Information on fluoride and water fluoridation (2023)

fluoride in nature

Fluorine is one of 102 naturally occurring elements in nature, like oxygen, carbon, iron or nitrogen. It is the 13th most common element and is found in the ocean, soil, plants, rocks and most foods Fluorine is one of the most common elements on earth and does not harm the environment. It occurs naturally in all bodies of water in varying concentrations. In Indiana, most surface and ground water has a natural fluoride concentration of 0.1-0.2 milligrams per liter (mg/L). are the basic chemical building blocks for all materials, be they solid, liquid or gaseous. Few elements occur freely in nature; Usually they are combined with other elements into compounds. In the case of fluorine, it is always found combined with other elements. When dissolved in water, each compound dissociates into its components called ions. Therefore, fluorine is present in water as fluoride ion. One fluoride ion is the same no matter what other elements it was originally combined with. There is no difference between water that naturally contains fluoride ions and water that has been intentionally fortified with fluoride ions at optimal levels to reduce tooth decay. Adding fluoride to water is no different from fortifying salt with iodine, milk with vitamins A and D, orange juice with vitamin C, or flour with iron and B vitamins.

How fluoride prevents tooth decay

Water fluoridation reduces tooth decay by 40-70% in children and 40-60% in adults. Fluoride prevents tooth decay in three ways. It reduces the ability of plaque bacteria to produce acid. It is absorbed into the crystalline structure of the tooth enamel, reducing the ability of acid to attack it. Finally, fluoride remineralizes tooth enamel that has lost minerals from attack by acid-producing bacteria. In fact, fluoride stops the decay process in teeth and can even reverse it. Fluoride is equally important for older Americans because it prevents or prevents tooth decay on exposed tooth roots. Most people are aware of the benefits of fluoridation for children. But it is also very beneficial in later life for older people and it is difficult for a dentist to treat them. Many older adults do not produce enough saliva, making cleaning their teeth difficult. Also, their gums recede, exposing the roots of their teeth, increasing the risk of tooth root formation and tooth decay. A 1988 survey showed that more than 90% of people aged 45 and over had some tooth root surfaces exposed. Fluoride remineralizes exposed tooth roots as well as tooth enamel.

(Video) Lies People Tell About Water – Part 1: Water Fluoridation

Facts supporting water fluoridation

Tooth decay remains the most common chronic disease in childhood. In the United States, tooth decay affects 50% of children ages 5 to 9, 67% of adolescents ages 12 to 17, and 94% of adults 18 years and older sharp decline in the prevalence and severity of tooth decay. Medical, dental and public health professionals attribute this decline to fluoridation of public water supplies. Decades of research and hundreds of studies around the world show that optimally fluoridated drinking water is safe and effective for reducing tooth decay. Water fluoridation is inexpensive and the most efficient way to reach the entire population. Everyone benefits equally from fluoridation without the need for expensive daily procedures like fluoride rinses, some can't afford it. Fluoridation reduces pain and tooth decay; it reduces time lost to school and work; and it reduces the cost of dental care. The average per capita cost of fluoridating a public water supply is $1 to $2 per year. The cost of just one tooth filling is more than $50. Data from the Federal Centers for Disease Control and Prevention (CDC) show that for every dollar spent on water fluoridation, $38 is saved in reduced dental care costs When fluoride is available, customers of non-fluoridated water supplies continue to have higher tooth decay rates than those served by fluoridated water supplies.

History of water fluoridation

In the early 1900s, dentist Dr. Frederick S. McKay of Colorado to investigate the cause of discolored teeth that were common among his patients. He found that this discoloration (dental fluorosis) also occurred in other parts of the country, including Texas. Fluorosis, in its mildest form, appears as small, white, opaque areas on the teeth. While mild dental fluorosis is almost invisible, severe fluorosis appears as a brown discoloration. In 1928 Dr. McKay found that this decay was greatly reduced in patients with discolored teeth, and concluded that both the staining and resistance to decay were caused by something in the water. By 1931 others had identified it as fluoride. Then the U.S. Public Health Service to determine if there was a level of fluoride in the water that would prevent tooth decay but not stain teeth. By examining the dental status of 7,000 children who drank naturally fluoridated water of varying concentrations in four states, they determined that the ideal concentration would be 1.0 mg/L. While this concentration did not stain, it reduced voids by two-thirds. The next step was to test fluoridation of the public water supply. Grand Rapids, Michigan was the first city in the United States to fluoridate its water supply, beginning January 25, 1945, at a level of 1.0 mg/L. Before that, in 1944, comparative studies were started in the neighboring towns of Newburgh and Kingston. New York; Muskegon and Grand Rapids, Michigan; Oak Park and Evanston, Illinois; and Sarnia and Brantford, Ontario. First the children in each town were examined by dentists and doctors; then fluoride was added to one of the two water supplies. Children in Newburgh, New York experienced 58% less tooth decay than children in unfluoridated Kingston years, the difference was so startling that hundreds of cities and communities began fluoridating their water after just five years. Wayne, Indianapolis, and Huntingburg, all in 1951. Close behind were Batesville, Bedford, Columbus, Kokomo, Logansport, Lyons, Marion, Michigan City, and Valparaiso, all of whom began fluoridating in 1952.In 2015, the Department of Health reduced the recommended level of fluoride in drinking water to 0.7 ppm

(Video) The Shocking History of Water Fluoridation | Why Fluoride is in the Water

Fluoridation worldwide

Contrary to the claims of some antifluoridators, water fluoridation has not been banned anywhere in the world. However, many countries use a different form of fluoridation called salt fluoridation, similar to our iodization of salt. Although salt fluoridation is very effective, it is not as efficient or accurate as water fluoridation because dietary intake of salt is more variable than water. In either case, a person's fluoride intake is adjusted to help prevent tooth decay. Countries adjusting fluoride intake in one way or another include Argentina, Austria, Australia, Barbados, Belgium, Bermuda, Bolivia, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Cyprus, Czech Republic, Denmark, Ecuador, Egypt, Estonia, Fiji, France, Gabon, Guatemala, Germany, UK, Grenada, Guyana, Haiti, Honduras, Hong Kong, Hungary, Iran, Ireland, Israel, Italy, Jamaica, Japan, Kiribati, Latvia, Libya, Lithuania, Malaysia, Mexico, Myanmar, Namibia, Nigeria, New Zealand, Norway, Panama a, Papua, Paraguay, Peru, Philippines, Poland, Puerto Rico, Senegal, Serbia, Sierra Leone, Singapore, South Africa, South Korea, Spain, Sri Lanka, Sweden, Switzerland, Taiwan, Thailand, Trinidad and Tobago, Turkey, Tuvalu, Uganda, USA, Uruguay, Venezuela, Vietnam, Zaire and Zambia. More than 360,000,000 people worldwide benefit from fluoridation.

Water fluoridation in the United States and Indiana

Of the 50 largest US cities, 47 are fluoridatedCDC, nearly two-thirds of US public water service customers receive fluoridated water. That's almost 162 million people. In Indiana, nearly 300 public water supplies and 33 rural schools are fluoridating; 4.3 million Hoosiers receive optimally fluoridated water. Many Hoosier water utilities supply water that is naturally fluoridated to optimum levels including: Advance, Albany, Albion, Aqua Source-Aboite Township, Aqua Source-North End, Arlington Utilities, Auburn, Avilla, Berne, Bluffton, Brownsburg, Bunker Hill , Butler, Churubusco, Clarks Hill, Columbia City, Danville, Decatur, Dunkirk, Elwood, Fairmount, Farmland, Flowing Wells/Indiana Heights, Fountain City, Francisco, Frankfort, Garrett, Geneva, Glenwood, Goodland, Grabill, Greenfield, Greentown, Hamilton, Hartford City, Huntington, Jamestown, Kingman, Kirklin, L&M Regional Utility, LaFontaine, Lebanon, Lewisville, Lynn, Markle, Mecca, Medaryville, Milltown, Monroeville, Montpelier, Morristown, North Judson, North Manchester, North Salem, Orestes, Orleans, Ossian, Pennville, Pierceton, Pittsboro, Portland, Redkey, Roanoke, Royal Center, Russiaville, St. Joe, Schneider, Sharpsville, Shirley, Sheridan, Silver Lake, Staunton, Summitville, Swayzee, Tipton, Union City, Upland, Van Bur en, Walton, Wa Terloo, West Lebanon, Windfall and Woodburn. It is estimated that 100,000 Hoosiers receive optimally fluoridated water from private wells. There's a good chance anyone who lives near any of the communities listed above also drinks optimally fluoridated water from their private wells.

(Video) Community Water Fluoridation

Currently, 84 Hoosier public water supplies do not fluoridate. Those serving more than 900 customers include: Aberdeen-Pate Water Corporation, Akron, Arcadia, Bicknell, Cataract Lake Water Corporation, Cayuga, Crawford County Water Company, Dugger, Eaton, Everton Water Corporation, Farmersburg, Fayette Township Water Corporation , Jennings Water Inc., Jennings Northwest Regional Utility, Jonesboro, Linton, Lyford, Odon, Painted Hills, Paxton, Remington, Rossville, Shelburn, St. Paul, Switz City, Suburban Utilities-El Paco , Tri-Township Water Corporation, Troy , Van Bibber Lake, Waynetown and West Terre Haute.

Fluoridation Advocates

During the 20th century, life expectancy for US citizens increased by more than 30 years. It is believed that 25 of those years can be attributed to advances in public health. The CDC has identified fluoridation as one of the ten greatest public health achievements of the 20th century. According to the CDC, water fluoridation "benefits children and adults in a safe and cost-effective manner by effectively preventing tooth decay, regardless of socioeconomic status or access to medical care." The CDC also stated, "For any report that casts doubt on fluoridation there are countless reports demonstrating their safety and effectiveness. It is not surprising that some disagreements can arise between scientists and professionals in research and medicine. What is surprising, however, is their almost universal acceptance of the safety and effectiveness of fluoridation.” Virtually every reputable national health association advocates water fluoridation, including the American Medical Association, the American Dental Association, the American Academy of Pediatrics, the American Academy of Family Physicians , the American Public Health Association, the American Dental Hygienists Association, the American Nurses Association, the National Environmental Health Association, and the American Water Works Association.

(Video) Why The Government Puts Fluoride In Our Water

The American people overwhelmingly support fluoridation. In 1998, the Gallop Organization surveyed consumers about fluoridation and found that 70% supported it; 18% opposed; while 12% had no opinion. A previous survey found that an even higher percentage of parents supported fluoridation.

CorrespondingMagazine Consumer Reports, “Of all the numerous diseases attributed to fluoridation, from cancer to constipation in dogs, none has ever been proven valid. The simple truth is that there is no 'scientific controversy' about the safety of fluoridation. Practice it is safe, economical and useful. The survival of this sham controversy represents, in CU's view, one of the greatest triumphs of quackery over science in our generation” (A Two Part Report on Fluoridation, July & August, 1978).

(Video) Fluoride in Water - The Good, The Bad & The Ugly

dr C. Everett Koop, President Ronald Reagan's Surgeon General, said, “Fluoride is not a mysterious substance. It's not an experiment. You will not be asked to approve anything based on uncertain evidence. Does everyone agree with me? No, far from it. But I have to tell you that you are wrong. I've never lied to you as a surgeon general. And the people who are against water fluoridation don't know what they're talking about.”

Dentists are constantly being asked to defend fluoridation. Had dentistry simply caved in to the demands of antifluoridation, there would have been far more cavities to treat and far more money in dentists' pockets. But dentists have staunchly supported fluoridation, knowing how important it is to public health and the solid science that supports it. After all, their families benefit from fluoridation just as much as the rest of us. No medical professional would subject their parents or children to fluoridated water if something was wrong with it.

(Video) What is Water Fluoridation? Is it Safe? Health Side Effects? Fluoride Facts by Austin Dentist

Safety of water fluoridation

In the United States, three chemicals are used to fluoridate drinking water: sodium fluoride (NaF); sodium fluorosilicate (Na2SiF6); and fluorosilicic acid (H2SiF6). Fluorosilicic acid is a by-product in the manufacture of phosphate fertilizer. It is recovered as a vapor, which ensures a high degree of purity. Both sodium fluoride and sodium fluorosilicate are produced from fluorosilicic acid obtained in this way. Sodium fluorosilicate is made by neutralizing fluorosilicic acid with caustic soda, which is itself a water treatment chemical. Sodium fluoride is made by neutralizing fluorosilicic acid with sodium chloride, table salt. Antifluoridationists have pointed out that industrial-grade fluoride chemicals are used by water utilities, suggesting that pharmaceutical-grade chemicals should be used instead. In fact, all of the 40+ water treatment chemicals used by US water utilities are industrial grade. But they all must meet the requirements of the National Sanitation Foundation (NSF) und American Water Works Association (AWWA) standards. Pharmaceutical grade fluoride compounds are used to make prescription drugs, not water treatment.


Which fluoride is used in water fluoridation? ›

Types of Fluoride Additives

Fluorosilicic acid: a water-based solution used by most water systems in the United States.

What are the harmful effects of fluoride in water? ›

Excess amounts of fluoride ions in drinking water can cause dental fluorosis, skeletal fluorosis, arthritis, bone damage, osteoporosis, muscular damage, fatigue, joint-related problems, and chronicle issues.

What is fluoridation of drinking water? ›

What is water fluoridation? Water fluoridation is the process of adding fluoride to the water supply so the level reaches approximately 0.7 ppm, or 0.7 milligrams of fluoride per liter of water; this is the optimal level for preventing tooth decay (1).

Is fluoride harmful to human health? ›

Excess exposure to fluoride can lead to a bone disease known as skeletal fluorosis. Over many years, this can result in pain and damage to bones and joints. The bones may become hardened and less elastic, increasing the risk of fractures.

What are the two types of fluoride? ›

Sodium fluoride and stannous fluoride are the two major active ingredients in modern toothpastes, with sodium fluoride by far the most common. Both prevent cavities.

What is the safe amount of fluoride in drinking water? ›

National survey data show that prevention of tooth decay can be maintained at the recommended level of 0.7 milligrams of fluoride per liter of drinking water. This recommended level updates and replaces the previously recommended range of 0.7 to 1.2 milligrams per liter.

Which organ is affected by fluoride in water? ›

Many studies have shown that exposed to high fluoride concentrations in drinking water elevated the levels of renal and liver function enzymes in serum and cause severe histological changes of the liver and kidneys [13–16].

Can you drink water with fluoride on? ›

Depending on your age, it may be safe to drink water that has fluoride levels higher than the maximum recommended level. Anyone can use water with fluoride levels above 1.5 mg/L for washing dishes, laundry, handwashing, and bathing since fluoride can't get through your skin.

Does bottled water have fluoride? ›

Does bottled water contain fluoride? Bottled water products may contain fluoride, depending on the source of the water. Fluoride can be naturally present in the original source of the water, and many public water systems add fluoride to their water.

Who benefits from water fluoridation? ›

Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults. By preventing cavities, community water fluoridation has been shown to save money both for families and for the US health care system.

What is the purpose of fluoridation? ›

Fluoride helps to rebuild and strengthen the tooth's surface, or enamel. Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping the tooth strong and solid, fluoride stops cavities from forming and can even rebuild the tooth's surface.

Why is fluoridation important? ›

Fluoride in the mouth (in the saliva and dental plaque) is an effective way to prevent tooth decay. Fluoride's action in preventing tooth decay benefits both children and adults throughout their lives. The health benefits of fluoride are: Fewer and less severe cavities.

What are the pros and cons of fluoride? ›

The sole purpose of fluoride is to strengthen the enamel of the teeth, which should (so research has shown) prevent cavities and tooth loss. This assumption has been called into question over time. In fact, many studies have shown that fluoride may cause a cosmetically damaging effect called fluorosis.

What are the cons of using fluoride? ›

The cons of fluoride

Certain studies have shown that fluoride may contribute to weakening the bones and maybe even the joint's connective tissues. Fluoride also causes a condition known as fluorosis, which causes tooth discoloration.

How do you remove fluoride from drinking water? ›

A reverse osmosis filtration system is a simple solution for removing fluoride from drinking water. A Reverse Osmosis (RO) system can remove 85-92%* of fluoride in your water. Essentially, reverse osmosis technology uses household water pressure to push tap water through the filtration process.

What is another name for fluoride? ›

Acidulated Phosphate Fluoride, Atomic number 9, Calcarea Fluorica, F, Fluorophosphate, Fluorure, Fluorure d'Hydrogène, Fluorure de Phosphate Acidulé, Fluorure de Sodium, Fluorure Stanneux, Fluoruro, Hydrogen Fluoride, Monofluorophosphate, MFP, Nombre Atomique 9, Sodium Fluoride, Sodium Monofluorophosphate, ...

What is the best source of fluoride? ›

Trace amounts of fluoride are found naturally in various foods, though people obtain most fluoride from fluoridated water and toothpastes. Brewed black tea and coffee naturally contain fluoride as the plants absorb the mineral in soil.

Which type of fluoride is best? ›

One study even found that stannous fluoride was far more effective in fighting bacteria compared to sodium fluoride. As a rule of thumb, if you're looking for all-around protection (and not just cavity prevention), then stannous fluoride is the preferred fluoride of choice for your oral health.

How much fluoride is in bottled water? ›

Today the U.S. Food and Drug Administration issued its final rule for added fluoride levels in bottled water titled Beverages: Bottled Water. This final rule amends the allowable level for fluoride in domestically packaged and imported bottled water to which fluoride is added to 0.7 milligrams per liter (mg/L).

Does Brita remove fluoride? ›

The three types of filters that can remove fluoride are reverse osmosis, deionizers (which use ion-exchange resins), and activated alumina. Each of these filters should be able to remove about 90% of the fluoride. By contrast, “activated carbon” filters (e.g., Brita & Pur) do not remove fluoride.

Where does the fluoride in water come from? ›

Fluoride is a naturally occurring mineral released from rocks into the soil, water, and air.

Where is most fluoride found in the body? ›

Approximately 99% of the fluoride in the human body is found in bones and teeth. Fluoride is incorporated into tooth and bone by replacing the hydroxyl ion in hydroxyapatite to form fluorohydroxyapatite.

What is fluoride made from? ›

Fluoride is created when salts from the element fluorine combine with minerals in soil or rocks. Fluoride is found naturally in soil, water, and many foods, and occurs naturally in the human body in bones and teeth.

What brand of water does not have fluoride? ›

Dasani is sourced from municipal water, and is much like filtered tap water. The brand removes fluoride from its bottled water, leaving you with fresh, clean drinking water that is fluoride-free!

What has more fluoride tap water or bottled water? ›

Bottled water typically contains significantly less fluoride (1, 17), thus increasing dental carie risk.

Why don't they put fluoride in bottled water? ›

Most bottled waters do not contain an optimal level of fluoride, and some brands don't contain any. “Most bottled water goes through a process of purification,” explains Dr. Liebman, and during that process, a lot of fluoride is removed.

Do dentists support water fluoridation? ›

Water fluoridation is supported locally, nationally and internationally by major medical, dental, and health organizations for the prevention of tooth decay.

Do you need fluoride to survive? ›

Although its role in the prevention of dental caries (tooth decay) is well established, fluoride is not generally considered an essential mineral element because humans do not require it for growth or to sustain life (2).

Do we need fluoride? ›

yes, fluoride helps prevent tooth decay – in fact, since 1950 the American Dental Association has backed fluoride as “safe, effective and necessary in preventing tooth decay”. By strengthening enamel and slowing its breakdown, fluoride limits the ability for plaque and bacteria to go to work on your teeth.

Why do people want fluoride free? ›

Why Use Fluoride-Free Toothpaste? In general, dentists dissuade patients from using fluoride-free toothpaste due to the mineral's effects on long-term tooth health. Yet select consumers may request a fluoride-free toothpaste if they: Have a fluoride allergy or experienced dental fluorosis.

Do you need fluoride? ›

For the majority of children and adults, fluoride provides excellent benefits to your teeth. While some people debate over whether or not to use fluoride, this naturally occurring mineral is a safe ingredient that helps protect your teeth from cavities.

What happens when you stop using fluoride? ›

“Previous research indicates that without the presence of optimal levels of fluoride in drinking water, and thus in the mouth and saliva, teeth may form with weaker enamel and lack the ability to remineralize early signs of decay,” the study researchers warn.

Can fluoride damage your bones? ›

High systemic fluoride exposures can lead to skeletal fluorosis, a condition hallmarked by osteosclerosis, ligament calcifications, and often accompanying osteoporosis, osteomalacia, or osteopenia (Christie, 1980; Wang et al., 2007).

Do fridge water filters remove fluoride? ›

Refrigerator water filters provide you with clean drinking water based on the contaminants it removes. Talking of contaminants, people also wonder if refrigerator water filters remove fluoride. The short answer to this is yes refrigerator water filters remove fluoride.

Does distilled water get rid of fluoride? ›

Distillation can remove nearly all impurities from water. Compounds removed include sodium, hardness compounds such as calcium and magnesium, other dissolved solids (including iron and manganese), fluoride, and nitrate.

How do you test for fluoride in water? ›

To perform the test, the user must mix a 4 ml water sample and 1 ml zirconium xylenol orange reagent. The color changes from pink to yellow depends on the fluoride concentration in the sample. By comparing the color produced with the color chart, the fluoride content in the water can be quantified.

What is fluoride used for in water treatment? ›

Fluoride helps to rebuild and strengthen the tooth's surface, or enamel. Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping the tooth strong and solid, fluoride stops cavities from forming and can even rebuild the tooth's surface.

Is calcium fluoride the same as fluoride? ›

First of all, calcium fluoride is not fluoride. It is a compound containing the fluoride ion. Second, calcium fluoride does not exist in groundwater. Fluoride is the anion of the naturally occurring element fluorine.

What is the most common form of fluoride? ›

Fluoride Toothpaste. Fluoride-containing toothpaste is the most commonly used form of self-applied fluoride worldwide. Fluoride in toothpaste is taken up directly by the dental plaque and demineralized enamel and also increases the concentration of fluoride in saliva.

What is the difference between calcium fluoride and sodium fluoride? ›

Sodium fluoride and calcium fluoride are fluoride salts. The main difference between sodium fluoride and calcium fluoride is that sodium fluoride contains one sodium cation in association with one fluoride anion whereas calcium fluoride contains one calcium cation in association with two fluoride anions.

What are three uses of fluoride? ›

Fluorine is critical for the production of nuclear material for nuclear power plants and for the insulation of electric towers. Hydrogen fluoride, a compound of fluorine, is used to etch glass. Fluorine, like Teflon, is used to make plastics and is also important in dental health.

What can replace fluoride? ›

These alternatives to fluoride have been proven beneficial for a healthy mouth. Suggesting xylitol, coral calcium, silver, arginine, and theobromine provides beneficial options to patients who choose not to use fluoride.

What are 3 types of fluoride? ›

Fluoride can be delivered from several different fluoride sources. The three most popular sources of fluoride globally, which are all accepted by the US FDA as clinically effective, are: stannous fluoride (SnF2) sodium fluoride (NaF)
  • Stannous fluoride. ...
  • Sodium fluoride. ...
  • Sodium monofluorophosphate.

What is the difference between fluoride and fluoride? ›

To summarize: fluorine is an element; fluoride is an ion or a compound which contains the fluoride ion. Fluorides are found in toothpaste and added to public drinking water in some countries.

Why do some dentists not use fluoride? ›

Concerns about Fluoride Toxicity

Excess fluoride ingestion is linked to dental fluorosis, a condition that causes tooth enamel to become discoloured and which when present can indicate that the rest of your body has been overexposed to fluoride as well.

Which fluoride treatment is best? ›

Fluoride varnish has greater efficacy when it comes to accomplishing what it is meant to accomplish: Treating sensitive teeth and reducing the rate of dental caries.

Why do dentists still use fluoride? ›

It's been an essential oral health treatment for decades. Fluoride supports healthy tooth enamel and fights the bacteria that harm teeth and gums. Tooth enamel is the outer protective layer of each tooth. Fluoride is especially helpful if you're at high risk of developing dental caries, or cavities.


1. What is Water Fluoridation? Is it Safe? Health Side Effects? Fluoride Facts by Austin Dentist
2. Dr. Seymour and ADA Address Unreliable Claims About Water Fluoridation
(Harvard School of Dental Medicine)
3. The History of Fluoride
(Delta Dental)
4. Is Water Fluoridation Bad for You?
(Today I Found Out)
6. CDC Grand Rounds Beyond the Data: Community Water Fluoridation
(Centers for Disease Control and Prevention (CDC))
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