The fluoridation issue is a contentious one, and rightly so. Fluoride has been a part of most public water sources in America for so long that the issue almost seems mundane. Fluoride seems to be an innocuous part of the water supply. Still, a number of alarming reports have indicated that the logic of amending the water with fluoride—namely, that it can prevent tooth decay—is flawed, and that fluoride is a toxin that is harmful to our bodies as well.
Before I begin, allow me to explain my personal bias on the subject. I had heard about fluoridation before and am naturally suspicious of the idea of adding any sort of chemical to the water supply. But in the interest of a balanced report, I did my best to consider any possible positive outcomes of fluoridation.
So let’s begin with the positives. A study on fluoridation by the CDC was overwhelmingly supportive. This is based on the notion that fluoride is the only nonprescription toothpaste ingredient proven to prevent tooth decay. Frequent exposure to fluoride maintains a steady level of fluoride in the mouth, reducing the risk for tooth decay. Interestingly, the report found that though lower incomes are correlated with higher rates of tooth decay, fluoridation works to bridge this gap (CDC, 2001).
The CDC report findings are impressive, but can be called into question because of the nature of fluoridation. It was impossible to devise an effective method of validating the results.
Studies on the effectiveness of adjusting fluoride in community water to the optimal concentration cannot be designed as randomized clinical trials. Random allocation of study subjects is not possible when a community begins to fluoridate the water because all residents in a community have access to and are exposed to this source of fluoride. In addition, clinical studies cannot be conducted double-blind because both study subjects and researchers usually know whether a community’s water has been fluoridated (CDC, 2001).
What are the detractors saying? There are a number of outspoken critics of fluoridation, including politicians like Ralph Nader. I chose to focus on a letter to the editor written by Dr. Hardy Limeback, the head of Preventative Dentistry at the University of Toronto. He first points out that new understandings of the mechanisms behind fluoride show that it is indeed effective, but through topical means. There is simply no need to swallow fluoride, and thus fluoridation of the water supply seems to be an ineffective tool (Limeback, 2000).
He corroborates this information about the ineffectiveness of fluoridation with a number of disturbing claims about negative effects on health. Fluoride is generally recovered from the smokestacks of fertilizer production facilities; this form of flouride has never been tested for health effects, and is generally contaminated with toxic amounts of heavy metals such as lead, arsenic, and radium. Additionally, half of all fluoride ingested remains within the system, and lifetime accumulation has a number of negative health implications. Finally, Limeback focuses on the point that tooth decay has been in decline for decades, and fluoridation is unnecessary if not extremely dangerous (Limeback, 2000).
Of course, Limeback is not the only one. Dr. John R. Lee (1995) writes that studies have the decline in tooth decay rates shows no relationship with whether the water was fluoridated. He further notes that bone cancer is correlated with water fluoridation, dental fluorosis is several times more common in fluoridated communities, hip fractures directly correlated with fluoridation exposure, and fluoride is an enzyme inhibitor with a high toxicity level (Lee, 1995).
The union of EPA workers came out with a statement rejecting the government’s support of fluoridation. The statement referenced research showing that rats suffered neurotoxic effects when exposed to fluoride, and several key chemicals were depleted by the chemical. The statement also discussed Chinese epidemiological studies correlating high fluoride consumption with decreased I.Q.’s in children. Another study found that fluoride interferes with the pineal gland (National Treasurers Employees Union Chapter 280, 1999).
The evidence goes on and on. The supporters of fluoridation say that because fluoride topically applied to the teeth is good for preventing tooth decay, placing fluoride in the water has been a significant contributor to declining tooth decay. It is my opinion that assuming causality here is a fallacy. Detractors state that the evidence that fluoridation has any impact on tooth decay is minimal, and emerging reports of negative side effects make fluoridation extremely undesirable. The source of the fluoride is nothing short of disturbing. It would seem as though residents would do well to avoid fluoridated water completely.
CDC (2001). Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Morbidity and Mortality Weekly Report, Vol. 50(RR14); 1-42.
Herzy, J. William (1999). Why EPA’s Headquarters Professionals’ Union Opposes Fluoridation. http://www.slweb.org/epa-union.html.
Lee, John. R (1995). The Truth About Mandatory Fluoridation. http://www.sonic.net/kryptox/politics/ab733lee.htm .
Limeback, Hardy (2000). Why I am now officially opposed to adding fluoride to drinking water. http://www.slweb.org/limeback.html.