Download Fact Sheet on Questions About Bottled Water and Fluoride Some

Fact Sheet on Questions About Bottled Water and Fluoride
Some consumers use bottled water as a beverage for various reasons, including
as a convenient means of hydration during their activities or as a taste
preference. Besides having a cost that is between one-to-five thousand times more expensive than tap
water, bottled water may not have a sufficient amount of fluoride, which is important for good oral health.
Some bottled waters contain fluoride, and some do not. Fluoride can occur naturally in source waters used
for bottling or be added. Most bottled waters contain fluoride at levels that are less than optimal for oral
health. This fact sheet covers common questions about bottled water and fluoride.
Is the amount of fluoride in bottled water listed on the label?
The U.S. Food and Drug Administration (FDA) does not require bottlers to list the fluoride content in a bottle
of water, but does require fluoride additives to be listed. In 2006, the FDA approved labeling with the
statement, “Drinking fluoridated water may reduce the risk of tooth decay,” if the bottled water contains
greater than 0.6 milligrams per liter (mg/L) and up to 1.0 mg/L.
How can I find out the level of fluoride in bottled water?
You must contact the manufacturer to ask about the fluoride content of a particular brand of bottled water.
Will the fluoride content change if the water is stored in a bottle for a lengthy period of time?
Fluoride will not react with other minerals in the water during storage, or with its plastic or glass container.
The FDA considers bottled water to be safe indefinitely if produced in accordance with quality standard
regulations and if stored in an unopened, properly sealed container without subsequent damage. However,
many bottlers list an expiration date. If there is no expiration date, it is a reasonable practice not to
consume water 2 years after the date of purchase because undetected deterioration of the packaging may
have occurred.
Does consuming bottled water lead to more cavities?
Your oral health—specifically how many cavities you have—depends on many factors, only one of which is
how much fluoride you get in the form of toothpaste, mouthwash, water, food, and applications by dental
professionals (other factors include how often and how well you brush and floss, what you eat, and whether
you get good dental care). If you mainly drink bottled water with no or low fluoride and you are not getting
enough fluoride from other sources, you may get more cavities than you would if fluoridated tap water were
your main water source.
Does the FDA regulate fluoride in bottled water?
Yes. The federal Food, Drug, and Cosmetic Act provides FDA with broad regulatory authority over food,
including bottled water, that is introduced or delivered for interstate commerce (produced and sold in more
than one state). Bottled water that is in intrastate commerce (produced and sold only in one state) is under
the jurisdiction of the state in which the bottled water is produced and sold. You need to contact the
manufacturer to ask if their product is under FDA jurisdiction or state jurisdiction.
What FDA regulations apply to bottled water?
The FDA regulations for governing the standards of “quality and identity” for bottled water are found in the
Code of Federal Register 21 CFR 165.110. The FDA standards of quality state that domestic bottled water
with no added fluoride may contain between 1.4 and 2.4 mg/L fluoride, depending on the annual average of
maximum daily air temperatures at the location where the bottled water is sold at retail. Imported bottled
water with no added fluoride may not contain fluoride in excess of 1.4 mg/L. Domestic bottled water with
added fluoride can contain between 0.8 and 1.7 mg/L fluoride, depending on the annual average of
maximum daily air temperatures at the location where the bottled water is sold at retail. Imported bottled
water with added fluoride may not contain more than 0.8 mg/L fluoride. The labeling requirements by the
FDA do not stipulate listing the actual fluoride content, so you will still need to contact the manufacturer to
inquire about verified fluoride levels of their product.
Does the EPA have jurisdiction over the quality of bottled water?
The EPA does not have jurisdiction over the quality of bottled water. The U.S. Environmental Protection
Agency (EPA) and the FDA have a 1979 Memorandum of Agreement specifying that the EPA regulates
safe drinking water in accordance with the Safe Drinking Water Act, and the FDA regulates bottled water as
a consumer beverage under the Food, Drug, and Cosmetic Act (Federal Register, Volume 44, No. 141,
July 20, 1979). The FDA has its own regulations on standards of quality, identity, and good manufacturing
practices that bottled water must meet.
Can I use fluoridated water for preparing infant formula?
Yes, you can use fluoridated water for preparing infant formula. However, if your child is exclusively
consuming infant formula reconstituted with fluoridated water, there is an increased potential for mild dental
fluorosis, which is a white spotting on teeth.
Content source: Division of Oral Health, National Center for Chronic Disease Prevention and Health
Promotion
Page Located on the Web at http://www.cdc.gov/fluoridation/fact_sheets/bottled_water.htm