The European Food Safety Authority (EFSA) re-assessed the potential risks to consumers from fluoride in drinking water, food, fluoridated table salt, and ingested fluoridated dental care products (EFSA Journal. 2025;23:e9478).
The European Commission asked EFSA to update its previous risk assessment of fluoride after recent studies suggested a possible link to harmful effects on the developing nervous system of children. EFSA also looked at the potential effects of fluoride on the thyroid, bones, and teeth.
EFSA set a safe level of intake of 3.3 mg/day for pregnant women and all age groups >8 years of age, derived from potential effects on the developing central nervous system of the fetus by assuming a drinking water concentration of 1.5 mg fluoride/L (legal limit) as a reference point.
Additionally, for infants and young children tolerable upper intake levels (ULs) were derived by EFSA as follows: 1 mg/day for infants 0 - 12 months of age, 1.6 mg/day for children 1 - 3 years of age, and 2 mg/day for children 4 - 8 years of age. Although derived from the risk of dental fluorosis, these ULs are considered protective of all other potential adverse effects for these age groups.
According to EFSA, in general, with the current concentrations of fluoride in European drinking water (usually less than 0.3 mg/L), total fluoride exposure does not exceed the new safe and tolerable upper intake levels for almost all age groups and therefore does not pose a health concern.
The only exception is for children aged 4 - 8 years. Assuming typical fluoride concentrations in drinking water and a very conservative estimate of total ingestion of dental care products, mild fluorosis (tooth discoloration) may occur.
Based on EFSA’s assessment, the European Commission may review the current legal limit for fluoride in drinking water to make sure it provides adequate protection from potential health risks.
