Wednesday, October 02, 2013

Fluoridation Fails; America’s Cavity Crisis Escalates, by Carol S. Kopf, BS, MA

Fluoridation Fails as America’s Cavity Crisis Escalates, by Carol S. Kopf, BS, MA

Tooth decay is a growing US epidemic (1) despite almost 7 decades of water fluoridation reaching record numbers of Americans and despite fluoridated toothpaste occuping 95% of the market.

While fluoride-overdose symptoms (discolored teeth or dental fluorosis) escalate fluoride isn’t doing much to prevent cavities. The CDC reports that up to 60% of US adolescents are afflicted with dental fluorosis. Yet,  51% have cavities, even though 41% of them have sealants.

Unrelated to and despite fluoridation, tooth decay is clearly a disease of poverty and malnutrition. In fact, new research indicates that people living in areas with fluoridated water and/or using fluoride toothpaste still get cavities and that, when less than 10% of total calories in the diet is made up of free sugars, there are much lower levels of tooth decay.

Fluoridation was implemented to preserve teeth, save money and put dentists out of business.  But none of that happened. Only politics and money keeps fluoridation alive. Science doesn’t.

The Bureau of Labor Statistics reports, employment of dentists is expected to grow by 21 percent from 2010 to 2020, faster than the average for all occupations.

Over a quarter (28%) of US 2-5 year-olds have tooth decay - a 15% jump from a decade earlier (2) Fluoridation even fails to protect low income children – 48% of preschoolers from low-income households experienced tooth decay and 35% had untreated cavities (compared to 11.4% and 6% of preschoolers from higher income households, respectively) (1b)

An astounding 44% of all five-year-olds have cavities (3)

To compare, only 25% of England’s five-year-olds have cavities (4) yet, only 11% of England’s water supplies are fluoridated and children’s toothpaste is sold at half the fluoride concentration of US brands.

In Japan, children's tooth decay is falling sharply where both the water and toothpaste is not fluoridated and fluoride supplements are not prescribed.

In Ireland, where fluoridation is mandated country-wide, "Irish dental surgeries are 'brimming' with children showing signs of irreparable tooth decay because of their intake of sugary drinks and treats.

The US lags behind 10 other, mostly non-fluoridated, peer countries in cavity rates, according to WHO statistics. (4a) And, a state of decay flourishes among older Americans, according to a report by Oral Health America. (1a)

In Connecticut, the 4th richest state, fluoridation is state-mandated since the 1960’s. Yet, 35% of white children, 50% of African American and 50% of Hispanic children have cavities – even though 42%, 35% and 49% have dental sealants, respectively. Up to 57% of low-income third graders have tooth decay, 18% untreated, despite an increase in Medicaid utilization. (4b) The CDC gave the state of Connecticut$1.5 million grant to improve dental health in September 2013.

In Minnesota, where fluoridation is also state mandated, 72% of low-income third-graders have tooth decay compared to 46% of non-poor. Between 2007 and 2010, Minnesota reported $148 million in emergency charges for preventable, non-traumatic dental care.  (4c)

In Oregon, 52% of first, second and third graders in fluoridated areas had one or more cavities but only 48% in the non-fluoridated Oregon city of Portland. (4d)

Published research shows that Kentucky, the most fluoridated state (99.9%) exceeds the US average for dental health problems as 13% of adults aged over 18 years are missing all of their teeth, compared to 6% nationally, placing Kentucky as the nation’s highest percentage of toothless persons.  

Forty-three percent of Kentucky’s under five-year-olds have severe early childhood dental decay. And, 50% of second graders and nearly 75% of 15 year olds in Kentucky have cavities.

In fact, after fluoridation was state mandated in Kentucky, tooth decay rates doubled.

The New York Times reported that dentists across the US say they are seeing more preschoolers at all income levels with 6 to 10 cavities or more (5)  CBS reported that "More preschoolers are showing up to dentists with 10 cavities or more.” (5a)

“’We have had a huge increase in kids going to the operating room,’ said Dr. Jonathan Shenkin, a pediatric dentist in Augusta, Me., and a spokesman for the American Dental Association. ‘We’re treating more kids more aggressively earlier,’” reported the NY Times.

In fact, the more highly fluoridated New York State counties have a greater number of 3- to 5-year-olds making tooth decay emergency department visits when compared to non-fluoridated counties. (See Below**)

Dental-related hospital emergency care more than doubled from 2000 to 2010, from 1 million to 2.3 million, and that doesn’t include seniors 65 and older (National Center for Health Statistics).(7)  The highest number were for 18-44 year-olds.

The Pew Foundation estimates that preventable dental conditions were the primary diagnosis in 830,590 visits to ERs nationwide in 2009—a 16 percent increase from 2006. (8 )

Between 2000-2008 there were 61,439 hospitalizations for tooth infections in the US, an increase of 41% from 2000 to 2008.  Sixty-six died; 89% occurred on an emergency/urgent basis; average age - 37 years-old.(Journal of Endodontics) (9)

Average annual out-of-pocket costs for dental services in the U.S. rose 26% from 1996 to 2010. (9a)

General Accounting Office (GAO) reported in 2008, “Extent of Dental Disease in Children Has Not Decreased, and Millions Are Estimated to Have Untreated Tooth Decay.” GAO estimates that 6.5 million children aged 2 through 18 in Medicaid had untreated tooth decay.

Tooth decal crises are occurring in all fluoridated cities and states. Americans are fluoride-overdosed and dentist-deficient. 


The most highly fluoridated US states are home to residents with the fewest teeth. For example,

Nationally, 16% of low-income non-elderly American adults (aged 18-64) lost six or more teeth, according to The Commonwealth Fund report, (10)  

The report, ”Health Care in the Two Americas," found big gaps between the lowest- and highest-performing states. For instance, low-income adults in 92% fluoridated West Virginia are far more likely to lose six or more teeth to decay or disease compared to 11% fluoridated Hawaii and 33% fluoridated Utah.(11)

Thirty-four percent of low-income older adults (65-74) lost all their teeth compared to 13% of non-poor. (National Center for Health Statistics Data Brief No. 104, August 2012) (12) Not counting wisdom teeth, 71% of adults, age 45-64, don’t have a full set of teeth. This includes 81% of Hispanics, 89% of Blacks and 65% of whites. 

Sen. Bernie Sanders and Rep. Elijah E. Cummings introduced legislation addressing this dental crisis. The bills – which would expand dental coverage through Medicare, Medicaid, the Affordable Care Act and the Department of Veterans Affairs and increase the dental work force – were filed one week after a new government study documented skyrocketing costs and limited access to dental care. (13)

The Government Accountability Office (GAO) reported that Americans spent about $108 billion on dentists in an inflation-adjusted increase from $64 billion in 1996. Forty-two percent of adults with tooth or mouth problems did not see a dentist in 2008 because they did not have dental insurance or could not afford the out-of-pocket payments.  And 4 million children did not obtain needed dental care because their families could not afford it.(14)

GAO's analysis showed that average annual dental out-of-pocket payments increased 26 percent, adjusted for inflation – 21% for the privately insured and 32% for the non-insured.  

In 2007, 12-year-old Deamonte Driver’s death from an untreated cavity, that festered and grew to attack his brain, first brought this dentist-deficiency to the nation’s attention. About two dozen dentists refused to treat him and $250,000 in public funds and a two week hospital stay couldn’t save his life. We’ve now learned that at least 66 Americans died in hospitals because of untreated tooth decay.(15)

Fluoridation Wastes Time and Money

Despite way too many money- and time-wasting conferences, congressional hearings, meetings, symposiums, reports, press conferences, studies and coalition-building among and between government agencies,  industry and organized dentistry including hundreds of millions of dollars wasted on fluoridation schemes throughout the country, very little has alleviated America's rotting teeth and rotting dental care industry.

Organized dentistry peddles more fluoride, making their corporate sponsors wealthier. But they continue to lobby against viable solutions such as Dental Therapists, which are to dentists what physicians’ assistants are to physicians.  Dental Therapists have worked successfully for decades in other first world countries with two years’ training. Only a well-funded persistent dental lobby keeps them from working more extensively in the US.
Fluoridation began in the 1945 when it was virtually the only fluoride source. Now fluoridated toothpaste is 95% of the market and is a multi-billion dollar international money-maker for powerful corporations. A myriad of fluoride dental products is on the market.  So it’s no wonder that the US Centers for Disease Control now reports that up to 60% of adolescents are fluoride-overdosed and afflicted with dental fluorosis – white spotted, yellow, brown and/or pitted teeth. Yet, 51% of them still have tooth decay.


*92% of West Virginia is fluoridated;  92% of Tennessee; 80% of Alabama; 55% of Mississippi, and 99.9% of Kentucky)

**In 75% fluoridated New York State, 66 per 10,000 tooth decay emergency department (ED) visits were made by 3-5 year olds.  But, in the non-fluoridated counties of Nassau, Suffolk and Rockland, the rate is much lower (23, 45 and 25 respectively) ED visits per 10,000 (ages 3-5) in highly water fluoridated counties, Monroe, Erie, Chemung, Broome, Wayne, and Ontario is 102, 66, 69, 182, 92, and 82, respectively.