions on fluoridation, osteoporosis experts agree that the best ways to promote bone health are:

• Getting regular weight-bearing (brisk walking, yoga, dance classes) and muscle strengthening exercise
• Not smoking or quitting smoking
• Limiting alcohol consumption
• Getting adequate amounts of calcium and vitamin D