Fluoride is considered a non-essential trace mineral, meaning there is no biological need for this mineral.1 It plays a possible physiological role in the maintenance of teeth and bone structure and is found in foods sources such as fish, meat, legumes, grains, and drinking water.1 The amount in fluoride in food is low and most Americans ingest fluoride from drinking water. Fluoride intake is about 3.4mg/day by the average American.1 The addition of fluoride to water is recommended by public health authorities of 0.7 to 1.2 mg of fluoride/liter.1 The major benefits of fluoride in human health is its effects on bone mineralization and the formation of dental enamel.1 The effect of fluoride in bone mineralization is by stimulation osteoblast proliferation, but it is not proven beneficial in the prevention or treatment of osteoporosis.1 The beneficial mechanism of fluoride on dental enamel include:
- deposition of fluoride in the hydroxyapatite forming fluorohydroxyapatite, which is resistant of cavity formation
- inhibition of acid production by oral bacteria, which inhibits plaque formation
- acceleration of new surface growth on demineralized subsurface crystals in dental cavities, which enhances remineralization1
The UL of fluoride is:
Infants < 6months is 0.7mg/day
Infants < 1yr 0.9mg/day
Children 1-3yrs 1.3mg/day
Children 4-8yrs 2.2mg/day
The lower UL standards for infants and children puts them at a higher risk for fluoridosis and subsequent health consequences. According to these guidelines it is conceivable that a bottle fed infant using fluorinated water could easily surpass the UL recommendations.2 Other groups that may be at risk for exceeding the UL guidelines include: individuals living in warmer climates, athletes, and diabetics, and children that may chronically ingest toothpaste while brushing. It is recommended that children be encouraged to use toothpaste sparingly, at about a pea sized portion because ingesting even a small amount of fluoride from toothpaste can be dangrous.1,2
There is much recent controversy about adding fluoride to the public water supply with the argument that the benefits of fluoride to prevent dental caries is topical and not systemic.2,5 Dr. William Marcus, the Chief toxicologist of the Office of Drinking Water of the EPA claims he was fired over the refusal to keep silent of his findings that fluoride should not be added to the public water supply due to its carcinogenic affects especially the increased risk of osteosarcoma in males especially if they lived in an area where the public water was fluorinated prior to the age of 7.3,4 A regression analysis of cancer incidence rates and water fluoride in the USA based on WHO data states that there may be a complexity of mechanisms of action of fluoride in the body and that we need to consider the likelihood of fluoride acting as a genetic cause of cancer.6 In this study, a positive association of fluoridated drinking water was made in cancers of the oral cavity and pharynx, colon, and rectum, hepato-biliary and urinary organs were postively associated as well.6 Also associated with fluoridated drinking water were cancers of the brain, T-cell system Hodgkin’s disease, non-Hodgkins lymphoma, multiple myeloma, melanoma of the skin and monocytic leukaemia.6
When I read how toxic fluoride could be in toothpaste, I was worried about my grandchildren’s unsupervised use of it. I’ve seen them squirt out much more than the pea-sized portion that is recommended. Even the commericals show a perfect ribbon of colorful toothpaste covering the entire surface of bristles on the toothbrush. I believe the toothpaste companies are putting a subliminal message in the viewers mind that this is the amount that we should put on our toothbrushes to adequately clean our teeth, disregarding the possible toxic effects it may have on our health. When my kids were little, the pediatrician prescribed little purple fluoride pills for me to give my kids. I think I did it for about a year, but luckily I was not very compliant with it. My son did end up with white spots on his front teeth, which he had cosmetically fixed because it was quite noticeable. Now, I know that it is probably due to fluorosis.
Grooper states that there is no biological need for this trace element and we do not need it for our survival.1 Therefore, in light of the controversies surrounding the current practice of adding fluoride to our public water supply, I would have to agree that current practices be suspended until further evidence proves the safety and efficacy of this practice!
The FDA lists 10 reasons to fluoridate the public water supply:
10 Reasons to Fluoridate Public Water
Single most effective public health measure to prevent tooth decay. The Centers for Disease Control and Prevention (CDC) has proclaimed community water fluoridation one of 10 great public health achievements of the 20th century.
Natural. Fluoride is already present in all water sources, even the oceans. Water fluoridation
is simply the adjustment of fluoride that occurs naturally to a recommended level for preventing
Similar to fortifying other foods and beverages. Water that has been fluoridated is similar to fortifying salt with iodine, milk with vitamin D, orange juice with calcium and bread with folic acid.
Prevents dental disease. It is the most efficient way to prevent one of the most common childhood diseases – dental decay. An estimated 51 million school hours are lost each year due to dental-related illness.
Protects all ages against cavities. Studies show that community water fluoridation prevents at least 25 percent of tooth decay in children and adults, even in an era with widespread availability of fluoride from other sources, such as fluoride toothpaste.
Safe and effective. For more than 65 years, the best available scientific evidence consistently indicates that community water fluoridation is safe and effective.
Saves money. The average lifetime cost per person to fluoridate a water supply is less than the cost of one dental filling. For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.
Recognized by more than 100 organizations. The American Dental Association (ADA) as well as the Centers for Disease Control and Prevention, the American Medical Association, the World Health Organization and more than 125 national and international organizations recognize the public health benefits of water fluoridation for preventing dental decay.
Availability of fluoridation continues to grow. In 2010, 73.9 percent of the U.S. population on public water systems (204.3 million people) received fluoridated water. This is an increase of almost nine percent from 2000. The Healthy People 2020 goal is for 79.6 percent of the population on public water systems to have access to fluoridated water.
Endorsed by the American Dental Association.One of the most widely respected sources for information regarding fluoridation and fluoride is the American Dental Association. Learn more on the ADA’s website at ADA.org/fluoride (Links to an external site.). 7
I found a list of 50 reasons to NOT fluoridate the public water supply:
1) Fluoride is the only chemical added to water for the purpose of medical treatment
2) Fluoridation is unethical
3) The dose cannot be controlled
4) The fluoride goes to everyone regardless of age, health or vulnerability
5) People now receive fluoride from many other sources besides water
6) Fluoride is not an essential nutrient
7) The level in mothers’ milk is very low.
8 ) Fluoride accumulates in the body
9) No health agency in fluoridated countries is monitoring fluoride exposure or side effects.
10) There has never been a single randomized controlled trial to demonstrate fluoridation’s effectiveness or safety.
11) Benefit is topical not systemic.
12) Fluoridation is not necessary.
13) Fluoridation’s role in the decline of tooth decay is in serious doubt.
14) NIH-funded study on individual fluoride ingestion and tooth decay found no significant correlation.
15) Tooth decay is high in low-income communities that have been fluoridated for years.
16) Tooth decay does not go up when fluoridation is stopped.
17) Tooth decay was coming down before fluoridation started.
18) The studies that launched fluoridation were methodologically flawed.
19) Children are being over-exposed to
20) The highest doses of fluoride are going to bottle-fed babies
21) Dental fluorosis may be an indicator of wider systemic damage
22) Fluoride may damage the brain
23) Fluoride may lower IQ.
24) Fluoride may cause non-IQ neurotoxic effects.
25) Fluoride affects the pineal gland
26) Fluoride affects thyroid function
27) Fluoride causes arthritic symptoms.
28) Fluoride damages bone.
29) Fluoride may increase hip fractures in the elderly
30) People with impaired kidney function are particularly vulnerable to bone damage.
31) Fluoride may cause bone cancer (osteosarcoma).
32) Proponents have failed to refute the Bassin-Osteosarcoma study
33) Fluoride may cause reproductive problems.
34) Some individuals are highly sensitive to low levels of fluoride
35) Other subsets of population are more vulnerable to fluoride’s toxicity.
36) There is no margin of safety for several health effects.
37) Low-income families penalized by fluoridation
38) Black and Hispanic children are more vulnerable to fluoride’s toxicity
39) Minorities are not being warned about their vulnerabilities to fluoride.
40) Tooth decay reflects low-income not low-fluoride intake
41) The chemicals used to fluoridate water are not pharmaceutical grade
42) The silicon fluorides have not been tested comprehensively.
43) The silicon fluorides may increase lead uptake into children’s blood
44) Fluoride may leach lead from pipes, brass fittings and soldered joints.
45) Key health studies have not been done
46) Endorsements do not represent scientific evidence
47) Review panels hand-picked to deliver a pro-fluoridation result.
48) Many scientists oppose fluoridation
49) Proponents usually refuse to defend fluoridation in open debate
50) Proponents use very dubious tactics to promote fluoridation.
This is a long list, and in the original article, there is a paragraph for each item with properly documented citations backing up each claim.8
Children between 2-4 yrs of age have about a 20% chance of developing dental caries.9(279) Most causes can be contributed to a constant bottle use or using a sippy cup with a sugary drink such as fruit juice or milk at bedtime creating a prolonged exposure of the teeth to sugar.9(279) This being said, I am likely to recommend offering a toddler only water in a sippy cup or bottle at bedtime to reduce the exposure of teeth to the fluids that are likely to increase the risk of dental caries. I am also likely to recommend teaching their child the proper amount of toothpaste to apply on their child’s toothbrush and teaching their child proper dental hygiene at an early age. I am not a proponent of giving fluoride tablets, as you might have guessed from my experience with my own children of developing permanent spots on my son’s teeth. I do think that a topical application of fluoride is beneficial as long as the child is supervised and taught to spit rather than swallow.
- Grooper, SS., Smith, JL, Advanced Nutrition and Human Metabolism. Sixth Edition. 2013. p. 547-550.
- Czajka M. Systemic Effects of Fluoridation. Journal of Orthomolecular Medicine. 2012. Vol 27(3):123-130.Link (Links to an external site.)
- New Life Journal: Carolina Edition. Dec 2002/Jan 2003. Vol 4(3):16. http://eds.a.ebscohost.com.libproxy.bridgeport.edu/ehost/results?sid=6c019adb-4e00-403b-a761-58426661da9f%40sessionmgr4004&vid=0&hid=4110&bquery=%28SO+%28New+Life+Journal%3a+Carolina+Edition%29%29AND%28DT+2002%29AND%28TI+part+ii%3a+why+epa%27s+headquarters+professionals%27+union+opposes+fluoridation.%29&bdata=JmRiPWF3aCZ0eXBlPTEmc2l0ZT1laG9zdC1saXZlJnNjb3BlPXNpdGU%3d (Links to an external site.)
- Bassin E, Wypij D, Davis R, etal. Age-specific Fluoride Exposure in Drinking Water and Osteosarcoma (US). Cancer Causes & Control. May 2006. Vol 17(4):421-428. http://link.springer.com.libproxy.bridgeport.edu/article/10.1007/s10552-005-0500-6 (Links to an external site.) Accessed April 20, 2015.
- Linus Pauling Institute. Micronutrient Info Center. http://lpi.oregonstate.edu/mic/minerals/fluoride. Accessed April 20, 2015.
- Takahashi K, Akiniwa K, Narita K. Regression Analysis of Cancer Incidence Rates and Water Fluoride in the USA based on IACR/IARC (WHO) Data (1978-1992). Jour of Epidemiology. 2001. Vol 11(4):170-179. https://www.jstage.jst.go.jp/article/jea1991/11/4/11_4_170/_article (Links to an external site.) Accessed April 20, 2015.
- Brown JE. Nutrition Through the Life Cycle. 4th Edition. 2011. Wadsworth, Cengage Learning.