Minerals · 3 min read ·

Fluoride: for teeth, not extra for the body

Fluoride is not essential for the body, but it protects teeth from decay. Most of it comes from toothpaste and water — and in 2025 EFSA set a stricter safe level.

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In a nutshell

1What it does

Fluoride is built into the enamel and dentine of growing teeth, forming fluorapatite, which resists acids better. On teeth that have already erupted it acts through contact with the enamel, in saliva and in dental plaque, where it slows bacteria. According to EFSA, a benefit for bones has not been shown.1

EFSA recommendation 0.05 mg/kg EFSA set the adequate intake of fluoride at 0.05 mg per kilogram of body weight a day for children and adults, from all sources including toothpaste. It is the amount at which tooth decay is reduced the most.1

2Where to find it

The main sources of fluoride in the diet are water and water-based drinks, tea, sea fish and fluoridated salt. 80–90% of it is absorbed.1 In the EU, supplements may contain it as calcium, potassium or sodium fluoride or sodium monofluorophosphate.3

3Teeth

Strong evidence — Cochrane 96 studies A Cochrane review (96 studies): toothpaste with 1,000–1,250 or 1,450–1,500 ppm fluoride reduces new tooth decay in children and adolescents compared with fluoride-free toothpaste, and it helps adults too. Higher concentrations, however, raise the risk of fluorosis — spots on growing teeth.4
Weak evidence — Cochrane 157 studies A new Cochrane review of water fluoridation: in the era of fluoride toothpaste, adding fluoride to water brings a smaller benefit than in old studies. At 0.7 mg/L, about 12% of people had spots on their teeth that bothered them aesthetically.5

4When it is too much

EFSA assessment 2025 3.3 mg In 2025 EFSA set a safe level of intake of 3.3 mg of fluoride a day from all sources for adults, pregnant women and children from 9 years. It is based on drinking water with more than 1.5 mg/L being linked to poorer brain development in the unborn child. According to EFSA, the current EU drinking water limit (1.5 mg/L) is not sufficiently protective.2
Moderate evidence 74 studies A summary of 74 studies, mostly from China: higher fluoride exposure was linked to lower IQ in children. For water with less than 1.5 mg/L the link was uncertain; it persisted only in the better-quality studies.6

What to take from this

Sources

Written on , based on studies available at that date. Newer research may change the conclusions.

  1. EFSA NDA Panel (2013). Scientific Opinion on Dietary Reference Values for fluoride. EFSA Journal 11:3332. doi.org/10.2903/j.efsa.2013.3332
  2. EFSA Scientific Committee (2025). Updated consumer risk assessment of fluoride in food and drinking water including the contribution from other sources of oral exposure. EFSA Journal 23:e9478. doi.org/10.2903/j.efsa.2025.9478
  3. Directive 2002/46/EC on food supplements, Annex II — forms of vitamins and minerals permitted in supplements (consolidated version 26 Nov 2025). eur-lex.europa.eu
  4. Walsh T. et al. (2019). Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev CD007868. doi.org/10.1002/14651858.CD007868.pub3
  5. Iheozor-Ejiofor Z. et al. (2024). Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev CD010856. doi.org/10.1002/14651858.CD010856.pub3
  6. Taylor K. W. et al. (2025). Fluoride exposure and children’s IQ scores: a systematic review and meta-analysis. JAMA Pediatr 179:282–292. doi.org/10.1001/jamapediatrics.2024.5542

This is general information and does not replace a doctor or dentist. Give children fluoride toothpaste in the amount your dentist recommends.