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FLUORIDATION:
TIME FOR A SECOND LOOK

In 1997 the union representing scientists, engineers and lawyersat the U.S. Environmental Protection Agency (EPA) in Washington,D.C., voted to support a California citizen initiative to stopfluoridation of public drinking water. In 1999 the union'svice-president released a paper explaining the union's oppositionto fluoridation.

Fluoridation is the practice of adding fluoride to the publicwater supply to reduce dental decay. U.S. fluoridation trialsbegan in 1945 and by 1992 approximately 56% of the U.S. publicreceived its water from fluoridated systems.

Typically, fluoride-containing (or -generating) compounds areadded to water to bring the level up to 1 milligram of fluorideion per liter (1 part per million). In 1986 EPA set a MaximumContaminant Level (MCL) for fluoride in drinking water at 4ppm.

The MCL was based on only one adverse health effect:skeletal fluorosis, a crippling bone disease.

Fluoridation of public water supplies has stirred passionatedebate for over 50 years. Now new data is refining the debate. Itappears that some of the early claims for fluoridation's benefitswere inflated. In recent years tooth decay has declined in bothfluoridated and non-fluoridated communities. In fact, the largestU.S. survey indicates that the benefit to fluoridated communitiesamounts to 0.6 fewer decayed tooth surfaces per child, which isless than one percent of the tooth surfaces in a child'smouth.

The public health community justified medicating wholecommunities via public drinking water using certain argumentsthat recent research has now shown to be false. For example, in1945 scientists believed that fluoride had to be swallowed to beeffective. However, the Centers for Disease Control (CDC) hasrecently acknowledged that fluoride's mechanism of action isprimarily topical, not systemic. This means that you don'tneed to swallow fluoride to reap its tiny benefits.

A second early belief, now known to be false, is that fluoride isan essential nutrient. There is no evidence of any diseaserelated to fluoride deficiency. Natural levels of fluoride inhuman milk (0.01 ppm) are approximately a hundred times less thanbaby formula reconstituted with fluoridated water.

A third early belief was that dental fluorosis (a defect of thetooth enamel caused by fluoride's interference with the growingtooth) would occur in only about 10% of the children drinkingwater fluoridated at 1 ppm and would occur only in its mildestform. Today fluorosis occurs on two or more teeth in 30% ofchildren in areas where the water is fluoridated, and not all inits mildest form.

A fourth early belief was that 1 ppm fluoride in drinking waterprovided an ample margin of safety against toxic effects. Notonly is there no safety margin for dental fluorosis but there isgrowing evidence that there may be no safety margin for changesto bone structure and impacts on the brain, thyroid, and othersoft tissues, especially when it is coupled with nutrientdeficiencies, particularly iodide.

THE EVIDENCE

1) In 1998 the results of a long-term, low-dose rat study werepublished. Two groups of rats were exposed to two differentkinds of fluoride at 1 ppm in distilled water. A third groupreceived only distilled water. Amyloid deposits (associated withAlzheimer's Disease and other forms of dementia) were elevated inthe brains of both fluoridated groups compared to the controlgroup. The authors speculate that fluoride enables aluminum tocross the blood-brain barrier.

2) Millions of people in India and China suffer a crippling bonedisease called skeletal fluorosis, caused by moderate to highnatural levels of fluoride (1.5 to 9 ppm) in their water.Skeletal fluorosis has several stages of severity, with the lesssevere being chronic joint pain. "Because some of the clinicalsymptoms mimic arthritis, the first two clinical phases ofskeletal fluorosis could be easily misdiagnosed." Arthritis isnow at epidemic levels in the U.S. Fluoride's plausiblecontribution has been ignored, but needs to be taken seriously.

3) Since fluoridation began in 1945 our exposure to other sourcesof fluoride has increased substantially. These include processingfood and beverages with fluoridated water; air pollution fromfluoride emitting industries; pesticide residues; vitamins; anddental products. If 1 ppm in drinking water were the only sourceof fluoride, the average person would ingest 2 milligrams (mg) offluoride each day, though some may get less because they usebottled water, or they drink less water than the average adult.In 1991, the federal Department of Health and Human Services(DHHS) estimated that the range of exposure in communities withapproximately 1 ppm fluoride in the water was 1.58 to 6.6 mg perday.

4) The dose of 1.58 to 6.6 mg per day overlaps the dose found todepress the functioning of the human thyroid gland. At 2.27 to4.54 mg/day, fluoride has been found to "completely relieve" thesymptoms of hyperthyroidism (overactive thyroid). Withfluoride's known capacity to depress thyroid activity, it seemsthat there may be a link between current fluoride consumption andthe prevalence of hypothyroidism (underactive thyroid). More thantwenty million people in the U.S. receive treatment for thyroidproblems and many others are thought to go undiagnosed.

5) Fluoride is a hormone disrupter. It mimics the action of manywater-soluble hormones by interacting with G proteins, whichtransmit hormonal messages across cell membranes.Additionally, fluoride accumulates in the pineal gland and mayreduce melatonin production.

6) Fluoride (50-75 mg per day) given to osteoporosis patients tostrengthen bones has actually increased their rate of hipfractures. Of 18 studies conducted since 1990, 10 havefound an association between water fluoridation and hip fracturesin the elderly. According to the Agency for Toxic Substancesand Disease Registry (ATSDR): "If this effect is confirmed, itwould mean that hip fracture in the elderly replaces dentalfluorosis in children as the most sensitive endpoint of fluorideexposure." Hip fracture is not a minor problem: in the U.S.up to 50,000 people die each year of osteoporosis-related hipfractures.

7) Some evidence suggests that fluoride causes bone cancer inmale rats and perhaps in young men.

8) A recent report by the Greater Boston Physicians for SocialResponsibility reviews studies showing that fluoride interfereswith brain function in young animals and in children, reducingIQ.

Most European countries have rejected fluoridation. Recognizingthat there are simple and effective alternatives, they haveapplied the precautionary principle. Their children's teeth havenot suffered as a consequence. Parents willing to expose theirchildren to fluoride can simply purchase fluoridated toothpaste(which contains 1000 to 1500 ppm fluoride -- read the warninglabel on the package). The American policy of giving fluorideto children by medicating whole communities with a potent drugthat may harm some people seems a dubious practice at best. Atworst it violates the primary principle of medical ethics: Firstdo no harm. Furthermore, it violates the ethical principle ofinformed consent.

In May 2000 the Fluoride Action Network (FAN) was formed by acoalition of activists and scientists from 12 countries (see:https://www.fluoridealert.org). FAN's goal is to end fluoridationand minimize exposure to fluoride. FAN's founding members includethe late David Brower; Teddy Goldsmith; Michael Colby; Gar Smith;Terri Swearingen; the union representing professional employeesat EPA headquarters; and Dr. Hardy Limeback, Canada's leadingdental authority on fluoridation who in 1999 apologized forhaving promoted fluoridation for 15 years.

We urge our colleagues working on public health and environmentalissues to become involved and take a second look at fluoridation.

Written by: Paul Connett, a professor of chemistry at St. LawrenceUniversity


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