by Paul Connett, PhD
November 28, 2002
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
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:
the individual's right to informed consent to
municipality cannot control the dose of the patient.
municipality cannot track each individual's response.
the fact that some people are more vulnerable to
fluoride's toxic effects than others. Some people will
suffer while others may benefit.
the Nuremberg code for human experimentation.
As stated by the recent
recipient of the Nobel Prize for Medicine (2000), Dr. Arvid
"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
As stated by Dr. Peter Mansfield, a physician from the UK and advisory board
member of the recent government review of fluoridation (McDonagh et
"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
- Fluoridation is UNNECESSARY because:
Children can have
perfectly good teeth without being exposed to fluoride.
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.
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
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).
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:
researchers concede that fluoride's benefits are topical not
systemic (Fejerskov 1981; Carlos 1983; CDC 1999, 2001; Limeback
1999; Locker 1999; Featherstone 2000).
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).
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, Online).
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).
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.
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:
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.
It accumulates in
our pineal gland, possibly lowering the production of melatonin
a very important regulatory hormone (Luke, 1997, 2001).
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).
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 and
In animal studies
fluoride at 1 ppm in drinking water increases the uptake of
aluminum into the brain (Varner et al, 1998).
Counties with 3 ppm
or more of fluoride in their water have lower fertility rates (Freni,
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
The margin of safety
between the so-called therapeutic benefit of reducing dental
decay and many of these end points is either nonexistent or
- Fluoridation is INEQUITABLE, because:
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.
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).
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:
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.
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
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:
In 1950, the US
Public Health Service enthusiastically endorsed fluoridation
before one single trial had been completed.
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
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.
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.
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).
The CDC's 1999, 2001
reports advocating fluoridation were both six years out of date
in the research they cited on health concerns.
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
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,
"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
It has distracted us
The failure of one
of the richest countries in the world to provide decent dental
care for poor people.
The failure of 80%
of American dentists to treat children on Medicaid.
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
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
The failure of the
US EPA to develop a Maximum Contaminant Level (MCL) for fluoride
in water which can be scientifically defended.
The fact that more
and more organofluorine compounds are being introduced into
commerce in the form of plastics, pharmaceuticals and
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
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
Fluoridation represents a very powerful "belief system" backed
up by special interests and by entrenched governmental power and