Fluoridation Overview

Introduction
Harvard Cancer Study
National Academy of Sciences Report
Dental Association Warnings
Fluoride is an Unapproved Drug
Fluoridation Compounds are Industrial Waste Byproducts
Health Effects
Environmental Effects
Inadequate Regulation
We are Getting Too Much
Fluoride Works Topically Not Systemically
Tooth Decay Correlates with Poverty, Not Fluoridation
Access to Safe, Clean Drinking Water is a Fundamental Human Right

Phosphate fertilizer plant

Introduction

Water fluoridation began much like other promising and seemingly beneficial practices and treatments of the 1940’s and ’50’s and was – and still is – billed as a panacea for dental care.  More than 50 years later, however, our understanding of its safety and efficacy has changed dramatically. 

Today we know that fluoride is a persistent, bio-accumulative pollutant, more acutely toxic than lead.  Fluoride compounds added to public water supplies are industrial waste by-products of the phosphate fertilizer and aluminum industry.  If not marketed as “products,” they could only be disposed of—at considerable cost—at a hazardous waste facility, never legally discharged directly into the environment.  While fluoridation proponents sanitize their image by calling them “co-products” rather than “by-products,” there is no dispute that fluoridation compounds come exclusively from the waste stream of industry.

There is also no dispute that these compounds are recovered waste products from phosphate ore mining operations, and are contaminated with heavy metals and carcinogens, including lead, arsenic, cadmium, and mercury.  While fluoridation proponents suggest that the levels of these toxins are too small for concern, even pro-fluoridation activists acknowledge they exceed EPA’s health based MCLG’s, which for lead and arsenic are set at zero.  Moreover, compounds used for fluoridation actually increase lead exposure in three ways: (1) the compounds themselves contain lead; (2) the pH level of the compounds cause lead to leach from lead plumbing and (3) the compounds actually increase cellular uptake of lead.  Therefore, fluoridation significantly impacts families whose homes are already contaminated with lead whether through lead plumbing, lead based paint and/or other sources.

In addition to the adverse effects of the contaminants, there are a number of significant human health threats from the fluoride compounds themselves.  A growing body of peer-reviewed research increasingly links fluoride consumption to a variety of adverse health effects including but not limited to hip fracture in the elderly, depressed thyroid function, lowered IQ in children, and bone cancer in young boys. 

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Harvard Cancer Study

A recently published study from Harvard found that young boys between the ages of five and ten years old who drink fluoridated water at so called “optimal” levels  of one part per million have a 500% greater likelihood of developing osteosarcoma, a rare and often fatal bone cancer, than boys who do not drink fluoridated water.  The study corroborates earlier studies on the fluoride/osteosarcoma link by the National Cancer Institute and the New Jersey Health Department.

By comparison, when the pharmaceutical Vioxx was shown to increase heart attack and stroke risk by a “mere” 200%, the manufacturer, Merk & Co., issued an immediate, voluntary recall, one of the biggest worldwide recalls in history.  What followed was a series of lawsuits, several of which resulted in million dollar verdicts against the manufacturer.

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National Academy of Sciences Report

In March of 2006, the National Research Council (NRC) of the National Academy of Sciences published a groundbreaking report confirming that chronic, low-level fluoride exposure can cause a variety of serious health conditions, including bone fracture, joint pain, and disruption of the nervous and endocrine systems, including the brain, thyroid and pineal glands (NRC Report, 2006).  The NRC Panel unanimously agreed that the current Maximum Contaminant Level Goal (MCLG) for fluoride (4 ppm) is too high and does not adequately protect against adverse health effects. 

This finding is significant because it narrows the margin of safety between the current MCLG of 4 ppm and the recommended 1 ppm which is added to fluoridate drinking water.  Several members of the NRC Panel also concluded there is no safe fluoride exposure level for those in our society who are most vulnerable to its deleterious effects, namely infants and children, the elderly, diabetics, high volume water consumers and individuals with decreased kidney and thyroid function.

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Dental Association Warnings 

More recently, the American Dental Association (ADA) and the Oregon Dental Association (ODA), both major promoters of mandatory fluoridation, issued a warning that fluoridated water should not be used to reconstitute infant formula.  While breastfeeding rates in Oregon are higher than the rest of the nation, on average, the overwhelming majority of babies here, as elsewhere, are formula fed.  Fluoridation therefore puts the additional burden and expense of purchasing and transporting bottled water on families with infants.  Low income families are especially impacted because they are more likely to rely on public transportation and are least able to afford the “luxury” of bottled water. 

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Fluoride is an Unapproved Drug

Despite the body of peer-reviewed research raising health concerns, fluoride when used in drinking water has never been safety tested or approved by the U.S. Food and Drug Administration (FDA).  The FDA confirms that fluoride meets the legal definition of a “drug” and has approved its topical use in toothpaste and mouthwash, but has not reviewed nor approved fluoride when it is to be ingested for a reduction in tooth decay.  Proponents have yet to produce any controlled, peer-reviewed studies showing that long-term ingestion of fluoride compounds is safe.

Proponents of fluoridation downplay concerns over the current standards for water additives while stressing the alleged benefits of fluoridation for children.  They obscure fluoride’s classification as a drug by saying “it occurs naturally,” or by calling it “a mineral,” or a “nutrient.”  They have erroneously stated that EPA is in charge of water additives, when, in fact, EPA jurisdiction over fluoride is only as a contaminant, and never as an intentional additive to drinking water.

Proponents excuse FDA’s lack of approval of any ingested form of fluoride for the purpose of reducing decay—including prescription fluoride drops and tablets—by either denying it is a drug or suggesting that fluoride’s approval was “grandfathered in,” which could only have happened if it were sold for that purpose before 1938, which it was not.   Both EPA and FDA appear to playing the good federal soldiers in deference to the Public Health Service, which has both promoted and defended fluoridation since its premature endorsement of the policy in 1950: the oldest of the experimental trials, designed to expose chronic effects over 10-15 years, had been in place for only 5 years.  Not only has FDA never reviewed or approved ingested fluoride for tooth decay, but EPA has treated fluoride as a “protected pollutant.”

Opponents state that the FDA has no jurisdiction over water.  This is a smokescreen.    Fluoride, by FDA’s own confirmation to Congress (12/21/00), when ingested for the purpose of preventing tooth decay, is a drug, and FDA is the only entity in the U.S. vested by Congress with the authority to approve its safety and efficacy.  FDA would be forced to finally review fluoride as a caries-preventing drug if it were submitted by manufacturers.
With regard to contaminants in the product, opponents use lay language, suggesting that contaminants comprise such “little bits,” they pose no health threat.  Rather than acknowledging the value of non-enforceable Maximum Contaminant Level Goals, set by EPA as the scientifically established point above which health harm occurs, they champion the enforceable MCL’s, which compromise health standards with economic considerations.  They ignore the fact that MCL’s were established to regulate contaminants already existing in water that are expensive to remediate, whereas with purely optional fluoridation, contaminants are purposefully being added in. 

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Fluoridation Compounds are Industrial Waste Byproducts

Unlike calcium or magnesium fluoride, which can occur naturally in water, the compounds used for artificial fluoridation—hydrofluosilicic acid, sodium fluorosilicate, and sodium fluoride—are waste byproducts of industry, so toxic they must be recovered and disposed of at a hazardous waste facility.  Rather than being purified to pharmaceutical standards, they are added to public water in their raw, industrial state.  No water district in the country currently uses pharmaceutical grade fluoride because it is cost prohibitive. 

The marketability of fluoridation compounds is contingent on their ability to fulfill a health claim, namely, that adding them to drinking water reduces tooth decay.  Ironically, this health claim has never been reviewed by the FDA, which classifies ingested fluoride as an unapproved drug.  The FDA is the only agency in the country vested with authority to evaluate safety or efficacy of drugs.  Claims of safety and efficacy of fluoride ingestion by any other entity – the Surgeon General, the CDC, the American Dental Association – are not proof of safety or efficacy because these entities have no legal authority to make any such claim.

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Health Effects of Fluoride

Growing concerns over new toxicity studies, coupled with requirements under the Safe Drinking Water Act, prompted EPA to ask the National Research Council to re-evaluate the adequacy of the current MCLG for fluoride.  After reviewing toxicological, epidemiological and clinical data, particularly data published since 1993, the NRC Panel concluded that the MCLG for fluoride was too high.  Among other things, the panel also found:

  • Fluoride increases the production of free radicals in the brain, raising the possibility that it increases the risk of Alzheimer’s disease; more research is needed to clarify fluorides’ biochemical effects on the brain.
  • Fluoride exposure could affect the pineal gland, resulting in altered melatonin production and altered timing of sexual maturity.  Recent information suggests that any agent that affects pineal function could affect sexual maturation, calcium metabolism, parathyroid function, postmenopausal osteoporosis, cancer and psychiatric disease.
  • Down’s syndrome is a biologically plausible outcome of fluoride exposure.
  • Because fluoride concentrates in the kidneys, the kidneys and renal system may be at higher risk of fluoride toxicity than most soft tissue.
  • Fluoride appears to have the potential to initiate or promote cancers, particularly of the bone, with osteosarcoma being of particular concern.

For more information, please refer to our “Health” section.

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Environmental Effects

Public awareness and concern is growing over the number of chemicals in our water supplies, how little we understand about the ways in which they react synergistically with one another, and what the long term human and environmental effects may be.  The recent Associated Press investigation underscores those concerns.  That report found that the drinking water of millions of Americans is contaminated with a wide range of pharmaceuticals, including antibiotics, sex hormones and drugs used to treat epilepsy and depression.  Ironically, fluoride compounds are “pharmaceuticals” intentionally added to drinking water. 

Moreover, numerous studies show adverse environmental effects from fluoride.  Of particular note are toxic effects in freshwater salmon at levels above 0.2 ppm, one-fifth the concentration added to fluoridated drinking water. Because of these impacts, many groups have formally opposed mandatory fluoridation bills, including: Sierra Club, Oregon Chapter, Columbia Riverkeeper, Willamette Riverkeeper, Tualatin Riverkeepers, Native Fish Society, Trout Unlimited, Oregon Council, Oregon Toxics Alliance, Oregon Center for Environmental Health, OSPIRG, Pacific Environmental Advocacy Center, Northwest Environmental Defense Center, and Northwest Environmental Advocates.

Water treatment plants are not designed to remove the tiny fluoride ion; therefore, fluoridation ultimately affects aquatic life as well as humans. 

For more information, please refer to our “Environment” section.

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Inadequate Regulation

An investigation into fluoridation in the U.S. House Committee on Science (1998-2000) produced documentation from federal agencies including EPA and FDA which have raised serious concerns over a lack of safety testing, approval, and regulation of compounds used for fluoridation.  For example, these and other federal agency documents revealed that: (1) standards for water additives are voluntary and essentially industry self-regulated, with representatives of Kaiser Aluminum and top supplier Cargill Fertilizer (and its distributor, LCI, Inc.) serving as members of the standards committee; (2) the two fluoride compounds ingested by 91% of the artificially fluoridated U.S. population (hydrofluosilicic acid and sodium fluorosilicate) have never been tested for their effect on human health.  Suppliers and distributors specifically disclaim responsibility for damage or injury resulting from hazards inherent in their products.

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We are Getting Too Much Fluoride

The human body is designed to protect its young from fluoride.  The fluoride content of human milk averages 5-10 parts per billion (compared to 1 part per million added to drinking water), even when the nursing mother is exposed to high fluoride levels.  Formula made with fluoridated water contains 250 times more fluoride than mother’s milk.  At current recommended levels of 1 ppm, children 6 months to 3 years old receive the full “prescription dose” of fluoride (0.25 milligrams) recommended for a child in a non-fluoridated community after drinking just one cup of water. 

When fluoridation began, Americans were minimally exposed to fluoride other than through a fluoridated water supply.  Today, however, there are multiple sources of exposure: toothpaste and other dental products and treatments, foods and beverages processed with fluoridated water or containing residue from fluoride-based pesticides or post-harvest fumigants (sulfuryl fluoride), pharmaceuticals, anesthetics and industrial emissions. 

America’s children are paying the price.  In 2005, the CDC reported that dental fluorosis now affects 32% of six to19-year-olds, up from 23% in 1986-87.  Studies show rates of fluorosis are significantly higher in fluoridated communities.  While dental fluorosis is generally dismissed by dentists as merely “cosmetic,” it is medically defined as “chronic fluorine poisoning” (Taber’s Medical Encyclopedia), and its spotting, pitting or mottling of teeth provides visible evidence of excessive fluoride exposure.  The damage is permanent, expensive to repair and not covered by insurance.

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Fluoride Works Topically Not Systemically

For decades, the dental community assumed that fluoride had to be ingested systemically to provide a protective benefit, but recent laboratory and epidemiologic studies by fluoridation proponents have shown that assumption to be incorrect.  The dental community and Centers for Disease Control now acknowledge that fluoride works primarily through topical means.  Today, more and more professionals advocate topical exposure through the use of fluoridated toothpaste or mouthwash and question the wisdom of swallowing fluoride to prevent decay, which has been likened to swallowing sunscreen to prevent sunburn.

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Tooth Decay Correlates with Poverty, Not Fluoridation

Others are looking to the root causes of decay and seeing the need to address nutrition, oral hygiene, and the high correlation of tooth decay with low income populations—in fluoridated and non-fluoridated communities alike—that lack access to dental care.  We now recognize that access to dental care is the best way to reduce tooth decay, not fluoridation.’

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Access to Safe, Clean Drinking Water is a Fundamental Human Right

The United Nations has declared that “access to safe [uncontaminated] water is a fundamental human need and, therefore, a basic human right.”  The public seems more aware and concerned with the growing trend of commodifying and privatizing water and the critical importance of its safety and availability.  In addition, many individuals hold that Americans have the right of informed consent regarding medication.  The addition of a contaminated, non-FDA approved medicament to a public water supply violates both of these most basic human rights.

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