- Water fluoridation is a peculiarly American phenomenon.
It started at a time when Asbestos lined our pipes, lead was added to gasoline,
PCBs filled our transformers and DDT was deemed so "safe and effective"
that officials felt no qualms spraying kids in school classrooms and seated
at picnic tables. One by one all these chemicals have been banned, but
fluoridation remains untouched.
- For over 50 years US government officials have confidently
and enthusiastically claimed that fluoridation is "safe and effective".
- However, they are seldom prepared to defend the practice
in open public debate. Actually, there are so many arguments against fluoridation
that it can get overwhelming.
- To simplify things it helps to separate the ethical from
the scientific arguments.
- For those for whom ethical concerns are paramount, the
issue of fluoridation is very simple to resolve. It is simply not ethical;
we simply shouldn't be forcing medication on people without their "informed
consent". The bad news, is that ethical arguments are not very influential
in Washington, DC unless politicians are very conscious of millions of
people watching them. The good news is that the ethical arguments are buttressed
by solid common sense arguments and scientific studies which convincingly
show that fluoridation is neither "safe and effective" nor necessary.
I have summarized the arguments in several categories:
- Fluoridation is UNETHICAL because:
- 1) It violates the individual's right to informed consent
- 2) The municipality cannot control the dose of the patient.
- 3) The municipality cannot track each individual's response.
- 4) It ignores the fact that some people are more vulnerable
to fluoride's toxic effects than others. Some people will suffer while
others may benefit.
- 5) It violates the Nuremberg code for human experimentation.
- As stated by the recent recipient of the Nobel Prize
for Medicine (2000), Dr. Arvid Carlsson:
- "I am quite convinced that water fluoridation, in
a not-too-distant future, will be consigned to medical history...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."
- As stated by Dr. Peter Mansfield, a physician from the
UK and advisory board member of the recent government review of fluoridation
(McDonagh et al 2000):
- "No physician in his right senses would prescribe
for a person he has never met, whose medical history he does not know,
a substance which is intended to create bodily change, with the advice:
'Take as much as you like, but you will take it for the rest of your life
because some children suffer from tooth decay. ' It is a preposterous notion."
- Fluoridation is UNNECESSARY because:
- 1) Children can have perfectly good teeth without being
exposed to fluoride.
- 2) The promoters (CDC, 1999, 2001) admit that the benefits
are topical not systemic, so fluoridated toothpaste, which is universally
available, is a more rational approach to delivering fluoride to the target
organ (teeth) while minimizing exposure to the rest of the body.
- 3) The vast majority of western Europe has rejected water
fluoridation, but has been equally successful as the US, if not more so,
in tackling tooth decay.
- 4) If fluoride was necessary for strong teeth one would
expect to find it in breast milk, but the level there is 0.01 ppm , which
is 100 times LESS than in fluoridated tap water (IOM, 1997).
- 5) Children in non-fluoridated communities are already
getting the so-called "optimal" doses from other sources (Heller
et al, 1997). In fact, many are already being over-exposed to fluoride.
- Fluoridation is INEFFECTIVE because:
- 1) Major dental researchers concede that fluoride's benefits
are topical not systemic (Fejerskov 1981; Carlos 1983; CDC 1999, 2001;
Limeback 1999; Locker 1999; Featherstone 2000).
- 2) Major dental researchers also concede that fluoride
is ineffective at preventing pit and fissure tooth decay, which is 85%
of the tooth decay experienced by children (JADA 1984; Gray 1987; White
1993; Pinkham 1999).
- 3) Several studies indicate that dental decay is coming
down just as fast, if not faster, in non-fluoridated industrialized countries
as fluoridated ones (Diesendorf, 1986; Colquhoun, 1994; World Health Organization,
- 4) The largest survey conducted in the US showed only
a minute difference in tooth decay between children who had lived all their
lives in fluoridated compared to non-fluoridated communities. The difference
was not clinically significant nor shown to be statistically significant
(Brunelle & Carlos, 1990).
- 5) The worst tooth decay in the United States occurs
in the poor neighborhoods of our largest cities, the vast majority of which
have been fluoridated for decades.
- 6) When fluoridation has been halted in communities in
Finland, former East Germany, Cuba and Canada, tooth decay did not go up
but continued to go down (Maupome et al, 2001; Kunzel and Fischer, 1997,
2000; Kunzel et al, 2000 and Seppa et al, 2000).
- Fluoridation is UNSAFE because:
- 1) It accumulates in our bones and makes them more brittle
and prone to fracture. The weight of evidence from animal studies, clinical
studies and epidemiological studies on this is overwhelming. Lifetime exposure
to fluoride will contribute to higher rates of hip fracture in the elderly.
- 2) It accumulates in our pineal gland, possibly lowering
the production of melatonin a very important regulatory hormone (Luke,
- 3) It damages the enamel (dental fluorosis) of a high
percentage of children. Between 30 and 50% of children have dental fluorosis
on at least two teeth in optimally fluoridated communities (Heller et al,
1997 and McDonagh et al, 2000).
- 4) There are serious, but yet unproven, concerns about
a connection between fluoridation and osteosarcoma in young men (Cohn,
1992), as well as fluoridation and the current epidemics of both arthritis
- 5) In animal studies, fluoride at 1 ppm in drinking water
increases the uptake of aluminum into the brain (Varner et al, 1998).
- 6) Counties with 3 ppm or more of fluoride in their water
have lower fertility rates (Freni, 1994).
- 7) In human studies the fluoridating agents most commonly
used in the US not only increase the uptake of lead into children's blood
(Masters and Coplan, 1999, 2000) but are also associated with an increase
in violent behavior.
- 8) The margin of safety between the so-called therapeutic
benefit of reducing dental decay and many of these end points is either
nonexistent or precariously low.
- Fluoridation is INEQUITABLE, because:
- 1) It will go to all households, and the poor cannot
afford to avoid it, if they want to, because they will not be able to purchase
bottled water or expensive removal equipment.
- 2) The poor are more likely to suffer poor nutrition
which is known to make children more vulnerable to fluoride's toxic effects
(Massler & Schour 1952; Marier & Rose 1977; ATSDR 1993; Teotia
et al, 1998).
- 3) Very rarely, if ever, do governments offer to pay
the costs of those who are unfortunate enough to get dental fluorosis severe
enough to require expensive treatment.
- Fluoridation is INEFFICIENT and NOT COST-EFFECTIVE because:
- 1) Only a small fraction of the water fluoridated actually
reaches the target. Most of it ends up being used to wash the dishes, to
flush the toilet or to water our lawns and gardens.
- 2) It would be totally cost-prohibitive to use pharmaceutical
grade sodium fluoride (the substance which has been tested) as a fluoridating
agent for the public water supply. Water fluoridation is artificially cheap
because, unknown to most people, the fluoridating agent is an unpurified
hazardous waste product from the phosphate fertilizer industry.
- 3) If it was deemed appropriate to swallow fluoride (even
though its major benefits are topical not systemic) a safer and more cost-effective
approach would be to provide fluoridated bottle water in supermarkets free
of charge. This approach would allow both the quality and the dose to be
controlled. Moreover, it would not force it on people who don't want it.
- Fluoridation is UNSCIENTIFICALLY PROMOTED. For example:
- 1) In 1950, the US Public Health Service enthusiastically
endorsed fluoridation before one single trial had been completed.
- 2) Even though we are getting many more sources of fluoride
today than we were in 1945, the so called "optimal concentration"
of 1 ppm has remained unchanged.
- 3) The US Public health Service has never felt obliged
to monitor the fluoride levels in our bones even though they have known
for years that 50% of the fluoride we swallow each day accumulates there.
- 4) Officials that promote fluoridation never check to
see what the levels of dental fluorosis are in the communities before they
fluoridate, even though they know that this level indicates whether children
are being overdosed or not.
- 5) No US agency has yet to respond to Luke's finding
that fluoride accumulates in the human pineal gland, even though her finding
was published in 1994 (abstract), 1997 (Ph. D. thesis), 1998 (paper presented
at conference of the International Society for Fluoride Research), and
2001 (published in Caries Research).
- 6) The CDC's 1999, 2001 reports advocating fluoridation
were both six years out of date in the research they cited on health concerns.
- Fluoridation is UNDEFENDABLE IN OPEN PUBLIC DEBATE.
- The proponents of water fluoridation refuse to defend
this practice in open debate because they know that they would lose that
debate. A vast majority of the health officials around the US and in other
countries who promote water fluoridation do so based upon someone else's
advice and not based upon a first hand familiarity with the scientific
literature. This second hand information produces second rate confidence
when they are challenged to defend their position. Their position has more
to do with faith than it does with reason.
- Those who pull the strings of these public health 'puppets',
do know the issues, and are cynically playing for time and hoping that
they can continue to fool people with the recitation of a long list of
"authorities" which support fluoridation instead of engaging
the key issues. As Brian Martin made clear in his book Scientific Knowledge
in Controversy: The Social Dynamics of the Fluoridation Debate (1991),
the promotion of fluoridation is based upon the exercise of political power
not on rational analysis. The question to answer, therefore, is: "Why
is the US Public Health Service choosing to exercise its power in this
- Motivations - especially those which have operated over
several generations of decision makers - are always difficult to ascertain.
However, whether intended or not, fluoridation has served to distract us
from several key issues. It has distracted us from:
- a) The failure of one of the richest countries in the
world to provide decent dental care for poor people.
- b) The failure of 80% of American dentists to treat children
- c) The failure of the public health community to fight
the huge over consumption of sugary foods by our nation's children, even
to the point of turning a blind eye to the wholesale introduction of soft
drink machines into our schools. Their attitude seems to be if fluoride
can stop dental decay why bother controlling sugar intake.
- d) The failure to adequately address the health and ecological
effects of fluoride pollution from large industry. Despite the damage which
fluoride pollution has caused, and is still causing, few environmentalists
have ever conceived of fluoride as a 'pollutant.'
- e) The failure of the US EPA to develop a Maximum Contaminant
Level (MCL) for fluoride in water which can be scientifically defended.
- f) The fact that more and more organofluorine compounds
are being introduced into commerce in the form of plastics, pharmaceuticals
and pesticides. Despite the fact that some of these compounds pose just
as much a threat to our health and environment as their chlorinated and
brominated counterparts (i.e. they are highly persistent and fat soluble
and many accumulate in the food chains and our body fat), those organizations
and agencies which have acted to limit the wide-scale dissemination of
these other halogenated products, seem to have a blind spot for the dangers
posed by organofluorine compounds.
- So, while fluoridation is neither effective nor safe,
it continues to provide a convenient cover for many of the interests which
stand to profit from the public being misinformed about fluoride.
- Unfortunately, because government officials have put
so much of their credibility on the line defending fluoridation, it will
be very difficult for them to speak honestly and openly about the issue.
As with the case of mercury amalgams, it is difficult for institutions
such as the American Dental Association to concede health risks because
of the liabilities waiting in the wings if they were to do so.
- However, difficult as it may be, it is nonetheless essential
- in order to protect millions of people from unnecessary harm - that the
US Government begin to move away from its anachronistic, and increasingly
absurd, status quo on this issue. There are precedents. They were able
to do this with hormone replacement therapy.
- But getting any honest action out of the US Government
on this is going to be difficult. Effecting change is like driving a nail
through wood - science can sharpen the nail but we need the weight of public
opinion to drive it home. Thus, it is going to require a sustained effort
to educate the American people and then recruiting their help to put sustained
pressure on our political representatives. At the very least we need a
moratorium on fluoridation (which simply means turning off the tap for
a few months) until there has been a full Congressional hearing on the
key issues with testimony offered by scientists on both sides. With the
issue of education we are in better shape than ever before. Most of the
key studies are available on the internet and there are videotaped interviews
with many of the scientists and protagonists whose work has been so important
to a modern re-evaluation of this issue.
- With this new information, more and more communities
are rejecting new fluoridation proposals at the local level. On the national
level, there have been some hopeful developments as well, such as the EPA
Headquarters Union coming out against fluoridation and the Sierra Club
seeking to have the issue re-examined. However, there is still a huge need
for other national groups to get involved in order to make this the national
issue it desperately needs to be.
- I hope that if there are RFW readers who disagree with
me on this, they will rebut these arguments. If they can't than I hope
they will get off the fence and help end one of the silliest policies ever
inflicted on the citizens of the US. It is time to end this folly of water
fluoridation without further delay. It is not going to be easy.
- Fluoridation represents a very powerful "belief
system" backed up by special interests and by entrenched governmental
power and influence.
- Paul Connett.
- All references cited can be found at