Fluoride shortage for US drinking water : NPR

This week, the City of Baltimore’s public water system reduced fluoride levels in its drinking water by nearly half due to supply chain issues linked to the Middle East conflict.

Matthew Garbark, director of the Baltimore City Department of Public Works, mentioned that their supplier had reduced deliveries from three to two per month. Consequently, the water system, serving 1.8 million people, is decreasing fluoride levels from 0.7 milligrams per liter, the U.S. Public Health Service’s recommendation, to 0.4 mg/L.

Baltimore is not unique in this challenge. Many U.S. water systems are experiencing a shortage of hydrofluorosilicic acid, a chemical used to fluoridate water to combat cavities. The shortage stems from the limited number of international producers of the chemical, with supply chain disruptions due to the Middle East conflict exacerbating the situation. U.S. water managers describe the current shortage as unprecedented.

The acid, primarily manufactured overseas, is imported by U.S. suppliers and transported to water treatment plants in liquid form via 5,000-gallon tanker trucks. Garbark confirmed that all chemicals are purchased and depend on the supply chain to reach their plants.

Factory staff deployed

Israel, a leading producer of this acid, is facing production challenges. Dan Hartnett, chief policy officer at the Association of Metropolitan Water Agencies, explained that a major supplier in Israel halted production after several employees were called for military service. As a result, the facility has not been producing or shipping the acid.

Hartnett noted that while widespread concern has not yet been reported among city water managers, a prolonged conflict could force more systems to reduce or stop adding fluoride. “If the conflict in Iran extends and supply disruptions persist, more systems might face similar challenges,” he indicated.

Currently, about 60% of the U.S. population receives fluoridated drinking water. Many communities have added fluoride to water as a public health measure, reportedly reducing cavities by approximately 25%.

The reduction in water fluoridation due to supply constraints is separate from activist efforts to end the practice over health concerns. The medical community continues to support low levels of fluoride in drinking water as safe.

Shortage leads to rationing

Ben Thompson, director of production at WSSC Water, which serves 1.9 million residents in Maryland, highlighted that while past global disruptions like COVID-19 caused delays in water treatment chemicals, they never had to reduce chemical usage until now. WSSC Water, like Baltimore, reduced fluoride levels from 0.7 mg/L to 0.4 mg/L due to a national shortage, as informed by their supplier.

Thompson expressed uncertainty about the duration of this shortage, emphasizing efforts to manage supplies, especially with increased water consumption in summer. Despite reaching out, Pencco, the Texas-based supplier for both Baltimore City DPW and WSSC Water, did not provide a response.

Meanwhile, in Pennsylvania, systems in Lititz Borough and Hanover Borough faced similar shortages in March but resolved their issues within weeks. Water utilities affirm that the reduction in fluoride does not compromise water safety, as fluoride is not mandated by the Environmental Protection Agency. “The reduction merely affects fluoride treatment, not water quality,” said Thompson.

Fluoride is also available from other sources like fluoridated toothpaste and certain teas and foods.

Thompson reassured that these reductions are temporary, aiming to restore fluoride levels to public health recommendations once supply issues are resolved, although he could not specify when that might be.