Fluoridation: Time for a second look ?
by Paul, Ellen and Michael Connett
Rachael's Environment and Health News, May 10,
In 1997 the union representing scientists, engineers and
lawyers at the U.S. Environmental Protection Agency (EPA) in Washington,
D.C., voted to support a California citizen initiative to stop
fluoridation of public drinking water. In 1999 the union's vice-president
released a paper explaining the union's opposition to fluoridation.
Fluoridation is the practice of adding fluoride to the public
water supply to reduce dental decay. U.S. fluoridation trials
began in 1945 and by 1992 approximately 56% of the U.S. public
received its water from fluoridated systems.
Typically, fluoride-containing (or -generating) compounds
are added to water to bring the level up to 1 milligram of fluoride
ion per liter (1 part per million). In 1986 EPA set a Maximum
Contaminant Level (MCL) for fluoride in drinking water at 4 ppm.
The MCL was based on only one adverse health effect: skeletal
fluorosis, a crippling bone disease.
Fluoridation of public water supplies has stirred passionate
debate for over 50 years. Now new data is refining the debate.
It appears that some of the early claims for fluoridation's benefits
were inflated. In recent years tooth decay has declined in both
fluoridated and non-fluoridated communities. In fact, the largest
U.S. survey indicates that the benefit to fluoridated communities
amounts to 0.6 fewer decayed tooth surfaces per child, which is
less than one percent of the tooth surfaces in a child's mouth.
The public health community justified medicating whole communities
via public drinking water using certain arguments that recent
research has now shown to be false. For example, in 1945 scientists
believed that fluoride had to be swallowed to be effective. However,
the Centers for Disease Control (CDC) has recently acknowledged
that fluoride's mechanism of action is primarily topical, not
systemic. This means that you don't need to swallow fluoride
to reap its tiny benefits.
A second early belief, now known to be false, is that fluoride
is an essential nutrient. There is no evidence of any disease
related to fluoride deficiency. Natural levels of fluoride in
human milk (0.01 ppm) are approximately a hundred times less than
baby formula reconstituted with fluoridated water.
A third early belief was that dental fluorosis (a defect of
the tooth enamel caused by fluoride's interference with the growing
tooth) would occur in only about 10% of the children drinking
water fluoridated at 1 ppm and would occur only in its mildest
form. Today fluorosis occurs on two or more teeth in 30% of children
in areas where the water is fluoridated, and not all in its mildest
A fourth early belief was that 1 ppm fluoride in drinking
water provided an ample margin of safety against toxic effects.
Not only is there no safety margin for dental fluorosis but there
is growing evidence that there may be no safety margin for changes
to bone structure and impacts on the brain, thyroid, and other
soft tissues, especially when it is coupled with nutrient deficiencies,
1) In 1998 the results of a long-term, low-dose rat study
were published. Two groups of rats were exposed to two different
kinds of fluoride at 1 ppm in distilled water. A third group received
only distilled water. Amyloid deposits (associated with Alzheimer's
Disease and other forms of dementia) were elevated in the brains
of both fluoridated groups compared to the control group. The
authors speculate that fluoride enables aluminum to cross the
2) Millions of people in India and China suffer a crippling
bone disease called skeletal fluorosis, caused by moderate to
high natural levels of fluoride (1.5 to 9 ppm) in their water.
Skeletal fluorosis has several stages of severity, with the less
severe being chronic joint pain. "Because some of the clinical
symptoms mimic arthritis, the first two clinical phases of skeletal
fluorosis could be easily misdiagnosed." Arthritis is
now at epidemic levels in the U.S. Fluoride's plausible contribution
has been ignored, but needs to be taken seriously.
3) Since fluoridation began in 1945 our exposure to other
sources of fluoride has increased substantially. These include
processing food and beverages with fluoridated water; air pollution
from fluoride emitting industries; pesticide residues; vitamins;
and dental products. If 1 ppm in drinking water were the only
source of fluoride, the average person would ingest 2 milligrams
(mg) of fluoride each day, though some may get less because they
use bottled water, or they drink less water than the average adult.
In 1991, the federal Department of Health and Human Services (DHHS)
estimated that the range of exposure in communities with approximately
1 ppm fluoride in the water was 1.58 to 6.6 mg per day.
4) The dose of 1.58 to 6.6 mg per day overlaps the dose found
to depress the functioning of the human thyroid gland. At 2.27
to 4.54 mg/day, fluoride has been found to "completely relieve"
the symptoms of hyperthyroidism (overactive thyroid). With
fluoride's known capacity to depress thyroid activity, it seems
that there may be a link between current fluoride consumption
and the prevalence of hypothyroidism (underactive thyroid). More
than twenty million people in the U.S. receive treatment for thyroid
problems and many others are thought to go undiagnosed.
5) Fluoride is a hormone disrupter. It mimics the action of
many water-soluble hormones by interacting with G proteins, which
transmit hormonal messages across cell membranes. Additionally,
fluoride accumulates in the pineal gland and may reduce melatonin
6) Fluoride (50-75 mg per day) given to osteoporosis patients
to strengthen bones has actually increased their rate of hip fractures.[15,16]
Of 18 studies conducted since 1990, 10 have found an association
between water fluoridation and hip fractures in the elderly.
According to the Agency for Toxic Substances and Disease Registry
(ATSDR): "If this effect is confirmed, it would mean that
hip fracture in the elderly replaces dental fluorosis in children
as the most sensitive endpoint of fluoride exposure."
Hip fracture is not a minor problem: in the U.S. up to 50,000
people die each year of osteoporosis-related hip fractures.
7) Some evidence suggests that fluoride causes bone cancer
in male rats and perhaps in young men.[20, 21]
8) A recent report by the Greater Boston Physicians for Social
Responsibility reviews studies showing that fluoride interferes
with brain function in young animals and in children, reducing
Most European countries have rejected fluoridation. Recognizing
that there are simple and effective alternatives, they have applied
the precautionary principle. Their children's teeth have not suffered
as a consequence. Parents willing to expose their children to
fluoride can simply purchase fluoridated toothpaste (which contains
1000 to 1500 ppm fluoride -- read the warning label on the package).
The American policy of giving fluoride to children by medicating
whole communities with a potent drug that may harm some people
seems a dubious practice at best. At worst it violates the primary
principle of medical ethics: First do no harm. Furthermore, it
violates the ethical principle of informed consent.
In May 2000 the Fluoride Action Network (FAN) was formed by
a coalition of activists and scientists from 12 countries (see:
http://www.fluoridealert.org). FAN's goal is to end fluoridation
and minimize exposure to fluoride. FAN's founding members include
the late David Brower; Teddy Goldsmith; Michael Colby; Gar Smith;
Terri Swearingen; the union representing professional employees
at EPA headquarters; and Dr. Hardy Limeback, Canada's leading
dental authority on fluoridation who in 1999 apologized for having
promoted fluoridation for 15 years.
We urge our colleagues working on public health and environmental
issues to become involved and take a second look at fluoridation.
Paul Connett is professor of chemistry at St. Lawrence University
in Canton N.Y.
Ellen Connett is editor of WASTE NOT , 82 Judson, Canton N.Y.
13617; Michael Connett is FAN's webmaster <http://www.fluoridealert.org>
 J. William Hirzy, "Why the union representing U.S.
EPA's professionals in Washington D.C. opposes fluoridation,"
WASTE NOT #448 ( May 1, 1999), pgs. 1-4. And see http://- www.fluoridation.com/epa2.htm.
 Centers for Disease Control and Prevention, National Center
for Prevention Services, Division of Oral Health, "Water
Supply Statistics" (Atlanta, Georgia: Centers for Disease
Control and Prevention, 1993). Available at http://www.cdc.gov/nohss/-
 Bette Hileman, "Fluoridation of water. Questions
about health risks and benefits remain after more than 40 years,"
CHEMICAL & ENGINEERING NEWS Vol. 66 (August 1, 1988), pgs.
26-42. Available at http://www.fluoridealert.org/hileman.htm.
 J.A. Brunelle and J.P. Carlos, "Recent Trends in
Dental Caries in U.S. Children and the Effect of Water Fluoridation,"
JOURNAL OF DENTAL RESEARCH Vol. 69, Special Issue (February 1990),
pgs. 723-727 and discussion pgs. 820-823.
 Centers for Disease Control, "Achievements in Public
Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental
Caries," MORBIDITY AND MORTALITY WEEKLY REPORT Vol. 48, No.
41 (October 22, 1999), pgs. 933-940.
 C.J. Spak and others, "Fluoride in Human Milk,"
ACTA PAEDIATRICA SCANDINAVICA Vol. 72, No. 5 (September 1983),
 Keith E. Heller and others, "Dental Caries and Dental
Fluorosis at Varying Water Fluoride Concentrations," JOURNAL
OF PUBLIC HEALTH DENTISTRY Vol. 57, No. 3 (Summer 1997), pgs.
 Julie A. Varner and others, "Chronic administration
of aluminum-fluoride and sodium-fluoride to rats in drinking water:
alterations in neuronal and cerebrovascular integrity," BRAIN
RESEARCH Vol. 784, No. 1-2 (February 1998), pgs. 284-298.
 S.S. Jolly and others, "Human Fluoride Intoxication
in Punjab," Fluoride Vol, 4, No. 2 (1971), pgs. 64-79.
 Ad Hoc Subcommitttee on Fluoride of the Committee to
Coordinate Environmental Health and Related Programs, Public Health
Service, Department of Health and Human Services. REVIEW OF FLUORIDE:
BENEFITS AND RISKS, REPORT OF THE AD HOC COMMITTEE ON FLUORIDE
OF THE COMMITTEE TO COORDINATE ENVIRONMENTAL HEALTH AND RELATED
PROGRAMS (February 1991), pg. 17.
 Pierre-M. Galletti and Gustave Joyet, "Effect of
fluorine on thyroidal iodine metabolism in hyperthyroidism,"
JOURNAL OF CLINICAL ENDOCRINOLOGY Vol. 18 (October 1958), pgs.
 Beth Ann Ditkoff and Paul Lo Gerfo, THE THYROID GUIDE
[ISBN 0060952601] (New York: Harper, 2000), cover notes.
 Anna Strunecka and J. Patocka, "Pharmacological
and toxicological effects of aluminofluoride complexes."
FLUORIDE Vol. 32, No. 4 (November 1999), pgs. 230-242.
 Jennifer Anne Luke, THE EFFECT OF FLUORIDE ON THE PHYSIOLOGY
OF THE PINEAL GLAND , Ph.D Thesis, University of Surrey, United
Kingdom (1997). See also Jennifer Luke, "Fluoride Deposition
in the Aged Human Pineal Gland," CARIES RESEARCH Vol. 35
(2001), pgs. 125-128.
 L.R. Hedlund and J.C. Gallagher, "Increased incidence
of hip fracture in osteoporotic women treated with sodium fluoride,"
JOURNAL OF BONE MINERAL RESEARCH Vol. 4, No. 2 (April 1989), pgs.
 B.L. Riggs and others, "Effect of fluoride treatment
on the fracture rates in postmenopausal women with osteoporosis,"
NEW ENGLAND JOURNAL OF MEDICINE Vol. 322, No. 12 (March 22 1990),
 Paul Connett and Michael Connett, "The Emperor Has
No Clothes: A Critique of the CDC's Promotion of Fluoridation,"
WASTE NOT #468 (October 2000), pgs. 27-28. Available at http://-
 Agency for Toxic Substances and Disease Registry, TOXICOLOGICAL
PROFILE FOR FLUORIDES, HYDROGEN FLUORIDE, AND FLUORINE (F) [ATSDR/TP-91/17].
(Atlanta, Ga.: U.S. Department of Health and Human Services, April
1993), pg. 57.
 K. Phipps, "Fluoride and bone health," JOURNAL
OF PUBLIC HEALTH DENTISTRY Vol. 55, No. 1 (Winter 1995), pgs.
 National Toxicology Program, TOXICOLOGY AND CARCINOGENESIS
(December 1990). This NTP study is summarized in reference 10,
 Perry D. Cohn, A BRIEF REPORT ON THE ASSOCIATION OF DRINKING
WATER FLUORIDATION AND THE INCIDENCE OF OSTEOSARCOMA AMONG YOUNG
MALES. (Trenton, N.J.: New Jersey Department of Health, November
 Ted Schettler and others, IN HARM'S WAY: TOXIC THREATS
TO CHILD DEVELOPMENT (Cambridge, Mass.: Greater Boston Physicians
for Social Responsibility [GBPSR] , May 2000). Available at http://www.igc.org/psr/
or from GBPSR in Cambridge, Mass.; telephone (617) 497-7440.
 Paul Connett and Ellen Connett, "The Fluoridation
of Drinking Water: a house of cards waiting to fall. Part 1: The
Science," WASTE NOT #373 (November 1996). See Table 2 pgs.