Fluoride in Drinking Water: Portugal & Spain explained
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Fluoride in Drinking Water: Portugal & Spain explained

Water is undoubtedly the elixir of life, an essential resource that sustains our well-being. It’s no surprise that we place great trust in the quality of the water we consume. However, hidden within this seemingly innocuous fluid lies a contentious element: fluoride. A topic that has sparked debates for decades, the addition of fluoride to drinking water has been both praised for its dental benefits and criticized for potential health concerns. As we navigate the ever-expanding world of health-conscious choices, it becomes imperative to explore the facts and consider alternative options, such as water filtration, to ensure we make informed decisions about our drinking water. In this article, we delve into the ongoing fluoride discourse, shedding light on its pros and cons, ultimately empowering you to take control of your water choices for the betterment of your well-being. In addition, we take a closer look at fluoride in Portugal and Spain.

The benefits of water fluoridation

Proponents of water fluoridation argue that it has significant dental health benefits. Studies have consistently shown that fluoride, when present in optimal amounts, helps prevent tooth decay by strengthening tooth enamel. This preventive measure has contributed to a decline in dental caries, particularly among children in communities with fluoridated water. Fluoridation is considered a cost-effective public health intervention, as it benefits people of all ages and socioeconomic backgrounds.

Natural & Artifical Fluoride

The key distinction between naturally occurring fluoride and added fluoride lies in the control and regulation of their concentrations. Naturally occurring fluoride levels can be highly variable, influenced by geological factors, and may occasionally exceed the optimal range for dental health. In contrast, added fluoride in drinking water is regulated to ensure it falls within the recommended range. This allows for a more targeted and controlled approach to fluoride supplementation.

Safety concerns and opposition

Despite the widespread acceptance of water fluoridation, there is a vocal opposition to the practice. Critics argue that the potential health risks associated with consuming fluoride outweigh its benefits. One common concern is dental fluorosis, a condition characterized by white specks or lines on teeth caused by excessive fluoride intake during tooth development. However, severe fluorosis is rare and usually occurs in areas with naturally high fluoride levels, not from water fluoridation.

Another contentious issue revolves around the potential neurotoxic effects of fluoride. Some studies suggest that excessive fluoride exposure may impair cognitive development in children, leading to lower IQ scores. However, these findings have been disputed by other research, and the evidence remains inconclusive. It is worth noting that the studies indicating adverse effects have been conducted in areas with significantly higher fluoride levels than what is recommended for water fluoridation.

Balancing optimal fluoride levels

Determining the optimal concentration of fluoride in drinking water is crucial to strike a balance between its benefits and potential risks. The World Health Organization (WHO) recommends a range of 0.5 to 1.5 milligrams per liter (mg/L) of fluoride in drinking water. This concentration is considered safe and effective in preventing tooth decay while minimizing the risk of dental fluorosis.

Fluoridation in Portugal

Portugal does not have a clear fluoridation scheme or program. Therefore, no fluoride is added to the drinking water in Portugal. However, naturally occuring fluoride does exist. As this 2015 investigation into the chemistry of Portuguese water for consumption indicates;

The presence of fluoride in the water usually is due to the dissolution of fluorite or other minerals such as
fluorapatite, muscovite and some amphiboles (Calado and Almeida, 1993), which are common on the North of the
country due to the existence of a large quantity of granitic rocks.

Another interesting quote from this investigation does confirm that fluorosis may occur in hot climate areas that have a naturally high-occurring fluoride concentration.

According to WHO, the water consumption of 1.5 to 2 mg/L of fluoride in hot climate areas, may
contribute to the occurrence of fluorosis. In continental Portugal, levels of fluorosis are low, but there are some
cases in Alentejo (DGS, 2008), which is a region with moderately hot climate and occurrence of high fluoride in
the tap water (Alentejo Litoral – 1.57 mg/L F).

Fluoridation in Spain

In contrast to Portugal, Spain does have a region-specific fluoridation program. These are present in;

  • Basque Country in the north (including the cities of Bilbao and San Sebastian)
  • Girona in the north east of Catalonia;
  • Parts of Murcia province in the south east of Spain
  • Parts of Andalucia province (including the cities of Seville and Cordoba)
Property of the British Fluoridation Society

The average concentration of fluoride found in Spain is 0.25 ± 0.23mg/l (0,01-1,34mg/l) as indicated by this research paper from 2014. The water of 95% of the cities studied contains less than 0.7mg/l. Only in five areas the concentration is higher than 0.7mg/l. Namely;

  • Vitoria and San Sebastián due to artificial fluoridation
  • San Cristóbal de La Laguna (Tenerife) due to known natural fluoridation
  • Eivissa and León contain more than 1mg/l.

Can you remove Fluoride from your drinking water?

In short, yes you can! However, Fluoride is difficult to remove. Therefore you need specific Fluoride-filters. These filter elements are specifically designed to remove Fluoride and typically last around six months before requiring replacement. In most cases these filter elements are made of ceramic and/or activatated alumina. In case you need these specific products, here are some that could help you:


The addition of fluoride to drinking water remains a controversial topic, with passionate arguments on both sides. While water fluoridation has undeniably played a significant role in reducing tooth decay, concerns regarding potential health risks persist. Striking a balance between the benefits and risks of fluoride consumption, as well as respecting individual autonomy, is essential in shaping future policies. As scientific research advances, it is crucial to remain open to new evidence and engage in informed discussions.

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