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Category: Fluoridation

The Fluoridation Promoters' 50 False Claims FAN Campaign Bulletin -Responses to 50 False Claims
May 10, 2005

A) FREEDOM OF CHOICE

1) CLAIM: Fluoridation is a legitimate use of the government's "police power" because we are facing a dental health crisis in this country.

Response: Fluoridation is an illegitimate use of "police power" because tooth decay is neither life threatening nor contagious in the community sense.

2) CLAIM: People are not forced to drink the water.

Response: The notion that you don't have to drink the water, does not apply to families of low-income, because they certainly cannot afford bottled water for drinking and all their cooking needs. They are trapped.

3) CLAIM: People can use filters to remove the fluoride if they want to.

Response: The typical Brita (i.e. carbon) filters are no good at removing fluoride. Households will need to use the more expensive reverse osmosis systems, distillation or ion exchange resins to accomplish this. Moreover, such strategies don't prevent one being forced to drink fluoridated water every time one drinks water in town, or a beverage made up with fluoridated water or at a friend's house which does not have an expensive removal system.

B) APPEALS TO AUTHORITY

4) CLAIM: Dozens of governmental agencies, health and dental organizations endorse the practice.

Response: This tactic is used frequently. For example, the ADA in their booklet Fluoridation Facts (ADA, 1999 available at www.ada.org) lists over 90 organizations which endorse fluoridation. For someone unfamiliar with the history of this issue, such a list is very impressive and is frequently enough to convince local officials to back this measure. It is certainly a lot easier to say, "If it is good enough for all these prestigious bodies, it's good enough for me", than to actually to read the literature or carefully weigh the arguments from both sides.

What one has to know to put this into perspective is that many of the organizations listed are either part of the US Public Health Service (US PHS), or largely funded by it. We have also to remember that the US PHS endorsed fluoridation before one single fluoridation trial had been completed and before any health study of any significance had been completed. For example, look at the timing of these endorsements with respect to the first fluoridation trials which were begun in 1945 and were intended to last 10-12 years.

American Water Works Association, June 1, 1949
State and Territorial Dental Health Directors, June 8, 1950
US Public Health Service, June 22, 1950
American Association of Public Health Dentists, October 29, 1950
American Dental Association, October 30-November 2, 1950
State and Territorial Health Officers, November 1950
American Public Health Association, November 1950

Even more telling than the timing of the endorsements is the general lack of any independent review by these organizations prior to their endorsements. Nor in many cases was the endorsement put to the vote of the total membership.
 

Simply put, once the mighty US Public Health Service endorsed this practice most of these agencies and organizations fell into line like one gigantic self-fulfilling prophecy.

But here is a simple test to see how secure these organizations are in their endorsements. I encourage anyone who is interested to contact the executive officers of these endorsing organizations and ask them:

a) When did they endorse fluoridation?

b) What review have they done since?

c) Can they provide any single member of their organization to defend their endorsement in an open public debate?

d) Will they respond in writing to Paul Connett's "50 Reasons to Oppose Fluoridation"? (www.fluoridealert.org/50reasons.htm)

I predict what you will get back is a circular argument: namely, they will provide you with the names of other organizations that endorse this practice! When everyone's guilty, there is no one to blame!

5) CLAIM: The CDC stated in 1999 that fluoridation is "One of the top 10 public health achievements of the Twentieth Century"

Response: This statement is cited all over the fluoridating world by government officials, representatives of dental associations, and journalists. Very few could have read the report to which it is attached, nor the blow by blow critique which my son and I published in the newsletter Waste Not and made available via the FAN web page (www.fluoridealert.org/CDC.htm). Had they done so, they would have been embarrassed by CDC's extremely weak defense of the claims that fluoridation is "safe" and "effective". The CDC was six years out of date with the literature they cite for safety, and the graph, which they produce to "demonstrate" that tooth decay has been coming down because the percentage of Americans drinking water has gone up, would make an undergraduate blush. The decline in tooth decay in American 12 year olds can be matched or exceeded by at least 16 unfluoridated countries (www.fluoridealert.org/who-dmft.htm).

6) CLAIM: US Surgeon General X, Y or Z supports fluoridation.

Response: These endorsements by successive US Surgeon Generals go with the job. He or she is the figurehead for US Public Health Service policy, and we know what that is! Just how much they have actually read on the issue is open to serious question. When some communities in the US are faced with a tough battle over a referendum, one powerful tactic is to produce Former Surgeon General Everett Koop a few days before the vote. Koop is reputed to receive $20,000 for speaking engagements. Once highly respected, some of Koop's prestige was tarnished when he had to admit that he had received one million dollars in consultancy fees from a company on whose behalf he spoke at a Congressional hearing. Although, the fee was for other services and not for the specific product on which Koop testified, the fact that he neglected to tell the Congresspersons of this potential conflict of interest, raised many eyebrows!

7) CLAIM: The World Health Organization endorses fluoridation.

Response: This is correct. The WHO officially does endorse fluoridation. The endorsement was made on July 23, 1969, in the final hours of a WHO assembly in Boston. (When the vote on fluoridation was taken, only 55 to 60 delegates were still present -- out of a total of 1000 delegates in the WHO at the time.)

An important point to consider about WHO's endorsement of fluoridation is the qualification the WHO has since added to it: namely, before introducing any fluoride program, health administrators should be aware of the total fluoride exposure in the population. To quote:

"Dental and Public health administrators should be aware of the total fluoride exposure in the population before introducing any additional fluoride programme for caries prevention." (WHO, 1984)

Seldom, if ever, is this recommendation followed by officials before fluoridating their community. If officials actually believe the fluoridation hypothesis, what they should do is determine the prevalence of dental fluorosis in their community. If that prevalence is over 10% - and it usually is (Heller et al., 1997) - then the children are already getting OVER the so called "optimal" dose of fluoride and don't need any more, and shouldn't get any more.

The most recent WHO panel which reviewed the fluoride drinking water guideline for fluoride had four dental researchers, three of them staunchly pro-fluoridation, including Professor Michael Lennon who is President of the British Fluoridation Society and is rabid in his promotion of fluoridation. The fact that such a biased panel should have been selected for this delicate task might give a clue to explaining why the WHO maintains its support fluoridation.

8) CLAIM: The Consumers Union concludes fluoridation is safe and effective.

Response: Often proponents will cite a scathing 1978 article written by a journalist at Consumer Reports, which stated: "The simple truth is that there's no scientific controversy over the safety of fluoridation."

There are, however, two essential points to note about CU's 1978 article:

First, CU has recently stated that the organization no longer stands by the conclusions of this article. In fact, in the summer of 2000, CU asked a prominent proponent of fluoridation (Dr. Michael Easley) to remove all reference to CU as supporting fluoridation. According to CU's letter:

"We have asked you numerous times to cease and desist using any reference to Consumers Union and Consumer Reports and our 1978 article on fluoridation. As you are well aware, that is now 22 years old. I would hardly call that current. Given the new research that is conducted by others - and not CU - we cannot state that we continue to stand behind that determination of 22 years ago." (Letter, Wendy Wintman)

Second, the scientist at CU most familiar with the water fluoridation controversy is Dr. Edward Groth, a recently-retired Senior Scientist who worked at CU for over 20 years. For the duration of his professional career, Dr. Groth has been a prominent mainstream critic of water fluoridation.

For his PhD dissertation at Stanford University, Groth examined the literature on fluoridation and concluded that the science underpinning the safety of fluoridation was extremely flawed and that many important questions and concerns had never been adequately addressed by Government promoters.

According to Groth, "a consistent, serious flaw" in the government's early research on the safety of fluoridation was the "commitment to pre-determined conclusions on the part of the investigators... Many of the investigations were carried out under political duress, and the clear objective of the studies was not to look for possible adverse effects, but to prove that there were none."

C) DENTISTS AND PROFESSIONALISM

9) CLAIM: Dentists who do not promote fluoridation are neglecting their professional responsibility (ADA).

Response: I disagree. In my view, dentists have a professional responsibility to read the literature before they advocate fluoridation. However, that is not the way the ADA sees it. This organization would prefer them not to read the literature. In their 1979 White Paper, the ADA states:

"Individual dentists must be convinced that they need not be familiar with scientific reports of laboratory and field investigations on fluoridation to be effective participants in the promotion program and that nonparticipation is overt neglect of professional responsibility."

10) CLAIM: When dentists speak out against fluoridation it is a "clear violation of professional ethics" (Easley)

Response: Twenty years after the ADA made the statement above (see 9) Dr Michael Easley, a sometime spokesperson for the ADA, repeated the imperative, in even more stark terms, when he wrote:

"A most flagrant abuse of the public trust occasionally occurs when a physician or a dentist, for whatever personal reason, uses their professional standing in the community to argue against fluoridation, a clear violation of professional ethics, the principles of science and community standards of practice." (Easley 1999)

Clearly, Easley's fanatical support for this practice doesn't allow him to contemplate the notion that a dental or health professional could read the literature and come to a different conclusion from his own, for other than personal reasons.

We are fortunate, that dentists, such as Dr. John Colquhoun in New Zealand, Dr. Don MacAuley in Ireland, Dr. David Kennedy in the US, Dr. Tony Lees in the UK, Dr. Tohru Murakami in Japan, and Dr. Hardy Limeback in Canada, have had the courage to step out of such restrictive and self defeating definitions of "professionalism" and have spoken the truth about this practice. Statements from some of these professionals can be found on the web page of the Fluoride Action Network, www.fluorideaction.net.

D) DEBATES

11) CLAIM: Fluoridation is beyond "scientific debate"

Response: It is a little unusual for one side of a controversial issue to declare by "fiat" that there is "no debate" and that the issue is settled. This is a bit like a boxer declaring that he is so good that he has no need to defend his title! While those with the "power" can get way with nonsense like this, in science no issue is ever beyond debate. One always has to remember that "an ugly fact can destroy a beautiful hypothesis." Nevertheless, since the US PHS endorsed fluoridation in 1950, a whole stream of "industrial fluoride defenders" and "fluoridation promoters" have declared that there is no debate on either the health issues or the benefits.

In 1957, Robert Kehoe of the Kettering Institute (which performed health studies for industry), declared "the question of the public safety of fluoridation is nonexistent from the viewpoint of medical science." (Waldbott, p305)

In 1961, ADA President, Dr. C.H. Patton, told an audience "I contend (that) the subject (of fluoridation) is not debatable" (Waldbott, p333)

1n 1965, Dr. H. Hillenbrand, Executive Secretary of the ADA, said that "Fluoridation of drinking water is no longer a subject that is scientifically debatable" (Waldbott , p333)

In 1966, ADA President, Dr. M. K. Hine, tried to extend the prohibition to the political arena, when he said: "Fluoridation is no longer debatable in the scientific community; it should not be debatable in the political community." (Waldbott, p333)

In 1999, Dr. Michael Easley, explained why dentists and other fluoridation promoters should not debate, when he declared:

"Debates give the illusion that a scientific controversy exists
when no credible people support the fluorophobics' view"

However, independent scientists have taken a very different view on the issue of whether fluoridation is debatable or not. 1n 1991, Groth wrote the foreword to an incisive sociological analysis of the fluoridation program ("The Social (Dynamics of the Fluoridation Debate") where he concluded that:

"[T]he political profluoridation stance has evolved into a dogmatic, authoritarian, essentially antiscientific posture, one that discourages open debate of scientific issues." (Groth, 1991)

Finally, in 1988, the Chemical & Engineering News, a journal which goes to every member of the American Chemical Society, provided a 17 page cover article on the fluoridation debate. This would have been hardly necessary if there was no debate (Hileman, 1988)

12) CLAIM: By debating, opponents steal proponents' credibility.

Response: Easley further explained his opposition to debates when he declared that:

" Like parasites, opponents steal undeserved credibility just by sharing the stage with respected scientists who are there to defend fluoridation."

It is interesting to contemplate for a moment Dr. Michael Easley sharing the stage with Dr. Arvid Carlsson, and watching the spectacle of this Nobel laureate maneuvering to steal some of Easley's credibility!

Actually, I don't think it is possible to steal someone else's credibility, in my experience you have to earn it.

E) EVERYONE IS DOING IT

13) CLAIM: 67% of the US population on public water supplies drink fluoridated water.

Response: if numbers impress, then contrast the total number of people who drink fluoridated water worldwide with the number who don't. Those that do amount to about 300 million people; those that don't amount to nearly 6 billion!

14) CLAIM: 47 of the top 50 the largest cities in the U.S. fluoridate.

Response: Portland, Oregon; Spokane, Washington, and Honolulu, Hawaii are to be praised for resisting the efforts to force fluoride on their populations. They are in good company. The following distinguished cities are among the vast majority of cities worldwide who do not force their citizens to drink fluoridated water.

Amsterdam, Athens, Belfast, Bergen, Berlin, Bonn, Brisbane, Brussels, Cambridge (UK), Cardiff, Christchurch, Cologne, Copenhagen, Dundee, Edinburgh, Florence, Frankfurt, Helsinki, London, Leipzig, Lisbon, Manila, Marseilles, Milan, Montreal, Nice, Oxford, Oslo, Paris, Prague, Rome, Rotterdam, Salzburg, Stockholm, Tokyo, Vancouver, Venice, Vienna and Zurich

15) CLAIM: Over 60 countries worldwide practice water fluoridation.

Response: This claim was made by the ADA in 1999 in their booklet Fluoridation Facts, and used by many officials since. However, when one checks the citation one finds that the ADA gives the British Fluoridation Society as the source for this "fact". When the British Fluoridation Society was asked by the National Pure Water Association (UK) for a list of these "60 countries" they were unable to do so. There are, in fact, very few countries which fluoridate their water. According to a recent report prepared for WHO there are only 18 countries (out of about 190) which have more than a million people drinking fluoridated water, and of these, only 8 (Australia, Columbia, Ireland, Israel, Malaysia, New Zealand, Singapore and the United States) have more than 50% of their population drinking fluoridated water. Thus the practice of water fluoridation is very much an Anglo-American phenomenon, with over half the people drinking fluoridated water worldwide, living in North America.

16) CLAIM: Many European countries don't fluoridate only because they have outdated or decentralized water delivery systems, otherwise they would.

Response: This is another extraordinary claim which does not bear scrutiny. On the FAN web page there is a list of statements from government and other officials from many of the European countries who do not fluoridate water, www.fluoridealert.org/govt-statements.htm

F) EFFECTIVENESS

17) CLAIM: Fluoridation explains why tooth decay has fallen in the U.S. over the last 30 ­ 40 years.

Response: No it doesn't. This CDC (1999) claim is based upon wishful thinking not science. The same decline in tooth decay which has been observed in the US, has also occurred in many non-fluoridated industrialized countries. See the figures available online from the WHO and displayed graphically at www.fluoridealert.org/who-dmft.htm. There must be other explanations for this decline, such as improved standard of living, better diets and possibly the universal availability of fluoridated toothpaste

18) CLAIM: Fluoridation lowers tooth decay by up to 60%.

Response: This is a huge overstatement. The largest survey in the US showed only a saving of 18% in the permanent teeth when the authors compared children who lived all their lives in fluoridated compared to non-fluoridated communities (Brunelle and Carlos, 1990). Even that is very misleading because a) this saving was not shown to be statistically significant and b) it amounted to an actual saving of just 0.6 of one tooth surface out of 128 tooth surfaces in a child's mouth. Converting these savings into percentages today is very deceptive, as it reflects the arithmetical vagaries of comparing two small numbers.

Recent studies in Australia indicate even less saving ­ 0.12 ­ 0.3 tooth surfaces (Spencer et al.,1996) and the latest study from South Australia found no saving in the permanent teeth at all (Armfield & Spencer, 2004).

19) CLAIM: Fluoride makes teeth stronger for life if ingested during the tooth-forming years.

Response: While this was clearly the view of both dentists and dental researchers in the 1950s-1970s, this is no longer the case. While many dentists and pediatricians continue to repeat the claim, most dental researchers (i.e. the scientists who actually study how fluoride impacts teeth) have abandoned it.

The current consensus of the dental research community is that fluoride's benefit comes primarily, if not entirely, from topical application to the exterior of teeth, not from ingestion and accumulation within. Even the pro-fluoridation Centers for Disease Control and Prevention (CDC) has acknowledged this view, affirming in 1999 that:

""[L]aboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children." (CDC, 1999)

Much of the research demonstrating the primacy of fluoride's topical effects is reviewed in Dr. John Featherstone's cover story in the July 2000 issue of the Journal of the American Dental Association.

As Dr. Featherstone (a pro-fluoridation scientist) makes clear, the fluoride that accumulates within the growing tooth does not make the tooth any more resistant to decay. As noted by Featherstone:

"Fluoride incorporated during tooth development is insufficient to play a significant role in caries protection." (p. 891)

More specifically:

"this means that fluoride incorporated during tooth mineral development at normal levels of 20 to 100 ppm (even in areas that have fluoridated drinking water or with the use of fluoride supplements) does not measurably alter the acid solubility of the mineral. Even when the outer enamel has higher fluoride levels, such as 1,000 ppm, it does not measurably withstand acid-induced dissolution any better than enamel with lower levels of fluoride." (p. 890)

20) CLAIM: When fluoridation is stopped, tooth decay rates increase.

Response: The American Dental Association has made this claim for many years. However, five carefully conducted studies over the past 5 years have found that tooth decay rates did not increase following the cessation of fluoridation.

The studies ­ from Canada, Cuba, Eastern Germany, Finland, and the United States ­ found that tooth decay did not increase, but usually continued to decrease, following the termination of the fluoridation programs. www.fluoridealert.org/health/teeth/caries/fluoridation.html#cessation

The results of these studies are consistent with the World Health Organization's large body of online data showing that tooth decay rates have declined just as significantly in unfluoridated areas as they have in fluoridated areas. See: www.fluoridealert.org/health/teeth/caries/who-dmft.html

21) CLAIM: The kids teeth in this unfluoridated community X are far worse than kids teeth in fluoridated community Y.

Response: These kind of statements, often coming from local dentists or state health officials, usually appear in the press shortly before an effort is made to fluoridate town X. Every effort is made to make the situation appear to be a dire emergency. The message: you must act now (i.e. don't think about it or read about it!) to save your children's teeth. However, such anecdotal observations or unpublished surveys mean very little. It is well established that the biggest factor determining tooth decay is standard of living. It usually dwarfs any difference attributable to fluoride. Thus unless the study is carefully designed to control for parental income these reports mean very little. That is why it is important for citizens to ask the person or official providing these comparisons to state whether or not the report has been peer-reviewed and published, if it hasn't it is worthless. If the claims center on the primary teeth, remember the biggest problem here is "baby bottle tooth decay" which even fluoridation promoters concede cannot be corrected with fluoride (see more in 41 below).

22) CLAIM: Water fluoridation is more effective than toothpaste.

Response: There are several major problems with this statement.

First, if it is correct, how can one explain the identical declines in tooth decay experienced in those western countries which do not fluoridate their water? http://fluoridealert.org/health/teeth/caries/who-dmft.html

When dental researchers from the U.S. and Europe were asked to identify the major factors explaining the decline in tooth decay in the western world, "only in the evaluation of 'fluoride toothpaste' was there a clear, positive, agreement among the experts." (Bratthall et al., 1996)

23) CLAIM: The reason that tooth decay is declining in non-fluoridated Europe is because they use fluoridated salt.

Response: In contrast to fluoride toothpaste and other topical fluorides which are universal throughout Europe, salt fluoridation is only practiced in a minority of European countries.

Moreover, the countries in Europe which do fluoridate salt (e.g. Austria, France, Germany, & Switzerland) do not have better tooth decay rates than the countries which do not fluoridate salt (e.g. Denmark, Finland, Iceland, Netherlands, Norway, Sweden, and the UK) .

In fact, based on the latest data from the World Health Organization, 3 of the countries which do not fluoridate salt rank in the top 4 for best teeth in Europe. See:www.fluoridealert.org/health/teeth/caries/who-dmft.html

G) SAFETY

24) CLAIM: "Thousands of studies" have established the safety of water fluoridation.

Response: Frequently, promoters will make this claim, however, when asked to name one study showing fluoridation to be safe for people with kidney disease, they are unable to do so.

When they fail to cite a single study, it will become clear ­ despite their strong views on the matter ­ that they have never read the primary scientific literature for themselves. They have only read other people's reviews.

However, even if they were familiar with the scientific literature, they would still be unable to cite a credible study establishing the safety of fluoridation for people with kidney disease. That's because no such study exists.

As noted by Dr. Edward Groth, who has conducted an extensive review of the primary scientific literature:

"It seems probable that some people with severe or long-term renal disease, which might not be advanced enough to require hemodialysis, can still experience reduced fluoride excretion to an extent that can lead to fluorosis, or aggravate skeletal complications associated with kidney disease... It has been estimated that one in every 25 Americans may have some form of kidney disease; it would seem imperative that the magnitude of risk to such a large sub-segment of the population be determined through extensive and careful study. To date, however, no studies of this sort have been carried out, and none is planned." (Groth, 1973)

There are other glaring holes in the scientific literature on fluoridation's safety but this one example will serve to make the point.

25) CLAIM: Community X or country Y has been fluoridated for 50 years and there are no health problems there.

Response: This is another old war horse. The problem is that governments who sanction the use of water fluoridation are not organizing the most rudimentary studies to see if many of the health problems we see escalating today are related to increased fluoride exposure. For example, we know that 50% of the fluoride we ingest each day accumulates in our bones, but no fluoridating country is tracking the levels of fluoride in our bones, or for that matter in our urine, or plasma. We are flying blind when it comes to these valuable biomarkers, which makes meaningful epidemiological studies practically impossible.

What we do know is that the first symptoms of bone poisoning by fluoride are identical to arthritis, and in America the CDC(2002) reports 1 in 3 American adults have some form of arthritis. Government officials cannot tell us that none of these cases are related to fluoridation because they simply have not taken the necessary steps to find out. The same argument applies to the dramatic increases in hypothyroidism, earlier onset of puberty, hyperactivity and attention deficit syndrome in children, as well as Alzeimer's disease in the elderly. All of these outcomes, from a biological perspective, are plausibly related to over exposure to fluoride. But as the old saying goes, "If you don't look, you don't find."

It is also worth remembering that when the US PHS endorsed fluoridation in 1950, they had not completed one single study on the health effects of fluoride. Their support for the practice was not scientifically based then, and it is not scientifically based today.

26) CLAIM: Millions of people worldwide have been drinking fluoridated water for many years, if there were any health problems we would have seen them by now.

Response: The same argument applies here as given in 25) above: "If you don't look, you don't find." A graphic example of this comes from Australia. In 1991 the National Health and Medial Research Council (NHMRC) recommended to the Australian health authorities that they begin to track the level of fluoride in bones to see if long term exposure to fluoride might be causing damage and they also recommended that they follow up in a scientific fashion the persistent anecdotal reports of people being hypersensitive to fluoride. After 14 years neither of these suggestions have been taken up by any state or federal agency, even though they continue to promote fluoridation. Furthermore, it would also appear that apart from one small study on cancer, there has been no health study on any tissue other than the teeth in the 30 plus years communities have been fluoridated in Australia! Is it not surprising then that there are no health effects to report?

27) CLAIM: Why would the government do this if it was going to harm anyone?

Response: This certainly is the $64,000 question. Chris Bryson went a long way to answering this question in his book, "The Fluoride Deception". Perhaps, the simplest explanation for their continuing this policy despite the growing evidence of harm is that governments have gone so overboard with their enthusiasm for this policy, that it is extremely difficult for them now to admit they were wrong. Governments do not like losing face or their credibility." Or, as Dr. William Hirzy, a US EPA scientist, said in a videotaped interview, "they are riding a tiger, and they don't know how to get off" (Hirzy, 2001).

The ADA and toothpaste manufacturers may have higher stakes in keeping this policy going at all costs, because they are probably very worried about the huge liabilities involved if they ever admitted any health effects from fluoride.

H) DENTAL FLUOROSIS

28) CLAIM: Dental fluorosis is merely a "cosmetic" problem not a health problem.

Response: Dental fluorosis is a systemic effect and caused by fluoride accumulating to excess levels within the tooth's structure and thereby damaging the enamel-forming cells (ameloblasts). Dental fluorosis is thus a physiological change produced by a toxic effect of accumulated fluoride upon the tooth-forming cells. This raises the question of what other fluoride-accumulating tissues in the body (e.g. bone, pineal gland, and kidney) may experience a similar toxic effect.

As Dr. Jennifer Luke (1997) concluded in her seminal research on fluoride and the pineal gland:

"The safety of the use of fluorides ultimately rests on the assumption that the developing enamel organ is most sensitive to the toxic effects of fluoride. The results from this study suggest that the pinealocytes may be as susceptible to fluoride as the developing enamel organ."

Moreover, Alarcon-Herrera et al. (2001) have shown that there is a linear correlation between the severity of dental fluorosis and the prevalence of bone fracture in children. It is therefore optimistic to assume that fluoride's toxic effects are constrained to the growing tooth.

I) TOXICITY AT 1 ppm

29) CLAIM: 1 ppm is equivalent to 1 inch in 16 miles or 1 cent in $10,000.00

Response: These comparisons are meant to imply that at 1 ppm in water, fluoride could not possibly cause any harm. However, whether 1 ppm represents a safe or dangerous concentration, depends entirely on the chemical in question. If we were talking about arsenic, 1 ppm would be a 100 times larger than the safe drinking water standard (0.01 ppm or 10 ppb) and would be a dangerous level to drink. If we were talking about dioxin 1 ppm would be about one million times higher than levels of concern, because we are concerned about parts per trillion for this chemical. When judging whether or not a chemical is safe at particular concentration, a toxicologist would compare it with the Lowest Observable Effect Level in animal or human studies.

I will do this for a number of animal and human studies, and I will do it in the same terms as used in the proponent's claim above.
 

At one inch in 16 miles, or 1 cent in $10,000 (i.e. 1 ppm fluoride in drinking water) fluoride has led to an increase in aluminum into their brains as well as the formation of beta amyloid deposits characteristic of Alzheimer's disease (Varner et al., 1998).

At 1.5 inches in 16 miles, or 1.5 cents in $10,000 (i.e. 1.5 ppm fluoride in drinking water) fluoride has led to a doubling of hip fractures in elderly citizens in China ( Li et al., 2001).

At 1.8 inches in 16 miles or 1.8 cents in $10,000 (i.e. 1.8 ppm fluoride in drinking water) it is estimated tha IQ in children will be lowered (Xiang et al., 2003)

At 2.3 inches in 16 miles or 2.3 cent in $10,000 (i.e. 2.3 ppm fluoride in drinking water) thyroid function has been lowered in Russia (Bachinskii et al., 1985).

At 3 inches in 16 miles or 3 cents in $10,000 (i.e. 3.0 ppm fluoride in drinking water) fertility is lowered in U.S. Counties (Freni, 1994).

At 4 inches in 16 miles or 4 cents in $10,000 (i.e. 4.0 ppm fluoride in drinking water) the U.S. EPA regulates fluoride as a toxic contaminant.

30) CLAIM: It is true that fluoride is toxic at high doses, but drinking water at 1 ppm is perfectly safe.

Response: When a substance has a supposed therapeutic benefit, but is toxic at higher doses, a toxicologist or a pharmacologist would examine the margin of safety (MOS) between the toxic dose and the therapeutic dose (i.e. toxic dose divided by the therapeutic dose). Ideally, he or she would want an MOS of 100.

For the end points discussed above in 29), the MOS is less than 5, and when we consider that we cannot control how much water people drink, there is no margin of safety at 1 ppm at all, especially for those with impaired kidney function.

31) CLAIM: Paracelsus said : "It is the dose that makes the poison."

Response: The sixteenth century toxicologist Paracelsus (1493-1541), who is sometimes referred to as the father of toxicology, was correct. But a modern toxicologist would quantify the issue as we have done in 29) and 30) above.

A proponent offering this argument on toxicity should be asked what margin of safety they feel would be necessary when exposing a whole population to a known toxic substance like fluoride. They dare not discuss this issue.

32) CLAIM: Everything is toxic at high doses, including salt, iron, oxygen even water.

Response: Again, this is correct, but in all these cases the margin of safety between the doses that we need and the doses that would cause harm is very large, unlike the case for fluoride.

33) CLAIM: You would need to drink 50 bath tubs full of water to get a toxic dose.

Response: This is another old war horse. An early use came in 1952, when John Knutson, Chief of the Division of Dental Health at the U.S. Public Health Service, said in a presentation in Salem, Massachusetts:

"We know that fluoride is toxic in excessive amounts [but] you would have to drink over 400 gallons of water containing 1.0 parts per million at one sitting to receive a toxic dose. Such a large drink might kill you, of course, but water alone would do the job without any help from the fluoride." (Knutson, 1952)

Something similar was used recently in promotion material from Dr. Mark Greer, the Dental Director for the state of Hawaii and Dr. Kassler from NH.

These claims confuse an acute (even lethal) dose with a chronic dose. Not many people opposing fluoridation are doing so because they think they are going to be killed by a glass of fluoridated water, but rather they are concerned about the impacts of drinking this water every day of their lives. A similar distinction could be made with smoking. Smoking one or two cigarettes probably wouldn't hurt you but smoking one or two every day of your life probably would. Chronic exposure is particularly important for substances like fluoride which accumulate in the bone and other calcified tissues.

However, there are some people (about 1% of the population) who are extremely sensitive to fluoride (Feltman and Kosel, 1961) and they would be concerned about acute responses from even very low exposure. 1% of the population of those drinking fluoridated water is a lot of people. Many people probably don't even realize that they might be sensitive to fluoride because the symptoms are similar to many of the things most of us experience from time to time in our everyday lives, like upset stomach, headaches and rashes. Most wouldn't think they were responding to a toxic substance in their water, nor would their doctors while stuffing them with pills to fight these common symptoms. No government promoting fluoridation has ever attempted to address this issue scientificially.

J) IS FLUORIDE NATURAL?

34) CLAIM: Fluoridation is merely a slight adjustment to a naturally occurring phenomenon.

Response: This statement obfuscates an important point: namely, that the vast majority (over 90%) of water supplies contain much less fluoride than we add to water.

In Canada, the average fluoride content of untreated water is 0.05 ppm, which is 20 times less than the concentration added to water for fluoridation (1.0 ppm). In the United States, the average fluoride concentration of spring water is 0.1 ppm, or 10 times less than the level added to water.

Also, the fact that fluoride ­ like arsenic ­ is found at high levels in some scattered regions of the U.S. is by no means an assurance of safety. Indeed, there are many naturally occurring compounds that are undesirable to ingest unnecessarily ­ e.g. arsenic, lead, and radium.

Mothers' milk is a far better indicator of what is "natural" and the levels of fluoride there are 0.005-0.012 ppm (Institute of Medicine, 1997) i.e. 100-200 times lower than that added to water.

35) CLAIM: Fluoridating chemicals are also natural, because they come from natural rocks.

Response: This argument comes from the following statement contained in a booklet circulated by the Department of Human Services in Victoria, Australia in 2004 .

"The fluoride added to water comes from natural rock. During the extraction process a gas is produced. Gases are difficult to handle so a piece of equipment called a scrubber can be used to convert the fluoride into a liquid or powder form which can be added to water supplies in a carefully controlled way. Some people think that because a scrubber is used fluoride must be a poison. This is not true."

This statement clearly reflects the need of promoters to defuse the growing public concern about the use of industrial grade waste products, generated largely by the superphosphate fertilizer industry, instead of pharmaceutical grade chemicals, to fluoridate public water supplies. Over 90% of the fluoridating chemicals used in the U.S. do not occur naturally.

The way this statement has been written is meant to imply that the "natural" rock is being mined for its fluoride content. It is not. The gaseous fluoride (hydrogen fluoride and silicon tetrafluoride) are toxic by-products from the superphosphate production processes. Up until the mid-twentieth century these waste gases had polluted the environment, damaged vegetation and crippled cattle in fields near the plants. Eventually, this industry was forced to put on wet scrubbers to minimize this damage. The product generated when these gases are dissolved in the water spray is hexafluorosilicic acid solution which is also contaminated with other toxic substances like heavy metals and trace amounts of radioactive isotopes (in the U.S. this same phosphate rock was mined for uranium). It is one of the supreme ironies that this scrubbing liquor cannot be dumped into the sea by international law but some health agencies allow it to be dumped into our drinking water! To suggest that this scrubbing liquor is not poisonous is total poppycock.

Moreover, Masters and Coplan (1999, 2000) have found in two studies a correlation between the use of these silicofluorides, obtained from the phosphate industry, and the uptake of lead into children's blood and the prevalence of violent behavior. They also discovered that these substances had never been tested in long term animal studies.

The response to Masters and Coplan has been that once these silicofluorides are diluted to 1 ppm they are completely dissociated into the free fluoride ion, and thus identical to a solution of sodium fluoride. However, Masters and Coplan disagree, and point out that;

"When the National Toxicology Program nominated silicofluorides for study in 2002, there was official government admission challenging the sufficiency of this claim as the basis of safety" (personal communication, May, 2005)

36) CLAIM: Adding fluoride to water is no different then adding vitamin D to milk.

Response: There are four key differences between adding vitamin D to milk and adding fluoride to drinking water:

a) Vitamin D is an essential nutrient fluoride is not.

b) The margin of safety between the beneficial dose for vitamin D and its toxic dose is very large, with fluoride there is no margin of safety.

c) The Vitamin D is pharmaceutical grade, the fluoridating chemicals are industrial grade waste products.

d) The consumer can choose milk without vitamin D added, thus they are not trapped by this practice as they are with water fluoridation.

K) "NUTRIENT" v. "MEDICATION"

37) CLAIM: Fluoride is an essential nutrient, not a medication.

Response: While this is still a commonly held view, it is outdated and no longer supported by the U.S. National Academies of Science. Here, for example, are the last 3 public statements the NAS has made on the "essentiality" of ingested fluoride:

a) "These contradictory results do not justify a classification of fluorine as an essential element, according to accepted standards." (NAS, 1989, p235)

b) "Fluoride is no longer considered an essential factor for human growth and development." (NRC, 1993, p30)

"First, let us reassure you with regard to one concern. Nowhere in the report is it stated that fluoride is an essential nutrient. If any speaker or panel member at the September 23rd workshop referred to fluoride as such, they misspoke. As was stated in Recommended Dietary Allowances 10th Edition, which we published in 1989: "These contradictory results do not justify a classification of fluoride as an essential element, according to accepted standards." (Alberts & Shine letter, 1998)

The fact that fluoride is not an essential nutrient is not surprising when considering 1) the recent concession that ingested fluoride provides little protection to teeth, and 2) the extremely low levels of fluoride found in breast milk (which is the place one normally expects to find essential minerals).

The fluoride concentration of breast milk is 100 to 200 times lower than the level added to water, and remains low even when the nursing mother receives fluoride supplementation. As a result, the breastfed infant receives the lowest fluoride exposure (mg/kg) of all age groups in the population, while the bottle fed baby, where the formula is made up with fluoridated water, gets the highest!