The Flouride Debate | Question 1 | What is fluoride and how does it prevent tooth decay?

ADA's Fluoridation Facts Short Answer
Fluoride is a naturally occurring element that prevents tooth decay systemically when ingested during tooth development and topically when applied to erupted teeth.

ADA's Fluoridation Facts Long Answer
The fluoride ion comes from the element fluorine. Fluorine, the 17th most abundant element in the earth's crust, is a gas and never occurs in its free state in nature. Fluorine exists only in combination with other elements as a fluoride compound. Fluoride compounds are constituents of minerals in rocks and soil. Water passes over rock formations and dissolves the fluoride compounds that are present, creating fluoride ions. The result is that small amounts of soluble fluoride ions are present in all water sources, including the oceans. Fluoride is present to some extent in all foods and beverages, but the concentrations vary widely.^14-16

Simply put, fluoride is obtained in two forms: topical and systemic. Topical fluorides strengthen teeth already present in the mouth. In this method of delivery, fluoride is incorporated into the surface of teeth making them more decay-resistant. Topically applied fluoride provides local protection on the tooth surface. Topical fluorides include toothpaste, mouth rinses and professionally applied fluoride gels and rinses.

Systemic fluorides are those that are ingested into the body and become incorporated into forming tooth structures.

In contrast to topical fluorides, systemic fluorides ingested regularly during the time when teeth are developing are deposited throughout the entire surface and provide longer-lasting protection than those applied topically.¹⁷ Systemic fluorides can also give topical protection because ingested fluoride is present in saliva, which continually bathes the teeth providing a reservoir of fluoride that can be incorporated into the tooth surface to prevent decay. Fluoride also becomes incorporated into dental plaque and facilitates further remineralization.¹⁸ Sources of systemic fluorides include water, dietary fluoride supplements in the forms of tablets, drops or lozenges, and fluoride present in food and beverages.

Researchers have observed fluoride's decay preventive effects through three specific mechanisms:^{19, 20}

Fluoride reduces the solubility of enamel in acid by converting hydroxyapatite into less soluble fluorapatite.
Fluoride exerts an influence directly on dental plaque by reducing the ability of plaque organisms to produce acid.
Fluoride promotes the remineralization or repair of tooth enamel in areas that have been demineralized by acids.

The remineralization effect of fluoride is of prime importance. Fluoride ions in and at the enamel surface result in fortified enamel that is not only more resistant to decay, but enamel that can repair or remineralize early dental decay caused by acids from decay-causing bacteria.^{17, 21-25} Fluoride ions necessary for remineralization are provided by fluoridated water as well as various fluoride products such as toothpaste.

Maximum decay reduction is produced when fluoride is available for incorporation during all stages of tooth formation (systemically) and by topical effect after eruption.

The ADA's answer to the question above leads one to believe that fluoride is something that occurs naturally in water, and that "water fluoridation is the adjustment of the natural fluoride concentration of fluoride-deficient water." One would assume from their statement that some type of natural fluoride is added. This is not the case; only calcium fluoride occurs naturally in water, and it has never been used for fluoridation.

The chemicals used to fluoridate 90% of public drinking water are industrial grade hazardous wastes captured in the air pollution-control scrubber systems of the phosphate fertilizer industry, called silicofluorides. ("Fluorine Recovery in the Fertilizer Industry - A Review," Phosphorus & Potassium, No. 103, Sept/Oct 1979.) (Also, see 1-1: "Fluoridation: A Mandate to Dump Toxic Waste in the Name of Public Health", George Glasser, Journalist, St. Petersburg, FL, July 22, 1995.)

These wastes contain a number of toxic contaminants including lead, arsenic, cadmium and even some radioactive isotopes. The phosphate rock mined in Florida for this purpose has also been mined for its uranium content!

If not dumped in our public water supplies, these silicofluorides would have to be neutralized at the highest rated hazardous waste facility at a cost of $1.40 per gallon. The cost could increase, depending on how much cadmium, lead, uranium, and arsenic are also present. The silicofluorides still contain these heavy metals, and other pollutants, when they are dumped into our water systems. According to Dr. Ludwig Gross, even if these pollutants are so dilute that they meet current regulatory standards, concerns remain about synergistic effects and the toxicity of both the silicofluoride ion and the bare fluoride ion itself.

"The plain fact that fluorine is an insidious poison, harmful, toxic and cumulative in its effects, even when ingested in minimal amount, will remain unchanged no matter how many times it will be repeated in print that fluoridation of water supply is 'safe'." (Dr. Ludwik Gross, Renowned Cancer Research Scientist, in N. Y. Times 3/6/57.)

Journal of the American Medical Association, Sept. 18, 1943, states that fluorides are general protoplasmic poisons — they inhibit enzyme systems, and water containing 1 part per million (ppm) or more fluoride is undesirable. This was the AMA's stand on fluoridation shortly before the U.S. Public Health Service endorsed nationwide fluoridation. (See 1-3).

Fluoride was an industry's menace until Oscar Ewing, an Alcoa Aluminum lawyer, became head of the U.S. Public Health Service in 1947. Alcoa was one of the biggest producers of hazardous fluoride waste at that time. Today, it is the phosphate fertilizer industries.

Under Ewing, the U.S. Public Health Service proceeded to conduct the fluoride experiment on thousands of people without their consent, even though they knew at the time that there was little or no margin of safety between the therapeutic dose and the toxic dose necessary to cause dental fluorosis for children and skeletal fluorosis for lifetime exposure.

Ten years later, by reading the statistics incorrectly they claimed a "65% reduction in tooth decay," and moved on to fluoridate more cities. (See Opponent's Response to Question 4).

Newburgh and Kingston were two of the original test cities. A recent study by the New York State Department of Health, showed that after nearly 50 years of fluoridation, Newburgh's children have a slightly higher number of cavities than never-fluoridated Kingston. (See 1-5: "New Studies cast doubt on fluoridation benefits," by Bette Hileman, Chemical & Engineering News. Vol. 67, No. 19, May 8, 1989).

The chart taken from this study done by Jayanth Kunar, D.D.S., verifies this statement. (See 1-5 A: "Pediatric Dentistry," NYSDJ, Feb. 1998, pg. 41).

Today there is a great deal of scientific agreement that ingested fluoride does not reduce tooth decay. The largest study of tooth decay in America, by the U.S. National Institute of Dental Research in 1986-1987, showed that there was no significant difference in the decay rates of 39,207 fluoridated, partially fluoridated, and non-fluoridated children, ages 5 to 17, surveyed in the 84-city study. The study cost the U.S. taxpayers $3,670,000, yet very few Americans are aware the study was ever performed. (See 1-5: "New studies cast doubt on fluoridation benefits." Bette Hileman, Chemical & Engineering News, Vol. 67, No. 19, May 8, 1989).

The EPA scientists recently concluded, after reviewing all the evidence, that the public water supply should not be used "as a vehicle for disseminating this toxic and prophylactically useless ... substance." They called for "an immediate halt to the use of the nation's drinking water reservoirs as disposal sites for the toxic waste of the phosphate fertilizer industry." The management of the EPA sides not with their own scientists, but with industry on this issue. (See 1-6: "Why EPA's Headquarters Union of Scientists Opposes Fluoridation", Chapter 280 Vice-President, J. William Hirzy, May 1, 1999).

A 1992 study of dental records for 26,000 children in Tucson, Arizona found that tooth decay increased in children as the natural level of fluoride increased from 0.2 to 0.8 ppm. (See 1-7: An Analysis of the Causes of Tooth Decay, Professor Cornelius Steeling, Department of Chemistry, University of Arizona).

Dr. John Colquhoun, Principal Dental Officer, in Auckland, New Zealand's largest city, wrote " ... tooth decay had declined, but there was virtually no difference in tooth decay rates between the fluoridated and non-fluoridated places. Those (statistics) for 1981 showed that in most Health Districts the percentage of 12- and 13-year-old children who were free of tooth decay — that is, had perfect teeth — was greater in the non fluoridated part of the district." (See 1-10: "Why I Changed My Mind About Water Fluoridation," Perspectives in Biology and Medicine. 41,1 Autumn 1997, University of Chicago).

In December 1993, a Canadian Dental Association panel concluded that ingested fluoride does not, in fact, prevent tooth decay. (Canadian Medical Association Journal, 1993:149.)

Dr. Richard G. Foulkes, a prominent British Columbia physician, while writing a government report in 1973, charges that he was given references which excluded studies already then extant that showed fluoride did not reduce tooth decay and that fluoride causes harm. (See 1-11: "Doctor Who Advocated Fluoridation Now Calls it a Fraud," Health Freedom News, July/Aug. 1992).

Boston has been fluoridated since 1978. About 90% of 107 Boston high school students were found to need dental treatment, according to a 1996 unpublished study. That report also estimated that the city's students had four times more untreated cavities than the national average. "City to Launch Battle Against Dental Caries," Boston Globe, p. A01, 11/27/99.

There is less tooth decay in the nation as a whole, but decay rates have also dropped in the non-fluoridated areas of the United States, and in Europe where fluoridation of water is rare. The observed world-wide decline in tooth decay over the past four decades has occurred at the same rate in areas that are not fluoridated as in areas that are. (See 1-12: "The Mystery of Declining Tooth Decay", Mark Diesendorf. Nature, July 10, 1986, pp. 125-29).

Japan, China, and 98% of Europe have stopped or rejected the addition of fluoride to their public water supplies. ("Special Report," Chemical and Engineering News, Aug.1, 1988.)

When the ADA claims that fluoride "prevents tooth decay systemically when ingested during tooth development," it is out of step with most leading dental researchers today who are now admitting that the major benefits of fluoride are accrued topically, not systemically. These authors include: Levine, 1976; Fejerskov, Thylstrup and Larsen, 1981; Carlos, 1983; Featherstone, 1987, 1999, 2000; Margolis and Moreno, 1990; Clark, 1993; Burt, 1994; Shellis and Duckworth, 1994 and Limeback, 1999, 2000.

This point has even been conceded by the Center for Disease Control and Prevention (CDC) in the very same article, which claimed that fluoridation was one of the top ten achievements of the twentieth century.

The CDC states: "Fluoride's caries-preventive properties initially were attributed to changes in enamel during tooth development because of the association between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. However, laboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children." ("Fluoridation of Drinking Water to Prevent Dental Caries," Achievements in Public Health, 1900-1999.)

While the CDC acknowledges this point, it does not draw the logical conclusion. If fluoride provides its benefits topically, it makes more sense to apply it in the form of toothpaste, than to put it in the drinking water, where systemic exposure and all the accompanying risks become inevitable. Moreover, by using this method of application, it not only avoids exposing tissues in the body, which do not need fluoride, but it also avoids exposing people who don't want this medication.

Thus the key question both the ADA and the CDC avoid is: Why should we run the risks of exposure of our whole system to fluoride, if the major benefits of fluoride come from topical application?