Kidney Health & Fluoride

Smile Spokane is committed to educating the public about community fluoride benefits and addressing concerns raised by opponents. Experts don’t support claims that water fluoridation is harmful to kidney health or people with kidney disease.

What do experts and evidence say?

Q. Is fluoridated water safe for kidney dialysis patients?

A. Yes! When asked about drinking fluoridated water, the National Kidney Foundation (NKF) gave this answer: “Fluoride will not harm a dialysis patient if it is ingested in normal amounts in water.” The NKF doesn’t have specific recommendations on fluoride intake. However, the health advice provided for people with kidney disease does not include advice to avoid drinking fluoridated water. *

*All water used for dialysis is treated to remove the chlorine and fluoride from the water.

Q. Is fluoridated water safe for people with Chronic Kidney Disease (CKD)?

A. Yes! In 2011, Kidney Health Australia — a leading patient advocacy group — reaffirmed its position. Based on the available research, there is “no evidence that consumption of optimally fluoridated drinking water poses any health risks” for folks who have CKD.

Q. Does research indicate community fluoridation levels are harmful to kidney health?

A. No! Anti-fluoride activists cite studies like this 2001 study from India and suggest that fluoride is harmful to kidney health. When the local water supply was 5 to 7 times higher than the concentration used for community fluoridation, the research links this excessive fluoride exposure to kidney stones.* Researchers who have reviewed studies like this often point out that “the subjects of this study were at increased risk of kidney stones due to malnutrition.”

Opponents also often cite a relevant 2019 study from the US which relied on data from a national health database. The study’s findings were far from conclusive. The authors themselves point out one way to interpret the findings “is that poorer kidney function may contribute to increased plasma fluoride levels rather than resulting from them.”

*There are roughly 200,000 Americans whose primary water source has naturally occurring fluoride that reaches or exceeds 4 mg/L, the EPA’s allowable limit for fluoride. People with kidney disease living in these communities are advised not to drink their tap water. Many of these Americans live in areas of Arizona, Colorado, New Mexico, and Texas.