HomeMy WebLinkAboutHEALTH 01052012
Board of Health Minutes
January 5, 2012
Present: Michael Healey, Chairman; Nancy Wall, Clerk; Catherine Memory; Joseph DeGirolamo.
1. Call to Order @ 7:05pm - Meeting Room 2A/B
2. Consent Agenda
a. Approval of December 1, 2011 minutes
b. Approval of a Disposai Works Installer's Permit
All Seasons Septic, Inc.
Brunelle Contracting, LLC
D. Berndt Sanitation & Excavating
Dubuc Excavating Co., Inc.
Earthwork Industries
Ferrara Construction
Hurley Services, Inc.
Kenny Jones, Corp.
LandMarc Contractors LLC
Le Solbo Excavating & Construction Co., Inc.
M. Property Services
Soares Pumping, Inc.
U.S. General Contractors
Wind River Environmentai
c. Approval of a Septage Pumping and Transporting Permit
All Seasons Septic Service, Inc.
Flowmaster, Inc.
L&R Sanitation
Miles of Excavation
Parker Sanitary Pumping
Podgurski Corp.
Pump Grump
Sanmass dba Sanl-kan Portable Sanitation
Soares Sanitation Pumping, Inc.
Stewa rt Septic Service
United Site Services Northeast, Inc.
Wind River Environmental, LLC
d. Approval of a Hauler's Permit
Attleboro Hauling
J.F McNamara
Waste Solutions
e. Approval of Tattoo Practitioner's Permit for Offering Tattoo and Body Piercing
Kerwin Chong
MOTION: TO APPROVE CONSENT AGENDA
WALL/DEGIROLAMO PASSED 4-0-0
Visitor: Marilyn Edge, Western Bristol County and Foxborough Tobacco and Alcohol Prevention
Collaborative: Marilyn Edge gave a presentation to the Board on the many tobacco products that are now
being sold both as a tobacco product and as stimulants that have tobacco as the major ingredient.
The board invited Ben Oyeransian to present to the Board a binder with information regarding the
negative affects of Fluoride in the water system of Mansfield. The Board and Mr. Oyeranslan engaged In
a conversation on his information. Mr. Healey will make copies of the presentation for all the Board
members.
3. Health Agent's Report
1. Letters were sent to all tobacco retailers in Mansfield congratulating them on diligence of no
tobacco sales to minors
2. Health Agent will be meeting with Public Health Commissioner Auerbach on January 12, 2012 to
discuss Arbovirus (Mosquito) Program.
3. Health Agent has inspected about two-thirds of septic pumping trucks on December 6th:
no failures or violations.
4. Adjournment
MOllON: TO ADJOURN
WALL/ DEGIROLAMO PASSED 4-0-0.
NEXT MEETING: FEBRUARY. 2, 2012 AT 7:00 PM
2- Z-/z-
Clerk
Date
All matters listed under Consent Ag nda are considered to be routine by the Board of Health
and will be enacted by one motion. There will not be separate discussion of these items. If
discussion is desired, that item will be removed from the Consent Agenda and will be
considered separately
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CompIled on paper by Ben Yeranslan +.
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January 5,2012 ~! .
b'ler "nS....." @CD MClol.Si-.(\~+
~OK.I/6'3.6"3 6'J
"The level of fluoride the government allows the public is based on
scientifically fraudulent information and altered reports. People can
be harmed simply by drinking water. "
Water Fluoridation
Water Fluoridation
A compilation of scientific summary regarding the dangers
of adding Fluoride to our water supply
A compilation of scientific summary regarding the dangers
of adding Fluoride to our water supply
Sources listed in Se.;:tion I
Thanks to FluorideAlcrt.org 1'i.1I" organizing I1Il1ch ()fthe information (j'on1 the
large number of studies.
Sources listed in Section I
Thanks to FluorideAlert.org for organizing much of the information from the
large number of studies.
Ccmpiled on paper J~lnttary 5, 2012, Oen Yeransian
'Tho lel/E.11 of fluoride the government allows the public is based on
scientifically fraudulent information and altered repolts. People can
be harmed simply by drinkinG' !II.:ater"
.D(. Robert Carton, Ph.D, former Environnlel,tai protectKJ/; Agency Sci()nti~t (20 years)
-Dr. Robert Carton. Ph.D. former Environmental Protection Agency Scientist (20 years)
"/ am appalled at the prospect of using water al; a ve/ticle for
drugs...."
"1 am appalled at the prospect of using water as a vehicle for
drugs...."
-[Jr. C.G. Heyd, former President of the American Medical Association
-Dr. C.G. Heyd, former President of the Amerlcan Medical Association
"Fluoride .;S a cDrcinogfm bV Clny standard we use. I believe EPA
SllOlIld act immediately to protoct the public, not just on tfle cancer
datiJ, but on l'he evidence of bone ,'mctures, arthritis. mula08nicity,
and other e;~'ects. " .
"Fluoride is a carcinogen by any standard we use. I believe EPA
should act immediately to protect the public, not just on the cancer
data, but on the evidence of bone fractures, arthritis, mutagenicity,
and other effects. " L:
. Dr William Marcus, Ph.D, Eml;romner.:ai Prolecl;""....gEJf1cy S':'entist
-Dr, William Marcus, Ph.D. Environmental Protection Agency Scientist
SECTION 1: 50 Reasons to Oppose Fluoridation. proven bv studies
Bassin EB. (2001). "Association Between Fluoride In Drinking Water During Growth and Development
and the Incidence of Osteosarcoma for Children and Adolescents," DMSc thesis, Harvard School of
Dental Medicine, Boston, Massachusetts.
Note:
There are too manv scientific studies for me to print them all out. The Following is a
list of 50 Reasons to Oppose Fluoridation, which summarizes all the studies
completed. To view the individual studies in pdfformat (entire scientific documents
with overview) please visit FluorideAlert.org
Bassin EB et al. (2006). Age-specific Fluoride Exposure In Drinking Water and Osteosarcoma (United
States). Cancer Causes and Control. 17 (4): 421-28.
Bayley TA, et al. (1990). Fluoride-induced fractures: relation to osteogenic effect. Joumal of Bone and
MIneraI Research.5(SuppI1):S217-22.
To show the maanitude of the scientific research comoleted in this area of studv, I
will start with the list of references. followed bv the 50 summarized conclusions from
these studies.
Beltran-Aguilar ED et al. (2010). Prevalence and severity of dental fluorosis In the United States, 1999-
2004. NCHS DataBrief No. 53. U.S. DHHS, CDC, National Center for Health Statistics,
Beltran-Aguilar ED et al. (2005). Surveillance for dental carles, dental sealants, tooth retention,
endentullsm, and enamel fluorosls--Unlted States, 1988- 1994 and 1999-2002. CDC, MMWR,
Surveillance Summaries, August 26. vol. 54, No SS-3, pp. 1-44. See Table 23.
References:
Bentley EM, et al. (1999). Fluoride Ingestion from toothpaste by young children. British Dental
Joumal. 186: 460-2.
(Studies proving the 50 reasons following)
Agency for Toxic Substances and Disease Registry (ATSDR) (1993). ToxicologIcal Profile for Fluorides,
Hydrogen Fluoride, and Fluorine (Fl. U,S. Department of Health & Human Services, Public Health
Service. ATSDRfTP-91117.
Bhatnagar M, et al. (2002). Neurotoxicity of fluoride: neurodegeneration In hippocampus of female
mice. Indian Joumalof Experimental Biology. 40: 546-54.
Blgay J, et al. (1987). Fluoride complexes of aluminium or beryllium act on G-protelns as reversibly bound
analogues of the gamma phosphate of GTP. EMBO Journal. 6:2907-2913.
Alarcon-Herrera MT, et al. (2001). Well Water Fluoride, Dental fluorosis, Bone Fractures in the Guadlana
Velley of Mexico. Fluoride. 34(2): 139-149.
Bigay J, et al. (1985). Fluoroalumlnates activate transducln-GDP by mimicking the gamma-phosphate of
GTP In Its binding site. FEBS Letters. 191:181-185.
Allain P, et al. (1996). Enhancement of aluminum digestive absorption by fluoride In rats. Research
Communications In Molecular Pathology end Pharmacology. 91: 225-31.
Brothwell D, L1meback H. (2003). Breastfeedlng Is protective against dental fluorosis In a nonfluorldated
rural area of Ontario, Canada.Journal of Human Lactation 19: 386-90.
Armfield JM and Spencer AJ (2004). Consumption of Nonpubllc Water: Implications for Children's Carles
Experience," CommunIty Dentistry and Oral Epidemiology, 32(4): 283-96
Brunelle JA, Carlos JP. (1990). Recentlrends In dental carles In U.S. children and the effect of water
fluoridation. Joumalof Dental Research. 69(Speclal edition): 723-727.
Arnold HA. (1980), Letter to Dr. Ernest Newbrun. May 28,1980. http://www.fluorldealert.orgluc-davis.htm
Bryson C. (2004), The Fluoride Deception. Seven Stories Press, New York.
Awadia AK, et al. (2002). Carles experience and carles predictors - a study of Tanzanian children
consuming drinking water with different fluoride concentrations. Clinical Oral Investigations. (2002) 6:98-
1~ .
Burgstahler AW, et al. (1997). Fluoride In California wines and raisins. Fluoride. 30: '142-146.
Bachlnskll PP, et al. (1985) Action of the body fluorine of healthy persons and thyroldopathy patients on
the function of hypophyseal-thyroid the system. Probl Endokrinol (Mask) 31: 25-
9. http://www.fluoridealert.org/epa-sf/appendix-e.pdf
Caffey J. On Fibrous Defects in Cortical Walls: Their Radiological Appearance, Structure, Prevalence,
Natura! Course, and Diagnosllc Significance in Advances in Pediatrics, ed, S. Z. Levin, (New York:
Intersclence, 1955).
Barbier O. (2010) Molecular mechanisms of fluoride toxicity. Chemico-Biologlcal Interactions. 188: 319-
333.
Calderon J et al. (2000). Influence of"fluorlde exposure on reaction time and vlsuospallal organization In
children. Epidemiology11 (4 ):S153.
Barnes GP, et al. (1992). Ethnlcily, locallon, age, and fluoridation factors In baby bottle tooth decay and
caries prevalence of Head Start children. Public Health Reports. 107: 167-73.
Carlsson A. (1978). Current problems ralatlng to the pharmacology and toxicology of fluorides. Journal of
the Swedish MedicalAssociation. 14: 1388-1392.
Carnow BW, Conlbear SA. (1981). Industrial fluorosis. Fluor/de. 14: 172-181.
Barot W. (1998), Occurrence of endemic fluorosis In human population of North Gujarat, India: human
health risk. Bulletin of Environmental Contamination and Toxicology. 61: 303-10.
Caspary WJ, et al (1967). Mutagenic activity of fluorides in mouse lymphoma cells. Mutation
Research. 167:165-60.
Connett M, (2004). Fluoride & Bone Damage: Published Data. Submission to National Research Council
(NRC).http://www.fluorldealert.orglbone-data.pdf
Centers for Disease Control and Prevention (CDC). (2002). Prevalence of Self-Reported Arthritis or
Chronic Joint Symptoms Among Adults -- United States, 2001. Mortality and Morbidity Weekly
Report. 51: 946-950.
Centers for Disease Control and Prevention (CDC). (2001), Recommendations for Using Fluoride to
Prevent end Control Dental Caries in the United States. Morbidity and Mortality Weekly
Report. 50(RR14): 1-42.
Connell, P. (2000). Fluoride: A Statement ot Concern. Waste Not #459. January 2000. Waste Not, 82
Judson Street, Canton, NY 13617.http://www.fluorldealert.orglfluoride-statement.htm
Connett P, Neurath C and Connett M. (2005). Revisiting the Fluoride-Osteosarcoma Connection In the
Context of Elise Bassin's Findings: Part II." Submission to the National Research Council of tha National
Academ!es review panel on the Toxicologic Risk of Fluoride In Drinking Water, March 21, 2005 (revised
April 8, 2005), http://www.fluorldealert.orglhealthlcancerlfan-nrc.parl2.pdf
Centers for Disease Control and Prevention (CDC). (1999). Achievements In Public Health, 1900-1999:
Fluoridation of Drinking Water to Prevent Dental Carles. Mortality and Morbidity Weekly Report. 46: 933-
940.
Czerwinski E, et al. (1986). Bone and Joint pathology In fluoride-exposed workers. Archives of
Environmental Health. 43:340-343.
Dambacher MA, et al. (1966). Long-term fluoride therapy of postmenopausal osteoporosis. Bone 7: 199-
205.
Chachra et al. (2010) The long-term effects of water fluoridation on the human skeleton. Journal of Dental
Research. 69(11): 1219-1223,
De L1efde B. (1996). The decline of carles In New Zealand over the past 40 Years. New Zealand Dental
Journal. 94: 109-113.
Chen J, et al. (2003). Selectlve decreases of nicotinic acetylcholine receptors In PC12 cells exposed to
fluoride. Toxicology. 163: 235-42.
Department of Health & Human Services. (U.S. DHHS) (1991). Review of Fluoride: Benefits and
Risks. Report of the Ad Hoc Committee on Fluoride, Commillee to Coordinate Environmental Health and
Related Programs. Department of Health and Human Services, USA.
Chen J, et al. (2003). Selectlve decreases of nicotinic acetylcholine receptors in PC12 cells exposed to
f!uorlde. Toxicology. 183: 235-42.
Chen J. et al. (2002). [Studies on DNA damage and apoptosis in rat brain Induced by fluorlde] Zhonghua
Yu Fang Vi Xue Za Zhl. 36 222-224.
Chen YC, et al. (1997). Nutrition survey in dental fluorosis-afflicted areas, Fluoride. 30(2):77-60.
Chlnoy NJ, Nerayana MV. (1994). In vitro fluorlde toxicity in human spermatozoa. Reproductive
Toxicology. 6:155-9.
Chinoy NJ, et al. (1991). Mlcrodose vasal Injection of sodium fluoride In the rat. R~productive
Toxicology. 5: 505-12.
DenBesten, P (1999). Biological mechanism ot dental fluorosis relevant to the use offluorlde
supplements. Community Dentistry and Oral Epidemiology. 27: 41-7.
De Stefano TM. (1954). The fluoridation research studies and the general practitioner. Bulletin of Hudson
County Dental Soclety.February.
Dlesendorf M.(1966). The mystery of declining tooth decay. Nature. 322: 125-129,
http://www.fluorldealert.org/dlesendorf.htm
Ding Y et al. (2010. The relationships between low levels of urine fluoride on children's Intelligence, dental
fluorosis In endemic fluorosis areas In Hulunbulr. Inner Mongolia, 'China. Journal of Hazardous Materials.
dol:1 0.1 016Ij.jhazmat.201 0.12.097.
Chlnoy NJ, Sequeira E. (1989), Effects of fluoride on the hlstoarchltecture of reproductive organs of the
male mouseReproductlve Toxicology. 3: 261-7,
Dltkoff BA, Lo Gerfo P. (2000). The Thyroid Guide. Harper-Collins. New York.
P. D. Cohn (1992), An Epidemiologic Report on Drinking Water and Fluoridation, New Jersey Department
of Health, Envlronmentel Health Service, November 6, 1992. Note: The original title of this report was A
Brief Report on the Association of Drinking Water Fluoridation and the Incidence of Osteosarcoma
Among Young Males. The word 'osteosarcoma' was deleted from the title soon after the report was
released; hllp:llfluorldealert.org/cohn-1992.pdf.
Colquhoun J. (1997). Why I changed my mind about Fluorldatlon, Perspectives In Biology and
Medicine 41: 29-44.hllp:llwww.fluorlde-joumal.comI96-31-21312103.htm
Douglass CW and Joshlpura K. (2006) 'Cautlon Needed In Fluoride and Osteosarcoma Study"
(Ieller), Cancer Causes & Control. 17 (4): 461-82.
Du L. 1992. The effect of fluorine on the developing human brain. Chinese Journal of
Pathology 21 (4):21 6-20 (republished In Fluoride41 :327-30). Online at http://fluorldealert.orglscherldu-
2006.pdf
Duan X. et al. (2011). Excess Fluoride Interferes with Chloride-channel-dependent Endocytosis In
Ameloblasts. J Dent Res. 90(2):175-160.
Connett PH, Beck J and Mlcklem S. The Case Against Fluoride: How Hazardous Waste EndedUp in Our
Drinking Water and the Powerful poritics and Bad Science ThaI Ke~p It There. Chelsea Green, White
River Junction, VT, 2010.
Easley, M. (1999). Community fluoridation In America: the unprincipled opposition. Dental
Watch,hllp:llwww.dentalwatch.org/fllopposltlon.pdf (accessed March 21, 2010),
Connett,P (2004) 50 Reasons to Oppose Fluoridation (updated April 12, 2004). Reprinted In
Medical Verlfes. 1 :70-60, hllp:/Iwww.fluorldealert.orgI50reasons.htm
'"
Ekambaram P, Paul V. (2001). Calcium preventing locomotor behavioral and dental toxicities of fluoride
by decreasing serum fluoride level In rats. Environmental Toxicology and Pharmacology. 9: 141-146.
Ghosh D, et al. (2002). Testicular toxicity In sodium fluoride treated rats: assoclallon with oxidative
stress. Reproductive Toxicolology. 16: 385.
Ekstrand J, et al. (1981). No evidence of transfer of fluoride from plasma to breast milk. British Medical
Journal (Clin Res Ed). 83: 761-2.
Gray, AS. (1987), Fluorldetlon: time for a new base line? Journal of the Canadian Dental Association. 53:
763-5.
Ekstrand J, et al. (1994). Fluoride pharmacokinetics in Infancy. Padlatric Research. 35:157-163.
Grobleri SR, et al. (2001). Dental fluorosis and caries experience In relation to three different drinking
water fluoride levels in South Afrlca.lntemational Journal of Paediatric Dentistry. 11(5):372-9.
Ekstrand J, (1996). Fluoride Intake. In: Fejerskov 0, Ekstrand J, Burt 8, Eds. Fluorida in Dantistry, 2nd
Edition., Munksgaard, Denmark. Pages 40-52.
Guan 'ZZ, et al (1998). Influence of chronic fluorosis on membrane lipids In rat brain. Neurotoxlcologyand
Tarato/ogy.20: 537-542.
Elbetleha A, et al. (2000). Fertility effects of sodium fluoride In male mice. Fluoride. 33: 128-134.
Fagin, D. (2008). Second Thoughts on Fluoride. Scientific American 298 (l)(January): 74-81; excerpts
athltp:/lwww.fluoridealert.orglsc.am.)an.2008.html
Gutlerldge DH, et al. (2002). A randomized trial of sodium fluoride (60 mg) +1- estrogen In
postmenopausal osteoporotic vertebral fractures: Increased vertebral fractures and peripheral bone loss
with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral
fractures. Osteoporosis International. 13(2):158-70.
Emsley J, et al (1981), An unexpectedly strong hydrogen bond: ab Initio calculations and spectroscopic
,studies of amidefluorlde systems.Joumal of the American Chemical Society. 103: 24-28.
Fein NJ, Cerklewskl FL. (2001). Fluor!de content of foods made with mechanlcaliy separated
chicken. Journal of Agricultural Food Chemistry. 49: 4284-6.
Gutlerldge DH, et al. (1990). Spontaneous hip fractures In fluoride-treated patients: potential causative
factors. Journal of Bone and Mineral Research. 5 Suppll :S205-15.
Feltman R, Kosel G, (1961). Prenatal and postnatal ingestion of fluorides - Fourteen years of Investigation
- Final report. Journal of Dental Medicine. 16: 190-99.
Han H, Cheng Z, L1u W. 1989. Effects of fluorine on the human fetus. Chinase Journal of Control of
Endamlc Disaasas 4:136-138 (republished In Fluoride 41:321-6). Online at
htlp:llwww.fluorideresearch.orgI414/fi1esIFJ2008_v41_ n4 y321-326.pdf
Finney WF et el. (2006) Reexamination of Hexafluoroslllcate Hydrolysis by Fluoride NMR and pH
Meesurement. Environmental Science & Technology 40 (8): 2572-77.
Hanmer R. (1983). Leiter from Rebecca Hanmer, deputy assistant administrator for water, U.S.
Environmental Protection Agency, to Leslie A. Russeli, D.M.D, March 30,
1983. hltp:llfluoridealert.orglre/hanmer1983.pdf
Fluoridation Forum (2002). Forum on Fluoridation (Dublin, Ireland: Stationery Office,
2002), http://fluorldealert.orglre/fluorldallon.forum.2002,pdf
'.
Hazan S. (2004). Leiter from Stan Hazan, General Manager, NSF Drinking Water Additives Certification
Program, to Ken Calvert, Chairman, Subcommiltea on Energy and the Environment, Commlltee on
Science, US House of Representatlves.July
7 .htlp:llwww.keepersofthewell.orglproductydfsINSF _response.pdf
Fomon SJ, et al. (2000). FI'uorlde Intake and prevalence of dental fluorosis: trends In fluoride intake with
special attention to Infants,Journal of Public Health Dentistry. 60: 131-9.
Franke J, et al. (1975). Industrial fluorosis. Fluoride. 8: 61-83.
Health Canada (2008). Findings and Recommendations of/he Fluoride Expert Panel (January 2007).
April 2008, hltp:llfluorldealert.orglre/canada.fluorlde.expert. panel.2007.pdf
Frenl SC. (1994). Exposure to high fluoride concentrallons In drinking water Is associated with decreased
birth rates. Journal of ToxiCOlogy and Environmental Health. 42: 109-121.
Health Canada (2010). Guidallnes for Canadian Drinking Water Qua/lly: Guideline Tachnical Document-
Fluoride. Health Canada Dated Dec 2010, published June 21, 2011. hltp:llwww.hc-sc.gc.calewh-
seml/pubs/water-eauI2011-f1uorlde-fluorure/index-eng.php
Freeze RA and Lehr JA. The Fluoride Wars: How a Modest Public Heaith Measure Became America's
Longest-Running Political Melodrama. (Hoboken, NJ: John Wiley, 2009).
Hedlund LR, Galiagher JC. (1989). Increased Incidence of hip fracture In osteoporotic women treated with
sodium fluoride. Journal of Bone and Mineral Research. 4: 223-5.
Frenl SC, Geylor DW. (1992). Internallonaltrends In the incidence of bone cancer are not related to
drinking water fluoridation. Cancer.70: 611-8.
Heliman JR et al. (1999). Assessing Fluoride Levels of Carbonated Soft Drinks. Journal of/ha Amarlcan
Dantal Association. 130 (11): 1593-99.
Galieltl P, Joyet G, (1958). Effect of fluorine on thyroidal Iodine metabolism In hyperthyroidism. Journal of
Clinical Endocrinology 1 8: 1102-111 O. htlp:llwww Jluorldealert,orglgalleltl. htm
Helier KE, et al (1997). Dental carles and dental fluorosis at varying water fluoride concentrations. Journal
of Public Health Dentistry. 57: 136-143.
Gerster JC, et al. (1983). Bliateral fractures of femoral ,neck in pallents with moderate renal faliure
receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed). 287(6394):723-5.
Hlieman B. (1989). New studies cast doubt on fluoridation benefits. Chemical and Enginearing
Naws. May 8.hltp:llwwwJluoridealert.orgINIDR.htm
Hileman B. (1988). Fluoridation of water: Questions about health risks and benefits remain after more
than 40 years. Chemical and Engineering News. August 1 : 26-
42. http://www.fluorldealert.orglhileman.htm
Komarek AE (2005). A Bayesian Analysis of Multivariate Doubly-Interval-Censored Dental
Data," Biostatistics. 6 (1):145-55.
Hirzy JW. (1999). Why the EPA's Headquarters Union of Scientists Opposes Fluoridation. Press release
from National Treasury Employees Union. May 1. hltp:llwww.f1uorldealert.org/hp-epa.htm
Kour K, Singh J. (1980). Histological finding of mice testes following fluoride Ingestion. Fluoride. 13: 160-
162.
Hong L, et al. (2006). Timing of fluoride Intake In relation to development of fluorosis on maxll!ary central
Incisors. Community Dentlsfry and Oral Epidemiology 34:299-309.
Kumar A, Susheela AK. (1994). Ultrastructural studies of spermiogenesis In rabbit exposed to chronic
fluoride toxicity. International Journal of Fertility and Menopausal Studies. 39:164-71.
Hoover RN, et al. (1991a). Time trends for bone and Joint cancers and osteosarcomas In the Surveillance,
Epidemiology and End Results (SEER) Program. National Cancer Institute In: Review of Fluoride:
Benefits and Risks Report of the Ad Hoc Commlllee on Fluoride of the Committee to Coordinate
Environmental Health and Related Programs US Public Hea!th Service. Appendix E.
Kumar JV, Green EL. (1998). Recommendations for fluoride use In children. NY State Dental Journal. 64:
40-7,
Kunzel W, Fischer T. (2000). Carles prevalence after cessation of water fluoridation In La Sa Iud,
Cuba. Carles Research.34: 20- 5.
Hoover RN, et al. (1991b). Time trends for bone and joint cancers and osteosarcomas In the Surveillance,
Epidemiology and End Results (SEER) Program. National Cancer Institute In: Review of Fluoride:
Benefits and Risks Report of the Ad Hoc Commillee on Fluoride of the Committee to Coordinate
Environmental Health and Related Programs US Public Health Service. Appendix F.
Kunzel W, et al. (2000). Decline In caries prevalence after the cessation of water fluoridation In former
East Germany. Community Dentistry and Oral Epidemiology. 28: 382-389.
Kunzel W, Fischer T. (1997). Rise and fall of carles prevalence In German towns with different F
concentrations In drinking water. Carles Research. 31: 166-73.
Inkovaara J, et al. (1975). Prophylactic fluoride treatment and aged bones. British Medical Journal. 3: 73-
4.
Institute of Medicine. (1997). Dietary Reference Intekes for Calcium, Phosphorus, Magnesium, Vitamin D,
and Fluoride. Standing Commlllee on the Scientific Evaluation of Dietary Reference Intakes, Food and
Nutrition Board. National Academy Press.
Kurttlo PN, et al. (1999). Exposure to natural fluoride In well water and hip fracture: A cohort analysis In
Finland. American Joumal of Epidemiology. 150(8): 817-824.
Lalumandler JA, et al. (1995). The prevalence and risk factors of fluorosis among patients In a pediatric
dental practice Pediatric Dentistry. 17: 19-25.
Johnson WJ, et al. (1979). Fluoridation and bone disease in renal patients. In: Johansen E, Taves DR,
Olsen TO, Eds.Contlnuing Evaluation of the Use of Fluorides, MAS Selected Symposium. Westvlew
Press, Boulder, Colorado. pp. 275-293.
Levy SM, Guha-Chowdhury N. (1999). Total fluoride Intake and implications for dietary fluoride
supplementation. Journal of Public Health Dentistry. 59: 211-23.
Joseph S, Gadhia PK. (2000). Sister chromatid exchange frequency and chromosome aberrations In
residents of fluoride endemic regions of South GuJarat. Fluoride. 33: 154-158.
Levy SM et al. (2009). Associations of fluoride intake with children's bone measures at age
11. Community Dent OraIEpldem/ol.37(5):416-26.
Juncos L1, Donadio JV. (1972). Renal failure and fluorosis, Journal of the Amer/can Medical
Association 222: 783-5.
Levy SM, et al. (2010). Associations Between Fluorosis of Permanent Incisors and Fluoride Intake From
Infant Formula, Other Dietary Sources and Dentifrice During Early Childhood. JADA 141:1190-1201.
Kelly JV. (2000). Leller to Senator Robert Smith, Chairman of Environment and' Public Works Commlllee,
U.S. Senate, August 14, 2000.hltp:llwww.fluorldealert.orglfda.htm
LI J, Yao L, Shao QL, Wu CY. 2004. Effects of high fluoride level on neonatal neurobehavloural
development. Chinese Journal of Endemlology 23:464-465 (republished In Fluoride 41:165-70). Online at
hllp:llfluoridealert.orglscherlli.2008.pdf
Kilborn LG, et al. (1950). Fluorosis with report of an advanced case. Canadian Medical Association
Journal. 62: 135-141.
LI L. (2003). The biochemistry and physiology of metallic fluoride: action, mechanism, and
implications. Critical Reviews of Oral Biology and Medicine. 14: 100-14.
Kim FM et al. (2011). An Assessment of Bone Fluoride and Osteosarcoma. J, DentRes. July 28, 2011
(published online).http://jdr.sagepub.comlcontenUearlyI20111071231002203451141 8828.full.pdf+html
LI XS. (1995). Effect of fluoride exposure on intelligence in children. Fluor/de 28: 189-192.
Klrllsy MC, et al. (1996). Assessing fluoride concentrations of juices and Ju!ce-f1avored drinks. Journal of
the Amer/can Dental Association. 127: 895-902.
LI Y, et al. (2001). Effect of long-term exposure to fluoride in drinking water on risks of bone
fractures. Joumel of Bone and Mineral Rasearch 16: 932-9.
Kishi K, Ishida T. (1993). Clastogenic activity of sodium fluoride in great ape celis. Mutation
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Section 2- More Information, Quotes, Concerns, Summaries
50 Reasons to Oppose Fluoridation:
Updated August, 2011
By Paul Connett, PhD and other members of the Fluoride Action Network (incl(!dlng
James Beck, MD, PhD, Michael Connett, JD, Hardy Limeback, DDS, PhD, David
McRae and Spedding Micklem, D.Phil.)
Introduction
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 milligrams of fluoride ion per liter (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 Europe, only Ireland (with 73% of the population
fluoridated), the U.K. (10%) and Spain (10%) fluoridate some of their water supplies. 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 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 18 unethical. Informed consent Is standard practice for all
medication, and one of the key reasons why most of Weatem 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. While referenda
are preferential to Imposed policies from government, it stili leaves the problem of
individual rights versus majority rule. 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).
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 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
randomized trials of water fluoridation" (Cheng 2007). Randomized 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 (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 deliv~r t~e
fluoride directly to the tooth in the form of toothpaste. Since swallowing f1uonde 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 1).
5. People now receive fluoride from many other sources besi~es
water. Fluoridated water is not the only way people are exposed to fluonde.
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 (National Research Council [NRC] 1993;
Institute of Medicine [10M] 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. biologica! proc~ss has been s~own 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 are indicating 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 re~arkably, 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 they ingest each day (Marier & Rose 1971). The remainder
Tooth Decay Trondo: Fluoridated VI. Unfluorldated Countrl..
,All d.llf41 "011I WOlf.. Hullh Or,Jrlj'.JtIO'"
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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 failed to
find a significant correlation. A multi-million dollar, U.S, National Institutes of
Health (NIH) -funded study (Warren 2009) found no relation between tooth decay
and the amount of fluoride ingested by children. This is the first time that 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, fluoridation has been repeatedly found 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 18 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 (Maupome 2001; Kunzel & Fischer, 1997,2000; Kunzel 2000; Seppa
2000),
17. Tooth decay was coming down before fluoridation started. Modem research
(e.g., Diesendorf 1986; Colquhoun 1997) 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 (see
Figure 2), Many other factors influence tooth decay.
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Flg~re 2. The number of decayed teeth in 5-year olds in New Zealand, over the
penod 1930-1990. The percentage of the population drinking fluoridated water
and the percentage of the total toothpaste sold containing fluoride are shown on
the right hand axis (Colquhoun, 1993).
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 arid
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) to 10% of children
(NRC 1993. pp. 6-7). In 2010, however, the Centers for Disease Control and
Prevention (COC) 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 fluor!dated water has b~en repe~te~ly
found to be a major risk factor for developmg 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.
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 it takes 5-20 times more fluoride to reach the
same plasma levels in rats as reached in humans (Sawan 2010). In fact, 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 I~vel
used in fluoridation programs), using either sodium fluoride or aluminum fluonde,
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 (Uu 2010).(For a complete
listing of these studies.
23. 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 (Un Fa-Fu 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. In the absence of iodine deficiency,
another research team (Xiang 2003a,b) estimated that fluoride may lower IQ at
1.9 ppm, while a recent preliminary study (Ding 2011) found a lowering of IQ ~n
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 f1uoride/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 (Shannon et aI., 1986) no
fluoridating country has investigated the matter for themselves.
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
three other studies have found an association between prenatal fluoride
exposure and fetal brain damage (Han 1989; Du 1992; 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
produ~tion and leads to an earlier onset of puberty (Luke 1997). Consistent with
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
prom~ters of fluoridation are content .to. dismiss dental fluorosis (in ,its ~i1der
forms) as merely a cosmetic effect, It IS rash to assume that fluonde IS not
impacting other developing tissues when it is visibly damaging the teeth ~y 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 are.as o~ naturally high levels of fluo!~de
the first indicator of harm is dental fluorosis In children. In the same communities
many older people develop skeletal fluorosis.
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 girts 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, Bachinskli (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 thvrold eland for those sufferine
from hVDerthvroidism (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 forrns 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 damage. 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 linesI' 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; Orce11990; 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 (L1 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 aI1991b), 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 accumula~es
to a high level in bone. Second, fluoride stimulates bone g.rowth. And, thJr~,
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 stu~!es
(TsutsuI1984; 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 200~,
Elise Bassin, a dentist, successfully defended her doctoral thesIs at Harv~rd In
which she found that young boys had a five-to-seven fold increased nsk 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 coun~ries. because
her thesis adviser Professor Chester Douglass (a promoter of fluondatlon and a
consultant for Colgate) promised a larger study that he claimed would ~!scount
her thesis (Douglass and Joshipura, 2006). Now, after 5 years of waiting th,e
Douglass study has finally been published (Kim 2011) but in no way does this
study discount Bassin's findings. The study, which used far fe~er ~ontrols th.an
Bassin's analysis, did not even attempt to assess the age-specific Window of rrsk
that Bassin identified. Indeed, by the authors' own admission, the study had no
capacity to assess the risk of osteosarcoma among children and adolesce~ts
(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 ~amages 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 Incr.eas~d rates of
infertility among couples living in areas with 3 ppm or ~ore f1~orrde In the wat~r
(Freni 1994), two studies have found reduced level of Circulating testosterone In
males living in high fluoride areas (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, ~,997, 199.8), t~e
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 (Shea 1967; Waldbott 1978; Moolenburgh
1987). In one study, which lasted 13 years, Feltman and Kosel (1961) sho~ed
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. 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 diabetics. Also vulnerable are those
who suffer from malnutrition (e.g., calcium, magnesium, vitamin C, vitamin D and
iodine deficiencies and protein-poor diets. See: Massier & Schour 1952; Marier &
Rose 1977; Un Fa-Fu 1991; Chen 1997; 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 argument is about
whether there is an adequate margin of safety between the doses that have been
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); lowered thyroid function (Galletti &
Joyet 1958; Bachinskii 1985; Un 1991); bone fractures in children (Alarcon-
Herrera 2001) or hip fractures in the elderly (Kurttio 1999; Li 2001). All 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
w~ite 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,
the Rev. 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 fomnula, 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 fomnerly 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 infomnation that changes our
practices and policies. So it is with fluoridation."
(see:http://WV1JW2.f1uoridealert.org/AlertlUnited-States/Georgia/Atlanta-
Civil-Rights-Leaders-Callfor- Halt~to-Water -Fluoridation)
39. Minorities are not being warned about their vulnerabilities to fluoride. The
COC is not waming 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.
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 f1uorosilicic 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 aI., 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 show an association
between the use of f1uorosilicic 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. 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 offluoridation 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:
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
f1uorosilicate and f1uorosilicic 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
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 pan." 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.
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 July 2011, over 3700 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 (see: www.FluorideAlert.org). 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.
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-f1uoridationist 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. .
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. Mic-hae\ Easley, a prominent lobbyist for fluoridation in
the US, "Debates give the illusion that a scientific controversy exists when no
credible people support the f1uorophobics' 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 profluoridationstance has evolved
into a dogmatic, authoritarian, essentially antisclentific 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
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 thatthe 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
would not be necessary if those promoting fluoridation were on secure scientific
and ethical grounds.
addendum at:http://www.dohc.le/other_healthJssues/dentaLresearch/. Paul Connett's
comprehensive response to this response can be accessed
athttp://www.fluoridealert.org/50reasons.htm 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. See: http://www.independent.le/natlonal-
news/staggering-sums-spent-on-reportscommissioned- by-the-state-
2841922.html Since 2004, there have been many major scientific developments
including the publication of the U.S. National Research Council report (NRC, 200B); the
publication of Bassin's study on Osteosarcoma (Bassin 200B), and many more studies
of fluoride's interaction with the brain, that have necessitated a major update of the 50
Reasons. This was compiled in August 2011,
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, DOT, PCBs, tetraethyllead, 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.
(See references at beginning of paper)
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 sUlvey ever conducted in the
US, amounts to less than one tooth surface (out of 128) in a chi/d'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
These 50 Reasons were first compiled by Paul Connett and presented in person to the
Fluoridation Forum in Ireland in October 2000, The document was refined in 2004 and
published in Medical Veritas. See: hltp://www.fluoridealert.org/50reasons.htmln the
introduction to this 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 {his response and
: I.
f)ECTION 2: More Information. Quotes, Concerns. Summaries
Included in this section:
. Page 1: Quotes raising concern- (frightening, eye-opening)
. Page 3-8: Fluoride & Your Body
. Page 8: Key Findings - Fluoride & the Brain
. Page 9: 10 Facts about Fluoride
. Page 13: Key Findings- Water Fluoridation and Tooth Decay
. Page 14: Recent Surveys of Water FluoridationfTooth Decay:
· Page 17: Topical vs. Systemic
. Page 21: One example of news article paraphrasing study
. Page 23: Water Fluoridation: A Review of Recent Research and
Actions, Joel M. Kauffman, Ph. D.
QUOTES. FLUORIDE HEALTH EFFECTS DATABASE
(Please notice source responsible for quote below each)
"[T]he political profluoridation stance has evolved into a dogmatic, authoritarian,
essentially antiscientific posture, one that discourages open debate of scientific
issues." - Dr. Edward Groth, Senior Scientist, Consumers Union, 1991.
"Journal editors often have refused for political reasons to publish information that
raises questions about fluoridation.". Chemical & Engineering News, August 1, 1988.
"We are left with compelling evidence that powerful interests with high financial stakes
have colluded to prematurely close honest discussion and investigation into fluoride
toxicity." - Dr. Sheldon Krimsky, Tufts University, August 16,2004.
"The Public Health Service, unfortunately, has locked itself into a position where it has
made this statement on the record that there is absolutely no hazard to fluoridating
public water supplies and the matter is closed. Now, that, of course, is immediately an
unscientific approach." - Ralph Nader, Consumer Advocate, 1971.
"Over the past ten years a large body of peer-reviewed science has raised concerns
that fluoride may present unreasonable health risks, particularly among children, at
levels routinely added to tap water in American cities..
ENVIRONMENTAL WORKING GROUP, July 2005.
"In summary, we hold that fluoridation is an unreasonable risk."
US ENVIRONMENTAL PROTECTION AGENCY HEADQUARTERS' UNION, 2001.
"Carefully conducted studies of exposure to fluoride and emerging health parameters of
interest (e,g., endocrine effects and brain function) should be performed in populations
in the United States exposed to various concentrations of fluoride."
1
2
US NATIONAL RESEARCH COUNCIL, 2006
"I am quite convinced that water fluoridation, in a not-too-distant future, will be
consigned to medical history."
Dr. ARVID CARLSSON, Pharmacologist, Nobel Laureate In Physiology and Medicine, 2000,
"Children under three should never use fluoridated toothpaste. Or drink fluoridated
water. And baby formula must never be made up using Toronto tap water. Never. In
fluoridated areas, people should never use fluoride supplements. We tried to get them
banned for children but (the dentists) wouldn't even look at the evidence we presented"
- Dr. Hardy Ltmeback, biochemist and Professor of Dentistry, University of Toronto, former consultant to
the Canadian Dental Association.
"The level offluoride the government allows the public is based on scientifically
fraudulent information and altered reports. People can be harmed simply by drinking
water!'
-Dr. Robert Carton, Ph.D, former Environmental Protection Agency Scientist (20 years), Food & Water
Journal, Summer 1998
"Fluoride is a carcinogen by any standard we use. i believe EPA should act immediately
to protect the public, not just on the cancer data, but on the evidence of bone fractures,
arthritis, mutagenicity, and other effects."
-Dr. William Marcus, Ph.D, Environmental Protection Agency Scientist, Food & Water Journal, Summer
1998
"Dental Fluorosis, no matter how slight is an irreversible pathological condition
recognised by authorities around the world as the first readily detectable clinical
symptom of previous chronic fluoride poisoning. To suggest we should ignore such a
sign is as irrational as saying that the blue-black line which appears on the gums due to
chronic lead poisoning is of no significance because it doesn't cause any pain or
discomfort."
-Dr. Geoffrey Smith, Dental Surgeon, New Sclentlsl, May 5, 1983
We do know that the use of drinking water containing as little as 1.2 - 3.0 parts per
million of fluorine will cause such developmental disturbances in bones as
osteosclerosis, spondylosis and osteopetrosis, as well as goiter, and we cannot afford
to run the risk of producing such serious systemic disturbances in applying what is at
present a doubtful procedure intended to prevent development of dental
disfigurements....
-Journal American Dental Association, October 1944, Editorial
"As a toxicologist Involved in fluoride research for over ten years, I was stunned by the
Calgary Regional Health Authority's glib comments proclaiming water fluoridation safe.
The 'fifty years~ of studies about fluoride safety, do not exist. The "ongoing intensive
3
research on fluorides and fluoridation', does not exist, certainly none investigating
safety."
-Dr. p. Mullenix, Ph.D., research scientist, 1997 !eUer to Calgary Councillors.
FLUORIDE ACCIDENTS & POISONINGS
Fluoride, the active ingredient in many pesticides and rodenticides, is a powerful polson
- more acutely poisonous than lead. Because of this, accidental over-ingestion of
fluoride can cause serious toxic symptoms.
"Many individuals with impeccable credentials in science, dentistry, and medicine have
published incontrovertible evidence that fluoridation is harmful and does not reduce the
incidence of dental caries".
-Dr. A. Schatz, Ph.D., co-discoverer, at age 23, of the fl(st effective treatment against tuberculosis -
streptomycin - 1997 letter to Calgary Councillors
Each year there are thousands of reports to Poison Control centers in the United States
related to excessive ingestion of fluoride toothpastes, mouthrinses, and supplements.
Water fluoridation accidents, resulting in excess levels of fluoride in water, have been
one of the sources of acute fluoride poisoning.
"Fluoride is an accumulative poison which accumulates in the skeletal structures,
including the teeth, when the body is exposed to small daily intakes of this element. ...it
is like lead accumulation in the bone until saturation occurs and then lead poisoning
sets in."
-Dr. p.H. Phillips, biochemist. University of Wisconsin
FLUORIDE & DENTAL FLUOROSIS
Excessive ingestion of fluoride during the early childhood years can damage the tooth-
forming cells, leading to a defect in the enamel known as dental fluorosis.
Teeth impacted by fluorosis have visible discoloration, ranging from white spots to
brown and black stains.
".;.the evidence is quite convincing that the addition of sodium fluoride to the public
water supply at one part per million is extremely deleterious to the human body.... Prior
to my hearing this case, I gave the matter of fluoridation little if any, thought but I
received quite an education, and noted that the proponents of fluoridation do nothing
more than try to impugn the objectivity of those who oppose fluoridation."
-Supreme Court Justice J.P. Fl~herty - former Chairman of the Pennsylvania Academy of Sciences -In a
1979 letter to the Mayor of Auckland, N.Z.
According to the Centers for Disease Control, 32% of American children now have
some form of dental fluorosis, with 2 to 4% of children having the moderate to severe
stages (CDC 2005).
According to Dr. Hardy Limeback, Head of Preventive Dentistry at the University of
Toronto, "it is illogical to assume that tooth enamel is the only tissue affected by low
daily doses of fluoride ingestion.
"I am appalled at the prospect of using water as a vehicle for drugs...."
-Dr. e.G. Heyd, former President of the American Medical Association
FLUORIDE & ALLERGY/HYPERSENSITIVITY
As acknowledged by the Physicians' Desk Reference, some individuals are
allergic/hypersensitive to fluoride. The largest, government-funded, clinical trial found
that 1 % of individuals exposed to 1 mg/day of fluoride exhibited allergic/hypersensitive
reactions, including skin reactions, gastric distress, and headache.
.....When medical practitioners everywhere also recognize the severity of the problems
of chronic fluoride toxicosis, and laws mandating truly safe drinking water are sincerely
enforced, the health of millions will dramatically improve...."
-The late Dr. George L. Waldbott, author of "Fluoridation, the Great Dilemma'
FLUORIDE & the KIDNEYS
The kidneys playa vital role In preventing the build-up of excessive fluoride in the body.
Among healthy individuals, the kidneys excrete approximately 50% of the dally fluoride
intake. However, among individuals with kidney disease, the kidneys' ability to excrete
becomes markedly impaired, resulting in a build-up of fluoride within the body.
It is well recognized that individuals with kidney disease have a heightened
susceptibility to the cumulative toxic effects of fluoride.
"Fluorine is a general protoplasmic poison, but the most Important symptoms of chronic
fluorine poisoning known at present are mottling of the teeth and interference with bone
formation."
-DeEds F, Fluorine In Relation to Bone and Tooth Development, JADA, 23, 1936, P 574
"...no laboratory test has ever shown that 1 part per million fluoride in the drinking water
reduces tooth decay."
-Chief Dental Officer, British Ministry of Health and Social Security, December 11,1980.
Of particular concern is the potential for fluoride, when accumulated in the skeletal
system, to cause, or exacerbate, renal osteodystrophy - a bone disease commonly
found among people with advanced kidney disease.
Fluoride & Your Body:
4
i.
"
In addition, fluoride has been definitively shown to poison kidney function at high doses
over short-term exposures in both animals and humans. The impact of low doses of
fluoride, given over long periods of time, has been inadequately studied. A recent
animal study, conducted by scientists at the US Environmental Protection Agency
(Varner 1998), reported that exposure to just 1 ppm fluoride caused kidney damage in
rats if they drank the water for an extended period of time, while a new study from China
found an increased rate of kidney disease among humans consuming more than 2 ppm
(Liu 2005). Hence, the adverse effects to kidney function that fluoride causes at high
doses over short periods of time, may also be replicated with small doses if consumed
over long periods of time.
According to the US National Research Council, "any agent that affects pineal function
could affect human health in a variety of ways, including effects on sexual maturation,
calcium metabolism, parathyroid function, postmenopausal osteoporosis, cancer, and
psychiatric disease."
FLUORIDE & the THYROID GLAND
According to the US National Research Council, "several lines of Information indicate an
effect of fluoride exposure on thyroid function" - particularly among individuals with an
iodine deficiency.
FLUORIDE & the BRAIN
Fluoride's potential to impair thyroid function is most clearly illustrated by the fact that _
up until the 1970s - European doctors used fluoride as a thyroid-suppressing
medication for patients with hyperthyroidism (over-active thyroid). Fluoride was utilized
because it was found effective at reducing the activity of the thyroid gland - even at
doses as low as 2 mg/day.
Today, many people living in fluoridated communities are ingesting doses of fluoride
(1.6-6.6 mg/day) that fall within the range of doses (2 to 10 mg/day) once used by
doctors to reduce thyroid activity in hyperthyroid patients. This is of particular concern
considering the widespread problem of hypothyroidism (under-active thyroid) in the
United States. Symptoms of hypothyroidism include obesity, lethargy, depression, and
heart disease.
Fluoride's ability to damage the brain represents one of the most active areas of
research on fluoride toxicity today.
Concern about fluoride's impact on the brain has been fueled by 18 human studies
(from China, Mexico, India, and Iran) reporting IQ deficits among children exposed to
excess fluoride, by 4 human studies indicating that fluoride can enter, and damage, the
fetal brain; and by a growing number of animal studies finding damage to brain tissue
(at levels as low as 1 ppm) and impairment of learning and memory among f1uoride-
treated groups.
According to the US National Research Council, "it is apparent that fluorides have the
ability to Interfere with the functions of the brain."
FLUORIDE & BONE DISEASE
FLUORIDE & the PINEAL GLAND
In the 1990s, it was discovered that the pineal gland is a major site of fluoride
accumulation within the body - with higher concentrations of fluoride than either teeth or
bone.
Subsequent animal studies Indicate that the accumulation of fluoride in the pineal gland
can reduce the gland's synthesis of melatonin, a hormone that helps regulate the onset
of puberty. Fluoride-treated animals were found to have reduced levels of circulating
melatonin and an earlier onset of puberty than untreated animals. The scientist who
conducted the research concluded:
Excessive exposure to fluoride is well known to cause a bone disease called skeletal
fluorosis.
Skeletal fluorosis, especially in its early stages, is a difficult disease to diagnose, and
can be readily confused with various forms of arthritis including osteoarthritis and
rheumatoid arthritis.
In its advanced stages, fluorosis can resemble a multitude of bone/joint diseases.
In individuals with kidney disease, fluoride exposure can contribute to, and/or
exacerbate, renal osteodystrophy.
"The safety of the use of fluorides ultimately rests on the assumption that the developing
enamel organ Is most sensitive to the toxic effects of fluoride. The results from this
study suggest that the pinealocytes may be as susceptible to fluoride as the developing
enamel organ" (Luke 1997).
FLUORIDE & BONE FRACTURE
The majority of animal studies investigating fluoride's effect on bone strength, have
found fluoride to either have no effect or a negative effect on strength. According to the
US National Research Council, "The weight of evidence indicates that, although fluoride
might increase bone volume, there is less strength per unit volume."
The fact that fluoride's impact on the pineal gland was never studied, or even
considered, before the 1990s, highlights a major gap in knowledge underpinning current
policies on fluoride and health.
b
.-------------~ I
7
Studies on human populations consuming fluoride in drinking water have found an
association between dental fluorosis and increased bone fracture in children; and
between long-term consumption of fluoridated water and increased hip fracture in the
elderly.
Perhaps not surprisingly, therefore, tooth decay rates have declined at similar rates in
all western countries in the latter half of the 20th century - irrespective of whether the
country fluoridates its water or not. Today, tooth decay rates throughout continental
western Europe are as low as the tooth decay rates in the United States - despite a
profound disparity in water fluoridation prevalence in the two regions.
Within countries that fluoridate their water, recent large-scale surveys of dental health -
utilizing modern scientific methods not employed in the early surveys from the 19305-
1950s - have found little difference in tooth decay, including "baby bottle tooth decay",
between fluoridated and unfluoridated communities.
Carefully conducted human clinical trials - including two "double-blind trials" - have
found that fluoride (at doses of 18-34 mglday for just 1-4 years) increases the rate of
bone fracture, particularly hip fracture, among osteoporosis patients.
FLUORIDE & CANCER
According to the National Toxicology Program, "the preponderance of evidence" from
laboratory 'in vitro' studies indicates that fluoride is a mutagenic compound. Many
substances which cause mutagenic damage also cause cancer.
While the concentrations of fluoride causing mutagenic damage in laboratory studies
are higher than the concentrations found in human blood, there are certain
"rnicroenvironments" in the body (e.g. the bones and the bladder) where the
concentrations of fluoride can ,accumulate to levels comparable to, or in excess of,
those causing mutagenic effects in the laboratory.
Fluoride has been found to cause bone cancer (osteosarcoma) in government animal
studies and rates of osteosarcoma among young males living in fluoridated areas have
been found to be higher than young males living in unfluoridated areas. Osteosarcoma,
while rare, is a very serious cancer. Children who develop osteosarcoma face a high
probability of death (usually within 3 years) or amputation.
Fluoride exposure has also been linked to bladder cancer - particularly among workers
exposed to excess fluoride in the workplace. According to the US National Research
Council, "further research on a possible effect of fluoride on bladder cancer risk should
be conducted."
Key Findings - Fluoride & the Brain:
1) Fluoride's ability to damage the brain represents one of the most active areas of
research on fluoride toxicity today.
2) The research on fluoride and the brain has been fueled by 18 human studies from
China, India, Iran, and Mexico finding elevated levels of fluoride exposure to be
associated with IQ deficits in children. Fluoride's impact on IQ is exacerbated among
children with low-iodine exposure.
3) The impact of fluoride on children's IQ has been documented even after controlling
for children's lead exposure, iodine exposure, parental education and Income status,
and other known factors that might impact the results (Rocha-Amador 2007; Xlang 2003
a,b).
4) In addition to fQ studies, 3 studies (Yu 1996; Du 1992; Han 1989) have found that
fluoride accumulates in the brain of the fetus, causing damage to cells 'and
neurotransmitters and 1 study (Li 2004) has found a correlation between exposure to
fluoride during fetal development and behavioral deficits among neonates.
5) Several recent studies have found that even adult exposures to fluoride may result in
central nervous system disturbances, particularly among industrial workers.
FLUORIDE & the GASTROINTESTINAL TRACT
Among people hypersensitive to fluoride, gastrointestinal ailments have been produced
following ingestion of 1 mg tablets of fluoride or consumption of 1 ppm fluoridated water.
A single ingestion of as little as 3 mg of fluoride, in carefully controlled clinical trials, has
been found to produce damage to the gastric mucosa in healthy adult volunteers. No
research on the gastric mucosa has ever been conducted to determine the effect of
lower doses with repeated exposure.
5) The findings of neurological effects in fluoride-exposed humans Is consistent with, .
and strengthened by, recent findings from over 40 animal studies published since 1992.
As With the studies on humans, the studies on animals have reported an impairment In
learning and memory prorcesses among the fluoride-treated groups.
6) The animal studies have also documented considerable evidence of direct toxic
effects of fluoride on brain tissue, even at levels as low as 1 ppm fluoride in water
(Varner 1998). These effects include:
FLUORIDE & TOOTH DECAY (Caries)
According to the current consensus view of the dental research community, fluoride's
primary - if not sole - benefit to teeth comes from TOPICAL application to the exterior
surface of teeth, not from ingestion.
- reduction in nicotinic acetylcholine receptors;
-- reduction in lipid content;
- impaired anti-oxidant defense systems;
8
9
-- damage to the hippocampus;
- damage to the purkinje cells;
- increased uptake of aluminum;
- formation of beta-amyloid plaques (the classic brain abnormality in Alzheimer's
disease );
- exacerbation of lesions induced by iodine deficiency; and
- accumulation of fluoride in the pineal gland.
4) Fluoridated water is no longer recommended for babies. In November of 2006, the
American Dental Association (ADA) advised that parents should avoid giving babies
fluoridated water (3). Other dental researchers have made similar recommendations
over the past decade (4).
Babies exposed to fluoride are at high risk of developing dental fluorosis - a permanent
tooth defect caused by fluoride damaging the cells which form the teeth (5). Other
tissues in the body may also be affected by early-life exposures to fluoride. According to
a recent review pUblished in the medical journal The Lancet, fluoride may damage the
developing brain, causing learning deficits and other problems (6).
5) There are better ways of delivering fluoride than adding it to water. By adding fluoride
to everyone's tap water, many infants and other at-risk populations will be put in harm's
way. This is not only wrong, it is unnecessary. As Western Europe has demonstrated,
there are many equally effective and less-intrusive ways of delivering fluoride to people
who actually want it. For example:
A) Topical fluoride products such as toothpaste and mouth rinses (which come with
explicit instructions not to swallow) are readily available at all grocery stores and
pharmacies. Thus, for those individuals who wish to use fluoride, it is very easy to find
and very inexpensive to buy.
B) If there is concern that some people in the community cannot afford to purchase
fluoride toothpaste (a family-size tube of toothpaste costs as little as $2 to $3), the
money saved by not fluoridating the water can be spent subsidizing topical fluoride
products (or non-fluoride alternatives) for those families in need.
C) The vast majority of fluoride added to water supplies is wasted, since over 99% of
tap water is not actually consumed by a human being. It is used instead to wash cars,
water the lawn, wash dishes, flush toilets, etc.
6) Ingestion of fluoride has little benefit, but many risks. Whereas fluoride's benefits
come from topical contact with teeth, its risks to health (which involve many more
tissues than the teeth) result from being swallowed.
Adverse effects from fluoride ingestion have been associated with doses attainable by
people living in fluoridated areas. For example:
a) Risk to the brain. According to the National Research Council (NRC), fluoride can
damage the brain. Animal studies conducted in the 1990s by EPA scientists found
dementia-like effects at the same concentration (1 ppm) used to fluoridate water, while
human studies have found adverse effects on IQ at levels as low as 0.9 ppm among
children with nutrient deficiencies, and 1.8 ppm among children with adequate nutrient
intake. (7-10)
10 Facts about Fluoride
1) 97% of Western Europe has chosen fluoride-free water. This includes: Austria,
Belgium, Denmark, Finland, France, Germany, Iceland, Italy, Luxembourg, Netherlands,
Northern Ireland, Norway, Scotland, Sweden, and Switzerland. (While some Europe.an
countries add fluoride to salt, the majority do not.) Thus, rather than mandating f1uorrde
treatment for the whole population, Western Europe allows individuals the right to
choose, or refuse, fluoride.
2) Fluoride is the only chemical added to drinking water for the purpose of medication
(to prevent tooth decay), All other treatmen.t chemi<;:als are added to tre.at .the water (to
improve the water's quality and safety - which fluonde does not do). ThiS IS one of the
reasons why most of Europe has rejected fluoridation. For instance:
In Germany, "The argumentation of the Federal Ministry of Health against a gen.eral
permission of fluoridation of drinking water is the problematic nature of compulSion
medication. "
In Belgium, it is "the fundamental position of the .dr~nking water sector.t~~t it is not its
task to deliver medicinal treatment to people. ThiS IS the sole responsIbility of health
services."
In Luxembourg, "In our views, drinking water isn't the suitable way for medicinal
treatment and that people needing an addition of fluoride can decide by their own to use
the most appropriate way." .
3) Contrary to previous belief, fluoride has minimal benefit when swallowed. When
water fluoridation began in the 1940s and '50s, dentists believed that fluoride needed to
be swallowed in order to be most effective. This belief, however, has now been
discredited by an extensive body of modern research (1).
According to the Centers for Disease Control, fluoride's "predominant effect is post-
eruptive and topical" (2). In other words, any benefits that accrue from the use of
fluoride, come from the direct application of fluoride to the outside of teeth (after they
have erupted into the mouth) and not from ingestion. There is no need, therefore, to
expose all other tissues to fluoride by swallowing it.
10
11
b) Risk to the thyroid gland. According to the NRC, fluoride is an "endocrine disrupter."
Most notably, the NRC has wamed that doses of fluoride (0.01-0.03 mg/kg/day)
achievable by drinking fluoridated water, may reduce the function of the thyroid among
individuals with low-iodine intake. Reduction of thyroid activity can lead to loss of mental
acuity, depression and weight gain (11)
c) Riskto bones. According to the NRC, fluoride can diminish bone strength and
increase the risk for bone fracture. While the NRC was unable to determine what level
of fluoride is safe for bones, it noted that the best available information suggests that
fracture risk may be increased at levels as low 1.5 ppm, which is only slightly higher
than the concentration (0.7-1.2 ppm) added to water for fluoridation. (12)
a) No difference exists in tooth decay between fluoridated & unfluoridated countries.
While water fluoridation is often credited with causing the reduction in tooth decay that
has occurred in the US over the past 50 years, the same reductions In tooth decay have
occurred in all western countries, most of which have never added fluoride to their
water. The vast majority of Western Europe has rejected water fluoridation. Yet,
according to comprehensive data from the World Health Organization, their tooth decay
rates are just as low, and, in fact, often lower than the tooth decay rates in the US. (25,
35,44)
b) Cavities do not increase when fluoridation stops. In contrast to earlier findings, five
studies published since 2000 have reported no increase in tooth decay in communities
which have ended fluoridation. (37-41)
d) Risk for bone, cancer. Animal and human studies - including a recent study from a
team of Harvard scientists - have found a connection between fluoride and a serious
form of bone cancer (osteosarcoma) in males under the age of 20. The connection
between fluoride and osteosarcoma has been described by the National Toxicology
Program as "biologically plausible." Up to half of adolescents who develop
osteosarcoma die within a few years of diagnosis. (13-16)
c) Fluoridation does not prevent oral health crises in low-income areas. While some
allege that fluoridation is especially effective for low-income communities, there is very
little evidence to support this claim. According to a recent systematic review from the
British government, "The evidence about [fluoridation] reducing inequalities In dental
health was of poor quality, contradictory and unreliable." (45) In the United States,
severe dental crises are occurring in low-income areas irrespective of whether the
community has fluoride added to its water supply. (46) In addition, several studies have
confirmed that the incidence of severe tooth decay in children ("baby bottle tooth
decay") is not significantly different in fluoridated vs. unfluoridated areas. (27,32,42)
Thus, despite some emotionally-based claims to the contrary, water fluoridation does
not prevent the oral health problems related to poverty and lack of dental-care access.
e) Risk to kidney patients. People with kidney disease have a heightened susceptibility
to fluoride toxicity. The heightened risk stems from an impaired ability to excrete fluoride
from the body. As a result, toxic levels of fluoride can accumulate in the bones, intensify
the toxicity of aluminum build-up, and cause or exacerbate a painful bone disease
known as renal osteodystrophy. (17-19)
7) The Industrial chemicals used to fluoridate water may present unique health risks not
found with naturally-occurring fluoride complexes. The chemicals - f1uorosilicic acid,
sodium silicofluoride, and sodium fluoride - used to fluoridate drinking water are
industrial waste products from the phosphate fertiliz{lr industry. Of these chemicals,
fluorosilicic acid (FSA) is the most widely used. FSA is a corrosive acid which has been
linked to higher blood lead levels in children. A recent study from the University of North
Carolina found that FSA can - in combination with chlorinated compounds - leach lead
from brass joints in water pipes, while a recent study from the University of Maryland
suggests that the effect of fluoridation chemicals on blood lead levels may be greatest in
houses built prior to 1946. Lead is a neurotoxin that can cause learning disabilities and
behavioral problems in children. (20-23)
9) Fluoridation poses added burden and risk to low-income communities. Rather than
being particularly beneficial to low-income communities, fluoridation is particularly
burdensome and harmful. For example:
a) Low-income families are least able to avoid fluoridated water. Due to the high costs
of buying bottled water or expensive water filters, low-income households will be least
able to avoid fluoride once it's added to the water. As a result, low-Income families will
be least capable of following ADA's recommendation that infants should not receive
fluoridated water. This may explain why African American children have been found to
suffer the highest rates of disfiguring dental fluorosis in the US. (47)
8) Water fluoridation's benefits to teeth have been exaggerated. Even proponents of
water fluoridation admit that it is not as effective as it was once claimed to be. While
proponents still believe in its effectiveness, a growing number of studies strongly
question this assessment. (24-46) According to a systematic review published by the
Ontario Ministry of Health and Long Term Care, "The magnitude of [fluoridation's] effect
is not large in absolute terms, is often not statistically significant and may not be of
clinical significance." (36)
b) Low-income families at greater risk of fluoride toxicity. In addition, it is now well
established that individuals with inadequate nutrient intake have a significantly
increased susceptibility to fluoride's toxic effects (48-51). Since nutrient deficiencies are
most common in income communities, and since diseases known to increase
susceptibility to fluoride are most prevalent in low-income areas (e.g. end-stage renal
failure), it is likely that low-income communities will be at greatest risk from suffering
adverse effects associated with fluoride exposure. According to Dr. Kathleen Thiessen,
a member of the National Research, Council's review of fluoride toxicity: "I would expect
low-income communities to be more vulnerable to at least some of the effects of
drinking fluoridated water." (51)
.12
.1:>
14
10) Due to other sources, many people are being over-exposed to fluoride. Unlike
when water fluoridation first began, Americans are now receiving fluoride from many
other sources' besides the water supply. As a result many people are now exceeding
the recommended daily intake, putting them at elevated risk of suffering toxic effects.
For example, many children ingest more fluoride from toothpaste alone than is
considered .optimal" for a full day's worth of ingestion. According to the Journal of
Public Health Dentistry:
''Virtually all authors have noted that some children could ingest more fluoride from
[toothpaste] alone than is recommended as a total daily fluoride ingestion." (52)
Because of the increase in fluoride exposure from all sources combined, the rate of
dental fluorosis (a visible indicator of over-exposure to fluoride during childhood) has
increased significantly over the past 50 years. Whereas dental fluorosis used to impact
less than 10% of children in the 1940s, the latest national survey found that it now
affects over 30% of children. (47,53)
Filled Teeth, and a minimal difference in Decayed, Missing & Filled Surfaces among
children who had lived their entire lives in a fluoridated or unfluoridated community.
5) Since 2000, four studies have reported that tooth decay does not increase, but
continues to decrease, after water fluoridation is stopped.
6) Water fluoridation is often promoted as a means of preventing dental crises within
low-income popUlations. It is becoming evident, however, that water fluoridation has
been ineffective at preventing widespread tooth decay in poor urban areas of the United
States - most of which have been fluoridated for 20 to 50 years.
Excerpts from the Scientific Literature - Recent Surveys af Water
Fluaridatian/Taath Decay:
. Sources of fluoride include: fluoride dental products, fluoride pesticides, fluorinated
pharmaceuticals, processed foods made with fluoridated water, and tea.
"This study assessed the relationship between dental caries and fluorosis at varying
fluoride levels in drinking water. Methods: Subjects were followed from birth with
questionnaires every 3-4 months to gather information on fluoride intake. 420 study
subjects received dental examinations at age 5 on primary teeth and at age 9 on early-
erupting permanent teeth... Conclusions: Fluorosis prevalence increased significantly
with higher water fluoride levels; however, caries prevalence did not decline
significantly."
SOURCE: Hong L, Levy S, Warren J, Broffit B. (2006). Dental caries and fluorosis in
relation to water fluoride levels. ADEAlAADRlCADR Conference, Orlando Florida,
March 8-11,2006.
Key Findings. Water Fluoridation & Tooth Decay:
1) The addition of fluoride to water for the purpose of preventing tooth decay began in
the 1940s with the belief that fluoride's primary benefit came from ingestion of fluoride
during the tooth-forming years. It is now acknowledged by the dental research
community, however, that fluoride's primary benefit comes from topical contact with
teeth, and not from ingestion as previously assumed. It is also now acknowledged that
fluoride is ineffective at preventing tooth decay in the pits & fissures of teeth - where the
majority of decay occurs.
"This study reports changes in non-cavitated tooth surface diagnoses after a 4-year
period... No fluoride, socioeconomic status or beverage variables were significantly
associated with lesion progression."
SOURCE: Warren JJ, Levy SM, Broffitt B, Kanellis MJ. (2006). Longitudinal study of
non-cavitated carious lesion progression in the primary dentition. Journal of Public
Health Dentistry 66(2):83-7.
2) It is well recognized that tooth decay rates declined quite dramatically in all western
countries in the latter half of the 20th century - irrespective of whether the country
fluoridated its water or not. Today, tooth decay rates thoughout continental western
Europe - where 98% of the population does not drink fluoridated water - are as low as
the tooth decay rates in the United States, where a majority of the population drinks
fluoridated water.
3) Within countries that fluoridate their water, recent large-scale surVeys of dental health
_ utilizing modem scientific methods not employed in the early surveys from the 19305-
1950s - have found little difference in tooth decay, including "baby bottle tooth decay",
between fluoridated and unfluoridated communities.
"In the present study, fluoridated water did not seem to have a positive effect on dental
health, as it might have been expected in a community with the respective caries
prevalence:
SOURCE: Meyer-Lueckel H, et al. (2006). Caries and fluorosis in 6- and 9-year-old
children residing in three communities in Iran. Community Dentistry and Oral
Epidemiology 34:63-70.
4) The largest dental survey ever conducted in the United States, by the National
Institute of Dental Research in 1986-87, found no difference in Decayed, Missing &
"Graphs of tooth decay trends for 12 year olds in 24 countries, prepared using the most
recent World Health Organization data, show that the decline in dental decay in recent
decades has been comparable in 16 nonfluoridated countries and 8 fluoridated
countries which met the inclusion criteria of having (i) a mean annual per capita income
in the year 2000 of US$1 0,000 or more, (Ii) a population in the year 2000 of greater than
3 million, and (iii) suitable WHO caries data available. The WHO data do not support
15
16
fluoridation as being a reason for the decline in dental decay in 12 year olds that has
been occurring in recent decades."
SOURCE: Neurath C. (2005). Tooth decay trends for 12 year olds in nonfluoridated and
fluoridated countries. Fluoride 38:324-325.
"[R]esults of recent large-scale studies in at least three countries show that, when
similar communities are compared and the traditional DMFT index of dental caries is
used, there is no detectable difference in caries prevalence. This has been
demonstrated for schoolchildren in the major cities of New Zealand, Australia, the US
and elsewhere."
SOURCE: Diesendorf, M. et al. (1997). New Evidence on Fluoridation. Australian and
New Zealand Journal of Public Health. 21: 187-190.
"A Bayesian survival analysis is presented to examine the effect of fluoride-intake on the
time to caries development of the permanent first molars in children between 7 and 12
years of age using a longitudinal study conducted in Flanders... Our analysis shows no
convincing effect of fluoride-intake on caries development."
SOURCE: Komarek A. et al. (2005). A Bayesian analysis of multivariate doubly-interval-
censored dental data. Biostatistics 6:145-55.
"In lifetime residents of fluoridated areas 47% had evidence of erosion; in 21% erosion
had progressed to the dentine or pulp. The corresponding figures in non-fluoridated
areas were 43% and 21% respectively...Levels in fluoridated and non-fluoridated areas
were similar. "
SOURCE: Harding MA, et al. (2003). Dental erosion in 5-year-old Irish school children
and associated factors: a pilot study. Community Dental Health 20(3):165-70.
"There was no statistically significant difference between DMFT in municipalities of the
same size, regardless of the presence or absence of fluoride in the water supply..."
SOURCE: Sales-Peres SH, Bastos JR. (2002). [An epidemiological profile of dental
caries in 12-year-old children residing in cities with and without fluoridated water supply
in the central western area of the State of Sao Paulo, Braziij. Cadernos de Saude
publica 18: 1281-8.
"Higher fluoride proportions appeared to be associated with lower dfs + DFS, with an
estimated difference between fluoridated and non-fluoridated groups of 0.65 decayed or
filled surfaces per child, but this association was not statistically significant. The effects
of fluoridation on the other outcomes were small and not statistically significant."
SOURCE: Domoto P, et al. (1996). The estimation of caries prevalence in small areas.
Journal of Dental Research 75:1947-56.
"lifetime exposure to fluoridation is associated with average reductions of 2.0 dmfs and
between 0.12 and 0.30 DMFS per child compared with non-exposed children," (Note:
DMFS = Decayed, Missing & Filled Surfaces. There are 128 tooth surfaces In a child's
mouth. This study found a difference of 0.12 to 0.30 decayed surfaces, out of 128,
between children in fluoridated & unfluoridated communities.)
SOURCE: Spencer AJ, et al. (1996). Water fluoridation in Australia. Community Dental
Health 13(SuppI2):27-37,
"Water fluoridation status of the children's area of residence did not have a significant
effect on Early Childhood Caries (ECC) at the 0.1 level of significance in the unadjusted
logistic regression analysis, nor was it found to be a confounder of the effect of
race/ethnicity on ECC prevalence in the multivariable model."
SOURCE: Shiboski CH, et al. (2003). The association of early childhood caries and
race/ethnicityamong California preschool children. Journal of Public Health Dentistry
63(1 ):38-46.
"Data from Head Start surveys show the prevalence of baby bottle tooth decay is about
three times the national average among poor urban children, even in communities with
a fluoridated water supply."
SOURCE: Von Burg MM et al. (1995). Baby Bottle Tooth Decay: A Concem for All
Mothers. Pediatric Nursing 21: 515-519~
"Children attending centers showed no significant differences (in baby bottle tooth
decay) based on fluoride status for the total sample or other variables."
SOURCE: Barnes GP, et al. (1992). Ethnicity, location, age, and fluoridation factors in
baby bottle tooth decay and caries prevalence of head start children. Public Health
Reports 107: 167-73.span>
"[E]ven a longitudinal approach did not reveal a lower caries occurrence in the
fluoridated thalT in the Jow-f1uoride reference community."
SOURCE: Seppa L. et al. (2002). Caries occurrence in a fluoridated and a
nonfluoridated town in Finland: a retrospective study using longitudinal data from public
dental records. Caries Research 36: 308-314.
"An analysis of national survey data collected by the National Institute of Dental
Research (NIDR) concludes that children who live in areas of the U.S. where the water
supplies are fluoridated have tooth decay rates nearly identical with those who live in
nonfluoridated areas."
SOURCE: Hileman, B. (1989). New Studies Cast Doubt on Fluoridation Benefits.
Chemical & Engineering News. May 8. (See article)
"The magnitude of [fluoridation's] effect is not large in absolute terms, is often not
statistically significant and may not be of clinical significance."
SOURCE: Locker, D. (1999). Benefits and Risks of Water Fluoridation. An Update of
the 1996 Federal-Provincial Sub-committee Report. Prepared for Ontario Ministry of
Health and Long Term Care.
"We found that caries prevalences do vary between the geochemical regions oHhe
state. In the total sample, however, there were no significant differences between those
children drinking optimally fluoridated water and those drinking suboptimally fluoridated
~~ .
17
18
SOURCE: Hildebolt CF, et al. (1989). Caries prevalences among geochemical regions
of Missouri. American Journal of Physical Anthropology 78:79-92.
"[SJurvey results in British Columbia with only 11 per cent orthe population using
fluoridated water, show lower average DMFT rates than provinces with 40-70 percent of
the population drinking fluoridated water. How does one explain this?.. [S]chool districts
recently reporting the highest caries free rates were totally unfluoridated." ,
SOURCE: Gray, AS. (1987). Fluoridation: Time for a New Base Line? Journal of the
Canadian Dental Association. 10: 763-765.
SOURCE: European Commission. (2005). The Safety of Fluorine Compounds in Oral
Hygiene Products for Children Under the Age of 6 Years. European Commission,
Health & Consumer Protection Directorate-General, Scientific Committee on Consumer
Products, September 20.
"The results of more recent epid~miological and laboratory studies can be summarized
by stating that posteruptive (topical) application of fluoride plays the dominant role in
caries prevention."
SOURCE: Hellwig E, Lennon AM. (2004). Systemic versus topical fluoride. Caries
Research 38: 258-62.
"Recent studies and reports agree that the differences in dental decay prevalence
between fluoridated and non-fluoridated areas in New Zealand are small. For 12- and
13-year old children nationally the percentages who were caries-free in each kind of
area differed by only 1 or 2 per cent, and were often higher in the non-fluoridated part of
a health district."
SOURCE: Colquhoun, J. (1987). Child Dental Health Differences in New Zealand.
Community Health Studies 6: 85-90.
"In this study in oral epidemiology, officially collected statistics are presented which
show that, 15 yr after fluoridation commenced in Auckland, New Zealand, there was still
a significant correlation between dental health of children and their social class. They
also show that treatment levels have continued to decline in both fluoridated and
unfluoridated areas, and are related to social class factors rather than to the presence
or absence of water fluoridation... When the socioeconomic variable is allowed for,
dental health appears to be better In the unfluorldated areas."
SOURCE: Colquhoun J. (1985). Influence of social class and fluoridation on child dental
health. Community Dentistry and Oral Epidemiology 13:37-41. SEE STUDY
Excerpts from the Scientific Literature - Topical Vs. Systemic:
'When it was thought that fluoride had to be present during tooth mineralisation to
'improve' the biological apatite and the 'caries resistance' of the teeth, systemIc fluoride
administration was necessary for maximum benefit. Caries reduction therefore had to
be balanced against increasing dental fluorosis. The 'caries resistance' concept was
shown to be erroneous 25 years ago, but the new paradigm is not yet fully adopted in
public health dentistry, so we still await real breakthroughs in more effective use of
fluorides for caries prevention."
SOURCE: Fejerskov O. (2004). Changing paradigms in concepts on dental caries:
consequences for oral health care. Caries Research 38: 182-91.
"Current evidence strongly suggests that fluorides work primarily by topical means
through direct action on the teeth and dental plaque. Thus ingestion of fluoride is not
essential for caries prevention."
SOURCE: Warren JJ, Levy SM. (2003). Current and future role of fluoride in nutrition.
Dental Clinics of North America 47: 225-43.
"Fluoride is most effective when used topically, after the teeth have erupted."
SOURCE: Cheng KK, et al. (2007). Adding fluoride to water supplies. British Medical
Journal 335(7622):699-702.
"[T]he majority of benefit from fluoride is now believed to be from its topical, rather than
systemic, effects."
SOURCE: Brothwell D, Limeback H. (2003). Breastfeeding is protective against dental
fluorosis in a nonfluoridated rural area of Ontario, Canada. Journal of Human Lactation
19: 386-90.
"it is now accepted that systemic fluoride plays a limited role in caries prevention."
SOURCE: Pizzo G, Piscopo MR, Pizzo I, Giuliana G. (2007). Community water
fluoridation and caries prevention: a critical review. Clinical Oral Investigations
11 (3):1 89-93.
"For a long time, the systemic effect of fluoride was regarded to be most important,
resulting in recommendations to use fluoride supplements such as tablets or drops.
However, there is increasing evidence that the local effect of fluoride at the surface of
the erupted teeth is by far more important."
SOURCE: Zimmer S, et al. (2003). Recommendations for the Use of Fluoride in Caries
Prevention. Oral Health & Preventive Dentistry 1: 45-51.
"the major anticaries benefit of fluoride is topical and not systemic."
SOURCE: National Research Council. (2006). Fluoride in Drinking Water: A Scientific
Review of EPA's Standards. National Academies Press, Washington D.C. p 13.
"By 1981, it was therefore possible to propose a paradigm shift concerning the
cariostatic mechanisms of fluorides in which it was argued that the predominant, if not
the entire, explanation for how fluoride controls caries lesion development lies in its
topical effect on de- and remineralization processes taking place at the interface
between the tooth surface and the oral fluids. This concept has gained wide
acceptance... With today's knowledge about the mechanisms of fluoride action, it Is
"Since the current scientific thought is that the cariostatic activity of fluoride Is mainly
due to its topical effects, the need to provide systemic fluoride supplementation for
caries prevention is questionable."
19
important to appreciate that, as fluoride exerts its predominant effect... at the tooth/oral
fluid interface, it is possible for maximum caries protection to be obtained without the
ingestion of fluorides to any significant extent."
SOURCE: Aoba T, Fejerskov O. (2002). Critical Review of Oral Biology and Medicine
13: 155-70.
"[F]luoride's predominant effect is posteruptive and topicaL"
SOURCE: Centers for Disease Control and Prevention. (2001). Recommendations for
Using Fluoride to Prevent and Control Dental Caries in the United States. Morbidity and
Mortality Weekly Report 50(RR14}: 1-42.
"The prevalence of dental caries in a population is not inversely related to the
concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not
necessarily more efficacious in preventing dental caries."
SOURCE: Centers for Disease Control and Prevention. (2001). Recommendations for
Using Fluoride to Prevent and Control Dental Caries in the United States. Morbidity and
Mortality Weekly Report 50(RR14}: 1-42.
"Fluoride incorporated during tooth development is insufficient to playa significant role
in caries protection."
SOURCE: Featherstone, JOB. (2000). The Science and Practice of Caries Prevention.
Journal of the American Dental Association 131: 887-899.
"Current evidence suggests that the predominant beneficial effects of fluoride occur
locally at the tooth surface, and that systemic (preeruptive) effects are of much less
importance."
SOURCE: Formon, SJ; Ekstrand, J; Ziegler, E. (2000). Fluoride Intake and Prevalence
of Dental Fluorosis: Trends in Fluoride Intake with Special Attention to Infants. Journal
of Public Health Dentistry 60: 131-9.
"Fluoride supplementation regimens suffer from several shortcomings, the first of which
may be their derivation from a time when the major effect of fluoride was thought to be
systemic. Although evidence that fluoride exerts its effects mainly through topical
contact is great, supplementation schemes still focus on the ingestion of fluoride."
SOURCE: Adair SM. (1999). Overview of the history and current status of fluoride
supplementation schedules. Journal of Public Health Dentistry 1999 59:252-8.
"The case is essentially a risk-benefit issue - fluoride has little preeruptive impact on
caries prevention, but presents a clear risk of fluorosis."
SOURCE: Burt BA. (1999). The case for eliminating the use of dietary fluoride
supplements for young children. Joumal of Public Health Dentistry 59: 260-274.
"Until recently the major caries-inhibitory effect of fluoride was thought to be due to its
incorporation in tooth mineral during the development of the tooth prior to
eruption...There is now overwhelming evidence that the primary caries-preventive
mechanisms of action of fluoride are post-eruptive through 'topical' effects for both
children and adults."
SOURCE: Featherstone JOB. (1999) Prevention and Reversal of Dental Caries: Role of
Low Level Fluoride. Community Dentistry & Oral Epidemiology 27: 31-40.
"[L]aboratory and epidemiologic research suggests that fluoride prevents dental carles
predominately after eruption of the tooth into the mouth, and its actions primarily are
topical for both adults and children."
SOURCE: Centers for Disease Control and Prevention. (1999). Achievements In Public
Health. 1900-1999: Fluoridation of Drinking Water to Prevent Dental Carles. Morbidity
and Mortality Weekly Report 48: 933-940.
I,'
"[R]esearchers are discovering that the topical effects of fluoride are likely to mask any
benefits that ingesting fluoride might have... This has obvious implications for the use of
systemic fluorides to prevent dental caries."
SOURCE: Limeback, H. (1999). A re-examination of the pre-eruptive and post-eruptive
mechanism of the anti-caries effects of fluoride: is there any caries benefit from
swallowing fluoride? Community Dentistry and Oral Epidemiology 27: 62-71.
"Although it was initially thought that the main mode of action of fluoride was through its
incorporation into enamel, thereby reducing the solubility of the enamel, this pre-
eruptive effect is likely to be minor. The evidence for a post-eruptive effect, particularly
its role in inhibiting demineralization and promoting remineralization, is much stronger."
SOURCE: Locker D. (1999). Benefits and Risks of Water Fluoridation. An Update of the
1996 Federal-Provincial Sub-committee Report. Prepared for Ontario Ministry of Health
and Long Term Care.
"Recent research on the mechanism of action of fluoride in reducing the prevalence of
dental caries (tooth decay) in humans shows that fluoride acts topically (at the surface
of the teeth) and that there is neglible benefit in ingesting it."
SOURCE: Diesendorf, M. et al. (1997). New Evidence on Fluoridation. Australian and
New Zealand Journal of Public Health 21 : 187-190.
"On the basis of the belief that an adequate intake of fluoride in early life Is protective
against caries in later life, fluoride supplements are recommended for infants and
children living in areas in which the fluoride content of the drinking water is low.
However, critical reviews of the evidence have led to the conclusion that the effect of
fluoride in decreasing the prevalence and severity of dental caries is not primarily
systemic but exerted locally within the oral cavity. Because fluoride supplements are
quickly cleared from the mouth, the possibility must be considered that they may
contribute to enamel fluorosis, which is unquestionably a systemic effect, while
providing relatively little protection against dental caries."
SOURCE: Ekstrand J, et al. (1994). Fluoride pharmaCOkinetics in infancy. Pediatric
Research 35:157-163.
20
21
"It is now well-accepted that the primary anti-caries activity of fluoride is via topical
action."
SOURCE: Zero DT, et al. (1992). Fluoride concentrations in plaque, whole saliva, and
ductal saliva after application of home-use topical fluorides. Journal of Dental Research
71 :1768-1775.
correlating lowered IQ with levels of fluoride in the water, the authors found a correlation
between lowered IQ and fluoride levels in children's blood."
For the study, researchers evaluated 512 children ages 8-13 in two Chinese villages,
one village with higher than average fluoride levels and the other with lower than
average fluoride levels. After aCGOunting for external variables like lead exposure, iodine
deficiency and other conditions that might affect brain health, the team still found that
the number of higher intelligence children in the low fluoride community was 350
percent higher than the number in the high fluoride community.
"I have argued in this paper that desirable effects of systemically administered fluoride
are quire minimal or perhaps even absent altogether."
SOURCE: Leverett DH. (1991). Appropriate uses of systemic fluoride: considerations
for the '90s. Journal of Public Health Dentistry 51: 42-7.
"It, therefore, becomes evident that a shift in thinking has taken place in terms of the
mode of action of fluorides. Greater emphasis is now placed on topical rather than on
systemic mechanisms....
SOURCE: Wefel JS. (1990). Effects of fluoride on caries development and progression
using intra-oral models. Journal of Dental Research 69(Spec No):626-33;
"[E]vidence has continued to accumulate to support the hypothesis that the anti-caries
mechanism of fluoride is mainly a topical one."
SOURCE: Carlos JP. (1983) Comments on Fluoride. Journal of Pedodontics Winter.
135-136.
"In this study we found a significant dose-response relation between fluoride level in
serum and children's IQ," wrote the study authors.
Though there have been numerous studies over the years the identify fluoride as a
neurotoxin, most mainstream medical professionals in the U.S. have ignored them and
continue to support water fluoridation. But the evidence continues to mount, and sooner
or later the medical community will have to come to grips with the truth about fluoride.
"Until recently most caries preventive programs using fluoride have aimed at
incorporating fluoride into the dental enamel. The relative role of enamel fluoride in
carles prevention is now increasingly questioned, and based on rat experiments and
reevaluation of human clinical data, it appears to be of minor importance... [A]ny method
which places particular emphasis on incorporation of bound fluoride into dental enamel
during formation may be of limited importance."
SOURCE: Fejerskov 0, Thylstrup A, Larsen MJ. (1981). Rational Use of Fluorides in
Caries Prevention: A Concept based on Possible Cariostatic Mechanisms. Acta
Odontologica Scandinavica 39: 241-249.
"This should be the study that finally ends water fluoridation," explained Tara Blank,
Ph.D., Science and Health Officer at FAN. "Millions of American children are being
exposed unnecessarily to this neurotoxin on a daily basis. Who in their right minds
would risk lowering their child's intelligence in order to reduce a small amount of tooth
decay, for which the evidence is very weak."
Study: Fluoridated water causes brain damage in children
Thursday, December 23, 2010 by: Ethan A. Huff, staff writer
(NaturaINews) A new study pre-published in the journal Environmental Health
Perspectives confirms that fluoridated water causes brain damage in children. The most
recent among 23 others pertaining to fluoride and lowered IQ levels, the new study so
strongly proves that fluoride is a dangerous, brain-destroying toxin that experts say it
could be the one that finally ends water fluoridation.
"This is the 24th study that has found this association," explained Paul Connett, Ph.D.,
director of the Fluoride Action Network (FAN). "[S]ut this study is stronger than the rest
because the authors have controlled for key confounding variables and in addition to
22
Water Fluoridation:
a Review of Recent Research and Actions
Joel M. Kauffman, Ph. D.
ABSTRACT
Fluoridation of drinking water began 60 years ago In the Untted
States, and It continues In 60% of public water supplies In tha
country today. Much of Australia, Canada, Ireland, and New
Zealand have fluoridated watar, but most developed non-English
speaking countries have rejected this practice as nonbeneflclal and
possibly harmful.
Current fluoridating agants, sodium hexafluoroslllcate and
hexafluorosllicic acid, which replaced sodium fluoride by 1980,
dlfler from the calcium fluoride In naturally fluoridated water, which
was the basis for clelms of tooth decay prevention In early
epidemiologic studies. Studies reported In the past 15 years
support only possible slight benefits from water fluoridation for the
deolduous teeth of 5-year-old children, although topical fluoride
treatments may be effective.
Harmful effects may Include bone and tooth fractures and
Increased cancer rates.
Complex legal maneuvars have been used In an effort to
prevent or stop fluoridation. The case against It has been weakened
by opponents' condemnation of all organofluorlne compounds.
Individuals can use several methods to remove fluoride from
water,
Essential Chemistry
Fluorine (F, or F-F) is clement #9 in the Periodic Table. The
fluoride ion (F), which has one negative charge, must be
accompanied by a cation such as sodium (N a J, as in sodium fluoride
(Na 'p' or NaP). Other inorganics, such as liquid hydrofluoric acid
(HF, often called hydrogen fluoride as a gas), hexafluorosilicic acid
(H,SiF J, and compounds with a P-F bond, such as the sodium
monofluorophosphate (Na'pO,F) ~ed in toothpaste, as well as
organics, such as methansulfonyl fluoride (CH,SO,F) and acetyl
fluoride (CH,COF), also fonn F' in water or alkali.
The trifluoromethyl group (CF,-) or the fluorophenyl group
(FC.H,-) are often incorporated into drug molecules to make them
more resistant to being metaholized. Organic polymers (Teflon)
and refrigerants with -CF,- groups are usually extremely stable
both chemically and thennally.
Brief History of Fluoridation
By the early 1900s it was noticed that inhabitants of some areas
of the United States, especially parts of Colorado and Texas, had
mottled teeth (dental fluorosis), and that children with fluorosis
tended to have fewer cavities,' Usually the natural mineral fluorite)
calcium fluoride (CaF,), is the source offluorideion.
Industries that produced large quantities of fluoride byproducts
were especially interested in this effect and have been accused by
38
antifluoridation activists of promoting water fluoridation as a
method of toxic waste disposaL'" Infonnation conceming the
quantities of the waste and the proportion used in fluoridation has
been unobtainable. The purported value of fluoridation for dental
health has, however, served to mitigate concerns al)outthe toxicity
offluoridewastes.
The Manhattan Project made use of uranium hexafluoride gas,
fluoroorganic lubricants for metal bearings, and other fluorine-
containing materials. Aluminum production, which increased
greatly in World War II, utilized cryolite (Na,AIF.). Zinc and
fluorocarbon production also soared with emissions of fluoride ion
or its precursors.
An Alcoa-sponsored biochemist, Gerald J. Cox, fluoridated
some laboratory rats in a study and concluded that fluoride reduced
cavities, writing that: "The case should be regarded as proved.'~
On Sept 29, ] 939, at a meeting of the American Water Works
Association in Johnstown, Pa., '"...Cox proposed that America
should now consider adding fluoride to the public water supply.'"
In the 1940s, certain major figures in the Manhattan Project and
in fluoride-waste-producing industries succeeded in using some
epidemiologic studies, now discredited,' to allow public water
supplies to have sodium fluoride added in order to prove that ] ppm
of fluoride ion would "prevent tooth decay in children." None of
these or later studies followed other dental or medical outcomes of
fluoride consumption over long periods, a flaw that remains in
many medical trials to this day.'
Henry Trend]ey Dean, D.D.S., a U.S, Public Health Service
researcher, at first opposed the addition of fluorides to city water
supplies because of toxicity. He later cbanged his mind, perhaps
believing that mottled teeth were a small price to pay for less decay,
or perhaps for other reasons. He later became the first Director of
the National Institute of Dental Research (NIDR), and then, in
] 953, atop official of the American DentalAssociation (ADA), two
organizations that remain unshakably committed to fluoridation.'
They claim the credit for the drop in tooth decay in the United States
during the past 50 years.
Once opposition by professionals was overcome, largely
through theADAand NIDR, the selling offluoridation to the public
was aided by hiring Edward L. Bernays, often called "the father of
public relations," who had been hired earlier by the tobacco
industry to persuade women to take up smoking.'
Fluoridation with sodium fluoride (NaF) was begun in the
United States in 1945, Today, fluoridation uses hexafluorosilicic
acid (H,SiF,) and its sodium salt (Na,SiF,) almost exclusively.
These are not pure, but recovered in crude fonn by scrubbing the
gaseous emissions from the treatment of pbosphate ores with
sulfuric acid. They contain variable amounts of lead, arsenic,
beryllium, vanadium, cadmium, and mercury.) Because of this
change in fluoridation agents, old studies based on the use of
natural calcium fluoride or on chemically pure sodium fluoride are
irrelevant, even had they been done correctly. Calcium is a strong
Journal of American Phy.lclans and Surgeon. Volume 10 Number 2 Summer 2005
12 ..
tl a.
!l i
:2 10 100
0 7.
Iii 0.
.s:::
0. 80 '5 i 6.
~ .e
'0 " 5.
S 7 I: E
'0 .. .
" 6 I: ~ ..
~ 0
0 5 1il
" '0 :;; 30
'0 4 '1: 0
'0 0 #-
" 2.
" 3 ..
.0 E ,.
E i=
" *'
Z t
0 .5 1.0 2.0
1930 1940 t950 ppm Fluoride
Agure 1. Tooth decay rates In 5-year-old children Oeft scale) va. water
fluorIdation percentage (right scale) and fluoride toothpaste percentage
(right scale) . From Colquhoun,' cited In Groves,' reprinted with permission.
Figure 2. Study of tooth decay In 29.000 elamantary schoolchildren In
Tucson, Ariz., VB. fluoride content of their drinking water. Reprinted from
Judd., wIth permission.
antagonist of fluoride, reduces its concentration in plasma, and
inhibits its absorption from the intestine.'
Fluoridation at I ppm fluoride reached its current extent by
1965. The proportion of fluoridated public water supplies is about
60% in the United States, 66% in Ireland, 55% in Canada, and 10%
in England. Australia and New Zealand also use fluoridation
extensively. At present almost none of the public water supplies in
Austria, Gennany, Luxemburg, Denmark, Finland, Norway,
Sweden, the Netherlands, Switzerland, France, Italy, Belgium,
Switzerland, Spain, Hungary, Portugal, Greece, Japan, and China
are fluoridated. About half of these countries tried fluoridation, saw
no benefit, and stopped it.'
U.S. studies on the toxicity of fluorine compounds, not
necessarily the ones used to fluoridate water, have reportedly been
suppressed, classified, censored, and removed from the National
Archives.' Some of this activity has been traced to Harold
Carpenter Hodge, Ph.D., a biochemist and toxicologist at the
University of Rochester, where he supervised experiments for the
Manhattan Project involving the injection of unsuspecting
hospital patient. with uranium and plutonium compounds. He
later became chairman of the National Research Council's
Committee on Toxicology and the leading promoter of
fluoridation in the United States during the Cold War. In 1953,
Hodge, using data from a European study,' estimated that the
amount of daily fluoride intake for 10-20 years that would not
cause crippling skeletal fluorosis was 20-80 mg/day. It was later
found that he had confused mglkg with mg/lb. An American
antifluoride campaigner, Darlene Sherrell, used the same
European study from] 93 7to estimate that skeletal fluorosis might
be avoided with intakes of no more than 10-25 mg/day.'
In ] 975, the U.S. Food and Drug Administration (FDA)
explicitly designated fluoride as "not generally recognized as safe"
and pennitted no fluoride whatsoever to be added to food or to over-
the-counter dietary supplements. Nevertheless, the Department of
Health, Education and Welfare (now Health and Human Services)
exempted fluoridated water from this ban, including fluoridated
water used to process food. I
In ]985, the U,S. Environmental Protection Agency (EPA) set4
ppm (up from 2 ppm) as the safe level for fluoride in drinking water
and prevailed in a lawsuit challenge.'
Journal of American Physicians and Surgeon. Volume 10 Number 2 Summer 2005
While the ADA, the Centers for Disease Control and Prevention
(CDe), and the NIDR of the National Institutes for Health (NlH)
still support fluoridation, some 17 U.S. organizationa have
withdrawn their support since 1990, including the American
Academy of Allergy and Immunology, the American Academy of
Diabetes, the American Cancer Society, the American Diabetes .
Association, the American Nurses Association, the American
Psychiatric Association, the National Kidney Foundation, and the
Society of Toxicology, '
Discussion of the scientific studies on fluoridation, as presented
in the following sections, has been neglected by most of the media
in the United States. The unique journat Fluoride is not covered by
PubMed. Michael Easley, M.P,H., national spokesman on
fluoridation for the ADA, posted the following on the internet for
dentists in 1996: .....anti-f1uoride cultists will not be dissuaded by
the truth.... Let them spew their garoage, ignore them, and go on
with your discussions as if they weren't there.... [T]heir twisted
minds have accepted the notion that it is OK to lie, slander, libel,
exaggerate, misquote.... [Slee what kooks they really are.'" Some
of the purported "lies" are presented in the next scctions.
Does Water Fluorldalion Prevent Tooth Decay?
Dean ran the first trial offluoridation in Grand Rapids, Mich., in
] 945, declaring it a success in comparison with nonfluoridated
Muskegon, Mich. Since that time, he twice confessed in court that
statistics from the early studies were invalid.'
Newburgh, N.Y., nexllo be fluoridated in 1945, was compared
with Kingston, N.Y., as a control. Early reporta were favorable. But
by] 989 workers at the New York State Department of Health found
a difference of less than ] fewer teeth decayed in 7-14-year-old
children in Newburgh, favoring fluoridation. And by 1995
children's teeth in Kingston hed slightly leas tooth decay and half as
mucb damage from fluoride.' This negative result was possibly
caused by a change in the fluoridation agent, or possibly by more
accurate reporting.
North Shields, England, has no natural fluoride in ita water,
while South Shields has 1.4 ppm. While children of the same age
had fewer decayed teeth in fluoridated South Shields, it was noticed
that the onset of decay was merely delayed 3 years.' This finding
39
..
..
r 60
..
ii..
.
! ..
~
~ 30
2'
Dec.y Incr.... with 1 ppm fluoride Incr.... = 7%
10
.5
1.0 ppm Fluoride 2.0
Agure 3. Study of toolh decay In 22,000 Japenese schoolchildren vs.
Ruorlde content of their drlnldng water. Reprinted from Judd, I with
permission.
..
..
f ..
= 50
i
! ..
l!
:c
0 JO
..
2.
J.O
.S
1.0 2.0
ppm Fluoride
J.o
Figure 4, Study o!tooth decay In 400,000 Indian schcolchlldren vs. fluortde
cQntent efthalr drinkIng water. Reprinted from Judd, I with permission.
may invalidate the early Michigan and New York trial results and
confirm the findings hy Yiamouyiannis' that fluoride lowers decay
of deciduous teeth only.
A favorahle report on fluoridation from New Zealand was
found to be biased by the deliberate choice of the nonfluoridated
communities with the highest tooth decay rate in comparison with
the two fluoridated communities with the lowest decay rates, When
all decay rates for all children in that area of New Zealand were
compared, there was no difference with respect to fluoridation.'
Also, in New Zealand the numh~ of decayed teeth per 5-yesr.old
child has decreased stesdily from 12 teeth in 1930 to 3 teeth in 1990.
Neither the introduction of fluoridated waler nor fluoridated
toothpaste changed the downward slope of the graph of decay (see
E'igure I). Because of this, rolm Colquhoun, appointed to promote
fluoridation in New Zealand, now opposes it'
According to World Health Organization (WHO) figures, the
most fluoridated country in the world, Ireland al66%, does not have
the least tooth decay, The five countries with less tooth decay
(Finland, Denmark. UK, Sweden, and the Netherlands) had little or
no water fluoridstion (the rate was 10% in the UK),'
Chile began fluoridating water in 1985, but Slopped it when the
average of6.0 decayed teeth per 12-year-old child, which dropped
to 5.3 by 1991,increased t06.7in 1995.'
A study of29,OOO elementary school children in Tucson, Ariz.,
.howed much more tooth decay when the fluoride level in the
:Irinking water was higher (see Figure 2).' The extremes ranged
from 6% of children with. some decay in areas with water
containing 0.0 ppm fluoride to 40% of children with some decay in
!U'Cas with water containing 1.0 ppm fluoride.
Fluoridstion was forced on parts of rapan during its occupation
by the United States. A study reported in 1972 on 22,000
,choolchildren (median age 13, range 5-17) showed 90% with
lame tooth decay at 0.0 ppm fluoride. This high number. was
,ttributed to the absence of calcium in the water. A minimum in
:Iecay (38% of children) occurred with 0.3 ppm fluoride and more
::s1cium content. This increased to 44% at 1.0 ppm fluoride and
further to 55% with decay at 3,0 ppm fluoride and still more
calcium (see Figure 3). rapan subsequently reduced the maximum
,Uowed fluoride level to 0.05 ppm.'
The largest study on fluoridation and footh decay involved
400,000 students (median sge 13, range 5-17) in India (see Figure
'0
4). The percentage of children with decay was 23% at 0,0 ppm F;
35% at 0.7 ppm; and 75% at 2.75 ppm." Other studies over a 30-
year period prompted Teotia and Teotia to write: "...dental caries
were caused by high fluoride and low dietary calcium intakes,
separately and through tbeir interactions.". The only practical and
effective public measure for the prevention and control of dental
caries is the limitation of the fluoride conteot of drinking water to
<0.5 ppm, and adequate calcium...(> I glday). ",
Over a 20-year period from 1965-1985, the average number of
decayed, missing, or filled teeth (DMFl) in 12-year-old children
dropped by 50% in the United States, Proponents of fluoridation
and vendors of fluoridated dental rinses and toothpastes took credit
for this. However, the following nonfluoridated countries had even
greater reductions in DMFT during similar 20-year periods: the
Netherlands, 72%; Sweden, 82%; Finland, 98%....No adjustments
were made for some of the obvious confounders, such as
consumption of refmed carbohydrates and the other mineral
conIenls of water supply. .. NativeAmericans on reservations in this
country have by farthe most decay of any ethnic group in the United
Ststes, despite forcible fluoridation of their water and free dentistry
for more than 50years.'
Tbere was an overaU increase in children 5-17 years old
(median age 13) with tooth decay after initiation of water
fluoridation. The tooth decay rate of children living in
nonfluoridated American cities with average decay rates was 65%
with natural fluoride levels of 0.4 ppm fluoride. This increased to
67% with fluoridation to I ppm. In high-decay cities, the decay rate
of71 % with 0.4 ppm fluoride increased to 75% with fluoridation to
I ppm, according to a 1990 study of39,207 children, aged 5-17, in
84 areas in the United States.... Reinterpretation of data from a
1986-1987 study by dentists trained by the NIDR sbowed that the
decay rate of deciduous teeth in 5-year-olds was significantly lower
in fluoridated areas (1.5 teeth per child) than in nonfluoridated
areas (2.0 teeth per child), as shown in Figure 5.' However, the
decrease was no longer significant in 6-year-olds, and did not exist
in children age 7 or older. Moreover, decay rates in permanent
teeth in children aged 5-17 did not differ significantly at any age in
areas with no, partial, or total fluoridation of water supplies (see
Figure 6),' Earlier, widely accepted claims of caries reduction of
60% by fluoridation, published in the Journal of the American
Journal of American Physlclan..nd Surgeon. Volume 10 Number Z Summer 200S
2.50
2.00
Decayod tJ
1.50
and fillod OPF
doclduoo
- (DF1) 1.00
per child "'F
0.50
s 7 8 9 fO If f2 13 f4 15 18 f7
Ago
Figure 5. Decay of deciduous teeth In 39,207 white children In 84 areas In
the United States. F, fluoridated; PF, partially fluoridated; NF,
nonfluorldated areas. Reprinted from Ylamouylannls,' with permission.
A
e
.5
Decayed,
mIulng, 4 [;J
end filled
pennonent 3 ONF
-
(DMF1) per 2 .PF
child
0
5 8 7 8 81011121314151817
Age
B
e
5
Decayed, ~
miNIng, 4
end finod
pennanent 3 ONF .
teeth
(DMF1) per 2 .PF
child
0
5 e 7 e 91011121314151817
Age
Agure 8. Decay of permanent teeth in 39,207 white children In 84 areas In
the United States. F, fluoridated; PF, partially fluoridated; NF,
nonfluorldatad areas. Reprinted from Y1amouylannls,' with permissIon.
Journ.1 of American Pby.lel.n.and Surgeon. Volume 10 Number 2 Summer 2005
MedicalAssociation and the JOl/rnal of Dental Research using data
from the same source, were not substantiated by Yiamouyiannis.
On tbe basis of observational studies, Hardy Limeback, B.Sc.,
Ph.D., D.D.S., head of the Department of Preventive Dentistry for
the University of Toronto and President of the Canadian
Association for Dental Research, announced a reversal of his
earlier profluoridation views. In an April 1999 interview,
Limeback, once the primary promoter of fluoridation, stated:
"Children under three should Dever use fluoridated toothpaste or
drink fluoridated water. And baby formula must Dever be made up
using Toronto tap water. Never." He remarked that l~ancouver,
never fluoridated, has a lower qavity rate than Toronto, which has
been fluoridaled for36years [through 1999]....."
In a recent article in the Journal of the American Dental
Association, Featherstone wrote that: l'Fluoride incorporated
during tooth development is insufficient to playa significant role in
caries protection. "IJ In fact, fluoridation of municipal water
supplies increases tooth decay overall in some studies and has not
been demonstrated to be effective in prevention of decay in the
most convincing studies, such as those of Colquhoun, Kalsbeek,
and Yiamouyiannis, he concluded.
The effects of fluoridation were praised in a 2004 book,
Fll/orides in the Environment: Effects on Plants and Animals by
L.H. Weinstein and A. Davison, but expert reviewers considered
the book 10 be blatantly biased,"
Fluoride Supplements and Topical Application
No adequate evidence for the effectiveness of fluoride
supplements as pills or drops, or topical application of fluoride by
means of toothpaste or dental rinses, had ever been presented.'
Colquhoun's study concluded there was also no benefit from
fluoridated toothpaste.'
UUntil recently, the rationale for most caries preventive
programs using fluoride was to incorporate fluoride into the
dental enamel. The relative role of enamel fluoride in caries
prevention is now increasingly questioned, and based on rat
experiments and reevaluation of human clinical data, it appears to
be of minor imparlance." ..," In fact, "... the prevalence of dental
caries in a population is not inversely related to the concentration
of fluoride in enamel, and a higher concentration of enamel
fluoride is not necessarily more efficacious in preventing dental
caries..... Limeback found on reexamining the literature that
topical effects offluoride on newly erupted teeth were more likely
to explain any benefit of fluoride than swallowing it in water or
pill form." In vitro experiments showed that topical fluoride
might protect tooth enamel by inhibition of bacterial metabolism,
limiting acid generation,l1
Is Fluoridation Sare for the General Population?
In a report authored by Perry D. Cohn, Ph.D., M.P.H., for the
New Jersey Department of Environmental Protection and the New
Jersey Department of Health, the rates of bone cancer in fluoridated
aod noofluoridated areas were compared. Both by counties or by
municipalities, males under the age of 50 had 3 to 7 times as many
bone cancers in the fluoridated areas. Males 10-19 years old fared
the worst. II An external review panel found no serious flaws with
the study.
4'
Cancer rates in the ten largest fluoridated cities in the United
States and in the ten largest nonfluoridated cities were found to be
the same before fluoridation began, After 20 years, tbe ten
fluoridated cities had 10% more cancer deaths than the
lontluoridated cities. The cancers were found in the tongue, mouth,
pharynx, esophagus, stomach, colon, rectum, pancreas, larynx,
bronchi, and lungs,l
Hip fractures in two cities in Utah were compared: fluoridated
Brigham City and nonfluoridated Cedar City. In the fluoridated (1
ppm) city, the hip fracture rate was twice as high as in the
nonfluoridated city, in women around age 75. Men aged 80-85 also
had twice the hip fracture rate in fluoridated Brigham City." The
insidious nature of fluoride toxicity is that it does not cause bone
density toss as found in osteoporosis by bone scans, but causes an
increase in bone density with no clinical benefit. Fluoride makes
both bones and teeth more brittle.'" Early reports of supposed
benefits of fluoridation to bone were quoted without citing later
corrections orretractions.1t
Dr. A. K. Susheela oflhe India Instiiute of Medical Sciences in
New Delhi found that fluoride severely disrupts formation of bone
matrix, inhibiting the hardening of bones. She found that about 20
countries in the world have serious health problems due to eXCess
fluoride. Her work showed that high levels of fluoride in drinking
water were associated with birth defects, stillbirths, and early
infant mortality.'
Excess fluoride may also have detrimental neurologic effects.
Rats given sodium fluoride in their drinking water at a concentration
producing a plasma level of fluoride equivalent to that found in
humans consuming water with 4 ppm of fluoride developed
symptoms resembling attention deficit-hyperactivity disorder. "
Gerard F, Judd, Ph.D., lists 113 ailments reportedly caused by
fluoride, all with literature citations to studies, of which 13 were
double-blinded.' So far, there are no known naturally occurring
compounds of fluorine in the human body." Fluorine is not listed as
even a trace element in whole body assays," showing that there is
no requirement foritat all.
Water fluoridated to J ppm fluoride is not safe in the general
population. How much of the toxicity results from the arsenic and
heavy metal contamination in the newer fluoridating agents is not
yet known. Additionally, certain populations such as patients with
diabetes or renal impairment are at increased risk, especially iflhey
drink more than average amounts of water." A study comparing 25
young adults with fluorosis against 25 matched controls showed
very significant impairment of glucose tolerance in those with
fluorosis, which, however, was reversible when water with low
fluoride levels was given."
How Antlfluoridationists Have Weakened Their Case
Groups such as Parents for Fluoride Poisoned Children (pFPC),
based in British Columbia, Canada, and the National Pure Water
Association Ltd. in the UK justifiably attempt to prevent
fluoridation of water. Unfortunately, they suffer from
chemophobia, which is not only 8 fear of all "chemic.ls," but a fear
of consulting with chemists. As . result, they list any material that
contains fluorine in any form as a danger by claiming that it
contains "fluoride," and certain book authors and many websitc
.uthors opposing fluoridation repeat this unsound assertion. The
list includes Teflon and Tefal non-stick pan co.tings, fluorocarbon
42
propellants, .nd many drugs. Drugs that contain fluorine include:
fluoxetine (Prozac), ciproflo".cin (Cipro), flunitrazepam
(Rohypnol), fluconllZole (Diflucon), f1uticasone (Flixonase or
Flixotide), trifluoperazine (Stelazine), flucoxacillin (Floxapen),
cerivastatin (Baycol), cisapride (Propulsid), astemizole
(Hismanal), and fenfluramine (Pondimin). In f.ct, none of these
materials either contain fluoride ion or are metabolized to generate
any significant amount of fluoride ion. All contain the very stable
carbon-fluorine hond in the form of trifluoromethyl (CF,-),
difluoromethylene (-CF,-), fluoroalkane (-CHF-), or
fluorophenyl (FC,H,-) groups. The fluoro groups are chosen for
the drugs to retard their metabolism, increasing the duration of
effective drug levels in the body. Judd, a chemist, did not make the
mistake of confusing fluorine with fluoride in his book.'
For Teflon, the maximum continuous service temperature is
listed as 2600C or 5000F in the Chemical Rubber Co. Handbook of
1976-]977. Overheating Teflon may produce.n irritant, perhaps
perfluorooctanoic acid, but tbe irritant is unlikely to be fluoride ion.
Asked for evidence on the toxicity of Teflon, the scientific .dvisor
to one ofthe antifluoridation groups sent cit.tions to four papers on
the decomposition of Teflon by ionizing radiation. Clearly this is
irrelevant to ordinary use in cooking.
Fluorocarbon refrigerants and propellants such as R]2, and
flourine-containing general anesthetics such as halothane and
methoxyflurane, are metabolized very slowly or not at all.
However, some of the fluorine in the general anesthetics enfluranc.
desflurane, and isoflurane is metabolized to fluorideion.J'
Asked for evidence on the toxicity of fluorinated drugs, the
scientific advisor to one of the antifluoridation groups provided
citations to 13 papers. Ten of the 13 were published in 1952 or
earlier, Some concerned analytical methods and methods of
synthesis of f1uorine-cont.ining compounds. Citations from the
] 930s showed the toxicity of sodium fluoride from its interference
with thyroid hormone biosynthesis." Anotber from 1949 showed
that that 3-f1uoro-5-bromo(or iodo)tyrosine waa toxic in mice, and
five other f1uoropbeny] compounds less so." The toxicity of 3-
f1uorotyrosine and 3,5-difluorotyrosine was confirmed, including
in humans,'J..l1 but this is a special case in which these amino acid
derivatives interfere with thyroid hormone biosynthesis.
Ciprofloxacin, like all drugs, is associated with some
toxicity-but not from fluoride. The scientific advisor to one of the
antifluoridation groups cited a report showing elevated serum Bnd
urine levels of fluoride in cbildren after administration of this
drug." The actual elevation of fluoride in serum was from 0.08 to
0.21 ppm in 12 bours, and could not .ccount for more than a fraction
of the fluorine (23 mg) in the 400 mg doses used of ciprofloxacio;
moreover, there was no follow-up measurement. The elevation of
fluoride in urine from 0.97 to 1.]2 ppm after a week was not
statistically significant. The .uthors did not try to measure
f1uorin.ted met.bolites or unchanged drug, and after MRI sc.nS
and about 2 yesrs of follow-up by physical examinations, they
pronounced short courses of ciprofloxacin safe in children.
Although ciprofloxacin liberates fluoride under UVB illumination
in vitro, it is metabolized in vivo mostly by hydroxyl.tion and N-
sulfation, not hy loss offluorideion."
The risk of rhabdomyolysis, the major toxicity of the statin
drugs, is about the same with atorvastatin and pravastatin, which
contain fluoro groups, and simvastatin, which does not." A group at
Duke University Medical Center searched the literature from
Journal of American Physician. and Surgeon. Volume 10 Number2 Summer 2005
November 1997 to February 2002 to find 60 cases of st. tin-induced
memory loss, of which 36 were due to simvBstatin_ 23 to
atorvastatin, and ] to pravastatin.J~ Clearly, there is no correlation
with the presence ofa fluoro group.
Thus, the scientific evidence presented by members of certain
antifluoridation groups and by othera does not support their
assertion that all fluorinated organic compounds are toxic because
they contain fluorine. The case against fluoridation needs to be
made solely on the basis of the effects of fluoride ions and their
precursors in drinking water.
Who Benell,. from Fluoridation?
Groves's book does not explain how water fluoridation can be
continued despite all the evidence against it. Bryson's book,
bowever, suggested tbat m.ny corporations benefit. These
included; US Steel, DuPont,Alcoa,Alc.n, Reynolds Met.ls, Kaiser
Aluminum, Pennsalt Chemicals (now ELF Atochem), Allied
Chemical, and the Florida phosphate fertilizer industry.
Philadelphia, Pa., obtains its hexafluorosilicic acid from Solvay
Fluoride. A dozen other manufacturers ofhexafluorosilicic acid are
listed on an antifluoridation website sponsored by the Fluoride
Action NetworkPesticideProject. Itis stated that industry is able to
profit by selling] 55,000 tons of fluoride byproducts per year for
water fluoridation instead of having to dispose of them as toxic
waste at great expense.) Another consideration might be avoiding
enormous tort liability th.t could be incurred if toxicity were
officially recognized (especi.lly in the.bsence of the EPA's "s.fe"
levelof4ppm).
How Can Fluoridation of Water BeStopped?
Despite evidence for negligible benefit and considerable risk,
the ADA, the American Medical Association (AMA), theCDC, the
NIDR, the British Fluoridation Society, the WHO, and otbers have
not retrested from their support for fluorid.tion. Bec.use
opposition has been margin.lized, primarily by ignoring it, the only
route to change appears to be througb litigation.
Had there been only one or two failed lawsuits over the years,
one might conclude that the antifluoridation cause is hopeless. In
fact, lawsuits have met with some success. Antifluoridation
lawsuits were argued by attorney Jolm Remington Graham in non-
jury trials in Pittsburgh, Pa., in 1978; Alton, Ill., in 1980; and
Houston, Tex., in 1982. In sll c.ses, the judges found for the
plaintiffs and issued injunctions .gainst fluorid.tion on the grounds
that it caused cancer and other ailments in humans. Based on the
injunction in the Pittsburgh c.se, the Province of Quebec, Canada,
stopped f1uorid.ting. However, .ll three cases were overturned on
appeat on trivial legalistic grounds. In spite of the appellate actions,
however, the judicial findings of f.ct, namely that fluoridation is .n
unreasonable risk to public health, rem.in on the record and
uncb.llenged. After the AIton c.se, an attorney for the ADA, wbo
w.s a member of the Rules Committee of the Illinois Supreme
Court, told an audience that he was the one wbo had secured a stay
oftbe execution of the nonfluorid.tion injunction."
There h.ve been five lawsuits resulting in judgments against
fluorid.tion: two in Pennsylvani. and one e.cb in Indiana, Ohio,
.nd Missouri. None were decided on the merits offluoridation, only
on leg.1 teclmicalities."
Joprnal of American Phy.lclan. and Sureeon. Volume 10 Number 1 Summer 2005
Since fluorides have been shown in .ome studies to increa.e the
risk of cancer, addition of any of them in any aIDount to water
viotated the Delaney Clause of the ]958 Amendment to the Food,
Drug, and eoametic Act of 1938," The Delaney Clause wa.
repealed in ] 996 with passage ofthe Food Quality ProtectionAct. A
stronger argument based on the c.ncer issue is that adding fluoride
violates the EPA policy on setting drinking water st.ndards under
the Safe Drinking Water Act. Under this provision, the Maximum
Contaminant Level Goal (a pure bealth-bssed standsrd) for
carcinogens is zero, so adding any fluoride should be banned. This
is apparently why the 1990 National Toxicology Program biosss.y
on sodium fluoride was "revised" so that the findings went from
Uclear evidence of carcinogenicity" to "equivocal" evidence.
Without that cbange, the fluoridation program would have been
unsustainable under law. Bottled water in a local .upc1'DI8rlcct
sports an FDA-style food l.bel, making it a food under the I.w. The
FDA position that fluoride is neitber an ellenti.l nor probably
essential nutrient and is not safe at .ny level is inconsistent with its
allowing fluoride to be .dded to. food.' .
Fluoride in water is .lao a medication that ia forced upon people
who do not want it. This is arguably. violation ofl.w, because in the
United States, people m.y no\ be medicated without their
permission. Fluoridation is different from chlorination of wster
because the chlorine is used to kill microbes, not to medicate people.
in Indi., the govemment constructed de fluoridation plants and
attempted to end sales of fluoridated toothp.ste, based on
Susheela's work on the toxicity of fluoride.' Unfortunately, in the
United St.tes, cl.ss-action lawsuits may be the only way to
influence municip.] .utborities, who ere operating on the basis of
old, erroneous information on which legal precedentreats.
Removal of Fluoride Ion from Tap Water
Since prevention or ending fluoridation of public w.ter supplies
is SO diffiGUlt. your patients may wish'" remove fluoride ion from
their drinking w.ter. Filters do not work because the diameter of a
fluoride anion is 0.064 run. Activated carbon "filtera" are not
effective, nor are water-.ofteners based on cation exchange resins
designed to take out calcium, magnesium, and iron, not anioDll. It
might bepossihle to make effective anion exch.ngers.
There are three effective methods: use of a cartridge contslning
activated alumina adsorbent, the most expensive because the
cartridge must be changed so often; reverse osmosi.; and
distillation, the least expensive method. Di.tillation costs sbout 7
cents per liter for electricity and about 2 cents per liter for
depreciation ofa diatiller costing $135 at Sears, assuming as-year
life. Distilled water is often passed through an activated csrbon
filter to removevol.tile orgsnics, .nd .erated forfl.vor,.....
Conclu.ions
Artificial fluoridation of drinking w.ler by municipalities at 1
ppm of fluoride ion probably does not reduce tooth decay, except
for a minor effect on deciduous teeth. Hexafluorosilicic acid .nd its
sodium s.lt, whicb cont.in other toxic substances because they ere
not purified, certainly have no significant benefit. ; ,
Proponents of fluorid.tion bave censored most media, ignored
intelligen' discussion of f1uorid.tion, slandered most opponents of
fluoridation, and overturned leg.l judgment. .gainst fluoridation in
~1
manner that demonstrates their political power. Many publisbed
tudies that hsd conclusions favoring fluoridation were later found
InsUpported by their I8W data.
There is evidence that fluoridation increases the incidence of
ancer, hip fractures, joint problems, and that by causing fluorosis it
""'ages both teeth and bones. Other medical problems may also
'ccur, including neurologic damage.
Antifluoridationists oompromise their credibility by
nwarranted assertions that many stable fluorine-containing
.aterials areharmful.
The EPA should set the enforceable Maximum Cootaminant
.evelat 0.4 ppm fluoride in drinking water,
The FDA should reverse its position on permitting sale of
,roducts containing fluoride that claim dental benefit without proof
ofsafety or .!fecti veness.
Fluoridation of municipal water should cease. Defluoridation
of naturally fluoridated water down to 0.4 ppm of fluoride should
,e mandated. Individuals should remove fluoride from their tap
-.ter iffluoridation cannot be stopped.
081 M. K8~ffmBn, Ph.D., Is Professor of Chemistry Emeritus at the
Inlverslty olll1e Sciences In Philadelphia, 600 S, 43rd St, Phllildelphla, PA,
9104-4495. E-mail: kaulfman@h.lc.org.
"'knowledgementa: Frances Eleanor HeckortPane, M.S.L.S.. and Aleyne
ills., M.D., edllad the manusorfpt and provided key relerencea, as did
1I000ael A. Pane, Jr.. J.D., LLM, and Laslle Ann Bowmen, A.M.L.S. Certain
;,v1ewers made Important contributions.
lole"tf_. contUct8 of Interest: The author has no 'financial Interest In
uorldatfon or alternate treabnents for publlo water supplies, or In any form
,fdolluortdatlcn.
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Jounal of American Phyllclaol and Surgeons Volume JO Number 2 Summer 2005