Fluoride Levels in Urine and Tap Water in Canada: Data from the Canadian Health Measures Survey 2012-2015 and Interpretation in a Risk-Based Context

Fluoride is recognized as beneficial to dental health because of its ability to prevent tooth decay. However, excessive fluoride intake may cause dental fluorosis, and at much higher levels skeletal fluorosis and other adverse health effects. For many years, water fluoridation has been introduced in various Canadian communities and around the world as a public health measure to prevent dental decay. Besides tap water, Canadians are exposed to fluoride through food, beverages, and fluoridated dental products. In order to track fluoride exposure in Canada, fluoride levels in urine and tap water of Canadians have been monitored in the Canadian Health Measures Survey (CHMS) in 2012-2015. Using CHMS data and municipal fluoridation information, this study examined fluoride levels in urine and tap water of the Canadian population and potential associations between urinary fluoride levels and various exposure factors. It also aimed at interpreting the urinary fluoride levels in a risk-based context using biomonit...