My question surrounds the safety of water for my six month old. Up until now, I have been using bottled water without fluoride to mix his formula. Now that he is six months old, I am debating whether to use fluoridated bottled water or a fluoride supplement (note: I am definitely pro-fluoride and know all the latest CDC recommendations for amounts). My worry is whether the flouride amounts in the bottled water are well regulated. The bottles all say "at least .3ppm OR at least .6ppm" depending on the bottler. But that doesn't indicate how much OVER that amount is in the water. For now, I have been mixing the fluoridated bottles with the regular at a 50/50 ratio to ensure that he doesn't receive too much fluoride.
Is it safe to switch to tap water at this point? At what age could I make that switch. The city I live in is fluoridated.

Dr. Greene's Answer

Hi Catherine, Thanks for your great question. As you know, the key to the benefits of fluoride is not to get too little, and not to get too much. Bottled waters are not closely regulated when it comes to fluoride. Most have low levels. Those that are labeled “with fluoride” are usually fine and have close to the amount indicated, but not always. Those that are not labeled “with fluoride” may or may not contain it.

Switching to tap water at 6 months has its advantages. It is convenient, consistent, and the most likely to result in a steady level of fluoride. I prefer filtering the tap water to remove chlorine. Filtered tap water is great for kids at that age (remember, these are the babies that like to put almost anything in their mouths anyway!) Most point-of-use filters, such as charcoal filters, remove most of the chlorine and contaminants, but do not remove the fluoride. Installed reverse osmosis water-filtration systems, however, are more powerful, but typically do remove fluoride.

If you know how much fluoride is in the primary source of drinking water, it is easy to decide if a supplement is needed, and if so, how much. Parents should keep in mind that the primary drinking water may be outside the home (at a relative’s house, day care, or workplace, for instance).

Whatever you choose, you can have the primary source of drinking water tested to find how much fluoride it has. If you choose the city water supply, the city has already done the testing for you. If you choose a specific brand of bottled water (or even well water), a local or state health department or school of dentistry will typically be happy to test it for you. There are also simple home tests that you can do yourself (such as FluoriCheck).

6 months old is the beginning of many new adventures – moving across the floor on one’s own, exploring with the mouth, and the adventure of new teeth, to name a few. Catherine, you sound knowledgeable, eager, and delighted with your son. I hope you deeply enjoy these unrepeatable months ahead!

Last medical review on: May 09, 2008
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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