There’s a lot of new research helping us better understand a simple but important question: Can regular tea drinking during childhood increase the risk of dental fluorosis? Fluorosis is the change in tooth enamel that can happen when developing teeth are exposed to too much fluoride, often seen as faint white lines or spots on the permanent teeth once they erupt. Severe forms can cause brown stains or pitting, though they remain mainly cosmetic.
In India, tea (chai) is a cultural cornerstone — it’s one of the most widely consumed drinks across all ages, including children and teens. The tea plant (Camellia sinensis) naturally absorbs fluoride from soil and water, and accumulates it in its leaves more than almost any other edible plant. When you brew tea, a large proportion of the fluoride ends up in the cup, and most of it is readily absorbed into the body.
Research from India and around the world shows that fluoride intake from tea can contribute to total daily fluoride exposure, especially in communities where fluoride from drinking water is already high. A study in Nalgonda district of Telangana found that when children drank tea made from local water and leaves, their daily fluoride intake often exceeded safe levels recommended for developing children. About 70% of children in that region were at risk for dental fluorosis because of overall fluoride exposure, with tea being one of the significant contributors alongside groundwater.
In another Indian context, research from Salem district in Tamil Nadu found a correlation between black tea consumption and dental fluorosis in schoolchildren, particularly where borewell water also had elevated fluoride levels. This suggests that tea’s contribution to fluoride exposure may be more important in places where drinking water already has fluoride.
It’s also clear from systematic reviews that not all tea is equal in terms of fluoride. Black and economy-grade teas (often broken or powdered and made from older leaves) release more fluoride when brewed than fine whole-leaf teas like those made from the younger “bud and two leaves.” Longer stirring or steeping times and using water with its own fluoride raised the total fluoride in the cup further.
Some global modelling studies suggest that heavy consumption of black tea could put some children above the daily reference fluoride dose used in risk assessments, especially at higher intake levels (more than a few cups per day). These risk models show that the potential for fluoride exposure to reach levels associated with dental fluorosis exists, particularly in children, because of their smaller body weight and ongoing tooth development.
That said, evidence specific to tea alone as an independent risk factor is mixed. In parts of Karnataka where water fluoride was low, ordinary daily tea with milk and sugar — usually one or two cups — did not show a strong independent link to fluorosis. In that context, milk may modestly reduce the free fluoride available in the brew, and lower brewing intensity may mean lower fluoride per cup.
Take-home points:
- Tea contributes fluoride to the diet because tea plants accumulate fluoride from soil and water.
- In areas where groundwater has high fluoride, tea can add another fluoride source, increasing total exposure for children.
- Higher fluoride in the brew is linked to black tea and older leaves; using milk and not over-brewing can modestly reduce fluoride released.
- Dental fluorosis risk depends on total fluoride exposure (water, tea, food, toothpaste), not tea alone. Community studies show high fluorosis where fluoride exposure from multiple sources is elevated.
If you’re thinking about children’s dental health, the practical takeaway isn’t to stop tea altogether — tea has many cultural and even health virtues — but to be mindful of how much and how often children sip tea as their main drink, especially in regions with known high fluoride groundwater. Opting for tea made with lower-fluoride sources and not using tea as the primary hydration for young kids helps keep their total fluoride intake closer to safe levels during tooth development.