Saturday, July 25, 2009

Water Fluoridation

As of late I have had many questions come up about Fluoride, specifically water fluoridation. I have spent many hours looking over all sorts of documents from all kinds of sources and this is my journey.

Water Fluoridation is the practice of putting fluoride compounds (sodium fluoride, fluorosilicic acid, or sodium fluorosilicate) into the tap water system to bring the fluoride levels up to “preferred levels”. Preferred by who, you might ask? Well, the ADA, CDC, WHO, FDA, and EPA they all seem to have similar takes on what is best for you and me. What does that matter? I think to myself “Is it ethical to medicate an uninformed and perhaps unwilling populace?” Hopefully everyone would agree; No it is not ethical. Does that stop them though, no, “It’s for the greater good” they say. Does the evidence support that claim, and would that still over rule doing it unethically? We’ll look into that. The Government will let us smoke, drink, refuse vaccines, and eat ridiculously unhealthy, all for the sake of freedom. But for whatever reason we seem to not have any say in putting a potential deadly chemical into our water system and into our bodies.

Investigation of the decay preventing effects of naturally occurring fluoride in water led to the start of community water fluoridation back in 1945 (in Grand Rapids, Michigan). Though even before that time other observations were made in Colorado Springs, CO for excessive fluoride levels causing brittle and stained teeth. For more than 60 years scientists have made observations and conducted epidemiological and animal studies to determine the effectiveness and safety of fluoride in water. It’s still up for debate and in need of further research.

Nearly all water on earth contains “naturally occurring” fluoride at levels below, equal to, or above those used in community water fluoridation. So how much is too much…

How deadly is Fluoride? The currently accepted estimate for the minimum lethal dose of fluoride is 5 mg/kg (i.e. 5 milligrams of fluoride for each kilogram of bodyweight). I’m 106.5kg so 533mg(.5g) should do it(don’t get any ideas). 5g = 1tsp so 1tsp could kill 10 of me! Yes, ALL fluoride toothpastes have the potential to kill if you ate the whole thing. That’s why they have those warning labels on them. A couple hundred parents (on behalf of their kids) contact poison control per year for eating tooth paste. There have been a few deaths over the years. Hopefully you would throw it up, and call poison control. This is some serious stuff. Link

By comparison, arsenic, is about 1 mg/kg (milligrams of arsenic per kilogram of body weight) Fluoride is only 1/5 as deadly as arsenic; are you comfortable with that?

How does it work?
Topically (on your teeth) and systemic (ingested). Fluoride primarily works by interfering with the demineralization mechanism of tooth decay. Tooth decay is an infectious disease the key feature of which is an increase within dental plaque of bacteria such as Streptococcus mutans and Lactobacillus. These produce organic acids when carbohydrates, especially sugar, are eaten. When enough acid is produced the acid dissolves tooth enamel (process known as demineralization.) After the sugar is gone, some of the mineral loss can be recovered—or remineralized—from ions dissolved in the saliva. Cavities result when the rate of demineralization exceeds the rate of remineralization, typically in a process that requires many months or years.

When ingested it attaches to calcium deposits (bone and teeth) to build them up to resistance. The ingested claim is more disputed than the oral one and even the CDC admits there is no need to ingest it. Link

So if a lot at once can kill you, what does it do if a little bit is ingested over a long time?
Exposure to high levels of fluoride over a long time can cause dental fluorosis, a condition which leads to mottled tooth enamel, tooth discoloration, and in some cases erosion of affected teeth to the gum line. The levels of fluoride found in drinking water are considered very low. Watch out if you live in certain parts of the world that have naturally high levels. Like the well water of west Texas, parts of china, and lots of other spots globally.

Drinking water’s fluoride content is limited under federal law. The maximum level of fluoride deemed acceptable by the US Environmental Protection Agency(EPA) is 4 milligrams per liter (mg/L). The CDC has established the “optimal level” for fluoride content in drinking water to be in the range of 0.7 to 1.2 mg/L. WHO (world health organization) says it should be between 0.5 and 1.1 mg/L.

Is it a carcinogen? No

In 1987, the International Agency for Research on Cancer (IARC) reviewed the available data concerning the carcinogenicity of fluoride and concluded that there was inadequate evidence of carcinogenicity in experimental animals (IARC, 1987). Two separate sets of long-term fluoride carcinogenicity studies in rats and mice have been published in the 1990s (NTP, 1990; Bucher et al., 1991; Maureret al., 1990, 1993). These studies have been extensively reviewed with the general conclusion that they do not provide adequate evidence to conclude that fluoride is carcinogenic (USNRC, 1993; WHO, 1996; IPCS, 2002).

Is it a nutrient? No.

Fluoride is not an essential nutrient (NRC 1993 and IOM 1997). No disease has ever been linked to a fluoride deficiency.

What if I want to remove it? Removal of fluoride from water is difficult. Most home treatment systems are installed at single faucets and use activated carbon filtration, which does not remove fluoride. Fluoride is not released from water when it is boiled or frozen. You would need a specific filter type to remove fluoride (most of them are expensive).

Infants and Fluorosis

A recent study, however, has raised the possibility that fluoride exposure during the first year of life may play a more important role on fluorosis development than was previously understood. It now appears that the amount of the fluoride contained in the water used for mixing infant formula may influence a child’s risk for developing enamel fluorosis, particularly if the child’s sole source of nutrition is from reconstituted infant formula.

If tap water is fluoridated or has substantial natural fluoride (0.7 mg/L or higher)[WHO recommended levels are .5 to 1.0mg/L], a parent may consider using a low-fluoride alternative water source. [Rowlett, TX is .8mg/L]

Parents should follow the advice of the formula manufacturer and their child’s doctor for the type of water appropriate for the formula they are using. Parents and caregivers of infants fed primarily with formula from concentrate who are concerned about the effect that mixing their infant’s formula with fluoridated water may have in developing enamel fluorosis can lessen this exposure by mixing formula with low fluoride water most or all of the time. This may be tap water, if the public water system is not fluoridated (check with your local water utility). If tap water is fluoridated or has substantial natural fluoride (0.7 mg/L or higher), a parent may consider using a low-fluoride alternative water source. Bottled water known to be low in fluoride is labeled as purified, deionized, demineralized, distilled, or prepared by reverse osmosis. Most grocery stores sell these types of low-fluoride water. Ready to feed (no-mix) infant formula typically has little fluoride and may be preferred for use at least some of the time.

Using only water with low fluoride levels to mix formula will not eliminate the risk of enamel fluorosis. But following such a practice may reduce the chance of fluorosis occurring.

“Breastfeeding is ideal for infants. CDC is committed to increasing breastfeeding rates throughout the United States and to promoting optimal breastfeeding practices.”

What’s your waters fluoride level?

Interesting observation from Australia:

“Until the 1980s the caries prevalence among the Aboriginal children were considered low, better than the non indigenous Australian children. Recent studies however suggest that the Indigenous children now have on average twice as much (or even five times as much in some communities) caries when compared with their counterparts.”

So… “Thanks for sharing your sugary drinks, beers, food and candies.” Now the government is experimenting with them and fluoridating the water system.

Humans can have perfectly good teeth without fluoridation. Call it good genes or good hygiene.

Behavior, behavior, behavior…

Fluoridated toothpaste (introduced in the 1970s) has been one of the defining factors of reduced tooth decay, not fluoridation. Eating an excessive amount of sugar food or drink is going to increase the acidity of your saliva and eat away at your teeth. Reduce the amount of sugary foods and brush your teeth will help reduce the amount of cavities you have more than any fluoride intake you may get. PDF

Water Fluoridation

Pros – supposedly provides for better tooth resistance to decay.

Potential Cons – skeletal fluorosis, dental fluorosis, aches that mimic arthritis, hypothyroidism (underactive thyroid), and osteosarcoma (in young males.)

Many of these problems don’t show up until later in life, from a lifetime of consuming fluoride. Try and have nice teeth, then have issues because of the ‘treatment’ for it, that’s nuts. If there is 0% tooth decay in fluoridated areas I’d probably be more for it. As it stands, the best way is to take care of your teeth. Scrub plague or food buildup off (brushing with or without fluoride), floss your teeth, and get dental checkups, eat less sugar. Good hygiene doesn’t have to involve fluoridation. As a community that cares about our quality of life at all stages (young or old, poor or rich) we should emphasize and work to achieve the availability of good hygiene for all.

As for me and my house:

1) If given the opportunity I would encourage our local government to review the studies on water fluoridation and see if they would stop putting fluoride in the water. Given the opportunity, I would filter it out at the kitchen sink (drinking and cooking water).
2) I and my wife will continue to use fluoride toothpaste (also per my dental hygienists’ request).
3) My son(and daughter) will not use fluoride toothpaste until he is able to spit it out of his mouth properly, and then with proper supervision and instruction.

4) I am not against the use of dental sealants.


Slightly related odd thought/fact:

I was trying to find out if any other chemical is forced upon society at large with such fervor “for the greater good”, and then I found this gem:

Did you know that the FDA has encouraged salt manufactures to put iodine into their product because of iodine deficiency (leading cause of mental retardation)? I suppose you could argue that they are putting chemicals into our food without us being informed. At least you can choose not to eat iodized salt, but then that would be like encouraging you to be a retard. The FDA recommends consumption of 150 micrograms of iodine (that’s super tiny) per day, for both men and women.


  1. "but then that would be like encouraging you to be a retard." Too funny Dave. Great post! Very informative!

  2. Thank you, glad you liked the gem at the end. I had to add some humor in it somewhere. Sarah likes that part too.
    Wish more people were more open about their dental choices, lack of fluoride and what not. I've had two people (including yourself) tell me they don't use fluoride toothpastes.