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National Research Council, Subcommittee on Health Effects of Ingested Fluoride. 1993. Health effects of ingested fluoride. Washington, DC: National Academy Press, 181 pp.

National Academies Press
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$57.00 plus shipping and handling; also available from the website. Document Number: ISBN 978-0-309-08668-4.

This report reviews the Environmental Protection Agency (EPA) standards related to fluoridated drinking water, examines the health effects of ingested fluoride, and addresses the question of whether the maximum contaminant level of 4 milligrams (mg) of fluoride per liter of drinking water is appropriate. The report discusses various kinds of toxicity that have been attributed to fluoride ingestion, including dental fluorosis; bone fracture; reproductive, renal, gastrointestinal, and immunologic toxicities; genotoxicity; and carcinogenicity. The report also assesses the current EPA drinking water standard for fluoride to determine whether it is protective of public health. The document is intended for use by EPA in deciding whether to maintain or revise its current drinking water standard for fluoride.

Keywords: Fluorides, Water, Toxicology, Oral health, Fractures, Carcinogens, Standards

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National Research Council, Committee on Fluoride in Drinking Water. 2006. Fluoride in drinking water: A scientific review of EPA's standards. Washington, DC: National Academies Press, 507 pp, brief (4 pp).

National Academies Press
500 Fifth Street, N.W., Keck 360
Washington, DC 20001

Telephone: (202) 334-3313
Secondary Telephone: (888) 624-8373
Fax: (202) 334-2451
E-mail: customer_service@nap.edu
Website: http://www.nap.edu
$56.00 plus shipping and handling; also available from the website. Document Number: ISBN 978-0-309-10128-8.

This report presents a review of the scientific basis of the Environmental Protection Agency's levels for fluoride, and the adequacy for protecting children and others from adverse health effects. Chapter contents include an introduction to fluoride in drinking water and its history; measures of exposure to fluoride; pharmacokinetics of fluoride; effects of fluoride on teeth, effects on systems including musculoskeletal, reproductive and developmental, endocrine, gastrointestinal, renal, hepatic, and immune; neurotoxicity and neurobehavioral effects, as well as genotoxicity and carcinogenicity. The final chapter focuses on drinking water standards for fluoride. References are provided and appendices include biographical information on committee members, supplementary information on measures of exposure to fluoride, ecologic studies in epidemiology, comparative pharmokinetics of rates and humans, and detailed information on endocrine studies of fluoride. A Report in Brief is also avaiable.

Keywords: Fluorides, Water, Oral health, Disease prevention, Adverse effects, Environmental exposure, Carcinogens, Medical research, Oral health

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National Maternal and Child Oral Health Resource Center Georgetown University