Deconstructing the recent fluoride flyer

Deconstructing the friendly flyer on fluroide

(At end of this article see 50 reasons to avoid fluoride, complete with scientific citations plus an article from Newsweek debunking fluoride)

 

By now, if you are a registered voter, you have received the friendly flyer from the phosphate fertilizer companies.  Of course that’s not the ones who signed it but they are the ones who funded this slick promo piece promoting the re-introduction of rat poison into our drinking water.

Packaged in purple and gold to confuse the sub-conscious mind of the reader to think this might be supported by the University of Washington, this puff-piece is riddled with bromides which, when taken individually, add up to no scientific information, no credible conclusions, merely chaotic disinformation.

It begins, “Fluoride has been added to water in the US for over 70 years because it reduces cavities.”  There is no scientific study cited to support this opening salvo.  The entire campaign promoting fluoride is bereft of any scientific support.  This writer has literally begged Doctors Locke and Kennedy to provide scientific studies to buttress their claims.  So far no facts.

We must remember, 50 years ago doctors thought Thalidomide was great for women experiencing morning sickness during pregnancy.  After deformed babies began showing up in delivery rooms they revisited the science and banned this toxic drug from the market.  When you can get someone to cite a scientific study supporting fluoride they are at least 50 years old and at odds with current science.

Fluoride studies at Harvard Medical School conclude fluoride-infused children are robbed of several points off their intelligence quotient–for life.  The Harvard study amalgamated dozens of independent studies from all over the world to come to the conclusion–fluoride is a neurotoxin.  Full stop.

Further, in the first paragraph of the slick flyer it urges us to, “…show that when given a chance, we choose common sense solutions to our everyday problems.”  Pray tell what is common sense about introducing a neurotoxin, scraped from the smoke-stacks of fertilizer factories, which includes other poisons including lead and arsenic, to our children’s drinking water?

Anytime chemicals are shipped over American roads or rails they must include a Materials Safety Data Sheet.  The MSDA information accompanying the fluoride sent to our water department show clearly it contains lead and arsenic.  However, they do not show in what percentages of the total volume.  There is no way of knowing how much of the compounds shipped  includes these other two deadly poisons.  This writer has repeatedly requested of the city an independent assay of the fluoride shipped to our water department.  So far there is no such independent assay released.  We merely put into the water whatever is shipped to us from the phosphate fertilizer industry.  If this toxic waste was put into the ground it would be a crime.  If it was dumped into rivers it would be a crime.  If it was allowed into the air it would be a crime.  However, if put into the city’s water supply it is supposed to be therapeutic.  Give me a break.

The flyer then states, “The overwhelming majority of scientists agree, based on over a half-century of experience, that fluoride in drinking water significantly reduces dental decay in children and adults.”  Again, no citation of these studies just platitudes attempting to imitate a scientific conclusion.  If you pin down some of these proponents they will admit no credible studies supporting fluoridation have come out in the past 50 years.  The most recent studies, like the Harvard study show just the opposite.  Local studies show there is no beneficial effect of fluoride in the water but these findings are kept hidden by the dental association.

Further attempting to cloud the issue they state one truth, “Fluoride is a naturally occurring mineral present in small amounts in nearly all water…”  This much is true.  However, this is real fluoride, naturally occurring fluoride.  What is introduced into our drinking water is hexafluorosilicic acid, an unnatural byproduct of fertilizer manufacturing and not chemically the same as the naturally occurring mineral.  Also, the “recommended dosage” of fluoride is already included naturally in the water we get from the Elwha River.  Even if fluoride is “safe and effective” it is the naturally occurring kind and not the toxic waste scraped from smokestacks of fertilizer plants.

More from the flyer, “Three out of four Americans have fluoridated community water, yet persistent activists against fluoridation are willing to harm our community by spreading conspiracy theories.”  In one sentence they attempt to marginalize all those “activists” who question the science of fluoridation.  They go on to dismiss “fluorosis,” the mottling spots left on the teeth by exposure to fluoride.  They claim it is “barely noticeable” and does not affect the health of the teeth.  Again, no scientific studies cited.  However, tell this to the teenager who puts his hand over his mouth every time he smiles lest one of his peers make fun of his splotched teeth.  Tell this to your grandparents who endure osteoporosis due to the buildup of fluoride in their bones.

Even if it does not affect the “health of the teeth” they will agree every atom of fluoride introduced into the body remains in the body for life.  Fluoride collects in the heavier bones of the body thus bringing on the huge increase of hip-fractures in the past 50 years.  How many of you have had elderly family members suffer hip fractures just from stepping off a curb?

More from the flyer, “Scientific organizations recommend fluoridation.”  Again, no citation of scientific authority.  The only “scientific organizations” named are the Center for Disease Control, American Dental Association and the American Medical Association.  All these organizations benefit from the phosphate industry either by funding grants or providing scholarships for shills who repeat the big lie.

First of all the Center for Disease Control is hardly an independent body.  It is funded by the U. S. government.  Naturally the government only funds those who publish studies in sync with larger government goals.  Governments, especially the current administrations, top to bottom, do not demonstrate a great deal of attention to the average “man on the street.”  It is difficult to imagine anyone in government giving a hoot about poor children’s dental health.  It is more likely they are interested in helping the giant phosphate industry dispose of a toxic waste in exchange for grants and or political contributions.

Furthermore, fluoride is a known carcinogen.  According to Dr. Dean Burke, PhD with 34 years at the National Cancer Institute says, “In point of fact, fluoride causes more human cancer, and causes it faster, than any other chemical.”  Think how much the AMA members rake in each year “fighting” cancer. Think how many orthopedic surgeons will benefit from hip replacements.  Think how many dentists will benefit from installing veneers for those seeking to hide their mottled teeth.

Many of you know fluoride is one of the compounds included in the mood altering drug, Prozac.  Prozac is prescribed as an antidepressant.  Many say it causes one to go into a somnambulistic or “sleep-walking” type existence where there are no emotional highs and lows but a simple ever-present placid emotional state.  What more could these governments and organizations ask for?

Imagine your government’s delight in having a placid population that never gets too upset about the decisions made by our governments including endless wars.   Imagine how dentists must enjoy having patients in their chair who are incapable of making rational decisions when the dentist is selling the next expensive procedure.  Imagine how delighted is the American Medical Association to have a placid population of patients who never question their authority–never question their next suggested procedure but go along calmly and make no waves in the face of malpractice.  What’s not to like about fluoride–when you want to control a population?  Adolph Hitler ordered fluoridation of the water in his prisons and death camps to keep the prisoners pacified and more easily controlled.

Finally, realizing we cannot get good science in the quid pro quo environment of today’s political structure let’s look north of the border.  Dr. Hardy Limeback, B.Sc., PhD., in Biochemistry, DDS, and head of Department of Preventative Dentistry for University of Toronto and president of Canadian Association for Dental Research who states, “ Here in Toronto we’ve been fluoridating for 36 years yet Vancouver, which has never fluoridated–has a cavity rate lower than Toronto.”  The same can be said of a comparison between Sequim and Port Angeles.  Sequim has never fluoridated its water.  According to a recent “Smile Survey” Sequim has less cavities than Port Angeles.

Most European countries do not fluoridate their water.

Finally, before I go, did I mention, fluoride is the active ingredient in rat poison?

50 Reasons to Oppose Fluoridation

By Paul Connett, PhD (updated in September 2012)

Introduction

Dr. Paul Connett

In Europe, only Ireland (73%), Poland (1%), Serbia (3%), Spain (11%), and the U.K. (11%) fluoridate any of their water. Most developed countries, including Japan and 97% of the western European population, do not consume fluoridated water.

In the U.S., about 70% of public water supplies are fluoridated. This equates to approximately 185 million people, which is over half the number of people drinking artificially fluoridated water worldwide. Some countries have areas with high natural fluoride levels in the water. These include India, China and parts of Africa. In these countries measures are being taken to remove the fluoride because of the health problems that fluoride can cause.

Fluoridation is a bad medical practice

1) Fluoride is the only chemical added to water for the purpose of medical treatment. The U.S. Food and Drug Administration (FDA) classifies fluoride as a drug when used to prevent or mitigate disease (FDA 2000). As a matter of basic logic, adding fluoride to water for the sole purpose of preventing tooth decay (a non-waterborne disease) is a form of medical treatment. All other water treatment chemicals are added to improve the water’s quality or safety, which fluoride does not do.

2) Fluoridation is unethical. Informed consent is standard practice for all medication, and one of the key reasons why most of Western Europe has ruled against fluoridation. With water fluoridation we are allowing governments to do to whole communities (forcing people to take a medicine irrespective of their consent) what individual doctors cannot do to individual patients.

Put another way: Does a voter have the right to require that their neighbor ingest a certain medication (even if it is against that neighbor’s will)?

3) The dose cannot be controlled. Once fluoride is put in the water it is impossible to control the dose each individual receives because people drink different amounts of water. Being able to control the dose a patient receives is critical. Some people (e.g., manual laborers, athletes, diabetics, and people with kidney disease) drink substantially more water than others.

4) The fluoride goes to everyone regardless of age, health or vulnerability. According to Dr. Arvid Carlsson, the 2000 Nobel Laureate in Medicine and Physiology and one of the scientists who helped keep fluoridation out of Sweden:

“Water fluoridation goes against leading principles of pharmacotherapy, which is progressing from a stereotyped medication — of the type 1 tablet 3 times a day — to a much more individualized therapy as regards both dosage and selection of drugs. The addition of drugs to the drinking water means exactly the opposite of an individualized therapy” (Carlsson 1978).

5) People now receive fluoride from many other sources besides water. Fluoridated water is not the only way people are exposed to fluoride. Other sources of fluoride include food and beverages processed with fluoridated water (Kiritsy 1996; Heilman 1999), fluoridated dental products (Bentley 1999; Levy 1999), mechanically deboned meat (Fein 2001), tea (Levy 1999), and pesticide residues (e.g., from cryolite) on food (Stannard 1991; Burgstahler 1997). It is now widely acknowledged that exposure to non-water sources of fluoride has significantly increased since the water fluoridation program first began (NRC 2006).

6) Fluoride is not an essential nutrient. No disease, not even tooth decay, is caused by a “fluoride deficiency.”(NRC 1993; Institute of Medicine 1997, NRC 2006). Not a single biological process has been shown to require fluoride. On the contrary there is extensive evidence that fluoride can interfere with many important biological processes. Fluoride interferes with numerous enzymes (Waldbott 1978). In combination with aluminum, fluoride interferes with G-proteins (Bigay 1985, 1987). Such interactions give aluminum-fluoride complexes the potential to interfere with signals from growth factors, hormones and neurotransmitters (Strunecka & Patocka 1999; Li 2003). More and more studies indicate that fluoride can interfere with biochemistry in fundamental ways (Barbier 2010).

7) The level in mothers’ milk is very low. Considering reason #6 it is perhaps not surprising that the level of fluoride in mother’s milk is remarkably low (0.004 ppm, NRC, 2006). This means that a bottle-fed baby consuming fluoridated water (0.6 – 1.2 ppm) can get up to 300 times more fluoride than a breast-fed baby. There are no benefits (see reasons #11-19), only risks (see reasons #21-36), for infants ingesting this heightened level of fluoride at such an early age (an age where susceptibility to environmental toxins is particularly high).

8 ) Fluoride accumulates in the body. Healthy adult kidneys excrete 50 to 60% of the fluoride ingested each day (Marier & Rose 1971). The remainder accumulates in the body, largely in calcifying tissues such as the bones and pineal gland (Luke 1997, 2001). Infants and children excrete less fluoride from their kidneys and take up to 80% of ingested fluoride into their bones (Ekstrand 1994). The fluoride concentration in bone steadily increases over a lifetime (NRC 2006).

9) No health agency in fluoridated countries is monitoring fluoride exposure or side effects. No regular measurements are being made of the levels of fluoride in urine, blood, bones, hair, or nails of either the general population or sensitive subparts of the population (e.g., individuals with kidney disease).

10) There has never been a single randomized controlled trial to demonstrate fluoridation’s effectiveness or safety. Despite the fact that fluoride has been added to community water supplies for over 60 years, “there have been no randomized trials of water fluoridation” (Cheng 2007). Randomized trials are the standard method for determining the safety and effectiveness of any purportedly beneficial medical treatment. In 2000, the British Government’s “York Review” could not give a single fluoridation trial a Grade A classification – despite 50 years of research (McDonagh 2000). The U.S. Food and Drug Administration (FDA) continues to classify fluoride as an “unapproved new drug.”

Swallowing fluoride provides no (or very little) benefit

11) Benefit is topical not systemic. The Centers for Disease Control and Prevention (CDC, 1999, 2001) has now acknowledged that the mechanism of fluoride’s benefits are mainly topical, not systemic. There is no need whatsoever, therefore, to swallow fluoride to protect teeth. Since the purported benefit of fluoride is topical, and the risks are systemic, it makes more sense to deliver the fluoride directly to the tooth in the form of toothpaste. Since swallowing fluoride is unnecessary, and potentially dangerous, there is no justification for forcing people (against their will) to ingest fluoride through their water supply.

12) Fluoridation is not necessary. Most western, industrialized countries have rejected water fluoridation, but have nevertheless experienced the same decline in childhood dental decay as fluoridated countries. (See data from World Health Organization presented graphically in Figure).

13) Fluoridation’s role in the decline of tooth decay is in serious doubt. The largest survey ever conducted in the US (over 39,000 children from 84 communities) by the National Institute of Dental Research showed little difference in tooth decay among children in fluoridated and non-fluoridated communities (Hileman 1989). According to NIDR researchers, the study found an average difference of only 0.6 DMFS (Decayed, Missing, and Filled Surfaces) in the permanent teeth of children aged 5-17 residing their entire lives in either fluoridated or unfluoridated areas (Brunelle & Carlos, 1990). This difference is less than one tooth surface, and less than 1% of the 100+ tooth surfaces available in a child’s mouth. Large surveys from three Australian states have found even less of a benefit, with decay reductions ranging from 0 to 0.3 of one permanent tooth surface (Spencer 1996; Armfield & Spencer 2004). None of these studies have allowed for the possible delayed eruption of the teeth that may be caused by exposure to fluoride, for which there is some evidence (Komarek 2005). A one-year delay in eruption of the permanent teeth would eliminate the very small benefit recorded in these modern studies.

14) NIH-funded study on individual fluoride ingestion and tooth decay found no significant correlation. A multi-million dollar, U.S. National Institutes of Health (NIH)-funded study found no significant relationship between tooth decay and fluoride intake among children. (Warren 2009) This is the first time tooth decay has been investigated as a function of individual exposure (as opposed to mere residence in a fluoridated community).

15) Tooth decay is high in low-income communities that have been fluoridated for years. Despite some claims to the contrary, water fluoridation cannot prevent the oral health crises that result from rampant poverty, inadequate nutrition, and lack of access to dental care. There have been numerous reports of severe dental crises in low-income neighborhoods of US cities that have been fluoridated for over 20 years (e.g., Boston, Cincinnati, New York City, and Pittsburgh). In addition, research has repeatedly found fluoridation to be ineffective at preventing the most serious oral health problem facing poor children, namely “baby bottle tooth decay,” otherwise known as early childhood caries (Barnes 1992; Shiboski 2003).

16) Tooth decay does not go up when fluoridation is stopped. Where fluoridation has been discontinued in communities from Canada, the former East Germany, Cuba and Finland, dental decay has not increased but has generally continued to decrease (Maupomé 2001; Kunzel & Fischer, 1997, 2000; Kunzel 2000; Seppa 2000).

17) Tooth decay was coming down before fluoridation started. Modern research shows that decay rates were coming down before fluoridation was introduced in Australia and New Zealand and have continued to decline even after its benefits would have been maximized. (Colquhoun 1997; Diesendorf 1986). As the following figure indicates, many other factors are responsible for the decline of tooth decay that has been universally reported throughout the western world.

18) The studies that launched fluoridation were methodologically flawed. The early trials conducted between 1945 and 1955 in North America that helped to launch fluoridation, have been heavily criticized for their poor methodology and poor choice of control communities (De Stefano 1954; Sutton 1959, 1960, 1996; Ziegelbecker 1970). According to Dr. Hubert Arnold, a statistician from the University of California at Davis, the early fluoridation trials “are especially rich in fallacies, improper design, invalid use of statistical methods, omissions of contrary data, and just plain muddleheadedness and hebetude.” Serious questions have also been raised about Trendley Dean’s (the father of fluoridation) famous 21-city study from 1942 (Ziegelbecker 1981).

Children are being over-exposed to fluoride

19) Children are being over-exposed to fluoride. The fluoridation program has massively failed to achieve one of its key objectives, i.e., to lower dental decay rates while limiting the occurrence of dental fluorosis (a discoloring of tooth enamel caused by too much fluoride. The goal of the early promoters of fluoridation was to limit dental fluorosis (in its very mild form) to10% of children (NRC 1993, pp. 6-7). In 2010, however, the Centers for Disease Control and Prevention (CDC) reported that 41% of American adolescents had dental fluorosis, with 8.6% having mild fluorosis and 3.6% having either moderate or severe dental fluorosis (Beltran-Aguilar 2010). As the 41% prevalence figure is a national average and includes children living in fluoridated and unfluoridated areas, the fluorosis rate in fluoridated communities will obviously be higher. The British Government’s York Review estimated that up to 48% of children in fluoridated areas worldwide have dental fluorosis in all forms, with 12.5% having fluorosis of aesthetic concern (McDonagh, 2000).

20) The highest doses of fluoride are going to bottle-fed babies. Because of their sole reliance on liquids for their food intake, infants consuming formula made with fluoridated water have the highest exposure to fluoride, by bodyweight, in the population. Because infant exposure to fluoridated water has been repeatedly found to be a major risk factor for developing dental fluorosis later in life (Marshall 2004; Hong 2006; Levy 2010), a number of dental researchers have recommended that parents of newborns not use fluoridated water when reconstituting formula (Ekstrand 1996; Pendrys 1998; Fomon 2000; Brothwell 2003; Marshall 2004). Even the American Dental Association (ADA), the most ardent institutional proponent of fluoridation, distributed a November 6, 2006 email alert to its members recommending that parents be advised that formula should be made with “low or no-fluoride water.” Unfortunately, the ADA has done little to get this information into the hands of parents. As a result, many parents remain unaware of the fluorosis risk from infant exposure to fluoridated water.

Evidence of harm to other tissues

21) Dental fluorosis may be an indicator of wider systemic damage. There have been many suggestions as to the possible biochemical mechanisms underlying the development of dental fluorosis (Matsuo 1998; Den Besten 1999; Sharma 2008; Duan 2011; Tye 2011) and they are complicated for a lay reader. While promoters of fluoridation are content to dismiss dental fluorosis (in its milder forms) as merely a cosmetic effect, it is rash to assume that fluoride is not impacting other developing tissues when it is visibly damaging the teeth by some biochemical mechanism (Groth 1973; Colquhoun 1997). Moreover, ingested fluoride can only cause dental fluorosis during the period before the permanent teeth have erupted (6-8 years), other tissues are potentially susceptible to damage throughout life. For example, in areas of naturally high levels of fluoride the first indicator of harm is dental fluorosis in children. In the same communities many older people develop skeletal fluorosis.

22) Fluoride may damage the brain. According to the National Research Council (2006), “it is apparent that fluorides have the ability to interfere with the functions of the brain.” In a review of the literature commissioned by the US Environmental Protection Agency (EPA), fluoride has been listed among about 100 chemicals for which there is “substantial evidence of developmental neurotoxicity.” Animal experiments show that fluoride accumulates in the brain and alters mental behavior in a manner consistent with a neurotoxic agent (Mullenix 1995). In total, there have now been over 100 animal experiments showing that fluoride can damage the brain and impact learning and behavior. According to fluoridation proponents, these animal studies can be ignored because high doses were used. However, it is important to note that rats generally require five times more fluoride to reach the same plasma levels in humans (Sawan 2010). Further, one animal experiment found effects at remarkably low doses (Varner 1998). In this study, rats fed for one year with 1 ppm fluoride in their water (the same level used in fluoridation programs), using either sodium fluoride or aluminum fluoride, had morphological changes to their kidneys and brains, an increased uptake of aluminum in the brain, and the formation of beta-amyloid deposits which are associated with Alzheimer’s disease. Other animal studies have found effects on the brain at water fluoride levels as low as 5 ppm (Liu 2010).

23) Fluoride may lower IQ. There have now been 33 studies from China, Iran, India and Mexico that have reported an association between fluoride exposure and reduced IQ. One of these studies (Lin 1991) indicates that even just moderate levels of fluoride exposure (e.g., 0.9 ppm in the water) can exacerbate the neurological defects of iodine deficiency. Other studies have found IQ reductions at 1.9 ppm (Xiang 2003a,b); 0.3-3.0 ppm (Ding 2011); 1.8-3.9 ppm (Xu 1994); 2.0 ppm (Yao 1996, 1997); 2.1-3.2 ppm (An 1992); 2.38 ppm (Poureslami 2011); 2.45 ppm (Eswar 2011); 2.5 ppm (Seraj 2006); 2.85 ppm (Hong 2001); 2.97 ppm (Wang 2001, Yang 1994); 3.15 ppm (Lu 2000); 4.12 ppm (Zhao 1996). In the Ding study, each 1 ppm increase of fluoride in urine was associated with a loss of 0.59 IQ points. None of these studies indicate an adequate margin of safety to protect all children drinking artificially fluoridated water from this affect. According to the National Research Council (2006), “the consistency of the results [in fluoride/IQ studies] appears significant enough to warrant additional research on the effects of fluoride on intelligence.” The NRC’s conclusion has recently been amplified by a team of Harvard scientists whose fluoride/IQ meta-review concludes that fluoride’s impact on the developing brain should be a “high research priority.” (Choi et al., 2012). Except for one small IQ study from New Zealand (Spittle 1998) no fluoridating country has yet investigated the matter.

24) Fluoride may cause non-IQ neurotoxic effects. Reduced IQ is not the only neurotoxic effect that may result from fluoride exposure. At least three human studies have reported an association between fluoride exposure and impaired visual-spatial organization (Calderon 2000; Li 2004; Rocha-Amador 2009); while four other studies have found an association between prenatal fluoride exposure and fetal brain damage (Han 1989; Du 1992; Dong 1993; Yu 1996).

25) Fluoride affects the pineal gland. Studies by Jennifer Luke (2001) show that fluoride accumulates in the human pineal gland to very high levels. In her Ph.D. thesis, Luke has also shown in animal studies that fluoride reduces melatonin production and leads to an earlier onset of puberty (Luke 1997). Consistent with Luke’s findings, one of the earliest fluoridation trials in the U.S. (Schlesinger 1956) reported that on average young girls in the fluoridated community reached menstruation 5 months earlier than girls in the non-fluoridated community. Inexplicably, no fluoridating country has attempted to reproduce either Luke’s or Schlesinger’s findings or examine the issue any further.

26) Fluoride affects thyroid function. According to the U.S. National Research Council (2006), “several lines of information indicate an effect of fluoride exposure on thyroid function.” In the Ukraine, Bachinskii (1985) found a lowering of thyroid function, among otherwise healthy people, at 2.3 ppm fluoride in water. In the middle of the 20th century, fluoride was prescribed by a number of European doctors to reduce the activity of the thyroid gland for those suffering from hyperthyroidism (overactive thyroid) (Stecher 1960; Waldbott 1978). According to a clinical study by Galletti and Joyet (1958), the thyroid function of hyperthyroid patients was effectively reduced at just 2.3 to 4.5 mg/day of fluoride ion. To put this finding in perspective, the Department of Health and Human Services (DHHS, 1991) has estimated that total fluoride exposure in fluoridated communities ranges from 1.6 to 6.6 mg/day. This is a remarkable fact, particularly considering the rampant and increasing problem of hypothyroidism (underactive thyroid) in the United States and other fluoridated countries. Symptoms of hypothyroidism include depression, fatigue, weight gain, muscle and joint pains, increased cholesterol levels, and heart disease. In 2010, the second most prescribed drug of the year was Synthroid (sodium levothyroxine) which is a hormone replacement drug used to treat an underactive thyroid.

27) Fluoride causes arthritic symptoms. Some of the early symptoms of skeletal fluorosis (a fluoride-induced bone and joint disease that impacts millions of people in India, China, and Africa), mimic the symptoms of arthritis (Singh 1963; Franke 1975; Teotia 1976; Carnow 1981; Czerwinski 1988; DHHS 1991). According to a review on fluoridation published in Chemical & Engineering News, “Because some of the clinical symptoms mimic arthritis, the first two clinical phases of skeletal fluorosis could be easily misdiagnosed” (Hileman 1988). Few, if any, studies have been done to determine the extent of this misdiagnosis, and whether the high prevalence of arthritis in America (1 in 3 Americans have some form of arthritis – CDC, 2002) and other fluoridated countries is related to growing fluoride exposure, which is highly plausible. Even when individuals in the U.S. suffer advanced forms of skeletal fluorosis (from drinking large amounts of tea), it has taken years of misdiagnoses before doctors finally correctly diagnosed the condition as fluorosis.

28) Fluoride damages bone. An early fluoridation trial (Newburgh-Kingston 1945-55) found a significant two-fold increase in cortical bone defects among children in the fluoridated community (Schlesinger 1956). The cortical bone is the outside layer of the bone and is important to protect against fracture. While this result was not considered important at the time with respect to bone fractures, it did prompt questions about a possible link to osteosarcoma (Caffey, 1955; NAS, 1977). In 2001, Alarcon-Herrera and co-workers reported a linear correlation between the severity of dental fluorosis and the frequency of bone fractures in both children and adults in a high fluoride area in Mexico.

29) Fluoride may increase hip fractures in the elderly. When high doses of fluoride (average 26 mg per day) were used in trials to treat patients with osteoporosis in an effort to harden their bones and reduce fracture rates, it actually led to a higher number of fractures, particularly hip fractures (Inkovaara 1975; Gerster 1983; Dambacher 1986; O’Duffy 1986; Hedlund 1989; Bayley 1990; Gutteridge 1990. 2002; Orcel 1990; Riggs 1990 and Schnitzler 1990). Hip fracture is a very serious issue for the elderly, often leading to a loss of independence or a shortened life. There have been over a dozen studies published since 1990 that have investigated a possible relationship between hip fractures and long term consumption of artificially fluoridated water or water with high natural levels. The results have been mixed – some have found an association and others have not. Some have even claimed a protective effect. One very important study in China, which examined hip fractures in six Chinese villages, found what appears to be a dose-related increase in hip fracture as the concentration of fluoride rose from 1 ppm to 8 ppm (Li 2001) offering little comfort to those who drink a lot of fluoridated water. Moreover, in the only human epidemiological study to assess bone strength as a function of bone fluoride concentration, researchers from the University of Toronto found that (as with animal studies) the strength of bone declined with increasing fluoride content (Chachra 2010). Finally, a recent study from Iowa (Levy 2009), published data suggesting that low-level fluoride exposure may have a detrimental effect on cortical bone density in girls (an effect that has been repeatedly documented in clinical trials and which has been posited as an important mechanism by which fluoride may increase bone fracture rates).

30) People with impaired kidney function are particularly vulnerable to bone damage. Because of their inability to effectively excrete fluoride, people with kidney disease are prone to accumulating high levels of fluoride in their bone and blood. As a result of this high fluoride body burden, kidney patients have an elevated risk for developing skeletal fluorosis. In one of the few U.S. studies investigating the matter, crippling skeletal fluorosis was documented among patients with severe kidney disease drinking water with just 1.7 ppm fluoride (Johnson 1979). Since severe skeletal fluorosis in kidney patients has been detected in small case studies, it is likely that larger, systematic studies would detect skeletal fluorosis at even lower fluoride levels.

31) Fluoride may cause bone cancer (osteosarcoma). A U.S. government-funded animal study found a dose-dependent increase in bone cancer (osteosarcoma) in fluoride-treated, male rats (NTP 1990). Following the results of this study, the National Cancer Institute (NCI) reviewed national cancer data in the U.S. and found a significantly higher rate of osteosarcoma (a bone cancer) in young men in fluoridated versus unfluoridated areas (Hoover et al 1991a). While the NCI concluded (based on an analysis lacking statistical power) that fluoridation was not the cause (Hoover et al 1991b), no explanation was provided to explain the higher rates in the fluoridated areas. A smaller study from New Jersey (Cohn 1992) found osteosarcoma rates to be up to 6 times higher in young men living in fluoridated versus unfluoridated areas. Other epidemiological studies of varying size and quality have failed to find this relationship (a summary of these can be found in Bassin, 2001 and Connett & Neurath, 2005). There are three reasons why a fluoride-osteosarcoma connection is plausible: First, fluoride accumulates to a high level in bone. Second, fluoride stimulates bone growth. And, third, fluoride can interfere with the genetic apparatus of bone cells in several ways; it has been shown to be mutagenic, cause chromosome damage, and interfere with the enzymes involved with DNA repair in both cell and tissue studies (Tsutsui 1984; Caspary 1987; Kishi 1993; Mihashi 1996; Zhang 2009). In addition to cell and tissue studies, a correlation between fluoride exposure and chromosome damage in humans has also been reported (Sheth 1994; Wu 1995; Meng 1997; Joseph 2000).

32) Proponents have failed to refute the Bassin-Osteosarcoma study. In 2001, Elise Bassin, a dentist, successfully defended her doctoral thesis at Harvard in which she found that young boys had a five-to-seven fold increased risk of getting osteosarcoma by the age of 20 if they drank fluoridated water during their mid-childhood growth spurt (age 6 to 8). The study was published in 2006 (Bassin 2006) but has been largely discounted by fluoridating countries because her thesis adviser Professor Chester Douglass (a promoter of fluoridation and a consultant for Colgate) promised a larger study that he claimed would discount her thesis (Douglass and Joshipura, 2006). Now, after 5 years of waiting the Douglass study has finally been published (Kim 2011) but in no way does this study discount Bassin’s findings. The study, which used far fewer controls than Bassin’s analysis, did not even attempt to assess the age-specific window of risk that Bassin identified. Indeed, by the authors’ own admission, the study had no capacity to assess the risk of osteosarcoma among children and adolescents (the precise population of concern). For a critique of the Douglass study, click here.

33) Fluoride may cause reproductive problems. Fluoride administered to animals at high doses wreaks havoc on the male reproductive system – it damages sperm and increases the rate of infertility in a number of different species (Kour 1980; Chinoy 1989; Chinoy 1991; Susheela 1991; Chinoy 1994; Kumar 1994; Narayana 1994a,b; Zhao 1995; Elbetieha 2000; Ghosh 2002; Zakrzewska 2002). In addition, an epidemiological study from the US found increased rates of infertility among couples living in areas with 3 ppm or more fluoride in the water (Freni 1994), two studies have found increased fertility among men living in high-fluoride areas of China and India (Liu 1988; Neelam 1987); four studies have found reduced level of circulating testosterone in males living in high fluoride areas (Hao 2010; Chen P 1997; Susheela 1996; Barot 1998), and a study of fluoride-exposed workers reported a “subclinical reproductive effect” (Ortiz-Perez 2003). While animal studies by FDA researchers have failed to find evidence of reproductive toxicity in fluoride-exposed rats (Sprando 1996, 1997, 1998), the National Research Council (2006) has recommended that, “the relationship between fluoride and fertility requires additional study.”

34) Some individuals are highly sensitive to low levels of fluoride as shown by case studies and double blind studies. In one study, which lasted 13 years, Feltman and Kosel (1961) showed that about 1% of patients given 1 mg of fluoride each day developed negative reactions. Many individuals have reported suffering from symptoms such as fatigue, headaches, rashes and stomach and gastro intestinal tract problems, which disappear when they avoid fluoride in their water and diet. (Shea 1967; Waldbott 1978; Moolenburgh 1987) Frequently the symptoms reappear when they are unwittingly exposed to fluoride again (Spittle, 2008). No fluoridating government has conducted scientific studies to take this issue beyond these anecdotal reports. Without the willingness of governments to investigate these reports scientifically, should we as a society be forcing these people to ingest fluoride?

35) Other subsets of population are more vulnerable to fluoride’s toxicity. In addition to people suffering from impaired kidney function discussed in reason #30 other subsets of the population are more vulnerable to fluoride’s toxic effects. According to the Agency for Toxic Substances and Disease Registry (ATSDR 1993) these include: infants, the elderly, and those with diabetes mellitus. Also vulnerable are those who suffer from malnutrition (e.g., calcium, magnesium, vitamin C, vitamin D and iodine deficiencies and protein-poor diets) and those who have diabetes insipidus. See: Greenberg 1974; Klein 1975; Massler & Schour 1952; Marier & Rose 1977; Lin 1991; Chen 1997; Seow 1994; Teotia 1998.

No Margin of Safety

36) There is no margin of safety for several health effects. No one can deny that high natural levels of fluoride damage health. Millions of people in India and China have had their health compromised by fluoride. The real question is whether there is an adequate margin of safety between the doses shown to cause harm in published studies and the total dose people receive consuming uncontrolled amounts of fluoridated water and non-water sources of fluoride. This margin of safety has to take into account the wide range of individual sensitivity expected in a large population (a safety factor of 10 is usually applied to the lowest level causing harm). Another safety factor is also needed to take into account the wide range of doses to which people are exposed. There is clearly no margin of safety for dental fluorosis (CDC, 2010) and based on the following studies nowhere near an adequate margin of safety for lowered IQ (Xiang 2003a,b; Ding 2011; Choi 2012); lowered thyroid function (Galletti & Joyet 1958; Bachinskii 1985; Lin 1991); bone fractures in children (Alarcon-Herrera 2001) or hip fractures in the elderly (Kurttio 1999; Li 2001). All of these harmful effects are discussed in the NRC (2006) review.

Environmental Justice

37) Low-income families penalized by fluoridation. Those most likely to suffer from poor nutrition, and thus more likely to be more vulnerable to fluoride’s toxic effects, are the poor, who unfortunately, are the very people being targeted by new fluoridation programs. While at heightened risk, poor families are least able to afford avoiding fluoride once it is added to the water supply. No financial support is being offered to these families to help them get alternative water supplies or to help pay the costs of treating unsightly cases of dental fluorosis.

38) Black and Hispanic children are more vulnerable to fluoride’s toxicity. According to the CDC’s national survey of dental fluorosis, black and Mexican-American children have significantly higher rates of dental fluorosis than white children (Beltran-Aguilar 2005, Table 23). The recognition that minority children appear to be more vulnerable to toxic effects of fluoride, combined with the fact that low-income families are less able to avoid drinking fluoridated water, has prompted prominent leaders in the environmental-justice movement to oppose mandatory fluoridation in Georgia. In a statement issued in May 2011, Andrew Young, a colleague of Martin Luther King, Jr., and former Mayor of Atlanta and former US Ambassador to the United Nations, stated:

“I am most deeply concerned for poor families who have babies: if they cannot afford unfluoridated water for their babies’ milk formula, do their babies not count? Of course they do. This is an issue of fairness, civil rights, and compassion. We must find better ways to prevent cavities, such as helping those most at risk for cavities obtain access to the services of a dentist…My father was a dentist. I formerly was a strong believer in the benefits of water fluoridation for preventing cavities. But many things that we began to do 50 or more years ago we now no longer do, because we have learned further information that changes our practices and policies. So it is with fluoridation.”

39) Minorities are not being warned about their vulnerabilities to fluoride. The CDC is not warning black and Mexican-American children that they have higher rates of dental fluorosis than Caucasian children (see #38). This extra vulnerability may extend to other toxic effects of fluoride. Black Americans have higher rates of lactose intolerance, kidney problems and diabetes, all of which may exacerbate fluoride’s toxicity.

40) Tooth decay reflects low-income not low-fluoride intake. Since dental decay is most concentrated in poor communities, we should be spending our efforts trying to increase the access to dental care for low-income families. The highest rates of tooth decay today can be found in low-income areas that have been fluoridated for many years. The real “Oral Health Crisis” that exists today in the United States, is not a lack of fluoride but poverty and lack of dental insurance. The Surgeon General has estimated that 80% of dentists in the US do not treat children on Medicaid.

The largely untested chemicals used in fluoridation programs

41) The chemicals used to fluoridate water are not pharmaceutical grade. Instead, they largely come from the wet scrubbing systems of the phosphate fertilizer industry. These chemicals (90% of which are sodium fluorosilicate and fluorosilicic acid), are classified hazardous wastes contaminated with various impurities. Recent testing by the National Sanitation Foundation suggest that the levels of arsenic in these silicon fluorides are relatively high (up to 1.6 ppb after dilution into public water) and of potential concern (NSF 2000 and Wang 2000). Arsenic is a known human carcinogen for which there is no safe level. This one contaminant alone could be increasing cancer rates – and unnecessarily so.

42) The silicon fluorides have not been tested comprehensively. The chemical usually tested in animal studies is pharmaceutical grade sodium fluoride, not industrial grade fluorosilicic acid. Proponents claim that once the silicon fluorides have been diluted at the public water works they are completely dissociated to free fluoride ions and hydrated silica and thus there is no need to examine the toxicology of these compounds. However, while a study from the University of Michigan (Finney et al., 2006) showed complete dissociation at neutral pH, in acidic conditions (pH 3) there was a stable complex containing five fluoride ions. Thus the possibility arises that such a complex may be regenerated in the stomach where the pH lies between 1 and 2.

43) The silicon fluorides may increase lead uptake into children’s blood. Studies by Masters and Coplan (1999, 2000, 2007), and to a lesser extent Macek (2006), show an association between the use of fluorosilicic acid (and its sodium salt) to fluoridate water and an increased uptake of lead into children’s blood. Because of lead’s acknowledged ability to damage the developing brain, this is a very serious finding. Nevertheless, it is being largely ignored by fluoridating countries. This association received some strong biochemical support from an animal study by Sawan et al. (2010) who found that exposure of rats to a combination of fluorosilicic acid and lead in their drinking water increased the uptake of lead into blood some threefold over exposure to lead alone.

44) Fluoride may leach lead from pipes, brass fittings and soldered joints. In tightly controlled laboratory experiments, Maas et al (2007) have shown that fluoridating agents in combination with chlorinating agents such as chloroamine increase the leaching of lead from brass fittings used in plumbing. While proponents may argue about the neurotoxic effects of low levels of fluoride there is no argument that lead at very low levels lowers IQ in children.

Continued promotion of fluoridation is unscientific

45) Key health studies have not been done. In the January 2008 issue of Scientific American, Professor John Doull, the chairman of the important 2006 National Research Council review, Fluoride in Drinking Water: A Review of EPA’s Standards, is quoted as saying:

What the committee found is that we’ve gone with the status quo regarding fluoride for many years—for too long really—and now we need to take a fresh look . . . In the scientific community people tend to think this is settled. I mean, when the U.S. surgeon general comes out and says this is one of the top 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on.

The absence of studies is being used by promoters as meaning the absence of harm. This is an irresponsible position.

46) Endorsements do not represent scientific evidence. Many of those promoting fluoridation rely heavily on a list of endorsements. However, the U.S. PHS first endorsed fluoridation in 1950, before one single trial had been completed and before any significant health studies had been published (see chapters 9 and 10 in The Case Against Fluoride for the significance of this PHS endorsement for the future promotion of fluoridation). Many other endorsements swiftly followed with little evidence of any scientific rational for doing so. The continued use of these endorsements has more to do with political science than medical science.

47) Review panels hand-picked to deliver a pro-fluoridation result. Every so often, particularly when their fluoridation program is under threat, governments of fluoridating countries hand-pick panels to deliver reports that provide the necessary re-endorsement of the practice. In their recent book Fluoride Wars (2009), which is otherwise slanted toward fluoridation, Alan Freeze and Jay Lehr concede this point when they write:

There is one anti-fluoridationist charge that does have some truth to it. Anti-fluoride forces have always claimed that the many government-sponsored review panels set up over the years to assess the costs and benefits of fluoridation were stacked in favor of fluoridation. A review of the membership of the various panels confirms this charge. The expert committees that put together reports by the American Association for the Advancement of Science in 1941, 1944 and 1954; the National Academy of Sciences in 1951, 1971, 1977 and 1993; the World Health Organization in 1958 and 1970; and the U.S. Public Health Service in 1991 are rife with the names of well-known medical and dental researchers who actively campaigned on behalf of fluoridation or whose research was held in high regard in the pro-fluoridation movement. Membership was interlocking and incestuous.

The most recent examples of these self-fulfilling prophecies have come from the Irish Fluoridation Forum (2002); the National Health and Medical Research Council (NHMRC, 2007) and Health Canada (2008, 2010). The latter used a panel of six experts to review the health literature. Four of the six were pro-fluoridation dentists and the other two had no demonstrated expertise on fluoride. A notable exception to this trend was the appointment by the U.S. National Research Council of the first balanced panel of experts ever selected to look at fluoride’s toxicity in the U.S. This panel of twelve reviewed the US EPA’s safe drinking water standards for fluoride. After three and half years the panel concluded in a 507- page report that the safe drinking water standard was not protective of health and a new maximum contaminant level goal (MCLG) should be determined (NRC, 2006). If normal toxicological procedures and appropriate margins of safety were applied to their findings this report should spell an end to water fluoridation. Unfortunately in January of 2011 the US EPA Office of Water made it clear that they would not determine a value for the MCLG that would jeopardize the water fluoridation program (EPA press release, Jan 7, 2011. Once again politics was allowed to trump science.

More and more independent scientists oppose fluoridation

48) Many scientists oppose fluoridation. Proponents of fluoridation have maintained for many years— despite the fact that the earliest opponents of fluoridation were biochemists—that the only people opposed to fluoridation are not bona fide scientists. Today, as more and more scientists, doctors, dentists and other professionals, read the primary literature for themselves, rather than relying on self-serving statements from the ADA and the CDC, they are realizing that they and the general public have not been diligently informed by their professional bodies on this subject. As of January 2012, over 4,000 professionals have signed a statement calling for an end to water fluoridation worldwide. This statement and a list of signatories can be found on the website of the Fluoride Action Network. A glimpse of the caliber of those opposing fluoridation can be gleaned by watching the 28-minute video “Professional Perspectives on Water fluoridation” which can be viewed online at the same FAN site.

Proponents’ dubious tactics

49) Proponents usually refuse to defend fluoridation in open debate. While pro-fluoridation officials continue to promote fluoridation with undiminished fervor, they usually refuse to defend the practice in open public debate – even when challenged to do so by organizations such as the Association for Science in the Public Interest, the American College of Toxicology, or the U.S. EPA (Bryson 2004). According to Dr. Michael Easley, a prominent lobbyist for fluoridation in the US, “Debates give the illusion that a scientific controversy exists when no credible people support the fluorophobics’ view” (Easley, 1999). In light of proponents’ refusal to debate this issue, Dr. Edward Groth, a Senior Scientist at Consumers Union, observed that, “the political profluoridation stance has evolved into a dogmatic, authoritarian, essentially antiscientific posture, one that discourages open debate of scientific issues” (Martin 1991).

50) Proponents use very dubious tactics to promote fluoridation. Many scientists, doctors and dentists who have spoken out publicly on this issue have been subjected to censorship and intimidation (Martin 1991). Dr. Phyllis Mullenix was fired from her position as Chair of Toxicology at Forsythe Dental Center for publishing her findings on fluoride and the brain (Mullenix 1995); and Dr. William Marcus was fired from the EPA for questioning the government’s handling of the NTP’s fluoride-cancer study (Bryson 2004). Many dentists and even doctors tell opponents in private that they are opposed to this practice but dare not speak out in public because of peer pressure and the fear of recriminations. Tactics like this would not be necessary if those promoting fluoridation were on secure scientific and ethical grounds.

Conclusion

When it comes to controversies surrounding toxic chemicals, vested interests traditionally do their very best to discount animal studies and quibble with epidemiological findings. In the past, political pressures have led government agencies to drag their feet on regulating asbestos, benzene, DDT, PCBs, tetraethyl lead, tobacco and dioxins. With fluoridation we have had a sixty-year delay. Unfortunately, because government officials and dental leaders have put so much of their credibility on the line defending fluoridation, and because of the huge liabilities waiting in the wings if they admit that fluoridation has caused an increase in hip fracture, arthritis, bone cancer, brain disorders or thyroid problems, it will be very difficult for them to speak honestly and openly about the issue. But they must, not only to protect millions of people from unnecessary harm, but to protect the notion that, at its core, public health policy must be based on sound science, not political expediency. They have a tool with which to do this: it’s called the Precautionary Principle. Simply put, this says: if in doubt leave it out. This is what most European countries have done and their children’s teeth have not suffered, while their public’s trust has been strengthened.

Just how much doubt is needed on just one of the health concerns identified above, to override a benefit, which when quantified in the largest survey ever conducted in the US, amounts to less than one tooth surface (out of 128) in a child’s mouth?

While fluoridation may not be the greatest environmental health threat, it is one of the easiest to end. It is as easy as turning off a spigot in the public water works. But to turn off that spigot takes political will and to get that we need masses more people informed and organized. Please get these 50 reasons to all your friends and encourage them to get fluoride out of their community and to help ban this practice worldwide.

Postscript

Further arguments against fluoridation, can be viewed at http://www.fluoridealert.org and in the book The Case Against Fluoridation (Chelsea Green, 2010). Arguments for fluoridation can be found at http://www.ada.org

Publication history of the 50 Reasons

The 50 Reasons were first compiled by Paul Connett and presented in person to the Irish Fluoridation Forum in October 2000. The document was refined in 2004 and published in Medical Veritas. In the introduction to the 2004 version it was explained that after over four years the Irish authorities had not been able to muster a response to the 50 Reasons, despite agreeing to do so in 2000. Eventually, an anonymous, incomplete and superficial response was posted on the Irish Department of Health and Children’s website (see this response and addendum at:http://www.dohc.ie/other_health_issues/dental_research/. Paul Connett’s comprehensive response to this response can be accessed at http://www.fluoridealert.org/50reasons.ireland.pdf. We learned on August 7, 2011 that this governmental response was prepared by an external contractor at a cost to the Irish taxpayers’ of over 30,000 Euros.

Since 2004, there have been many major scientific developments including the publication of the U.S. National Research Council report (NRC, 2006); the publication of Bassin’s study on Osteosarcoma (Bassin 2006), and many more studies of fluoride’s interaction with the brain, that necessitated a major update of the 50 Reasons in August 2011. This update was made with the generous assistance of James Beck, MD, PhD, Michael Connett, JD, Hardy Limeback, DDS, PhD, David McRae and Spedding Micklem, D.Phil. Additional developments in 2012, including FAN’s translation of over 20 Chinese studies on fluoride toxicity and publication of the Harvard team’s meta-review of fluoride and IQ (Choi 2012), warranted a further update in August 2012, with the extremely helpful assistance of my son, Michael Connett.

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And finally, this from Newsweek:  Republished under Fair Use Doctrine as educational

Fluoridation May Not Prevent Cavities, Scientific Review Shows

By Douglas Main On 6/29/15 at 2:57 PM

There is little recent or high-quality evidence that fluoridation reduces tooth decay, according to a review. Shannon Stapleton / REUTERS

If you’re like two-thirds of Americans, fluoride is added to your tap water for the purpose of reducing cavities. But the scientific rationale for putting it there may be outdated, and no longer as clear-cut as was once thought.Water fluoridation, which first began in 1945 in Grand Rapids, Michigan, and expanded nationwide over the years, has always been controversial. Those opposed to the process have argued—and a growing number of studies have suggested—that the chemical may present a number of health risks, for example interfering with the endocrine system and increasing the risk of impaired brain function; two studies in the last few months, for example, have linked fluoridation to ADHD and underactive thyroid. Others argue against water fluoridation on ethical grounds, saying the process forces people to consume a substance they may not know is there—or that they’d rather avoid.

Despite concerns about safety and ethics, many are content to continue fluoridation because of its purported benefit: that it reduces tooth decay. The Centers for Disease Control and Prevention’s Division of Oral Health, the main government body responsible for the process, says it’s “safe and effective.”

You might think, then, that fluoridated water’s efficacy as a cavity preventer would be proven beyond a reasonable doubt. But new research suggests that assumption is dramatically misguided; while using fluoridated toothpaste has been proven to be good for oral health, consuming fluoridated water may have no positive impact.

The Cochrane Collaboration, a group of doctors and researchers known for their comprehensive reviews—which are widely regarded as the gold standard of scientific rigor in assessing effectiveness of public health policies—recently set out to find out if fluoridation reduces cavities. They reviewed every study done on fluoridation that they could find, and then winnowed down the collection to only the most comprehensive, well-designed and reliable papers. Then they analyzed these studies’ results, and published their conclusion in a review earlier this month.

The review identified only three studies since 1975—of sufficient quality to be included—that addressed the effectiveness of fluoridation on tooth decay in the population at large. These papers determined that fluoridation does not reduce cavities to a statistically significant degree in permanent teeth, says study co-author Anne-Marie Glenny, a health science researcher at Manchester University in the United Kingdom. The authors found only seven other studies worthy of inclusion dating prior to 1975.

The authors also found only two studies since 1975 that looked at the effectiveness of reducing cavities in baby teeth, and found fluoridation to have no statistically significant impact here, either.

The scientists also found “insufficient evidence” that fluoridation reduces tooth decay in adults (children excluded).

“From the review, we’re unable to determine whether water fluoridation has an impact on caries levels in adults,” Glenny says. (“Tooth decay,” “cavities” and “caries” all mean the same thing: breakdown of enamel by mouth-dwelling microbes.)

“Frankly, this is pretty shocking,” says Thomas Zoeller, a scientist at UMass-Amherst uninvolved in the work. “This study does not support the use of fluoride in drinking water.” Trevor Sheldon concurred. Sheldon is the dean of the Hull York Medical School in the United Kingdom who led the advisory board that conducted a systematic review of water fluoridation in 2000, that came to similar conclusions as the Cochrane review. The lack of good evidence of effectiveness has shocked him. “I had assumed because of everything I’d heard that water fluoridation reduces cavities but I was completely amazed by the lack of evidence,” he says. “My prior view was completely reversed.”

“There’s really hardly any evidence” the practice works, Sheldon adds. “And if anything there may be some evidence the other way.” One 2001 study covered in the Cochrane review of two neighboring British Columbia communities found that when fluoridation was stopped in one city, cavity prevalence actually went down slightly amongst schoolchildren, while cavity rates in the fluoridated community remained stable.

Overall the review suggests that stopping fluoridation would be unlikely to increase the risk of tooth decay, says Kathleen Thiessen, a senior scientist at the Oak Ridge Center for Risk Analysis, which does human health risk assessments of environmental contaminants.

“The sad story is that very little has been done in recent years to ensure that fluoridation is still needed [or] to ensure that adverse effects do not happen,” says Dr. Philippe Grandjean, an environmental health researcher and physician at Harvard University.

The scientists also couldn’t find enough evidence to support the oft-repeated notion that fluoridation reduces dental health disparities among different socioeconomic groups, which the CDC and others use as a rationale for fluoridating water.

“The fact that there is insufficient information to determine whether fluoridation reduces social inequalities in dental health is troublesome given that this is often cited as a reason for fluoridating water,” say Christine Till and Ashley Malin, researchers at Toronto’s York University.

Studies that attest to the effectiveness of fluoridation were generally done before the widespread usage of fluoride-containing dental products like rinses and toothpastes in the 1970s and later, according to the recent Cochrane study. So while it may have once made sense to add fluoride to water, it no longer appears to be necessary or useful, Thiessen says.

It has also become clear in the last 15 years that fluoride primarily acts topically, according to the CDC. It reacts with the surface of the tooth enamel, making it more resistant to acids excreted by bacteria. Thus, there’s no good reason to swallow fluoride and subject every tissue of your body to it, Thiessen says.

Another 2009 review by the Cochrane group clearly shows that fluoride toothpaste prevents cavities, serving as a useful counterpoint to fluoridation’s uncertain benefits. Another study that year which tracked the fluoride consumption of more than 600 schoolchildren in Iowa showed there was no significant link between fluoride ingestion and tooth decay.

Across all nine studies included in the review looking at caries reductions in children’s permanent choppers, there was evidence linking fluoridation to  26 percent decline in the prevalence of decayed, missing or filled permanent teeth. But the researchers say they have serious doubts about the validity of this number. They write: “We have limited confidence in the size of this effect due to the high risk of bias within the studies and the lack of contemporary evidence.” Six of the nine studies were from before 1975, before fluoride toothpaste was widely available.

The review also found fluoridation was associated with a 14 percent increase in the number of children without any cavities. But more than two-thirds percent of the studies showing this took place more than 40 years ago, and are not of high quality.

Nearly all these papers were flawed in significant ways. For example, 70 percent of the cavity-reducing studies made no effort to control for important confounding factors such as dietary sources of fluoride other than tap water, diet in general (like how much sugar they consumed) or ethnicity.

When it comes to fluoridation research, even the best studies are not high quality. Although this was already well-established, it doesn’t seem to be well-known.

“I couldn’t believe the low quality of the research” on fluoridation, Sheldon says.

The data suggest that toothpaste, besides other preventative measures like dental sealants, flossing and avoiding sugar, are the real drivers in the decline of tooth decay in the past few decades, Thiessen says. Indeed, cavity rates have declined by similar amounts in countries with and without fluoridation.

Rates of cavities have declined by similar amounts in countries with and without fluoridation. KK Cheng et al / BMJ

Meanwhile, dental health leaves much to be desired in widely fluoridated America: About 60 percent of American teenagers have had cavities, and 15 percent have untreated tooth decay.

One thing the review definitively concluded: Fluoridation causes fluorosis.

This condition occurs when fluoride interferes with the cells that produce enamel, creating white flecks on the teeth. On average, about 12 percent of people in fluoridated areas have fluorosis bad enough that it qualifies as an “aesthetic concern,” according to the review. According to Sheldon, that’s a “huge number.” A total of 40 percent of people in fluoridated areas have some level of fluorosis, though the majority of these cases are likely unnoticeable to the average person.

In a smaller percentage of cases, fluorosis can be severe enough to cause structural damage, brown stains and mottling to the tooth.

Sheldon says that if fluoridation were to be submitted anew for approval today, “nobody would even think about it” due to the shoddy evidence of effectiveness and obvious downside of fluorosis.

There is also a definite issue of inequality when it comes to fluorosis. Blacks and Mexican-Americans have higher rates of both moderate and severe forms of the condition. Blacks also have higher levels. As of 2004, 58 percent of African-Americans had fluorosis, compared to 36 percent of whites, and the condition is becoming more common.

The Cochrane review concerned itself only with oral health. It didn’t address other health problems associated with fluoride, which Grandjean says need to be researched.

Many of the Cochrane study’s conclusions conflict with statements by the CDC, the American Dental Association and others that maintain fluoridation is safe and effective. The ADA, for example, maintains on its website that “thousands of studies” support fluoridation’s effectiveness—which is directly contradicted by the Cochrane findings. The ADA didn’t immediately respond to requests for comment.

The  CDC remains undeterred. “Nothing in the Cochrane review” reduces the government’s “confidence in water fluoridation as a valuable tool to prevent tooth decay in children as well as adults,” says Barbara Gooch, a dental researcher with CDC’s Division of Oral Health.

The CDC and others “are somehow suspending disbelief,” Sheldon says. They are “all in the mindset that this is a really good thing, and just not accepting that they might be wrong.” Sheldon and others suggest pro-fluoridation beliefs are entrenched and will not easily change, despite the poor data quality and lack of evidence from the past 40 years.

Derek Richards, the editor of the journal Evidence-Based Dentistry (published by the prestigious Nature group) concedes that “we haven’t got any current evidence” that fluoridation reduces cavities, “so we don’t know how much it’s reducing tooth decay at the moment,” he says. “But I have no qualms about that.” Richards reasons that because fluoridation may help reduce cavities in those who don’t use toothpaste or take other preventative measures, including many in lower socioeconomic groups, it’s likely still useful. He also argues that there’s no conclusive evidence of harm from fluoridation (other than fluorosis), so he doesn’t see a large downside.

But most scientists interviewed for this article don’t necessarily think fluoridation’s uncertain benefits justify its continuation without more stringent evidence, and argue for more research into the matter.

“When you have a public health intervention that’s applied to everybody, the burden of evidence to know that people are likely to benefit and not to be harmed is much higher, since people can’t choose,” Sheldon says. Everybody drinks water, after all, mostly from the tap. “Public health bodies need to have the courage to look at this review,” says Sheldon, “and be honest enough to say that this needs to be reconsidered.”

1 Comment

  1. I Prefer Clean Water, Please

    The folks who tout this are nothing but bribe-takers with no moral compass. I genuinely feel sorry for them worshipping false gods.

    Reply

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