Fluoridation Fallacy

Fluoridation probably does more damage than good says a Canadian government report. The best solution is to cease fluoridation, the author suggests (1). Despite fraudulent news releases, a British team of investigators found that fluoridation is based on poor science, has overstated benefits, and puts children at high risk of developing dental fluorosis (2).

Dentists claim hundreds of studies prove fluoride reduces decay. However, a US National Institutes of Health (NIH) panel convened this year to actually evaluate those and other dental studies and found them lacking. (3) An NIH news release reported: “...the panel was disappointed in the overall quality of the clinical data that it reviewed. According to the panel, far too many studies were small, poorly described, or otherwise methodologically flawed,” (including 562 studies evaluating fluoride use). So while the use of fluoride is often cited as the reason for decay reduction, there is little, if any, science to support that.

Furthermore, cavity rates declined in several cities that stopped water fluoridation (4), contradicting American Dental Association (ADA) predictions (5).

Fluoride overdose is widespread in both fluoridated and non- fluoridated communities(6) at the same time the United States Surgeon General dubbed oral disease a silent epidemic in his recent Oral Health Report (7). And Americans, men and women equally, are spending about $1.5 billion a year on dental bleaching products, and that may be the tip of the iceberg (8). How much is that due to dental fluorosis?

Additionally, fluoridated water should not be used to prepare infant cereals and infant formulas (10) forcing parents, who can afford it, to buy bottled water to avoid their fluoridated tap water - leaving the poor at a disadvantage, yet again.

Ironically, dentists often warn parents against using bottled water because of its lack of fluoride. Yet one of the best selling bottled water in health food stores is Trinity Springs with a natural fluoride content of 3.6 mg per Liter - enough to almost guarantee a child fluorosed teeth if he or she consumed it regularly. In some states the maximum contaminant level of fluoride which governments allow in public water supplies is only 2 mg per liter.

In the world’s most fluoridated country, where fluoride toothpastes are 95% of the market and where dental fluorosis rates are growing, the US youngest and poorest children have almost 5 times as much tooth decay as children of higher income families according to the National Institute of Dental Research and, in poor children with decay, almost 80% of it remains untreated(11). Ironically, African Americans have the highest dental fluorosis rates (14) and are among the minority groups experiencing the most decay.

In fact, after over 50 years of water fluoridation, children in Newburgh, New York, have more cavities and more dental fluorosis than children in never-fluoridated Kingston, NY(12).

Newburgh and Kingston are the experimental cities that helped launch fluoride into the water systems that 62% of Americans now drink. Research shows a much greater difference in cavity rates between poor and nonpoor children than when fluoridation status is compared (13). And the difference between fluoridated and non-fluoridated decay rates was a mere 6/10’s of one tooth surface (there are 128). Yet dentists routinely promise up to a 70% reduction in tooth decay for children who drink fluoridated water.

The poorest oral health in the US is found among non-Hispanic blacks, Hispanics, and American Indians and Alaska Natives(7). However, many of these populations already live in fluoridated communities according to the US census and US fluoridation census. And not so coincidentally, these are the same groups that eat the least vegetables, consume the most sugar and have the poorest overall health, according to government statistics.

“Bleeding gums, impacted teeth and rotting teeth are routine matters for the children I have interviewed in the South Bronx (one of the US poorest areas),” writes Jonathan Kozol in 'Savage Inequalities.' Children get used to feeling constant pain...I have seen children in New York (City) with teeth that look like brownish, broken sticks. I have also seen teen-agers who were missing half their teeth. But to me, most shocking is to see a child with an abscess that has been inflamed for weeks and that he has simply lived with and accepts as part of the routine of life.”

New York City has been fluoridated since 1965. Kozol’s book was published in 1991.

Today, researchers recommend children cut back on fluoride(15). However, that message rarely reaches parents. And it’s not unusual for dentists to instigate legislation to force more fluoride on children even when the literature suggests less. Children from Connersville, Indiana, were studied and found to already ingest more than sufficient fluoride through their food, beverages and dental products(15). Nonetheless, dentists still successfully lobbied trusting town legislators to fluoridate Connersville water supply increasing children’s dental fluorosis risk unnecessarily. (“Indiana Vote Focuses on Fluoridation, “Associated Press 10-31-1999 & “Indiana Town OKs Fluoridated Water,” AP, 2-28-00).

This happens often all over the US while 80 percent of the poorest youngsters do not receive dental care. One major reason is that dentists refuse to treat poor children because they aren’t paid enough to do so. Half of Medicaid-insured children never visit a dentist, and many who do are not given needed care(16)

The World Health Organization ranks the US 24th in healthy life expectancy because of the “miserable standards among the US poor” (NY Newsday, 6/5/2000). Over 11% of US poor children go hungry most days (17). The most cavity prone populations are also the least healthiest. Malnutrition has been associated with Early Childhood Caries (ECC)(18) or severely decayed primary dentition. ECC is currently at epidemic proportions in some US minority populations (19).

A well nourished child who gets proper dental treatment will most probably have sound teeth and the only side effect will be a sound body, too. Fluoride is not the cure for tooth decay it was expected to be. An August 1995 Journal of the American Dental Association article reported "Recent studies have identified that the incidence of dental caries among U.S. children seems to be concentrated in about 20 to 25 percent of the U.S. child population - despite access to fluoride and other preventive measures."(19a)

Dental researcher and Professor, Brian Burt, BDS, University of Michigan reported to the NIH panel in March 2001, “...avoiding consumption of excess sugar is a justifiable part of caries prevention, if not the most crucial aspect.”

It’s time to stop throwing more fluoride at children - especially since the silicofluorides most used for fluoridation have never been safety tested (sodium fluoride was used in experiments). Silicofluorides also deliver trace amounts of arsenic, mercury, lead and more along with the fluoride. Recent research by Masters, et al,(20) show that children who live in silicofluoridated communities have higher blood lead levels than children who live in non- or sodium fluoridated communities. Other studies show that high blood lead levels are associated with more tooth decay (21).

Ingested fluoride supplements aren’t the answer either since fluoride’s alleged beneficial properties are mostly topical (22) and because optimal fluoride intake was never proved scientifically (23).

Instead of spending millions of dollars funding researchers to determine just how much fluoride is too much and what kind should or should not be in the water, that money should go to feed the hungry and treat the dental disease of poor children.

Tooth decay appears to be, not a disease of the fluoride deficient, but a disease of the poor, undernourished and dentally undertreated.

END

References:

1) “Benefits and Risks of Water Fluoridation: An Update of the 1996 Federal-Provincial Sub-committee Report,” Public Health Branch, Ontario Ministry of Health, First Nations and Inuit Health Branch, Health Canada, by Dr David Locker, Faculty of Dentistry, University of Toronto, November 1999 and releases January 2001,http://www.gov.on.ca/MOH/english/pub/ministry/fluoridation/fluoridation.html

2) British Medical Journal, October 7, 2000
a) “Systematic review of water fluoridation.” McDonagh MS, et al http://bmj.com/cgi/content/full/321/7265/855?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=McDonagh&searchid=1022727232537_2367&stored_search=&FIRSTINDEX=0&resourcetype=1,2,3,4,10

3) National Institutes of Health, Consensus Development Conference Statement, Diagnosis and Management of Dental Caries Throughout Life, March 26-28, 2001,http://odp.od.nih.gov/consensus/cons/115/115_intro.htm

4) a) “Caries trends 1992-1998 in two low-fluoride Finnish towns formerly with and without fluoridation,”
Caries Research, Nov-Dec 2000
b) “Caries prevalence after cessation of water fluoridation in LaSalud, Cuba,” Caries Research Jan-
Feb. 2000
c) “Decline of caries prevalence after the cessation of water fluoridation in the former East Germany,”
Community Dentistry and Oral Epidemiology, October 2000
d) “The effects of a break in water fluoridation on the development of dental caries and fluorosis,”
Journal of Dental Research, Feb. 2000
e) “Patterns of dental caries following the cessation of water fluoridation,” Community Dentistry and
Oral Epidemiology, February 2001
f) “Caries experience of 15-year-old children in The Netherlands after discontinuation of water
fluoridation,” Caries Research, 1993

5) “Dental decay can be expected to increase if water fluoridation in a community is discontinued for one
year or more, even if topical products such as fluoride toothpaste and fluoride rinses are widely used.”
http://www.ada.org/public/topics/fluoride/facts-benefit.html#5

6) Clark DC, Trends in prevalence of dental fluorosis in North America, Community Den Oral Epidemiol,
1994, 22, 148-52 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8070241&dopt=Abstract

7) Oral Health in America: A Report of the Surgeon General, Department of Health and Human Services,
May 2000

8) Kiplinger’s Magazine, April 2001, “Smile Therapy,” by Christina Lanzito

10) Pediatric Dentistry 2000, Jul-Aug, “Risk factors for dental fluorosis: a review of the recent literature,”
Mascarenhas;
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10969430&dopt=Abstract

11) http://www.nidcr.nih.gov/sgr/children/kidsbyte.htm (Factoid #2)

12) Kumar, Green, Recommendations for Fluoride Use in Children,” NYS Dental Journal, February 1998
See Chart (Figure 1) page 41
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9542393&dopt=Abstract

13) “Oral Health Status of Second Grade School Children in Upstate New York,” New York State Dental
Journal, February 2001, Kumar, Green Coluccio, Davenport

14) Journal of Public Health Dentistry, Summer 2000, “Low birth weight and dental fluorosis: is there an
association?,” Kumar & Swango;
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11109214&dopt=Abstract

15) Rojas-Sanchez F, Kelly SA, Drake KM, Eckert GJ, Stookey GK, Dunipace AJ, Fluoride intake from
foods, beverages and dentifrice by young children in communities with negligibly and optimally
fluoridated water: a pilot study. Community Dent Oral Epidemiol. 1999 Aug;27(4):288-97;
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10403089&dopt=Abstract

16) "A longitudinal study of schoolchildren's experience in the North Carolina dental Medicaid program,
1984 through 1992," by Valerie A. Robison, D.D.S., Ph.D., M.P.H., R. Gary Rozier, D.D.S., M.P.H.,
and Jane A. Weintraub, D.D.S., M.P.H., in the November 1998 American Journal of Public Health
88(11), pp. 1669-1673

17) America’s Children: Key National Indicators of Well-Being, Federal Interagency Forum on Child and
Family Statistics 1999

18) Ismail AI, The role of early dietary habits in dental caries development, Spec Care Dentist 1998, Jan-
Feb

19) Tinanoff N. Introduction to the Early Childhood Caries Conference: initial description and current
understanding, Community Dent Oral Epidemiol 1998;26(1 suppl)

19a)"Using Anticipatory Guidance to Provide Early Dental Intervention," Nowak, et al, JADA August 1995 pg 1156

20) Masters, Coplan, Hone, International Journal of Environmental Studies, August 1999, and
“Association of Silicofluoride Treated Water with Elevated Blood Lead,” NeuroToxicology, December
2000, Masters, Coplan, Hone, Dykes

21) a)Sci Total Environ 2000 June “Heavy metals in human primary teeth: some factors influencing the
metal concentrations,” Tvinnereim, Eide, Riise
b)JAMA 1999 June, “Association of dental caries and blood lead levels,” Moss et al

22) Burt, The case for eliminating the use of dietary fluoride supplements for young children, J Public
Health Dent 1999 Fall

23) Levy SM, Kohout FJ, Kiritsy MC, Heilman JR, Wefel JS Infants' fluoride ingestion from water,
supplements and dentifrice, J Am Dent Assoc 1995 Dec