In Defense of Fluoride | By Mike Ross

Recently, the #yegvote twitter feed has been occupied with a lot of discussion about water fluoridation, particularly from mayoral candidate Curtis Penner (including him tweeting a bibliography of 70 consecutive journal articles early Thursday morning). As has been pointed out, a lot of the twitter debate has devolved into personal attacks on both sides, but the question of water fluoridation is important and worth discussing on its merits alone.

First of all, some fun fluoridation facts!

  • Low concentrations of fluoride in your mouth reduces the rate at which your enamel breaks down.
  • Fluoride is often naturally present in water all over the world in different concentrations, and about 5% of the world has fluoride added to the water supply at low concentrations (including Edmonton).
  • Different studies have shown that the presence of fluoride in water can reduce cavities by between 27 and 40% relative to regular brushing.

The ideal concentration for fluoride in water appears to be somewhere between 0.5-1.0 milligrams per liter. This is lower than the natural levels found in lots of communities, and in many parts of the world fluoride concentrations are reduced or even eliminated before being pumped into municipal water supplies.

Mr. Penner’s platform for mayor includes a lengthy paragraph against water fluoridation. The first argument references the Material Safety Data Sheet (MSDS) for the chemical that’s being used in Edmonton to add fluoride to the water, hydrofluosilicic acid. His claim appears to be that as this chemical is listed as corrosive and dangerously reactive, we shouldn’t have anything to do with it. This is at best a red herring, and not an argument at all—at the high concentrations that the chemical is stored, very nearly anything is poisonous. We add chlorine to our water supply explicitly to kill living organisms, and its MSDS warnings are even more severe than fluoride. This isn’t to say that the concentrated version of the chemical is ok to drink, but the final product in our taps is millions of times less concentrated than the solution the data sheet refers to.

Dropping evil-sounding chemical names and referring to alarming MSDS data sheets can’t form an argument alone. People regularly consume citric acid and acetic acid, whose MSDS data sheets name them as flammable and corrosive and include pages of toxicity warnings, but we enjoy them as orange juice and vinegar. The fact of the matter is that data sheets have to cover all possibilities and naturally make anything sound evil – even the data sheet for plain old boring water has lethal dosage information.

Mr. Penner then goes on to reference this Harvard meta-analysis on the effects of fluoride on children. His claim is that the study indicates that “children who do not drink fluoride have a 20% better chance of having high intelligence, whereas those who do drink fluoride have a 9% better chance of developing mental retardation.” Oddly enough, the words “mental retardation” and the figure “20%” don’t show up in the journal article at all. In fact, they write instead that their “results support the possibility of adverse effects of fluoride exposures on children’s neurodevelopment.” Their major finding, actually, is that children who had “high exposure” to fluoride had an IQ that was 0.45 points lower than reference children.

What constituted “high exposure” in the Harvard study? High concentrations ranged from about 3-12 mg/L. Their reference points—the points the study considered not exposed to fluoride—were between 0.34-2.35 mg/L. In fact, some of the reference healthy populations were drinking water that was two to three times more fluoridated than what would ever be allowed in Edmonton’s water. An overwhelming majority of the over 70 studies tweeted by Mr. Penner that supposedly support his position deal with high concentrations of naturally-occurring fluoride in India or China, not low concentrations carefully monitored in Canada. So while it most likely is true that high concentrations of fluoride can cause adverse effects, it is far more likely that increasing your intake of any substance by a factor of 5 to 10 over what scientists recommend would be similarly poisonous.

It has also been pointed out that Calgary stopped water fluoridation in 2011. This is true – and already has dentists raising alarms about increases in cavities (and don’t forget, dentists get less work if people have fewer cavities. They must be really concerned…).

With studies showing the positive effects of low concentrations of fluoride, and other studies showing adverse effects only at levels significantly higher than Edmonton’s, the scientific argument for those opposing the current fluoride program doesn’t seem that strong. The remaining argument is one of policy – is it morally acceptable to add a substance to the water with the goal of treating an entire population?

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  • Arundeep

    Nicely done, Michael.

  • If fluoridation reduced tooth decay, you would be right; but it doesn’t. Tooth decay crises are occurring in all fluoridated cities and states http://www.FluorideNews.Blogspot.com

  • James Reeves

    It is bad enough that fluordidation is ineffective and dangerous for chidren.

    No doctor ever prescribes fluoride for ADULTS, because it is a deadly poison, has no purpose in the body. It cures or heals nothing. So, exactly why would anyone choose to drink this toxic waste poisonous fluoride in every glass of water every day of their life?

    50% of all you consume builds up in the body, in the glands, the brain and the bones. This results in cancer, thyroid & pineal gland damage, broken hips from brittle bones, lowered IQ, kidney disease, arthritis and other serious health problems.

    • EMR

      Citations, please.

      • Don Eglinski

        It’s pretty common to find, the pineal gland accumulates fluoride, which leads to calcification. Try Google Scholar.

      • James Reeves

        Re: citations, start with these short articles backed by 58 scientific references

        Disadvantaged Communities Are the Most Disadvantaged by Fluoride

        Most Developed Countries Do Not Fluoridate Their Water

        Fluoridated Countries Do Not Have Less Tooth Decay Than Non-Fluoridated Countries

        Fluoride Affects Many Tissues in the Body Besides the Teeth

        40% of American teenagers show visible signs of fluoride over-exposure.

        For Infants, Fluoridated Water Provides No Benefits, Only Risks

        Fluoride Supplements Have Never Been Approved by the FDA

        Fluoride Is the Only Medicine Added to Public Water

        Swallowing Fluoride Provides Little Benefit to Teeth

        All with 58 scientific references

        http://www.fluoridealert.org/articles/fluoride-facts/

        Fluoride’s ability to damage the brain is one of the most active areas of fluoride research today. In the past three decades, over 100 studies have found that fluoride exposure can damage the brain.

        http://www.fluoridealert.org/issues/health/brain/

  • Don Eglinski

    My concern isn’t with dental hygiene. I think parents should do a better job and not have to rely on mass medication, but that is just my opinion, weighed on the ethics of it. However, since toxicological studies have not been pursued until recently it’s impossible to say that it doesn’t care longterm negative effects, such as what was indicated by the Harvard School for Public Health: Impact of fluoride on neurological development in children.

    Pro-fluoride supporters seem to conveniently avoid the subject of toxicology. Serious study outside of epidemiology have not been pursued until the past years. I just post this if you are curious, from Dr Paul Connett, Professor of Chemistry, St Lawrence University:

    “Some people ridicule opponents of fluoridation for the long list of health effects sometimes claimed for the simple fluoride ion. It is easy to score cheap points here, but the fact is that fluoride has a high biological activity that is very general in nature—for example, it inhibits many enzymes, it interacts with calcium ions (either directly or indirectly), and in the presence of a trace amount of aluminum, it interferes with hormonal messaging systems. Since enzymes and hormones are essential to all physiological processes, such activities are like to produce a variety of effects.”

    A review article by E. Gazzano et al., “Fluoride Effects: The Two Faces of Janus,” has been published and summarises much of what is known about fluoride’s mechanisms of toxicity. Of particular interest is the ability of fluoride to cause oxidative stress by interfering with the body’s defence mechanisms against reactive oxidative species (ROS), which can otherwise attack membranes (lipid peroxidation) and presage inflammation and a whole range of degenerative diseases.

    In 2003, the National Research Council appointed a panel to undertake the review requested by the US’s Environmental Protection Agency. The brief to the panel was to examine not the benefits of fluoridation, but the toxicology of fluoride. In fact, the name of the NRC study from its inception was Toxicologic Risk of Fluoride in Drinking Water (BEST-K-02-05-A) until it was published in March 2006, at which time it was changed to Fluoride in Drinking Water: A Scientific Review of EPA’s Standards.

    The review, which occupied the panel intensively for more than two years, was finally published in March 2006; it ran to 507 pages, including over 1,100 references.

    Unlike those of the York Review and the NHMRC, the NRC panel members did not restrict themselves to epidemiological studies but availed themselves of all the science that might throw some light on fluoride’s toxic potential. That included biochemical studies, animal studies, modelling calculations, clinical trials, and human epidemiological studies. That allowed a “weight-of-evidence” approach to assess potential harm.

    In short, parents need to teach better hygiene but the use of fluoride is ethically dubious and its effects cannot with any certainty be claimed to be harmless according to modern toxicology since the research has only begun to see the light of day since 2006. Stop citing dental papers as they lack the scope to address the larger picture.

  • stever

    thanks for the detailed and factual analysis, Michael! I had suspected that the ‘devil was in the details’ wrt the value and hazards of fluoridating water. I agree that it’s more of a policy issue; i.e. whether the gov’t has the ‘right’ to add things to water, thus affecting all its citizens, even if it is of overall benefit.

    a couple of thoughts…
    1. if it is beneficial (and cost-effective), why do not more municipalities/countries add it? they can’t all have natural levels of fluoride that are high enough? perhaps because it becomes a bitter debate over using/misusing stats?

    2. why is the practice of using water to deliver a medical benefit limited to fluoride? after all, it is a cheap and widespread delivery system. why don’t we use it to also deliver vitamins, iron, etc.?

    thanks again!

    • Pat

      Hey! These are awesome questions, Im not the author but I thought I’d take a sec to answer the second question for you. I’m not a water policy expert so me taking a stab at the first would be pointless!
      As for your second question, it’s a matter of the actual chemistry behind delivery.

      A lot of vitamins are fat soluble, meaning they don’t dissolve in water well. If they don’t dissolve in water, it cant be delivered that way, its like oil and water. Thats why a lot of vitamins have recommendations on the back that suggest eating with food, because the fat in the food will increase uptake of the vitamin. That being said, some vitamins are water soluble, and could in theory be delivered this way. Then it becomes more a matter of cost, vitamins are expensive, a lot more expensive then a vat of hydrofluosylic acid.

      I think its also important to consider that whatever you put in the water will ultimately end up back in the river at some point too, so it might be a waste (cost wise), or could be a potential environmental problem to put back. Fluoride is a mineral, so it’s not going to really be a problem in the environment. It will be deposited on rocks or in sediments as it usually is in the environment. Vitamins alternatively are usually metabolized, they make things grow or do things in the body of both us and plants, so to add that back into the rivers could have some biological consequences.

      Furthermore, you’ve probably seen that there are daily recommended values for certain vitamins, this is because vitamins, are as I said, metabolized, and too much can have definite consequences on the body. Fluoride, being water soluble and a building block, will pass right through you if you’ve got enough. Vitamins will often be processed and stored and this can be at a cost to the body, notably the liver and kidneys. Its an issue of too much of a good thing, considering that many people do supplement.

      However, in countries where vitamins are scarce, and where clean drinking water may not be acceptable, a better way of delivering things like vitamins to the masses is through food. Have you heard about Golden Rice? It’s a real marvel and has greatly improved the health of many people in developing countries. Hopefully this gives you a start to further research!! =)

      • stever

        thanks, Pat… that’s helpful!

      • Hey pat, Calcium Fluoride (CaF2) is a mineral and natural but still toxic, H2SiF6 (Hydrofluorosilicic acid) is a liquid, not a mineral, Sodium Fluoride (NaF) is a mineral salt, and Fluoride as an ion even in the water is a gas.
        END chemistry lesson…
        Nutritionally, Fluoride especially as an ion delivered in the water supply and in any other form is not a nutrient and is not a regulated drug although it is used as such, since it is meant to mitigate tooth decay.

    • James Reeves

      FLUORIDE IS A WASTE OF TAX MONEY

      In addition to being ineffective for teeth and dangerous to health, fluorde is extremely wasteful of tax money. See http://www.fluoridealert.org for the truth on this.

      All Civil Engineers and Water Managers know that people drink only 1/2% of the water they use, so for every $1000 of fluoride chemical added to water, $995 is directly wasted down the drain in toilets, showers, dishwashers, etc., $5 is consumed in water by the people, and less than $0.50 (fifty cents) isconsumed by children, the target group for this outdated practice.

      That would be comparable to buying one gallon of milk, using six-and-one-half drops of it, and pouring the rest of the gallon in the sink.

      • stever

        so Michael writes a good, well-researched article with actual numbers… and you, in your reply, do not challenge any of his analysis, but make a couple of generalizations and reference a website of unknown quality. is that how you pursue a debate?

        • James Reeves

          Perhaps I am adding some new important information.
          I don’t expect you to know this, but as I said: “All Civil Engineers and Water Managers know this.”
          Why is it acceptable to waste tax money directly down the drain equaling over
          99 1/2% of the cost of fluoride added?

  • dont force medicate me.

    Fine. take it out of the water. Let people have the choice. Have stores sell it in pill form like vitamin C. If you want it you, can have it. Don’t force everyone . They dont force vitamin C on you by putting it in your water and we know thats good for you.

  • For an MSc, Michael is rather obtuse in his presentation, and has chosen to regurgitate fluoridationist propaganda instead of looking at all the research on the impact of the Fluorine element on human health once in an aqueous solution.

    He should review the data at the Second Look web site, http://slweb.org/bibliography.html

    BTW, dihydrogen monoxide = water! H2O: di = 2, 2 molecules of Hydrogen compounded with one of Oxygen. – is this a joke!?

  • Karen Stephens

    According to Environment Canada, naturally occurring non polluted fresh water is only .1 PPM and Edmonton treats to .7 (seven times the amount! ) and most Edmontians choose not to be forced medicated with fluoride. What about our children. .the elderly. .sick. .etc. There is a paucity of studies on the benefits to these groups. ..and lots of srudies pointing to the harm. Until more research is done. ..Edmonton needs to STOP adding fluoride. Let us choose to add fluoride or not. Don’t force it upon us.

  • Karen Stephens

    Get the evidence from medical doctors, not propaganda. http://www.WeDeserveSafeWater.com See Event November 21, 2013 7pm in Edmonton at the University of Alberta.

    • Karen Stephens

      This is put on by a biophysicist.. you can learn what fluoride actually is, what it does, safety issues, and if it is medically ethical.

  • Beck

    November 8, 2013

    Wanderer Online
    Edmonton
    The contribution of Mike Ross, 30Jul13, In Defense of Fluoridation, has come to my attention only now. There are serious misstatements in it. Broadly, only one of the three “fun fluoridation facts” is true.
    I am a physician and scientist. I have studied the science and ethics of fluoridation for fourteen years and am co-author of a 2010 book on fluoridation. I have concluded that it is neither safe nor substantially effective in preventing cavities.
    Mr. Ross makes no direct reference to any scientific studies on the effectiveness or safety of fluoridation except for his comments on the meta-analysis from the Harvard School of Public Health on the possible association of lower IQ with higher exposure to fluoride. His comments on that study are almost all incorrect. The most specific example is his claim that “Their major finding, actually, is that children who had ‘high exposure’ to fluoride had an IQ that was 0.45 points lower than reference children.” That statement may reflect an erroneous report on the HSPH website which was later “updated” to say that the study showed a difference between the mean IQ of the high-exposure subjects and the lower-exposure subjects of -0.45 of the standard error (a statistical term representing the spread of the normal distribution of a sample). That difference, as stated in the actual paper, is equivalent to a difference of -6.9 IQ points.
    A medical officer of health of Alberta Health Services gave the same misstatement in testimony before a city council at a public meeting. If it was because he relied on a report on a website rather than on reading and understanding the full paper, then he was irresponsible. However, he was informed of this misstatement and it was suggested to him that he correct his testimony. He said he would consider doing that, but then chose not to do so. This suggests something worse than the irresponsibility of using inadequate sources to make judgements affecting the well-being of four million people.
    If you are interested in a brief discussion of the scientific questions of effectiveness and safety of fluoridation and/or a discussion of the ethics of it, I would write something more complete for you. It would not do credit to Wanderer Online to leave Mr. Ross’s article uncorrected in the context of published investigations.
    Thank you for any consideration you may give to this.

    James S. Beck, MD, PhD
    Professor Emeritus of Medical Biophysics
    University of Calgary

  • Lucia Adams

    To mass medicate a nation is a cretinous thing. While fluoride might be good for you, mister-average-joe, it may cause damage to me. If Hitler used it, then it’s really to be question… Shouldn’t it? If there are naturally occurring traces of fluoride in water, then our bodies (and teeth), have adapted to this over millennia, our evolution is to adapt to the earth. The minute we try to force feed the body elements or foods that are naturally occurring, we find we toxify it instead. The endocrine system is a finely tuned one, that has been compromised for the last 60 years by fluoridation. I suggest you filter your water for about three months, then rewrite this article after detoxifying your body.