Fluoridation: Time for a second look ?

by Paul, Ellen and Michael Connett

Rachael's Environment and Health News, May 10, 2001


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.[1]

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.[2]

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.[3] 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.[4]

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.[5] 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.[6]

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 form.[7]

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, particularly iodide.


1) In 1998 the results of a long-term, low-dose rat study were published.[8] 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 blood-brain barrier.

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.[9] 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."[3] 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.[10]

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).[11] 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.[12]

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.[13] Additionally, fluoride accumulates in the pineal gland and may reduce melatonin production.[14]

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.[17] 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."[18] Hip fracture is not a minor problem: in the U.S. up to 50,000 people die each year of osteoporosis-related hip fractures.[19]

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 IQ.[22]

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).[23] 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>

[1] 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.

[2] 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/- FSSupplyStats.htm.

[3] 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.

[4] 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.

[5] 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.

[6] C.J. Spak and others, "Fluoride in Human Milk," ACTA PAEDIATRICA SCANDINAVICA Vol. 72, No. 5 (September 1983), pgs. 699-701.

[7] 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. 136-143.

[8] 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.

[9] S.S. Jolly and others, "Human Fluoride Intoxication in Punjab," Fluoride Vol, 4, No. 2 (1971), pgs. 64-79.

[10] 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.

[11] Pierre-M. Galletti and Gustave Joyet, "Effect of fluorine on thyroidal iodine metabolism in hyperthyroidism," JOURNAL OF CLINICAL ENDOCRINOLOGY Vol. 18 (October 1958), pgs. 1102-1110.

[12] Beth Ann Ditkoff and Paul Lo Gerfo, THE THYROID GUIDE [ISBN 0060952601] (New York: Harper, 2000), cover notes.

[13] Anna Strunecka and J. Patocka, "Pharmacological and toxicological effects of aluminofluoride complexes." FLUORIDE Vol. 32, No. 4 (November 1999), pgs. 230-242.

[14] 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.

[15] 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. 223-225.

[16] 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), pgs. 802-809.

[17] 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://- www.fluoridealert.org/cdc.htm.

[18] 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.

[19] K. Phipps, "Fluoride and bone health," JOURNAL OF PUBLIC HEALTH DENTISTRY Vol. 55, No. 1 (Winter 1995), pgs. 53-56.

[20] National Toxicology Program, TOXICOLOGY AND CARCINOGENESIS (December 1990). This NTP study is summarized in reference 10, pgs. 71-73.


[22] 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.

[23] 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. 6-7.

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