Researchers developed a two-stage system using bone char and hydroxyapatite, a mineral that can bind fluoride. In continuous-flow laboratory tests, using the materials in sequence produced more than twice as much treated water before fluoride reached the World Health Organization guideline of 1.5 milligrams per liter, compared with either material alone.

The team then installed the combined filter in a rural Ethiopian village. It reduced fluoride in the groundwater from 9.46 milligrams per liter to 0.14 milligrams per liter in treated water, while more than doubling the replacement interval for the filter materials.