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May/June 2005 Living Now
Why is Fluoridation Failing?

by Lynne Campbell

America is in "dental crisis" mode, according to reports from some of the nation's largest cities, including Cincinnati, Detroit, Manhattan, Pittsburgh, and Boston. How could tooth decay be such a big problem when these cities have been fluoridating their drinking water for decades?

On the other hand, why do children have lower-than-average cavity rates here in Oregon, one of America's least fluoridated states? A national Oral Health Report Card (published in 2000 after a CDC review) gave Oregon an "F" for water fluoridation, but a "B" for low cavity rates in our kids. Only three states earned "A's" in the cavity category, but they also showed poorly in "Fluoridation," with a "C" and two "D's."

The largest U.S. government study cited as "proof" fluoridation works, actually found an insignificant 0.5% difference in tooth decay between fluoridated and non-fluoridated groups (only 0.6 of 128 tooth surfaces). That's only about half a cavity, but through mathematical sleight of hand, promoters have touted an 18% reduction (for details, see: www.ProtectOurWater.US/spin.html). Based on this survey, Chemical & Engineering News (5/8/89) concluded that decay rates of children regardless of fluoridation were "nearly identical."

So is fluoridation actually accomplishing anything? It's an open question, according to UNICEF's overview of fluoride: "It has long been known that excessive fluoride intake carries serious toxic effects," says the report. "But scientists are now debating whether fluoride [in water] confers any benefit at all" (www.unicef.org/wes/fluoride.pdf).

New science undermines fluoridation's early claims

More than a half-century ago, water fluoridation commenced on the assumption that children needed to swallow fluoride while their teeth were developing. But new, definitive research led the Centers for Disease Control to report in 2001 that "fluoride's predominant effect is posteruptive and topical." In other words, it works when in direct contact with teeth after they have broken through the gums (see pg 4, www.cdc.gov/mmwr/PDF/rr/rr5014.pdf).

Products that deliver fluoride topically, like toothpaste and mouthwash, have FDA approval as effective and safe, if they're not swallowed (check out their warning labels). But, believe it or not, FDA recently told a Congressional subcommittee that it has never even reviewed (let alone approved) the safety and effectiveness of any fluoride-containing product meant for ingestion for the purpose of reducing tooth decay.

So, if fluoride works topically, and systemic forms do not have FDA approval, why we would implement a systemic form of delivery, with no control over dose, through the water supply?

Fluoride is ineffective against the most common types of decay

Even the dental community agrees that fluoride doesn't protect the chewing surfaces of teeth from "pit and fissure decay," which accounts for almost 90% of decay in children's permanent teeth (CDC, MMWR, 11/30/01). Sealants work, and that's why they're being used.

Similarly, fluoride does not prevent "baby bottle tooth decay," devastating decay which requires parental education: Children older than a year must not be given a bottle of juice or some other sugary liquid at bedtime.

Oregonians already ingest too much fluoride

Fifty years ago, fluoride was added to drinking water at a so-called "optimal" level of 1 part per million so people would consume about one milligram (mg) of fluoride per day. Today, there's so much fluoride in our food chain that even people living in non-fluoridated areas, according to the Public Health Service (ATSDR, 1993), get that milligram a day without having it in their water.

Interestingly, newborns are protected from fluoride exposure naturally. Even when a mother's fluoride intake is elevated, her breast milk will average only 5-10 parts per billion (Ekstrand, 1981), a tiny fraction of the 1,000 parts per billion of fluoride delivered in tap water.

Adding fluoride to water in addition to current exposures -- knowing fluoride's effect is topical – increases rates of dental fluorosis in our children. This permanent damage to teeth, which appears as spotting, striping, pitting and/or staining, is clear, visible evidence of excessive exposure to fluoride while a child's teeth were developing.

True costs of fluoridation must include:

Repairing dental fluorosis
It is well documented that rates of dental fluorosis, defined by Taber's Medical Encyclopedia as "chronic fluorine poisoning," have been climbing dramatically in the U.S. and are significantly higher in fluoridated communities. Whether that poisoning affects other parts of the body or is localized in tooth enamel is a matter of controversy. Even if the damage were only cosmetic, fluorosis causes embarrassment and psychological distress, and the considerable costs for repair are not covered by insurance. That dentists profit from this damage, while dismissing it as a non-issue, might be seen as a conflict of interest.

Consequences of lead and arsenic in fluoridation chemicals
Fluoridation's proponents like to label fluoridation as "economical." But their economics are based on the use of contaminated, rather than pharmaceutical grade, fluoride compounds. These compounds never occur naturally in drinking water, but are the recovered toxic waste byproducts of industry, primarily phosphate fertilizer production. Contaminants include arsenic and lead, both of which are recognized scientifically as unsafe at any level. The considerable costs to families and society in terms of neurological damage and cancer caused by calculable exposure to these toxins are never factored by promoters into the costs of fluoridation.

Multiple adverse health effects
Fluoride is more acutely toxic than lead and, like lead, accumulates in the body. The Physicians Desk Reference acknowledges hypersensitivity to fluoride, which appears to affect about 1% of a population (see www.fluoridealert.org/health/allergy). That's 34,200 Oregonians! Hundreds of legitimate, peer-reviewed studies in the medical/scientific literature show adverse health effects: from hip fracture and cancer to IQ deficits in children (www.slweb.org/bibliography.html). If proven conclusive, all have tremendous economic costs.

Fluoride toxicity to salmon
Studies have shown that low levels of fluoride harm salmon in soft, fresh water, typical of our rivers (Damkaer/Dey, 1989). Some are already near or above the 0.2 ppm fluoride threshold of harm for migratory chinook and coho. Yet, water treatment equipment is NOT designed to remove fluoride before it is discharged into rivers. Why would we invest so heavily in protecting this endangered species, while simultaneously implementing a practice with real potential for causing harm?

Expensive water purifiers
Carbon filters do not remove fluoride from tap water. Anyone choosing or needing to avoid fluoride for medical reasons, must purchase bottled water or expensive reverse osmosis or distillation systems, simply to enjoy the basic right of access to safe, clean drinking water.

The elephant in the room: Access to dental care

To effectively reduce decay in Oregon and convert our "B" grade for cavity rates to an "A," we must focus on access to care. The CDC reports that 80% of tooth decay in the permanent teeth of children occurs in only 25% of the child population, kids from low-income homes without insurance or access to a dentist. For them, adding fluoride to drinking water is like putting a band-aide on a surgical wound, a meaningless gesture that WILL NOT produce the desired result. Just look at the dental crises in fluoridated cities across the U.S.

How do we protect Oregon's children, rather than hurting them?

First, the "YES" bill: Let's say YES to SB 852, which will fix the problems and loopholes in current standards by establishing basic safety criteria for medicinal water additives. We already have a federal law, the Safe Drinking Water Act, that prohibits the "addition of any substance for preventive health care purposes unrelated to contamination of drinking water." Now we need to pass a state law, the Water Quality Assurance Act (SB 852), which strengthens safety standards by enacting that:

No entity can add any substance to public water meant to treat a person's physical or mental health for which the manufacturer has not first shown proof that the substance:

• has been specifically FDA-approved as safe and effective for the intended purpose, and
• will not contribute contaminants, like lead and arsenic, to finished water in excess of the EPA's health-based goals, called "Maximum Contaminant Level Goals."

Second, the "NO" Bills: Let's say NO to the mandatory fluoridation bills (HB 2025-A and SB 539) that would force cities of 10,000 or more in Oregon to fluoridate water supplies when funding for implementation is provided by a third party (which is happening as we speak in other states, like California).

How to Help:

In March, HB 2025-A passed in the House, and now both the YES and NO bills have been referred to the Environment and Land Use Committee in the Senate, chaired by Sen. Charlie Ringo.

You can help by immediately writing to Sen. Ringo and members of this committee and urging their YES vote on SB 852 and their NO vote on HB 2025-A and SB 539.

Send or email your message to the committee administrator, Matt Shields, at matt.shields@state.or.us.

For more information and supporting documentation to this article, access www.keepers-of-the-well.org and www.fluorideaction.org (see "50 reasons to oppose fluoridation").

For further involvement, contact Oregon Citizens for Safe Drinking Water by phone at 503-675-7451 or email at ocsdw@earthlink.net