Fluoride intake during pregnancy: calculation of realistic exposure scenarios for individual risk assessment

Abstract

Using the methodological approach of systematic review several regulatory bodies and associations have performed an assessment of existing evidence on the adverse effects of fluoride. The most recent review by EFSA published in 2025 recommended a fluoride level in drinking water of below 1.5 mg/L and a maximum total daily intake of 3.3 mg of fluoride as safe level with particular respect to pregnant women and the exposed unborn child. Our work focusses on individual exposure aspects, evaluating the contribution of major sources, specifically those which can be influenced by personal behaviour. We demonstrate that black or green tea and fluoridated household salt—even at salt intake levels below the population 25th percentile—are main contributors of the daily fluoride exposure in the population. Using the safe level proposed by EFSA, we have calculated different exposure scenarios that may be used by individuals to estimate their specific exposure to fluoride from known sources. Considering that the safe level proposed by EFSA can be exceeded e.g. by drinking more than two cups (300 mL) of black or green tea daily and using even low amounts of fluoridated salt, our findings highlight the need for clear labelling of the fluoride content of products to allow informed consumer choices.

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