Fluoridation is the practice of adding a fluoride compound to the public drinking water supply ostensibly for the purpose of fighting tooth decay. The levels used range from 0.6 to 1.2 milligrammes of fluoride ion per litre (or parts per million, ppm). The practice began in the U.S. in 1945 and was endorsed by the U.S. Public Health Service (PHS) in 1950. Very few countries have adopted this practice to any significant extent. Only eight countries in the world have more than 50% of their populations drinking artificially fluoridated water (Australia, Colombia, Ireland, Israel, Malaysia, New Zealand, Singapore, and the U.S.). In the U.S., about 70% of the population is drinking fluoridated water – that is approximately 200 million people and about 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 out of the water because of the health problems that fluoride can cause.
1. 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. No one should be made to ingest sodium fluoride.
2. 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 labourers, athletes, diabetics, and people with kidney disease) drink substantially more water than others.
3. 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:
4. Fluoride is not an essential nutrient. (National Research Council [NRC] 1993; Institute of Medicine [IOM] 1997, NRC 2006). No disease has ever been linked to a fluoride deficiency. It has never been shown that ingested fluoride is needed to produce decay-free teeth. 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.
5. Fluoride accumulates in the body. Healthy adult kidneys excrete 50 to 60% of the fluoride they ingest each day. The remainder accumulates in the body, largely in calcifying tissues such as the bones and pineal gland. 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).
6. 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).
7. There has never been a single randomised clinical 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 randomised trials of water fluoridation”. Randomised studies 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. The U.S. Food and Drug Administration (FDA) continues to classify fluoride as an “unapproved new drug.”
8. Any benefit of fluoride is topical, not systemic. The Centers for Disease Control and Prevention (CDC, 1999, 2001) has now acknowledged that the mechanisms 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.
9. 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.
10. Tooth decay does not go up when fluoridation is stopped. Where fluoridation has been discontinued in communities from Canada, East Germany, Cuba and Finland, dental decay has not increased but has generally continued to decrease.
11. 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. 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.
12. 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) to 10% of children. 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. As the 41% prevalence figure is a national average and includes children living in fluoridated and un-fluoridated 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.
13.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, a number of dental researchers have recommended that parents of newborns not use fluoridated water when reconstituting formula. 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 of fluoridated water.
14. Fluoride may lower IQ. There have now been 24 studies from China, Iran, India and Mexico that have reported an association between fluoride exposure and reduced IQ. One of these studies 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. In the absence of iodine deficiency, another research team estimated that fluoride may lower IQ at 1.9 ppm, while a recent preliminary study ( 2011) found a lowering of IQ in children drinking water at levels ranging from 0.3 to 3 ppm. The authors of this latter study reported that for each increase of 1 ppm fluoride measured in the urine there was a loss of 0.59 IQ points. None of these studies indicates 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.” Except for an early and small IQ study from New Zealand no fluoridating country has investigated the matter for themselves.
15. 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. Consistent with Luke’s findings, one of the earliest fluoridation trials in the U.S. reported that on average young girls in a fluoridated community reached menstruation 5 months earlier than girls in non-fluoridated communities. Inexplicably, no fluoridating country has attempted to reproduce Luke’s findings or examine the issue any further.
16. 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) . 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.
17. Fluoride damages bone. An early fluoridation trial found a significant two-fold increase in cortical bone defects among children in a fluoridated community. 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, 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.
18. 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 of 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. 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.
19. 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. 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, two studies have found reduced level of circulating testosterone in males living in high fluoride areas, and a study of fluoride-exposed workers reported a “subclinical reproductive effect”. The National Research Council (2006) has recommended that, “the relationship between fluoride and fertility requires additional study.”
20. Other subsets of a population are more vulnerable to fluoride’s toxicity. In addition to people suffering from impaired kidney function discussed in reason #18 other subsets of the population are more vulnerable to fluoride’s toxic effects. According to the Agency for Toxic Substances and Disease Registry these include: infants, the elderly and diabetics. Also vulnerable are those who suffer from malnutrition (e.g., calcium, magnesium, vitamin C, vitamin D and iodine deficiencies and protein-poor diets.
21. 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. 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.
22. 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 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.
23. The silicon fluorides may increase lead uptake into children’s blood. Studies by Masters and Coplan 1999, 2000, 2007 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.
24. 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.
25. 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 realising that they and the general public have not been diligently informed by their professional bodies on this subject. As of July 2011, over 3700 professionals have signed a statement calling for an end to water fluoridation worldwide.
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 organised. Please get these 25 reasons to all your friends and encourage them to get fluoride out of their community and to help ban this practice worldwide.