By Glenn Ellis
Fluoride in water has long been known to reduce dental cavities and tooth extractions in both children and adults. Yet, a recent study published in Journal of the American Medical Association Pediatrics has given new life to a long-running debate: whether adding fluoride to drinking water is a safe way to prevent tooth decay, or a potentially toxic mistake.
These new research findings, which looked at mother-child pairs from six Canadian cities, found that high fluoride exposure during pregnancy was correlated with lower IQ scores among young children, especially boys.
First let’s clear up a common mistake that many of us make: We think that fluoride and fluorine are the same. Wrong!
Fluoride is the world’s 13th most abundant of all the naturally occurring elements and make up 0.08 percent of the Earth’s crust. Fluoride is a mineral found naturally in your bones and teeth. It’s also in the water; soil; plants; rocks; and in the air.
Fluoride is what you will find in toothpaste and drinking water. Fluorine, on the other hand, is a highly reactive, poisonous, pale yellow gas. In fact, fluorine plays a major role in the depletion of the ozone. The long and short of it is that fluorine is poisonous to humans. If inhaled in small amounts, fluorine causes severe irritation to the respiratory system (nose, throat, and lungs). In larger amounts, it can cause death.
Community, or artificial, water fluoridation – the addition of a fluoride compound to public drinking water supplies is still, nevertheless, a controversial public health intervention. The benefits and harms of which have been debated since its introduction in the USA.
It all began in 1945, when Grand Rapids, Michigan added fluoride to its water supply and became the first city to implement community water fluoridation. The latest data from Centers for Disease Control and Prevention (CDC) show that in 2014, 74.4 percent of the U.S. population on public water systems (or 211.4 million people) consume fluoridated water. As the studies showed, dental cavities have dropped significantly in those communities and municipalities with fluoridated water.
Remarkably Safe
Fluoridation has been shown to be a remarkably safe and effective means of reducing risk of the commonest disease in the western world.
Questions on the safety of water fluoridation has been investigated time and time again by a variety of advocacy groups, scientists, researchers, medical groups, as well as national and international commissions. Allegations have been made that water fluoridation is linked to almost every conceivable condition known to medicine – and some conditions beyond. The range of allegations covers such diverse items as cancer, Alzheimer’s disease, effects on salmon spawning, and even the increasing crime rates in American cities.
One of the early controversies following the completion of the post-1945 Grand Rapids trial of water fluoridation was how fluoride ingested by humans should be classified. Is it a nutrient, medication, or pollutant?
While fluoride is a naturally occurring compound, it can still cause side effects when consumed in large doses.
Researchers from around the world have conducted hundreds of studies that look at the safety of adding low concentrations of fluoride to drinking water. There’s no evidence that low levels of fluoride added to local water supplies in the United States causes any health problems, aside from the occasional mild case of dental fluorosis.
Dental Fluorosis
One of the unwanted results of fluorinating water is something called dental fluorosis. This happens when you consume too much fluoride while your teeth are still forming under your gums. This results in white spots on the surface of your teeth. Other than the appearance of white spots, dental fluorosis doesn’t cause any symptoms or harm. Generally, this tends to affect only children under the age of 8 who have permanent teeth still coming in.
In spite of my own efforts to find facts, one way or another, the one thing I found for certain is that the Food & Drug Administration (FDA) has never approved fluoride supplementation as a “safe and effective treatment” despite 50-plus years of prescriptions. In fact, the statements by the FDA seem to be all over the place!
In 2000, the FDA issued a statement that said, “Fluoride, when used in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or animal, is a drug that is subject to Food and Drug Administration (FDA) regulation.” Yet, in 2015, a response from the FDA stated the following: “the FDA does not regulate the quality of water, including water fluoridation, as this is regulated by the United States Environmental Protection Agency (EPA).”
Health Benefit
Fluoridation does continue to provide a valuable public health benefit. However, like any preventive measure, it only makes sense where there exists a significant disease risk.
The time may come in a particular society where the decay risk is too small to continue fluoridating or to consider starting.
The official consensus of the medical and scientific community is that fluoridation poses no threat to public health.
For people concerned that they or their families may be exposed to too much fluoride, there are some steps you can take to reduce your exposure. Know the level of fluoride in your drinking water, and people who live in areas with high levels of fluoride in the water might consider using alternate sources of drinking water, such as bottled water.
To find out if your public water is fluoridated, you can use this tracker from the CDC: https://nccd.cdc.gov/DOH_MWF/Default/Default.aspx
Glenn Ellis, is Research Bioethics Fellow at Harvard Medical School and author of Which Doctor?, and Information is the Best Medicine. Listen to Glenn, on radio in Birmingham or V94.9, Sundays at 7:50pm, or visit: www.glennellis.com.
