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#724 - Fluoridation: Time For A Second Look?, 09-May-2001

by Paul, Ellen and Michael Connett*

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

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

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

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).[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

[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

[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

[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
(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.

[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.

[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
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.

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.

[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

[18] Agency for Toxic Substances and Disease Registry,
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.

MALES. (Trenton, N.J.: New Jersey Department of Health, November
8, 1992).

[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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