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Document ID ca-gcdwqgtd-2011-06-20-2 Title Guidelines for Canadian Drinking Water Quality: Guideline Technical Document – Fluoride URL https://www.canada.ca/en/health-canada/services/publications/healthy-living/guidelines-canadian-drinking-water-quality-guideline-technical-document-fluoride/page-3-guidelines-canadian-drinking-water-quality-guideline-technical-document-fluoride.html Jurisdiction /ca Subdomain(s) Drinking water, Water treatment processes Language en Status completed Analyzed at 2026-03-18 13:44:32.523234+00:00 Relevance Technical document supporting Canadian drinking water quality guidelines for fluoride.

Q Qualitative Requirements (20)

Req ID Category Intent Legal Status Name Subdomain(s) Context Conditions Confidence
#Q001monitoringoperationalrecommendedSPADNS Colorimetric Method Sample Preparationdrinking waterWhen using this method, the preliminary distillation method 4500F-B should be used to prepare sample when these contain interfering ions or are coloured or turbid.When using the SPADNS colorimetric method and samples contain interfering ions or are coloured or turbidhigh
#Q002treatmentoperationalmandatoryActivated Alumina Pretreatmentdrinking waterIn order to prevent fouling of the AA column, there needs to be sufficient oxidation of iron and manganese ions followed by filtration of the raw water, before the AA beds.When using Activated Alumina (AA) treatment technologyhigh
#Q003treatmentoperationalguidanceActivated Alumina pH Adjustmentdrinking waterIn order to optimize the removal efficiency of the process, an adjustment of a pH of the water may be required, prior to and after the treatment process.To optimize the removal efficiency of the Activated Alumina processhigh
#Q004treatmentoperationalmandatoryReverse Osmosis Pretreatmentdrinking waterA pretreatment of the feed water is required to prevent scaling and fouling of the RO membranes.When using Reverse Osmosis (RO) treatment systemshigh
#Q005treatmenttreatmentmandatoryReverse Osmosis Post-treatmentdrinking waterThe RO product water typically requires post-treatment, consisting of pH and alkalinity adjustments (U.S. EPA, 1984, 2002).After Reverse Osmosis (RO) treatmenthigh
#Q006designoperationalrecommendedMembrane Selection Testingdrinking waterResults from this study also indicated that water quality and pilot-scale membrane units should be used when selecting membranes for full scale applications (Cohen and Conrad, 1998).When selecting membranes for full-scale applicationsmedium
#Q007treatmentoperationalmandatoryLime Softening pH Adjustmentdrinking waterAs the magnesium hydroxide precipitates at a pH greater than 10.5, adjustment of the pH is necessary.When using the lime softening processhigh
#Q008treatmenttreatmentrecommendedLime Softening Application Restrictiondrinking waterLime softening is an expensive process and is not recommended unless there is also a need to reduce hardness in the raw water (Singh and Clifford, 1981; U.S. EPA, 1984, 2002).Considered for fluoride removalhigh
#Q009treatmenttreatmentrecommendedAdditional Residential Treatment Restrictiondrinking waterGenerally, it is not recommended that drinking water treatment devices be used to provide additional treatment to municipally treated drinking water.Applicable to users receiving municipally treated drinking waterhigh
#Q010treatmenthealthrecommendedResidential Treatment Device Certificationdrinking waterHealth Canada does not recommend specific brands of drinking water treatment devices, but it strongly recommends that consumers use devices that have been certified by an accredited certification body as meeting the appropriate NSF International/American National Standards Institute (ANSI) drinking water treatment unit standards.When consumers select private residential drinking water treatment deviceshigh
#Q011treatmentoperationalguidanceResidential RO Pretreatmentdrinking waterA consumer may need to pretreat the influent water to reduce fouling and extend the service life of the membrane.When operating point-of-use reverse osmosis (RO) systemshigh
#Q012monitoringoperationalrecommendedResidential Treatment Device Testingdrinking waterPeriodic testing by an accredited laboratory should be conducted on both the water entering the treatment device and the water it produces to verify that the treatment device is effective.When using residential drinking water treatment deviceshigh
#Q013operationaloperationalrecommendedResidential Treatment Device Maintenancedrinking waterDevices can lose removal capacity through usage and time, and need to be maintained and/or replaced. Consumers should verify the expected longevity of the components in their treatment device as per the manufacturer's recommendations.Over the operational lifespan of residential drinking water treatment deviceshigh
#Q014operationalhealthrecommendedToothpaste Use for Children Under 3otherHealth Canada recommends children under the age of three should have their teeth brushed by an adult without using any toothpaste.For children under the age of threehigh
#Q015operationalhealthrecommendedToothpaste Use for Children 3-6otherHealth Canada also recommends children 3-6 years of age should be supervised during brushing and use only a small amount (e.g., pea-sized portion) of fluoridated toothpaste.For children 3-6 years of agehigh
#Q016monitoringhealthrecommendedMonitoring Dental Fluorosis Prevalencedrinking waterThe experts from the fluoride expert panel meeting recommend monitoring the prevalence of dental fluorosis in the Canadian population on an on-going basis, based on a clear definition for "moderate dental fluorosis," and using a common rating system that is compatible and/or comparable between researchers (Health Canada, 2008).high
#Q017operationaloperationalrecommendedBone Char pH Maintenancedrinking waterBone char is soluble in acid and the recommended pH to prevent loss of the media is approximately 7.0.When using bone char for fluoride removalhigh
#Q018treatmentoperationalguidanceMagnesium Salt Addition in Lime Softeningdrinking waterIf the raw water has a low magnesium content, magnesium salt may be added.When using lime softening and the raw water has a low magnesium contenthigh
#Q019administrativeunknownmandatoryCertification Body Accreditationdrinking waterCertification organizations provide assurance that a product conforms to applicable standards and must be accredited by the Standards Council of Canada (SCC).For organizations certifying drinking water devices and materials meeting NSF/ANSI standardshigh
#Q020operationalunknownmandatoryTreatment Sludge Managementdrinking waterThis quantity would result in generation of a large volume of sludge, which requires pretreatment and disposal (U.S. EPA, 2002).When using treatment processes like alum coagulation or lime softening that generate significant sludge volumeshigh

P Quantitative Requirements (34)

Req ID Category Intent Legal Status Name Subdomain(s) Limit Type Limit Value Context Conditions Confidence
#P001chemicaltreatmentmandatoryFluoride (NSF/ANSI Standard 58 influent challenge)drinking waterrequirement8.0 mg/LFor a drinking water treatment device to be certified to NSF/ANSI Standards 58, the device must be capable of reducing the concentration of fluoride in water from an influent (challenge) concentration of 8.0 mg/LReverse Osmosis Drinking Water Treatment Systemshigh
#P002chemicaltreatmentmandatoryFluoride (NSF/ANSI Standard 58 maximum effluent)drinking waterMAC<= 1.5 mg/Lreduce the concentration of fluoride in water to a maximum of 1.5 mg/LReverse Osmosis Drinking Water Treatment Systemshigh
#P003chemicaltreatmentmandatoryFluoride (NSF/ANSI Standard 62 influent challenge)drinking waterrequirement8.0 mg/LFor a drinking water treatment device to be certified to NSF/ANSI Standard 62, the device must be capable of reducing the concentration of fluoride in water from an influent (challenge) concentration of 8.0 mg/LDrinking Water Distillation Systemshigh
#P004chemicaltreatmentmandatoryFluoride (NSF/ANSI Standard 62 maximum effluent)drinking waterMAC<= 2.0 mg/Lreduce the concentration of fluoride in water to maximum of 2.0 mg/LDrinking Water Distillation Systemshigh
#P005chemicalhealthrecommendedFluoride (optimal target concentration)drinking watertreatment_goal0.7 mg/Lthe optimal concentration of fluoride in drinking water for dental health has been determined to be 0.7 mg/L.Where municipalities choose to fluoridate their water supplies as a public health measure for the prevention of dental carieshigh
#P006chemicalhealthguidanceFluoride (health-based value)drinking waterunknown0.9 mg/LThe health-based value for fluoride is 0.9 milligrams per litrehigh
#P007chemicalhealthguidelineFluoride (World Health Organization guideline)drinking waterunknown1.5 mg/LThe World Health Organization first established a guideline for fluoride in drinking water of 1.5 mg/L in 1984Based on increased risk of objectionable dental fluorosishigh
#P008chemicalhealthguidelineFluoride (Australia guideline)drinking waterunknown1.5 mg/LIn Australia, the guideline value of 1.5 mg/L has been establishedTo protect children from the risk of dental fluorosishigh
#P009chemicalhealthmandatoryFluoride (United States EPA Maximum Contaminant Level)drinking waterMAC4 mg/LThe United States EPA's Maximum Contaminant Level (MCL) for fluoride in drinking water is 4 mg/LTo protect against crippling skeletal fluorosishigh
#P010chemicalaestheticmandatoryFluoride (United States EPA secondary MCL)drinking waterAO2 mg/Lwith a secondary MCL of 2 mg/L to protect against dental fluorosisUnited States EPA considers a cosmetic rather than adverse effecthigh
#P011chemicalhealthmandatoryFluoride (California MCL)drinking waterMAC1.4-2.4 mg/LThe California MCL for fluoride in drinking water is 1.4 to 2.4 mg/LDepending on the ambient temperaturehigh
#P012chemicalhealthguidelineFluoride (European Union Drinking Water Directive - naturally occurring)drinking waterunknown1.5 mg/LThe European Union Drinking Water Directive (1998) recommends a standard value of 1.5 mg/LFor supplies with naturally occurring fluoridehigh
#P013chemicalhealthguidelineFluoride (European Union Drinking Water Directive - fluoridated)drinking waterunknown1.0 mg/LThe European Union Drinking Water Directive (1998) recommends a standard value... of 1.0 mg/LFor fluoridated supplieshigh
#P014chemicalhealthmandatoryFluoride (Maximum Acceptable Concentration)drinking waterMAC1.5 mg/Lexposure to fluoride in drinking water at typical levels found in Canadian drinking water (e.g. at the maximum acceptable concentration of 1.5 mg/L)high
#P015chemicalhealthguidelineFluoride (Tolerable Daily Intake)drinking waterrequirement105 µg/kg bw/dayAdding all the sources of exposure relevant to Dean's time, the updated TDI is about 105 µg/kg bw/day.To prevent moderate dental fluorosis for a 1- to 4-year-old childhigh
#P016chemicaloperationalmandatoryFluoride (US EPA Practical Quantitation Limit)drinking waterrequirement0.5 mg/LThe current U.S. EPA practical quantitation limit (PQL) (based on the ability of laboratories to measure the concentration of an analyte within reasonable limits of precision and accuracy) for fluoride is 0.5 mg/Lhigh
#P017operationaltreatmentrecommendedAlum Coagulation Fluoride Removal (Optimal pH)drinking waterOG6.2-7.0 pHExperimental data illustrated that the optimum pH range for removal of fluoride is between 6.2 and 7.0high
#P018operationaltreatmentrecommendedActivated Alumina Fluoride Removal (Optimal pH)drinking waterOG5.5-6.0 pHoptimum fluoride removal by AA is achieved at pH between 5.5 and 6.0high
#P019operationaltreatmentmandatoryLime Softening Fluoride Removal (Required pH)drinking waterrequirement> 10.5 pHAs the magnesium hydroxide precipitates at a pH greater than 10.5, adjustment of the pH is necessary.When using lime softening for fluoride removalhigh
#P020operationaltreatmentrecommendedBone Char Fluoride Removal (Recommended pH)drinking waterOG7.0 pHBone char is soluble in acid and the recommended pH to prevent loss of the media is approximately 7.0.When using bone char for fluoride removalhigh
#P021operationalreportingguidelineFluoride (WHO Daily Intake Trigger)drinking waterrequirement6 mg/dayWHO mentioned that where intakes are likely to approach or be greater than 6 mg/day, it would be appropriate to consider setting a standard or local guideline at a concentration lower than 1.5 mg/LApplicable when evaluating local guideline adjustmentshigh
#P022chemicalhealthguidanceFluoride (Minimum Acute Adverse Effect Threshold)drinking waterunknown5 mg/kg bwAn acute dose of 5 mg fluoride/kg bw has been considered to be the minimum that might lead to adverse health effectsSingle acute ingestionhigh
#P023physicaloperationalguidelineSPADNS Colorimetric Method (Linear Analytical Range)drinking waterrequirement0-1.4 mg/LThe SPADNS 4500F-D colorimetric method... has a linear analytical range of 0 to 1.4 mg/L.Method SM 4500F-Dhigh
#P024physicaloperationalguidelineAutomated Complexone Method (Analytical Range)drinking waterrequirement0.1-2 mg/LIn the Automated Complexone method SM 4500F-E... The method is suitable for fluoride concentrations ranging from 0.1 mg/L to 2 mg/L.Method SM 4500F-Ehigh
#P025operationalreportingguidelineFluoride (EPA Method 300.0 MDL)drinking waterrequirement0.01 mg F-/LEPA method 300.0 Revision 2.1 is based on ion chromatography, and has a method detection limit (MDL) of 0.01 mg F-/L.Analytical method approved by EPAhigh
#P026operationalreportingguidelineFluoride (Method SM 4110B MDL)drinking waterrequirement0.002 mg F-/LAn MDL is not stated for method SM 4110B, but is identified as 0.002 mg F-/L in the most recent version of APHA et al. (2005).Analytical method approved by EPAhigh
#P027operationalreportingguidelineFluoride (CEAEQ Method MA.303 detection limit)drinking waterrequirement0.03 mg/LThe Centre d'expertise en analyse environnementale du Québec (CEAEQ, 2007) reported a method (MA.303 - Anions 1.0) for measuring fluoride in drinking water with a detection limit of 0.03 mg/L.Method used in accredited laboratories in Quebechigh
#P028operationalreportingguidelineFluoride Analytical Range (Method SM 4500F-C)drinking waterrequirement0.1 to >10 mg/LThese methods are suitable for fluoride concentrations ranging from 0.1 mg/L to more than 10 mg/L (APHA et al.,1998)Manual electrode methodhigh
#P029operationalreportingguidelineFluoride Analytical Range (Method D1179-93B)drinking waterrequirement0.1 to 1000 mg/LThese methods are suitable for fluoride concentrations ranging from... 0.1 mg/L to 1000 mg/L (ASTM, 1993)Manual electrode methodhigh
#P030unknownhealthguidanceStandard Daily Soil Intake (0 to <6-month-olds)otherunknown35 mg/dayThe estimated standard values for the daily intake of soil in the Canadian population are 35 mg/day for 0- to <6-month-oldsExposure assessment for the Canadian populationhigh
#P031unknownhealthguidanceStandard Daily Soil Intake (6-month- to <5-year-olds)otherunknown50 mg/dayThe estimated standard values for the daily intake of soil in the Canadian population are... 50 mg/day for 6-month- to <5-year-oldsExposure assessment for the Canadian populationhigh
#P032unknownhealthguidanceStandard Daily Soil Intake (5- to <12-year-olds)otherunknown35 mg/dayThe estimated standard values for the daily intake of soil in the Canadian population are... 35 mg/day for 5- to <12-year-oldsExposure assessment for the Canadian populationhigh
#P033unknownhealthguidanceStandard Daily Soil Intake (Adults)otherunknown20 mg/dayThe estimated standard values for the daily intake of soil in the Canadian population are... 20 mg/day for adults (Health Canada, 1994).Exposure assessment for the Canadian populationhigh
#P034chemicalhealthunknownFluoride Lethal Dose (LD100)otherunknown32-64 mg/kg bwThe LD100 for fluoride in the average adult has been estimated to be 32-64 mg/kg bw (as sodium fluoride).Acute ingestion in the average adulthigh

D Definitions (57)

Req ID Category Name Context Confidence
#D001practical quantitation limit (PQL)based on the ability of laboratories to measure the concentration of an analyte within reasonable limits of precision and accuracymedium
#D002AIBy definition, an AI is an average nutrient intake that appears to be sufficient to sustain a defined nutritional state in a specified populationhigh
#D003Skeletal fluorosisSkeletal fluorosis is an excessive accumulation of fluoride in bone associated with increased bone density and outgrowths (exostoses)high
#D004"crippling" skeletal fluorosisClinical stage III has been termed "crippling" skeletal fluorosis because mobility is affected as a result of excessive calcifications in joints, ligaments, and vertebral bodieshigh
#D005"equivocal evidence of carcinogenic activity"defined as a marginal increase in neoplasms that may be related to chemical administrationhigh
#D006Dental fluorosisDental fluorosis is a permanent hypomineralization of tooth enamel due to fluoride-induced disruption of tooth developmenthigh
#D007"halo" or "diffusion" effectoccurs when foods and beverages processed in a fluoridated community are consumed in a non-fluoridated one and vice-versahigh
#D008otosclerosisformation of spongy bone in the earhigh
#D009uroliathiasiskidney stoneshigh
#D010bone mineral density (BMD)bone mineral densityhigh
#D011fluorine gaselemental form of fluorine rather than a combined formhigh
#D012disodium monofluorophosphate (MPF)disodium monofluorophosphatehigh
#D013method detection limit (MDL)method detection limithigh
#D014United States Environmental Protection Agency (EPA)United States Environmental Protection Agencyhigh
#D015activated alumina (AA)activated aluminahigh
#D016reverse osmosis (RO)reverse osmosishigh
#D017total dissolved solids (TDS)total dissolved solidshigh
#D018polyaluminum chloride (PACl)polyaluminum chloridehigh
#D019empty bed contact time (EBCT)empty bed contact timehigh
#D020nanofiltration (NF)nanofiltrationhigh
#D021Lime softening (LS)a precipitative process for the removal of calcium and magnesium ions of hard waterhigh
#D022Anion exchange (AX)a physical/chemical process which employs exchange of negatively charged ions in the raw water with ions sorbed at the solid phase of the synthetic resinshigh
#D023Electrodialysis (ED)an electrochemical separation process in which ions are transported through semi-permeable membranes under the influence of an electric potentialhigh
#D024Donnan Dialysis (DD)process similar to ED/EDR, but the driving force of the process is a difference in the chemical potential rather than an electrical potentialhigh
#D025Bone chara blackish, porous, granular material with a specific affinity for fluoridehigh
#D026Standards Council of Canada (SCC)Standards Council of Canadahigh
#D027physiologically-based pharmacokinetic (PBPK)physiologically-based pharmacokinetichigh
#D028DMFT indexassess dental caries experience by counting the number of decayed (D), missing (M), and filled (F) permanent teeth (T)high
#D029sodium fluoride (NaF)sodium fluoridehigh
#D030stannous fluoride (SnF2)stannous fluoridehigh
#D031SPADNS colorimetric methodbased on the reaction between fluoride and a zirconium-dye lake, where the colour of the sample becomes lighter as the fluoride concentration increaseshigh
#D032sister chromatid exchange (SCE)sister chromatid exchangehigh
#D033intelligence quotient (IQ)intelligence quotienthigh
#D034no-observed-adverse-effect levels (NOAELs)no-observed-adverse-effect levelshigh
#D035glutathione (GSH)glutathionehigh
#D036Maximum Contaminant Level (MCL)Maximum Contaminant Levelhigh
#D037Automated Complexone method SM 4500F-Ethe sample is distilled, and the distillate reacts with alizarine fluorine blue-lanthanum reagent to form a blue complexhigh
#D038AAgamma-aluminum trioxidehigh
#D039electrodialysis reversal (EDR)the polarity of the electrodes is changed periodically across the ion exchange membraneshigh
#D040NCI SEERNational Cancer Institute Surveillance, Epidemiology and End Resultshigh
#D041sudden infant death syndrome (SIDS)sudden infant death syndromehigh
#D042DMFSdecayed, missing and filled tooth surface indexhigh
#D043tolerable daily intake (TDI)tolerable daily intakehigh
#D044Health-based Value (HBV)Health-based Valuehigh
#D045relative risk (RR)relative riskhigh
#D046confidence interval (CI)confidence intervalhigh
#D047National Toxicology Program (NTP)National Toxicology Programhigh
#D048International Agency for Research on Cancer (IARC)International Agency for Research on Cancerhigh
#D049acetylcholinesterase (AChE)acetylcholinesterasehigh
#D050gestation days (GD)gestation dayshigh
#D051aMT6surinary 6-sulphatoxymelatoninhigh
#D052T4thyroxinehigh
#D053T3triiodothyroninehigh
#D054nAChRsneuronal nicotinic acetylcholine receptorshigh
#D055dfsdecayed or filled surfaceshigh
#D056AlF3aluminum fluoridehigh
#D057As2O3arsenic trioxidehigh