The Latest Science Indicates That the Practice Must Stop
Water
fluoridation is the deliberate addition of a substance containing, or
yielding, fluoride (that is, in the form of the free fluoride ion) to
the public water supply with the ostensible aim of reducing tooth decay.
The concentrations of fluoride used for this purpose in the U.S. range
from 0.7 to 1.2 milligrams of fluoride per liter of water (0.7-1.2 parts
per million or ppm). When the practice began in the U.S. and Canada in
1945 there were no published studies available which demonstrated that
consuming fluoride at these levels was safe.
Without
any formal study, it was assumed that because some people in some
places had consumed natural fluoride levels higher than 1 ppm for many
years, with no “apparent” harm recorded, adding fluoride to water would
be safe.
The authors both work for the Fluoride Action Network (FAN),1 a
nonprofit dedicated to education and sharing information on the
toxicity of fluoride. FAN maintains the largest database dedicated to
fluoride’s toxicity on blood,2 bone,3 brain,4 heart,5 kidney,6 liver,7 lung,8 the reproductive system,9 and the thyroid gland;10 as well as the largest collection of news articles on fluoride11 that
are accessible by country, by state for the U.S. and by province for
Canada. The website also contains links to many videotaped interviews,12 government reports by country,13 fluoride industrial emissions by state14 and more.
NEITHER ETHICAL NOR SCIENTIFIC
It
was neither ethical nor scientific to force people to consume fluoride
in 1945, and it is not ethical or scientific to do it today. The
arguments get stronger as U.S. authorities are finally getting around to
doing the studies on tissues that they should have conducted many years
ago—and should have done before they started what has amounted to one
of the largest public health experiments in U.S. history.
PROTECTING A BELIEF SYSTEM
The
dilemma for those who believe that this practice is causing harm is how
to end it when most people don’t even know their water is being
fluoridated and don’t know the potential risks it may be posing to their
children. Sadly, most doctors and dentists simply follow the policies
of their professional bodies without reading the literature for
themselves. The media are not telling the public about the latest health
studies and are simply parroting statements from organizations like the
American Dental Association (ADA) and agencies like the Oral Health
Division of the Centers for Disease Control and Prevention (CDC), which
hold a long standing “belief” in the “safety and effectiveness” of this
practice. Meanwhile, government health departments at all levels appear
to be more interested in protecting this outdated policy than protecting
the health of our children.
The
task that FAN has set itself since 2000 is to share the science about
the dangers posed by this practice with those who are willing to read
and listen, mainly through our web page at FluorideALERT.org and through
public presentations (for example, in Seattle15). The latest science makes it very clear that the practice of fluoridation must stop!
FLUORIDE AND INTELLIGENCE
In
2006, the National Research Council (NRC) of the National Academies
concluded that “fluorides have the ability to interfere with functions
of the brain”16 and for the first time called fluoride an endocrine disruptor.17
In
2006, there were only five IQ studies available to the NRC panel.
Subsequently, many more have been published (including studies that were
previously only available in Chinese). As of 2019, we now have sixty
studies, fifty-three of which have shown a lowered IQ in children in
communities with high fluoride exposure compared to communities with
lower fluoride exposure.18
Most
of these studies have been carried out in China, but others took place
in India, Iran and Mexico. In 2012, twenty-seven of these studies were
subjected to a meta-analysis by a team from Harvard, which was published
in one of the world’s leading environmental health journals, Environmental Health Perspectives.19 While
this team had concerns about the lack of information on several
possible confounding factors in many of these studies, they were struck
by the consistency of the results. Even though the research was carried
out over a period of twenty-one years, by many different research teams,
in two countries (China and Iran) and in many different locations,
twenty-six out of the twenty-seven studies found the same result: a
lowering of IQ. The average lowering was seven IQ points.
It
should be noted that a shift downward of five IQ points in a large
population would halve the number of very bright children (IQ greater
than one hundred thirty) and increase by over 50 percent the number of
mentally handicapped (IQ lower than seventy). Such a downward shift
would have both huge economic and social consequences for a country like
the USA.
Promoters
of fluoridation have done their best to diminish the significance of
these findings for fluoridated communities, but recent findings have
largely undermined their self-serving arguments. A rigorous U.S.
government-funded study carried out by a highly qualified research team
headed by Dr. Morteza Bashash confirmed that fluoride is neurotoxic at
levels currently experienced in fluoridated communities and, for this
effect, the most vulnerable stage of human life is during fetal
development.20 This
study was conducted in Mexico City with two hundred ninety-nine
mother-offspring pairs. The authors found strong associations between
fluoride exposure to the pregnant women (as measured in their urine) and
lowered IQ in their offspring at age four and again at six to twelve
years of age. Subsequently, in 2018, a study reported that the lowering
of IQ in the same cohort also occurred in an earlier age range (one to
three years).21
In
2018, using the same Mexico City cohort, Dr. Bashash found that there
was a strong association between some of the symptoms of ADHD in the
children and urine fluoride levels in the pregnant women.22 A
2015 study found a relationship between the prevalence of ADHD in the
U.S. and fluoridation status by state; the higher the percentage of the
state fluoridated, the greater the prevalence of ADHD.23
It is hard to overstate the importance of the 2017 Bashash study.20 Strikingly,
it was funded by U.S. government agencies, two of which (National
Institutes of Health and the Environmental Protection Agency) have
promoted (NIH) and defended (EPA) the safety of water fluoridation. The
study was part of a twenty-five-year ELEMENT research project (Early
Life Exposures in Mexico to Environmental Toxicants) directed by
professor Howard Hu from the University of Toronto. The Bashash study
took over twelve years and involved researchers from many distinguished
universities and institutions in Canada, the U.S. and Mexico. These
included the universities of Toronto, McGill, Indiana, Illinois,
Michigan, Harvard, as well as Mount Sinai and the National Institute of
Perinatology in Mexico. These researchers have published over fifty
studies conducted along similar lines for other neurotoxicants. Of
particular importance was the fact that, unlike most of the other IQ
studies on fluoride, this study involved measurements at the individual
(not community) level for both mother and child. Based upon their
extensive experience, the authors controlled for a large number of
potential confounding variables, and even after controlling for these
they still found a very strong relationship between fluoride exposure
during pregnancy in the mother and lowered IQ in their offspring.
Fluoridation
promoters, including the American Dental Association, have claimed that
this study was not relevant to fluoridated communities in the U.S.
because Mexico City does not have artificial fluoridation and pregnant
women there are likely to have higher doses of fluoride from fluoridated
salt and some naturally fluoridated water areas. Such arguments are not
convincing because the biometric of exposure used was fluoride levels
in the urine, which is a measure of total dose of fluoride and is
independent of the source. Moreover, the range of exposure in Mexico
City was within the range of fluoride levels in the urine of adults in
the U.S. This point was further confirmed by a subsequent national study
of the urine fluoride levels in pregnant women in Canada. This study
found that levels of fluoride in the urine of Canadian women living in
fluoridated communities were almost identical to the levels in Mexico
City, namely 0.87 ppm in Canada versus 0.91 ppm in Mexico City.24
As
far as the politics of fluoridation are concerned, it is significant
that some of the world’s leading neurotoxicologists, like Phillipe
Grandjean (mercury specialist) and David Bellinger (lead specialist),
are now participating in this research as well as reviewing the
literature.25,26 They
now see fluoride’s neurotoxicity in the same vein as that of lead,
arsenic, mercury and other well-established neurotoxicants.
It
should also be stressed that in addition to the fifty-three IQ studies
discussed above, there are many other animal, human, biochemical and
cellular studies that provide an overwhelming weight of evidence that
fluoride is neurotoxic. These include one hundred thirty human brain
studies;27 two hundred forty-one animal brain studies;28 thirty-three cellular brain studies;29 and thirty review studies.30
FLUORIDE AND HYPOTHYROIDISM
In
the 1930s, ’40s and ’50s, doctors in Argentina, France and Germany used
sodium fluoride to lower the activity of the thyroid gland for those
suffering from hyperthyroidism (overactive thyroid gland).31 -37 Despite
this knowledge, government agencies in the U.S. and other fluoridating
countries have never seen fit to investigate a possible relationship
between fluoride exposure and the rising level of hypothyroidism in
their countries. Only recently have scientists reviewed the matter.38-41
A
2018 study, reported that while they could find no relationship between
fluoride exposure and TSH levels (thyroid stimulating hormone and an
indicator of hypothyroidism) and fluoridation status among the general
population, they did find that for those who had low or even borderline
iodine intake, fluoride exposure was associated with an increase in
their TSH levels.42
The
importance of this finding is that it gives a very plausible mechanism
for why fluoride might lower IQ in children born to mothers with high
fluoride exposure. When the fetus comes into existence it has no thyroid
gland. It is entirely dependent on the mother’s thyroid levels for its
early mental development. So any depression in the mother’s thyroid
hormone levels will increase the risk of lowered IQ in their offspring
(see Vyvyan Howard’s explanation of this situation in a PowerPoint
presentation he gave in New Zealand in 2018).43
WARNING PREGNANT WOMEN
One
of the sad consequences of the medical community’s acceptance of the
safety-and-effectiveness argument for water fluoridation, based upon
dogma rather than upon the latest science, is that many doctors are
oblivious of these findings. The result is that women are not being
warned to avoid fluoride exposure during pregnancy. They are not being
warned by their doctors, by health departments, by professional bodies
or by the media. It has been left to non-governmental bodies like FAN to
get the word out the best we can via social media, the Internet (see
the Moms 2B Campaign),44 press releases,45 leaflets
and talks. We have been trying to do so since 2017, but it is an
extremely difficult task, as is the continuing battle to try to end the
well-entrenched practice of water fluoridation.
LAWSUIT PROVIDES NEW HOPE
In
November 2016, the Fluoride Action Network, along with Food & Water
Watch, the American Academy of Environmental Medicine, the
International Academy of Oral Medicine and Toxicology, Moms Against
Fluoridation, the Organic Consumers Association and individuals,
petitioned the EPA46 to ban the deliberate addition of fluoride to public drinking water under provisions in the Toxic Substances and Control Act.
We argued that “[t]he risk to the brain posed by fluoridation additives is an unreasonable risk because, inter alia,
it is now understood that fluoride’s predominant effect on tooth decay
comes from topical contact with teeth, not ingestion. Since there is
little benefit in swallowing fluoride, there is little justification in
exposing the public to any risk of fluoride neurotoxicity, particularly
via a source as essential to human sustenance as the public drinking
water and the many processed foods and beverages made therefrom. The
addition of fluoridation chemicals to water thus represents the very
type of unreasonable risk that EPA is duly authorized to prohibit
pursuant to its powers and responsibilities under Section 6 of TSCA, and
Petitioners urge the Agency to exercise its authority to do so.”
In September 201747 the
EPA rejected our petition on its scientific merits. In response to an
appeal from FAN, a federal court denied EPA’s motion to dismiss in
December 2017.48
Also in December 201749 the
EPA argued that no other studies should be added to the case after our
petition was first delivered to them in November 2016. The court
disagreed with EPA50 and
ruled to allow new studies, such as those by Bashash and others
discussed above. A trial date has been set to take place in federal
district court in San Francisco in August 2019.
We
are confident that we can win this case. In order to do so, it will
require us to demonstrate three things: 1) that fluoride poses a hazard
to the developing brain; 2) that there is a risk at current exposure
levels (from all sources combined) in fluoridated communities; 3) that
this is an unreasonable risk because there are other ways that tooth
decay can be prevented.
Moreover,
even if fluoride is one of those alternatives, there are other and more
appropriate ways of delivering fluoride to the surface of teeth than
putting fluoride into the drinking water. Indeed, the majority of
countries worldwide that do not fluoridate their water have actually
demonstrated this over many years.
SUMMARY AND CONCLUSIONS
There
are many ethical and scientific arguments against the seventy-year
practice of water fluoridation. The evidence that swallowing fluoride
reduces tooth decay remains weak. Not a single randomized controlled
trial has been attempted to demonstrate this, and promoters have relied
on studies with far weaker methodologies.65 Meanwhile,
the number of studies that indicate harm can be caused, even at the
doses experienced in fluoridated communities, has been growing,
particularly studies on the brain.20,22,24,42,46
With
such risks on the table, it is unconscionable, in our view, that
governments continue to promote the deliberate addition of a known
neurotoxic and endocrine-disrupting substance to the drinking water of
millions of people, most of whom have not been informed of the risks
involved, or been given the opportunity to give—or refuse—their consent
on the matter.
SIDEBARS
ELEVEN ARGUMENTS WHY FLUORIDATION SHOULD BE ENDED
1.
Fluoridation is unethical. Using the public water supply to deliver
dental therapy goes against all recognized principles of modern
pharmacology and ethical healthcare practice. It imposes medication on
all water consumers indiscriminately and without the individual’s
informed consent. These include the unborn, bottle-fed infants, persons
with chronic diseases known to be aggravated by fluoride (such as poor
kidney function), the poorly nourished (such as those with low iodine
intake) and the elderly. It does so with uncontrolled dosage, no
monitoring of adverse effects and no possibility of avoiding treatment
for most, if not all, people. This is especially true for those on a
low-income budget who simply cannot afford avoidance measures like
reverse osmosis filtration systems.
2.
Fluoridation is unusual. The vast majority of countries worldwide do
not fluoridate their drinking water. Out of one hundred ninety-six
countries, only twenty-four have any fluoridated cities, and of those,
only ten, including the U.S., fluoridate more than half their
population. Ninety-five percent of the world’s people drink water
without artificial fluoridation. Over half of those who do, live in the
U.S. In Europe, where forty-three out of forty-eight nations have no
water fluoridation, 98 percent of the population is not forced to drink
fluoridated water. A few European countries (namely France, Germany,
Switzerland and Austria) have fluoridated salt available, but people are
not forced to buy this salt, as non-fluoridated salt is also available.
Despite this, World Health Organization (WHO) data61 indicate that
since the 1960s, tooth decay in twelve-year-olds has been coming down as
fast in non-fluoridated countries as in fluoridated ones.
3.
Children in fluoridated communities are being grossly over-exposed to
fluoride. In the U.S. and other fluoridated countries, there has been a
dramatic increase in young children and teens in the prevalence of
dental fluorosis (discoloration of tooth enamel caused by low-level
systemic fluoride toxicity during tooth formation). This condition
indicates that children have been grossly over-exposed to fluoride
before their permanent teeth have erupted. The latest national survey
indicates that over 60 percent of U.S. teens have dental fluorosis.52,53 Of
those, 24 percent have moderate and nearly 2 percent have severe levels
of the disease. These levels can produce yellow and brown staining and
structural damage to the enamel. To put this into context, the early
promoters of fluoridation anticipated only 10 percent of the children in
fluoridated communities would be affected by this condition, and these
would be only in the “very mild” category. They believed that this was
an acceptable trade-off for reducing tooth decay. Even avid promoters of
fluoridation no longer accept that the current prevalence rates as
acceptable but they tend to blame other sources of fluoride—rather than
water fluoridation—for the dramatic increase. In reality, every source
of fluoride ingested contributes to this prevalence. The contribution
from water fluoridation can be eliminated with a simple policy change.
4.
Fluoride has the potential to damage many other tissues. Because of the
prevalence of dental fluorosis, there is no question that fluoride can
damage the developing teeth. Nor is there any question from the evidence
provided in countries with large areas of endemic fluorosis (such as
India and China) where millions of people have both dental and skeletal
fluorosis, that high doses of fluoride can damage other tissues
including bones, connective tissue, the brain, the endocrine system, the
gut and kidneys. The Indian Ministry of Health & Family Welfare,54 provides
an excellent description of the problems faced by thousands of villages
poisoned by fluoride. For the Western world, much of this evidence was
provided in a comprehensive review of the literature conducted by the
National Research Council of the National Academies in 2006.16 What
has emerged since 2006 is a growing body of evidence that this harm can
occur at doses experienced in artificially fluoridated communities.
5.
Fluoridation is unnecessary. Fluoride is not an essential nutrient. No
one has ever demonstrated that a single biological process in the human
body needs fluoride to function properly. There is no such thing as a
“fluoridedeficiency” disease. Children can have perfectly good teeth
without ingesting fluoride. Even promoters of water fluoridation admit
that the predominant benefit of fluoride is topical, not systemic.55-58 Thus,
it is morally indefensible to force people to ingest fluoride via the
public water supply, when for those who want fluoride, fluoridated
toothpaste is universally available. Moreover, the fluoride used in
toothpaste is pharmaceutical grade whereas the fluoride used to
fluoridate water is an industrial grade hazardous waste product from the
phosphate fertilizer industry.25
6.
Today’s fluoride is worse. The fluoridating chemical used in over 90
percent of the fluoridating communities in the U.S. is a substance
called hexafluorosilicic acid (H2SiF6). This substance is removed from
the scrubbing systems of the phosphate fertilizer industry as a 23-25
percent solution. It is contaminated with trace amounts of other toxic
substances including aluminum, arsenic, lead and radioactive isotopes
(the same ore that is mined for fluoride in Florida is also mined for
uranium). Ironically, this waste product cannot be dumped into the sea
by international law, but health authorities blandly allow it to be put
untreated into the public water supply!
7.
Fluoride is very toxic and nature has developed protection mechanisms
for many living things. For lower creatures like bacteria and fungi,
there are genes—switched on by high levels of fluoride—which code for
proteins called fluoride exporting proteins (FEX proteins). These
proteins are located in the cellular membranes and pump fluoride out of
the cell.26 In
mammals, the kidney excretes about 50 percent of fluoride ingested each
day from healthy individuals, and most of the rest is rapidly
sequestered in hard tissues like the bones. Importantly, the human
breast appears to act as a fluoride filter for the new born baby. The
level in mothers’ milk is remarkably low (0.004 ppm).27 Thus,
a bottle-fed baby, when the formula is made up with fluoridated tap
water (0.7 to 1.2 ppm), will get approximately two hundred times more
fluoride than a breastfed infant (that is, two hundred times more than
nature intended).
8. Fluoridation is unscientific. Fluoridation is promoted with PR techniques like endorsements, not with sound
science.
Most of the endorsements were made shortly after the U.S. Public Health
Service endorsed water fluoridation in 1950 with virtually no science
on the short-term—let alone long-term—health effects. Citizens should be
very wary of taking such endorsements at face value unless they are
accompanied by an up-to-date review of the literature—and very few are.
Incredibly, in over seventy years there has been no randomized control
trial (RCT) to demonstrate that swallowing fluoride lowers tooth decay.
As far as the U.S. Food and Drug Administration (FDA) is concerned, an
RCT is the gold standard for approving new drugs. According to the FDA,
fluoride is an unapproved drug28 and
the FDA has never approved fluoride tablets for ingestion. Many
decision makers and journalists around the world are impressed when they
read the notorious statement from the CDC in 1999 that “Fluoridation is
one of the top public health achievements of the 20th century.”63 However,
what they may not realize is that this statement did not come from the
CDC itself (which has about thirty thousand employees, many of whom are
highly qualified in many medical fields as well as toxicology) but from
the CDC’s small Oral Health Division with only thirty employees, most of
whom only have dental qualifications. Moreover, their job is defined as
promoting fluoridation. They even admit to not following—or being
responsible for—the science pertaining to fluoride’s harmful effects.
Journalists and others have been impressed by a public relations
exercise by a promotional body, not by a body that maintains a careful
overview of any harm the practice may be causing.
9.
Health risks are ignored in fluoridated countries. Sadly, because the
imposed dental practice of water fluoridation is so entrenched in the
psyche of the medical, dental and public health establishments in
fluoridated countries, neither governments nor the mainstream media are
warning the public about the large and growing
body of scientific research30 that shows that fluoride exposure poses many health risks.
10.
Fluoridation violates the precautionary principle. The scientific
evidence that swallowing fluoride lowers tooth decay is weak,31 but
the weight of evidence that it causes harm to the developing brain is
so one-sided, that to wait for further studies before halting the
deliberate addition of fluoride to water is a rash and irresponsible
public health position.
11.
Fluoridation violates the principles of environmental justice. The
addition of fluoride to public water is an environmental injustice to
people living in poverty in fluoridated areas who do not have access to
alternative water
sources and are captive to tap water for all their water needs. Moreover, it is well established that those with poor
nutrition are more vulnerable to fluoride’s toxic effects, and poor nutrition is more likely to occur among those
with low incomes.
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51. WHO Data, http://fluoridealert.org/issues/caries/who-data/.
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58. Featherstone JD. 2000. The science and practice of caries prevention. Journal of the American Dental Association. July: 131(7):887-99.
59. Fluoride Action Network, Phosphate Fertilizer Industry, see http://fluoridealert.org/articles/phosphate01/
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61. Ibid at 16, page 40, https://www.nap.edu/read/11571/chapter/4#40.
62. Moore, Robert J. 2005. Fluoride is an unapproved drug. Letter from Food and Drug Administration to Daniel Stockin. www.fluoridealert.org/wp-content/uploads/fda-2005a.pdf.
63. Centers for Disease Control & Prevention. 1999. Ten Great Public Health Achievements–United States, 1900-1999. Morbidity and Mortality Weekly Review. December 24, 1999 / 48(50);1141
64. Fluoride Action Network. Study fluoridealert.org/studytracker/.
65. Iheozor-Ejiofor Z, et al. 2015. Water fluoridation for the prevention of dental caries. Cochrane Database of Systematic Reviews. June 18. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010856.pub2/abstract.
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