Moderators: Elvis, DrVolin, Jeff
With nearly 200 million Americans drinking fluoridated tap water these days, is it time to ask ourselves, do we really need the fluoridation?
Fluoridation and the Red Scare
I grew up in the 1950s when municipalities across the nation began fluoridating their drinking water to promote dental health. My parents thought it was a good idea and so, so did I. But I remember hearing friends say their parents were against it, some even claiming that fluoridation was a communist plot to undermine capitalism by poisoning our water supply.
(This communist myth was carried to extremes in Stanley Kubrick’s 1964 classic black comedy Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb in which a mad general, Jack D. Ripper, played by Sterling Hayden, cites the fluoridation of water as a primary motive for a nuclear strike against the Soviet Union.)
While back then such a communist plot seemed pretty scary, now it just seems far-fetched. But today there are people, thoughtful people, who, despite decades of living with fluoridated tap water, oppose it. What’s the fear now and is it grounded in reality? I decided to find out.
We Fluoridate Water in the Name of Healthy Teeth
We add fluoride [pdf], a reduced form of the naturally occurring fluorine, to water (which contains some amount of fluoride naturally) to prevent tooth decay. And while to you or me a cavity may seem little more than a hassle — the sting of Novocain, the rrreenee-reenee of the dentist's drill, a drooping lip for a few hours — it’s a big deal from a general and public health point of view. Consider the following:
* One of the most common chronic childhood diseases, tooth decay affects almost 80 percent of U.S. children by the time they reach age 17, and children in economically disadvantaged families are disproportionately affected.
* While statistics are hard to come by, every so often patients die in the dental chair from a reaction to the anesthetic while having a tooth filled.
* Tooth decay (as well as peridontal disease) may have a casual link to serious, life-threatening conditions such as heart disease.
So, if your job is protecting public health, fluoridating drinking water might seem like a very good idea. But it’s only a good idea if it works. Does it?
Fluoridation Testimonials and Then the Fine Print
To find out, I first Googled the Centers for Disease Control (CDC) and the Surgeon General. Results?
* Fluoridation, the CDC reports, is “a safe and healthy way to effectively prevent tooth decay” and “one of 10 great public health achievements."
* The Surgeon General, in a report from 2000, credits fluoridation with reducing cavities by 15 to 60 percent, depending on the year of study, population size, and type of tooth.
But after heaping accolades on fluoridation in one paragraph, the Surgeon General waffles later on: “There are no randomized, double-blind, controlled trials of water fluoridation because its community-wide nature does not permit randomization of people to study and control groups. … Conducting a study in which individuals are randomized to receive or not receive fluoridated water is unnecessary and is not feasible.” Not feasible? Maybe. But unnecessary? I don’t think so.
In 2000 the Centres for Review and Dissemination at the University of York in England similarly equivocated in a review of fluoridation research. While reporting [pdf] “a beneficial effect of water fluoridation," the researchers also note the data “could be biased” because of the potential for “confounding factors,” and went on to state that: “Given the level of interest surrounding the issue of public water fluoridation, it is surprising to find that little high quality research has been undertaken."
So, apparently the studies touting the benefits of fluoridation are not all that iron-clad. And then there are the studies that seem to show that fluoridation is plain out ineffective.
Studies Finding Fluoridation Ineffective
Several studies from Europe and elsewhere (see here [pdf], here and here) show that developed countries now have similar levels of cavities whether they fluoridated their water or not — a change from the 1970s and '80s when countries that did not fluoridate their water had more tooth decay on average than those that did.
Today, according to these studies, the incidence of tooth decay is universally low regardless of fluoridation.
What’s the Harm of Adding Fluoride to Drinking Water?
The problem is fluorosis, dental and skeletal. Mild forms of dental fluorosis lead to faint discoloring or mottling of the tooth surface, a condition easily covered up by a dentist.
More severe fluorosis is characterized by dark stains and pitted teeth, in which the tooth's protective enamel is severely compromised. (See more pictures of fluorosis here.)
Skeletal fluorosis can be a lot more serious. In its mild form, skeletal fluorosis brings painful stiff joints; but in severe cases, individuals can experience crippling calcification and/or fusing of the vertebrae.
How Much Fluoride Is Too Much Fluoride
U.S. municipalities add between 0.7 to 1.2 parts per million (ppm) of fluoride to our drinking water. The U.S. Environmental Protection Agency’s standard for safe drinking water is 4 ppm, well above the 1.2 ppm maximum from fluoridation. So all’s well, right? Not quite:
* In addition to being added to a lot of our drinking water, fluoride is in our foods, our soft drinks, and of course our toothpaste. In fact there’s a lot more fluoride in the average American diet today than in 1962 when the standards were established. Depending on your diet, your drinking water's 0.7-1.2 ppm dose of fluoride may or may not be safe. For example, a recent study illustrated that babies fed food reconstituted with optimally fluoridated water would exceed the safe fluoride intake for infants.
* In a 2006 report the U.S. National Academy of Sciences concluded that EPA’s 4 ppm standard for fluoride in water is not sufficiently protective and should be lowered — a recommendation that EPA has yet to respond to (see story) and one indicating that the margin of safety between the supposed beneficial levels of fluoridation and harmful levels leading to fluorosis is much narrower than current regulations imply.
* And then there's the kicker — the health risks of fluoridation may include cancer. For example, Elise Bassin of the Harvard School of Dental Medicine and colleagues found [pdf] that the incidence of osteosarcoma (a rare and deadly form of bone cancer) increased by a factor of about five to six for boys who drank moderately fluoridated water as compared to those who drank water with little to no fluoride (more on study). (Without minimizing this result, bear in mind that the chances of an adolescent boy contracting osteosarcoma is only about eight per one million boys per year. So, if correct, this study suggests that the risk increases to about 40 to 48 boys per million per year. Those are still pretty long odds, long enough to suggest that it might make sense to accept the increased but still minuscule cancer risk for the benefit of avoiding tooth decay — that is, if fluoridation really protects you from tooth decay.)
So, What to Conclude About Fluoridating Water?
Fluoridation, controversial in the ‘50s, is still controversial today. Maybe fluoridation fights cavities, maybe not. Maybe it’s safe, maybe not. But there’s one more wrinkle.
When the U.S. policy to fluoridate our drinking water was first developed, scientists and dentists believed that only ingested fluoride benefited teeth. We now know that that’s not true. Topical application (e.g., from brushing teeth with toothpaste) is also effective at reducing cavities, by about 24 percent on average, though it's not without its own risks. In the decades since 1955 when Crest with stannous fluoride first hit the market, it's become hard to find a toothpaste without fluoride. Do we need fluoridation if we’ve got fluoride toothpaste?
All this makes me wonder, could fluoridating drinking water now be as anachronistic as fears of a communist plot?
When Watsonville accepted $1.6 million from the California Dental Association Foundation to fluoridate the city’s water on Sept. 28, the hope was that the new system would reduce tooth decay, particularly among the poor. But what happens when one of the biggest employers, water consumers and most well-known businesses in town is vehemently against fluoridation?
Such is the dilemma currently facing John Martinelli, president of world famous juice maker S. Martinelli & Co.
A strong opponent of fluoridation, Martinelli has played a key role in the decade-long struggle to convince the Watsonville City Council that fluoride has not been proven safe or effective. But with a state law that says cities with 10,000 or more people must fluoridate if costs are covered by an outside agency, a refusal to comply would mean a fine of $200 per day against the city.
Regardless of the penalty, Martinelli sees it as a violation of human rights. “We really believe that fluoridation is morally and ethically wrong,” he says. “People should not be subjected to medicine without their consent. It should be a person’s choice.”
While Watsonville councilmembers Nancy Bilicich, Greg Caput and Emilio Martinez opposed fluoridation in the 4-3 vote that set the plan in motion, theirs and Martinelli’s pleas were no match to what the Centers for Disease Control and Prevention has called “one of 10 great public health achievements of the 20th century.”
But that doesn’t mean that Martinelli won’t do everything in his power to stop it from impacting his 142-year-old family business.
Prior to this summer, the company, which created nonalcoholic cider as a stand-in for champagne during Prohibition, would not have been impacted by fluoridation due to the fact that none of their 100-percent juices and ciders contains water. However, Martinelli’s new Fruit Virtues line of acai, pomegranate, gogi and blueberry juices use water to reconstitute concentrate.
For this reason, Martinelli has decided to detach his company from the city’s water supply and build his own well.
A costly venture estimated at around $300,000, Martinelli’s plans to use its own money to drill down to the uncontaminated Aromas Red Sands Aquifer. While the president is not at all thrilled to have to invest in a well, he does not believe they have a choice with the fluoridation system estimated to be up and running in the next two years.
“We can’t believe that the city is taking good water and ruining it,” says Martinelli. “The well will cost a significant amount of money that we don’t have, but we don’t feel that we can ask the city to help us pay for it. Each resident should have the opportunity to ask the city for reverse fluoridation.”
According to the American Dental Association, Watsonville residents are now a part of the projected 72.4 percent of the U.S. population served by public water systems that receive optimally fluoridated water. Other fluoridated cities in California include Los Angeles, Long Beach, Beverly Hills and Huntington Beach.
The Association claims that fluoridation, which was first implemented in Grand Rapids, Mich. in 1945, works by halting or reversing decay and keeping tooth enamel strong. And many local dentists seem to agree, calling Watsonville’s dental hygiene “an epidemic” that needs immediate attention. Michelle Simon, a pediatrician whose joint practice cares for 6,000 Watsonville children, told the L.A. Times that she “has never seen such bad teeth outside Nicaragua.”
But critics across the country continue to believe that health officials are distorting scientific studies and lying about fluoride’s relation to thyroid problems, kidney malfunction and fetal damage.
If Martinelli’s were to continue depending on the city’s water system, they have no doubt that suspicious customers would boycott their products altogether.
“We’ve received quite a bit of feedback since we’ve stood up to fluoridation,” says Martinelli. “Ninety-percent of that feedback has been appreciative with the majority of our consumers agreeing with us and the other 10 percent are passionately upset that we’ve fought it.”
While a number of Santa Cruz residents have been attending meetings and actively supporting the company’s rejection of fluoridated water, Martinelli warns Watsonville’s neighbor to the north that they’re coming for us next.
“Santa Cruz may not want fluoridation,” says Martinelli. “But they have to know they’re on the list.”
The state has been attempting to fluoridate both cities for years, but in 1999 Santa Cruz prohibited the additive with an initiative known as Measure N and just four years later it was banned in Watsonville with Measure S.
At first, the decision to fluoridate in Watsonville caused Martinelli to consider moving his company, which placed Watsonville on the global map, out of the city. But local officials have since urged him to stay.
“We definitely feel that the city appreciates us and wants to keep us in the community, even offering to provide us with fluoride-free water,” says Martinelli. “But we’re not interested in being a special case with a separate hook up. That would just cause backlash from residents and other businesses.”
Surprisingly, Martinelli’s is one of the only major companies in Watsonville that relies on city water. Del Mar Food Products has their own well and so did Smuckers and Birds Eye Foods, Inc.
Losing Martinelli’s as a water consumer, when the company’s annual water expenses exceed $100,000 per year, is a huge risk for the city that is already facing a $5 million deficit. But considering that Watsonville’s newly adopted contract with the California Dental Association Foundation ensures that they will fund the fluoridation systems, operating and maintenance for the next two years, they may be able to cushion the blow.
Much of the buzz surrounding the September decision to fluoridate appears to have died down—including the threat to fight the law all the way to the Supreme Court—but Martinelli remains firm in his position that city residents should not be exposed to it.
“Fluoride is not an essential nutrient for the body,” he says. “And while most people agree that it works when applied topically, there are no tests to prove that it reduces tooth decay when ingested—in fact, it’s been linked to osteoporosis and cancer, and it’s on the California Office of Environmental Health Hazard Assessment ‘watch list’ of Prop 65 chemicals.”
The biggest problem, according to Martinelli, is that few people or small businesses have the money and resources to opt out of fluoridation even if they want to.
“This was not a vote against Martinelli’s,” he says. “But Watsonville could have at least driven a hard bargain instead of giving the foundation what they wanted.”
whipstitch wrote:Watsonville, CA is being forced by the state to flouridate their water after defeating local flouridation measures in elections twice in the last decade. Very depressing.
Montag wrote:
Fluoride Lowers IQ in Kids, New Study Shows
Sunday, 29 July 2012 | Written by Alex Newman
A review of some two dozen studies by Harvard University researchers published this month in a peer-reviewed federal journal suggests that fluoride added into water supplies “significantly” decreases the IQ of children, leading to renewed calls by activists to end the controversial practice of fluoridation. Most public water supplies in the United States still have the chemical added in by authorities under the guise of preventing tooth decay.
"The children in high fluoride areas had significantly lower IQ than those who lived in low fluoride areas," noted the Harvard research scientists about the results of their study, echoing claims by the Environmental Protection Agency (EPA) that there is substantial evidence of developmental neurotoxicity associated with the chemical. “The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment.”
The researchers also expressed concerns about the potential of fluoride to cause irreversible brain damage in unborn children. "Fluoride readily crosses the placenta,” they observed. “Fluoride exposure to the developing brain, which is much more susceptible to injury caused by toxicants than is the mature brain, may possibly lead to damage of a permanent nature."
The study, which was published on July 20 in the journal Environmental Health Perspectives of the U.S. National Institute of Environmental Health Sciences, also called for further studies on the issue. While fluoride may cause neurotoxicity in animals and adults, not enough was known about the chemical’s effects on the neurodevelopment of children, the researchers said.
“Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain,” noted senior study author Philippe Grandjean, a professor of environmental health at Harvard. “The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.”
Of course, the latest study is hardly the first to document the toxic effects of fluoride on the human brain. Even recently, after some two dozen studies documented the problem, scientists and experts spoke out about the dangers of fluoridation.
“In this study we found a significant dose-response relation between fluoride level in serum and children’s IQ,” observed Fluoride Action Network director Paul Connett, Ph.D., after a previous study was released showing the same effects. “This is the 24th study that has found this association, but this study is stronger than the rest.”
Numerous other studies, including a 2006 report by the U.S. National Academy of Science, have concluded that fluoride affects brain function and can cause other health problems. Most of the research so far, however, has been conducted abroad — much of it in countries without government fluoridation of public water supplies.
In the United States, authorities have been fluoridating the water for decades, and very few proper investigations have studied its potential effects — especially on the developing minds of children. But opposition to the practice is growing quickly, with each new study adding fuel to the fire.
A broad coalition of American attorneys, doctors, dentists, and activists has long demanded that authorities stop adding fluoride to the public’s drinking water. And like other recent studies highlighting the myriad dangers, the latest research — especially because it was published in a federal journal — has already been seized on by opponents of water fluoridation.
"It's senseless to keep subjecting our children to this ongoing fluoridation experiment to satisfy the political agenda of special-interest groups," said attorney Paul Beeber, president of the New York State Coalition Opposed to Fluoridation. "Even if fluoridation reduced cavities, is tooth health more important than brain health? It's time to put politics aside and stop artificial fluoridation everywhere."
Alleged dental benefits aside, other critics of water fluoridation oppose the controversial practice in principle, pointing out that instead of being used to purify the water supply, it is added to treat people in what amounts to the mass-medication of populations without lawfully required individual consent. Some experts even challenge the supposed usefulness of fluoride in preventing cavities.
As evidence about the dangers of fluoridation continues to build, however, communities across America have been debating whether or not to stop medicating people through the water supply. More than a few municipal governments have already stopped the controversial practice altogether. But as analysts have noted, officials and much of the mainstream medical establishment have tended to ignore the growing amount of research exposing the toxicity of fluoride.
“Will the latest Harvard-backed study be ignored by major public health organizations, or will serious change be initiated?” wondered Natural Society’s Anthony Gucciardi, citing decades-old evidence that the toxic chemical leads to a wide array of health problems including brain damage, accelerated tumor growth, and even death. “This should come as no surprise to those who have followed fluoride research over the past several years.”
The most recent study on fluoride relied on more than two dozen previous studies documenting the effects of the chemical on the brains. Researchers concluded that future investigations should examine information on exposure by unborn children and neurobehavioral performance.
Activists hope the latest research may be the beginning of the end for proponents of mass medicating Americans through the water supply. However, considering the vast amount of research already available that has been largely overlooked or even concealed by public health authorities, it remains unclear whether any significant reforms will be forthcoming.
Are We Crazy?
The fluoridation controversy is the most unwanted stepchild of American politics. Merely to mention that you have concerns about the addition of fluoride to drinking water is enough for many people to classify you as potentially unhinged. They may conjure up caricatures about “tin foil hats,” or make many assumptions as to what your beliefs must be about a range of other, often unrelated things. They may avoid speaking to you!
Cliches about anti-fluoridation advocates are embedded in our culture: General Jack D. Ripper, from the Stanley Kubrick film Dr. Strangelove, went mad with paranoia about Communists attacking his “precious bodily fluids” via water fluoridation. This fictional character is surely still far better known than the many environmental scientists and medical professionals, even the dozen Nobel Prize winners like the Swedish pharmacologist Arvid Carlsson, who have spoken out against fluoridation.
In this mindset, those who bring up fluoridation as an issue are anti-science, irrational and ignorant, perhaps right wing, and oblivious to public health. This mindset is closed. It will not admit contrary facts. It preemptively rules out the moral question, about whether it is right to administer a medication to an entire population involuntarily via drinking water, even if the medication is considered beneficial. Ingesting fluoride has no harmful effects and is good for teeth – Think of the children! Think of the poor people who otherwise wouldn’t get dental care! Therefore it is a public health good opposed only by the uncultured, the deluded, and hard-hearted libertarians. Besides, most dentists support it. End of story.
The Case Against Fluoridation
One undeniable fact is that controversy about fluoridation is almost exclusive to English-speaking countries: the United States, the UK, Ireland, Canada and Australia. That is because these are almost the only countries in the world where municipalities still commonly practice water fluoridation. Every other country has either never adopted fluoridation, or – in the case of regions in Japan and a series of European nations including the two Germanys and the Soviet Union – practiced fluoridation starting in the 1950s and abolished it again starting in the early 1970s through 1990. (Note: No more than about 10 percent of the UK population and no more than half of Canadians receive fluoridated tap water, but majorities do in the other countries mentioned above.)
The areas that never fluoridated, or fluoridated and then quit, have not experienced a cumulative rise in rates of tooth decay as a result. On the contrary, in recent decades every developed nation has seen a constant and dramatic decline in rates of tooth decay. This international trend has been unrelated to whether or not a nation fluoridates its water. The following chart shows tooth decay trends for “unfluoridated” and “fluoridated” nations since the 1960s, and is based on the United Nations World Health Organization country index for “DMFT” – a measure of the rate of decayed, missing, or filled teeth among 12 year-olds:![]()
Real-world data are rarely this definitive. The DMFT index has declined in all developed countries, whether or not the drinking water is fluoridated.
Despite gathering this data, the World Health Organization curiously still supports water fluoridation, as does the UN’s biggest financial sponsor, the United States government. The US Centers for Disease Control (CDC) have called water fluoridation one of the greatest public health achievements of the 20th century. It is true, as fluoridation advocates hold, that the period of fluoridation has coincided with a dramatic decline in tooth decay; but the above evidence serves to falsify the hypothesis that water fluoridation was a major factor in improved dental health.
The period of water fluoridation has also coincided with the widespread use of fluoride toothpastes. Fluoridation advocates agree that the only supposed medical benefit from fluoride comes from topical application, directly to one’s teeth. No other health benefits from fluoride are claimed. It is not a nutrient. The EPA classifies it as a contaminant: a poison, if taken in sufficient quantities. In all of the countries on the above list, almost everyone applies fluoride topically to their teeth every day by picking up a toothbrush. They squeeze fluoride toothpaste out of tubes with labels that warn them to call a doctor if they accidentally ingest more than a pea-sized quantity of the toothpaste. They brush their teeth, then spit out the toothpaste and wash out their mouths. Why then do they also need to ingest the same chemical, and take it into their bloodstream, every time they drink tap water?
Even if the quantities in the tap water are too low to affect human health, as fluoride advocates claim, no one can deny that some people drink more water than others, or that people below the average weight – children, for example – may build up higher concentrations of the substance. Even the champion lobby for the fluoridation of water in the US, the American Dental Association, has recommended since 2006 that fluoridated water not be used in mixing baby formula. (Note: Newborns do not have exposed teeth, and cannot enjoy the reported benefits of topical application of fluoride; but they do need water.) According to the ADA, their recommendation is due to the association of fluoride with an increasingly common condition known as dental fluorosis: a persistent discoloration and sometimes pock-marking of the teeth (ironically enough) caused by the ingestion – not the topical application – of fluoride. Fluorosis generally affects children, and does so at much higher rates in areas that fluoridate water. The ADA states that fluorosis is a strictly cosmetic condition that can be corrected by dental treatments. However, dentists are not doctors of internal medicine, and teeth are made largely of the same stuff as bones. The degree to which fluorosis affects bones has not been established, and the science on many other hypothesized ill effects of fluoride ingestion is far from definitive.
The US National Kidney Foundation (NKF), formerly an endorser of fluoridation, adopted a neutral position in 2008, and issued a warning about possible effects of fluoride on patients with chronic kidney disease. Since the international comparison torpedoes the central hypothesis that water fluoridation provides major dental health benefits, why do we need to conduct this public health experiment any further?
Fluoridation is Forced Medication
Fluoridation in the United States began in the 1940s. The New York City water supply has been fluoridated at levels around 1 ppm (part per million) since 1965. Fluoride is the only chemical added to drinking water not to treat the water (in order to make it safer to drink, like chlorine), but ostensibly to treat the consumer of the water.
[...]
Fluoridation is an example of corporate profiteering
We have come to view the practice of water fluoridation as an example of government once again putting private corporate profits before the interests and rights of the 99 percent of the people. The fluoride added to drinking water is a by-product of the production of fertilizers and aluminum, and is classified as a contaminant by the United States EPA. The producers of fluoride do not pay for the cost of disposing of their pollutants. Instead, they are paid a cumulative of hundreds of millions of dollars by thousands of communities, including New York City, to dump fluoride into our drinking water.
Summary
Fluoridation is not a public health benefit, it is a public health risk, and a violation of the right to choose. Fluoride is the only chemical added to drinking water not to treat the water to make it safer, but ostensibly to treat the consumer of the water. While the evidence that water fluoridation has beneficial effects against tooth decay is weak, medical studies have associated the ingestion of fluoride with a number of harmful medical conditions, including dental fluorosis (a deformation of the teeth that may also affect bones). Even supporters of water fluoridation, like the American Dental Association, recently adopted the recommendation not to give fluoridated water to infants. Fluoridation has been banned in almost all jurisdictions of Western Europe, without consequences to dental health. Many countries have come to view it as a form of “forced medication.”
Fluoridation violates the individual right to choose and does not protect public health, but puts it at risk. Fluoridation makes no sense.
AhabsOtherLeg wrote:In Britain the fears about fluoridisation (going back to the Sixties at least) were always associated with the political far right - "this monstrous commie plot to sap and impurify all of our precious bodily fluids." That was the gist of the argument back then, as Kubrick well knew. I have always been suspicious of the suspicions raised over fluoridation for that reason - I mean, fluoridation of water might well be harmful, and excessive fluoridation of water undoubtedly is, but the most vocal opponents of fluoridation tend to make me think it must be doing some good as well because I have never seen these people aligned against something that wasn't beneficial to the majority.
But I have not watched the documentary yet, so I'll see I suppose. The most frightening thing about fluoridisation, even if fluoride was not harmful in itself (which it is), is that there is an undeniable and established near-global system in place to interfere chemically with the water supply before it reaches it's consumers. That alone is worrying enough for me. But then i have never had to worry about the risks of drinking unfiltrated water from a ditch beside the road. So far.
justdrew wrote:The whole fluoridation thing reminds me of a sketch I just saw on "The Day Today" - a new plan to dispose of highly radioactive waste - distribute a small amount to each schoolchild to take home and loose. (or the real (I think aborted) plan to mix low-level radioactive waste into US coins)
Users browsing this forum: No registered users and 161 guests