The Fluoride Debate

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TABLE OF CONTENTS

INTRODUCTION

HISTORY/
ENVIRONMENT

CENSORSHIP

THE FLUORIDE
DEBATE

BENEFITS
Question 1
Question 2
Question 3
Question 4
Question 5
Question 6
Question 7
Question 8

ALTERNATIVES
Question 9
Question 10
Question 11
Question 12


SAFETY
Question 13
Question 14

OVERDOSE
Question 15
Question 16
Question 17

DISEASES
Question 18
Question 19
Question 20
Question 21
Question 22
Question 23
Question 24
Question 25
Question 26
Question 27
Question 28
Question 29
Question 30
Question 31
Question 32
Question 33

PUBLIC
POLICY

Question 34
Question 35
Question 36
Question 37
Question 38
Question 39
Question 40

COST
EFFECTIVENESS
Question 41
Question 42
Question 43

CONCLUSION

SAFETY

Question 13.
Does fluoride in the water supply, at the levels recommended for the prevention of tooth decay, adversely affect human health?

ADA's Fluoridation Facts Short Answer
The overwhelming weight of scientific evidence indicates that fluoridation of community water supplies is both safe and effective.

ADA's Fluoridation Facts Long Answer
For generations, millions of people have lived in areas where fluoride is found naturally in drinking water in concentrations as high or higher than those recommended to prevent tooth decay. Research conducted among these persons confirms the safety of fluoride in the water supply.54, 92-95 In fact, in August 1993, the National Research Council, a branch of the National Academy of Sciences, released a report prepared for the Environmental Protection Agency (EPA) that confirmed that the currently allowed fluoride levels in drinking water do not pose a risk for health problems such as cancer, kidney failure or bone disease.96

Based on a review of available data on fluoride toxicity, the expert subcommittee that wrote the report concluded that the EPA's ceiling of 4 ppm for naturally occurring fluoride in drinking water was "appropriate as an interim standard."96 Subsequently, the EPA announced that the ceiling of 4 ppm would protect against adverse health effects with an adequate margin of safety and published a notice of intent not to revise the fluoride drinking water standard in the Federal Register.97

As with other nutrients, fluoride is safe and effective when used and consumed properly. No charge against the benefits and safety of fluoridation has ever been substantiated by generally accepted scientific knowledge. After 50 years of research and practical experience, the preponderance of scientific evidence indicates that fluoridation of community water supplies is both safe and effective.98

Additional discussion on this topic may be found in Question 19 and Question 32.

Many organizations in the U.S. and around the world involved with health issues have recognized the benefits of community water fluoridation. The American Dental Association adopted its original resolution in support of fluoridation in 1950, and has repeatedly reaffirmed its position publicly and in its House of Delegates based on its continuing evaluation of the safety and effectiveness of fluoridation.3 The American Medical Association's (AMA) House of Delegates first endorsed fluoridation in 1951.

In 1986, and again in 1996, the AMA reaffirmed its support for fluoridation as an effective means of reducing dental decay.99 The World Health Organization, which initially recommended the practice of water fluoridation in 1969,100 reaffirmed its support for fluoridation in 1994 stating that: "Providing that a community has a piped water supply, water fluoridation is the most effective method of reaching the whole population, so that all social classes benefit without the need for active participation on the part of individuals."82 Following a comprehensive 1991 review and evaluation of the public health benefits and risks of fluoride, the U.S. Public Health Service reaffirmed its support for fluoridation and continues to recommend the use of fluoride to prevent dental decay.54

National and international health, service and professional organizations that recognize the public health benefits of community water fluoridation for preventing dental decay may be viewed in the Compendium.

Repeat of Question 13.
Does fluoride in the water supply, at the levels recommended for the prevention of tooth decay, adversely affect human health?

Opposition's Response

A letter from the FDA on August 15, 1963, states: "Sodium fluoride used for therapeutic effect would be a drug, not a mineral nutrient. Fluoride has not been determined essential to human nutrition. Above 2 milligrams per day of total intake of fluorides can cause tooth mottling in sensitive persons. It would be impossible to state a safe amount for supplementation by an individual without knowledge of the amount of fluorides already being consumed by him from such sources as drinking water and food grown in soils that are rich in fluorides." (See 13-1: copy of letter from FDA, and see Overdose section).

"The Food and Drug Administration Office of Prescription Drug Compliance has confirmed, to my surprise, that there are no studies to demonstrate either the safety or effectiveness of these (fluoride) drugs, which FDA classifies as unapproved new drugs." (See 13-2: letter by John V. Kelly, New Jersey Assemblyman, dated June 3, 1993).

On May 26, 1995, John V. Kelly also wrote: "Children's fluoride supplements are marketed without the required New Drug Applications demonstrating safety and effectiveness. This situation exists as a result of manufacturers introducing products directly into the market prior to 1962 without seeking FDA approval. According to the FDA Office of Prescription Drug Compliance there are approximately 3,000 drugs in this category." (See 13-8: Letter. Also see www.citizens.org).

Yet the American Dental Association leads us to believe that it is safe for everyone, that the Environmental Protection Agency (EPA) endorses fluoridation, and that they consider up to 4 ppm fluoride in the water as "perfectly safe."

When the EPA was engaged in revising its drinking water standard for fluorine in 1985, the EPA's Headquarters Union of Scientists (consisting of 1,500 professional people) made a thorough investigation into the pros and cons of fluoridation, and found that there is a great deal of proof that it is neither safe nor effective.

Their conclusions were: The public water supply should not be used "as a vehicle for disseminating this toxic and prophylactically useless (via ingestion, at any rate) substance."

They also stated: "Recent, peer-reviewed toxicity data, when applied to EPA's standard method for controlling risks from toxic chemicals, require 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." (See 1-6: "Why EPA's Headquarters Union of Scientists Oppose Fluoridation," by Union Vice-Pres., J. W. Hirzy, May 1, 1999. It covers the many reasons why they arrived at this conclusion).

Because (these) EPA scientists refused to back down on their insistence that the maximum contaminate level (MCL) for fluoride should be reduced, the EPA (management team) contracted with the National Academy of Sciences (NAS), a private agency, to review the fluoride MCL of 4.0 ppm. The NAS formed a seven-member National Research Council (NRC) subcommittee dominated by long-time fluoridation promoters from the National Institute of Dental Research (NIDR). Although a number of researchers have published evidence of harm from fluoridation, not one of them was asked to participate in the work of the subcommittee.

At the same time that this NIDR-dominated subcommittee was evaluating the safety of water containing 1.0 - 4.0 ppm fluoride, the NIDR was informing New Jersey Assemblyman Kelly that it "could not produce any research demonstrating either the safety or the effectiveness of prescription fluoride in doses of the same magnitude as those administered in fluoridated water."

Nonetheless, a 1988 administrative decision in the EPA raised the MCL for fluoride from 2.0 ppm to 4.0 ppm (with no proof of safety) in order to relieve certain water suppliers of the burden of removing excess endemic fluorides from their water. Removing fluoride from water is expensive. In most cases it requires distillation or reverse osmosis filtration. Charcoal filters used to remove chlorine and other substances from water do not remove fluorine compounds. (See 13-3: details in "Comments on Reevaluating the Fluoride in Drinking Water Standard," by Robert J. Carton, Ph.D., Vice-President, Local 2050 of the National Federation of Federal Employees, before the Drinking Water Committee of the Science Advisory Board of the Environmental Protection Agency, Arlington, VA, Nov. 1, 1991. At that time this union represented the 1,100 scientists, lawyers, and engineers at EPA Headquarters).

"Our members' review of the body of evidence over the last eleven years, including animal and human epidemiology studies, indicate a causal link between fluoride/fluoridation and cancer, genetic damage, neurological impairment, and bone pathology. Of particular concern are recent epidemiology studies linking fluoride exposure to lowered IQ in children." (Letter dated July 2, 1997, from J. William Hirzy, Ph.D. to Jeff Green. The union (now NTEU, Chapter 280) consists of and represents all of the toxicologists, chemists, biologists and other professionals at EPA headquarters, Washington, D.C.)

Regarding the silicofluorides used in 90% of US fluoridation programs, EPA states, "In collecting the data for the fact sheet, EPA was not able to identify chronic studies for these chemicals." (Letter of June 23, 1999, from EPA Asst. Adm. J. Charles Fox to US Representative Ken Calvert, Chairman, Subcommittee on Energy and The Environment, Washington, DC.)

Dr. Hardy Limeback, B.Sc.,Ph.D. (biochemistry), D.D.S., Head of Departmant of Preventative Dentistry, University of Toronto, Ontario, Canada, leading Canadian fluoride authority and consultant to the Canadian Dental Association, after surveying the growing evidence, makes this statement: "Children under three should never use fluoridated toothpaste. Or drink fluoridated water. And baby formula must never be made up using Toronto (fluoridated) tap water. Never." He goes on to say: " ... we are now spending more treating dental fluorosis than we would spend treating cavities if water were not fluoridated." (See 13-4: "A Crack Appears in the Fluoride Front," from Toronto Star, Apr. 25, 1999).

John D. MacArthur states, "History repeats itself. Just like the acidic leaves that leeched lead from the paint on that 18th century roof, fluosilicic acid leaches lead from plumbing. This was graphically demonstrated in two communities that stopped fluoridating their water systems. Their lead levels dropped significantly. During a 1992 drought in Tacoma, Washington, they temporarily stopped fluoridating their water and lead levels dropped from 32 ppb (parts per billion) to 17 ppb. When Thurmont, Maryland stopped fluoridating their drinking water in 1994, the lead level in homes dropped from 30 ppb to 7 ppb. (The EPA's Maximum Contaminant Level is 15 ppb). ("Fluoride Banned in Thurmont, Maryland," Frederick Post , Feb. 3, 1994, p. A-9.) Also see, 13-5: "Letter from C.R. Myrick, Water Quality Coordinator, Tacoma Public Utilities to Washington State Dept. of Health", Dec. 2, 1992, in which he states: "It is interesting to note the 90th percentile lead concentration was 17 ppb this time compared to 32 ppb last time. We have not been using fluoride since the drought this summer." Fluoride was held responsible for the high lead level.

In research funded in part by the Environmental Protection Agency Office of Criminal Enforcement, Forensics and Training (published in August 1999 in the International Journal of Environmental Studies), a survey of over 280,000 Massachusetts children, comparing a matched group in 30 towns that do not use silicofluorides to children in 30 communities that use these chemicals to fluoridate, showed that when silicofluorides were present in the water the children were more than twice as likely to suffer from blood lead above the danger level of 10 micrograms per deciliter of blood. The correlation with blood lead levels is especially serious because lead poisoning is associated with higher rates of learning disabilities, hyperactivity, substance abuse and crime. (See 13-6: "Water Treatment With Silicofluorides and Lead Toxicity," by Roger D. Masters and Myron J. Coplan from the International Journal of Environmental Studies, 1999, Vol. 56. pp. 435-449).

"Children who are black or Hispanic given the same exposures as white children absorb significantly more lead. ... This means that the level set by EPA is marginally safe for white adults, but unsafe for African American or Hispanic children." (See 13-7: letter by William L. Marcus, Ph.D., D.A.B.T., Board Certified Consulting Toxicologist).

Herbert L. Needleman, of the University of Pittsburgh's School of Medicine, said, "He found much higher lead rates in a group of juvenile delinquents than in a control group. He used 416 youths-216 delinquents and 200 in a control group. Adjusting for such factors as race, parental education, occupation, family size and crime rate in the neighborhood the youths came from, he found those with high lead levels were twice as likely to be delinquent than those with low levels." ("Chemicals and Crime: A Truly Toxic Effect," by Judy Mann, May 26, 2000, page C 11, Washington Post. Judy Mann can be reached at (202) 334-6109 or at Mannj@washpost.com.)

Dr. Pierce Anthony, (D.D.S.) Editor, in an Editorial in the Journal of the American Dental Association (just five months before the people of Grand Rapids, Michigan, were fluoridated) made this statement: "To be effective, fluorine must be ingested into the system during the years of tooth development, and we do not yet know enough about the chemistry involved to anticipate what other conditions may be produced in the structure of the bone and other tissues of the body generally. We do know that the use of drinking water containing as little as 1.2 to 3.0 parts per million of fluorine will cause such developmental disturbances in bones as osteosclerosis, spondylosis and osteopetrosis, as well as goiter, and we cannot afford to run the risk of producing such serious systemic disturbances in applying what is at present a doubtful procedure intended to prevent development of dental disfigurements among children."

"Fluoride is capable of a very wide variety of harmful effects, even at low doses." (Dr. Patrick, Harvard Ph.D., former National Institute of Health scientist.)

"Because of our anxiety to find some therapeutic procedure that will promote mass prevention of caries (cavities), the seeming potentialities of fluorine appear speculatively attractive, but, in the light of our present knowledge or lack of knowledge of the chemistry of the subject, the potentialities for harm far outweigh those for good. — The control of the dosage to the children would be impossible since scientific investigation reveals that children drink different amounts of water, some 25 times more than others. Some would get too little, and what is more serious, some would get too much." (Dr. Max Spencer Rohde, (M.D.), F.A.C.S., F.I.C.S., New York City.)

"Fluoridation has never been proved to be safe. The medical literature abounds in reports from all parts of the world of damage from natural fluoride water." (Dr. L. A. Alesen, Past President of California Medical Association and member of American Medical Association House of Delegates.)

American Medical Association, 535 N. Dearborn St., Chicago Il.,60610 official policy statement as to safety and practicality, contains this proviso which nullifies any so-called 'endorsement in principle.' "In localities with warm climates, or where for other reasons the ingestion of water or other sources of considerable fluoride content is high, a lower concentration of fluoride is advisable. ... It is manifestly impossible to adjust the concentration to allow for the many variables in consumption or exposure to fluoride."

"If one wants to experiment with fluoridation, fluoride can easily be taken by the individual in tablet form or mixed with foods. If fluoride were put in the drinking water it would have a harmful effect on people with skin disease, those with low calcium, with kidney trouble, or with diabetes." (Dr. William Wolf, Endocrinologist, former Clinical Professor of Dental Medicine at New York University.)

"I believe that the widespread use of fluoridated water is a faulty procedure and will lead to unhappy results." (Dr. Alford D. Scholl, Associate Research in Pediatrics, Harvard University, Campridge.)

"For water fluoridation at one part per million the short distance to toxic (poisonous) dosage seems to imply a serious hazard. We have even to pay attention to the great individual variation in sensitivity and in consumption of drinking water. Because of that fluoridation of tap water should not be allowed until more research work may have established that it is harmless." (Dr. Hugo Theorell, (M.D.) Nobel Prize Winner in report to Royal Medical Board of Sweden.)

"The question is asked as to what is the effect of fluoridated water if continued throughout lifetime. The answer is simply this-that no one knows for sure." (Dr. M. B. Dymond, Minister of Health, Province of Ontario.)

The Agriculture Yearbook, 1939, page 212, states " ... fluorine interferes with the normal calcification of the teeth, and it should be avoided from birth to age of 12." " ... this dental disease is always found when water containing even as little as 1 part per million of fluorine is used continuously during the period of formation of the permanent teeth." This was a known fact when the U. S. Public Health Service started their fluoride experiment on the people. (See 13-7 A).

Compulsory fluoridation could well be a much greater medical mistake than putting iodine in the water, stilbestrol, lithium or thalidomide. Many endorse fluoridation, but no one guarantees its safety.

The Food and Drug Administration requires, as of April 7, 1997, that all fluoride-containing toothpaste and mouth rinse must carry a poison label, warning that the products be kept out of the reach of children under 6, and to contact a Poison Control Center if more than the amount for brushing (pea-sized drop) is swallowed. Fluoride is not "just a mineral nutrient that is safe and harmless."

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