Water fluoridation was first introduced in America in the 1940s, since then it has been the source of considerable controversy. Pro-fluoridation supporters advocate that the process is “safe and effective” for reducing cavities, especially in populations of low socioeconomic status. Fluoride works by binding to tooth enamel, preventing bacteria from sticking to teeth as easily, thus, making the teeth more resistant to acid attack from bacteria.
Water fluoridation is endorsed by the American Medical Association, the American Dental Association, and the Centers for Disease Control and Prevention (CDC), which proclaimed it as one of the top 10 public health achievements of the 20th century. Currently, about 74% of Americans are drinking fluoridated water.
Without doubt, tooth decay has declined in the U.S. since fluoridation began, however, it has also declined in other countries that do not fluoridate. Opponents of fluoridation insist that it is an unethical form of mass-medication, without each individual’s consent or knowledge. By putting fluoride in drinking water, the dosage cannot be controlled, as some people drink more water than others.
Is fluoride a drug or a nutrient? The U.S. Federal Drug and Administration (FDA) has long recognized that fluoride is not necessary to human health or development. When used to prevent disease, the FDA considers fluoride to be a drug. For that reason, fluoride supplements are only available by prescription, not over-the-counter. Opponents, therefore, contend that if fluoride is a drug, why is it that there have never been any randomized trials of water fluoridation, which is the current standard for all drugs.
Is fluoride harmful? The most obvious side effect of excess fluoride exposure is dental fluorosis, which when mild includes white streaks, and when severe includes brown stains, pits, and broken enamel. According to the CDC, one-third of children and adolescents 6 to 19 years have dental fluorosis. Dental fluorosis is not simply a “cosmetic” effort; it is the first visible sign of fluoride poisoning.
In recent years, more and more published studies have uncovered other adverse effects of ingesting fluoride, including
- lowering of children’s IQ,
- hypothyroidism (an under-active thyroid),
- skeletal fluorosis, and
- adverse effects on the kidney.
Therefore, it is imperative that the public is aware of the risks and benefits of fluoride so that they can make an informed decision on whether they should make a conscious effort to reduce their fluoride exposure.
Fluoridation Around The World
About 74% of Americans get fluoridated water and over 65% get the artificially fluoridated water. The U.S. is only one of 11 countries in the entire world that fluoridates more than 50% of its water supply. The other 10 are Australia (80%), Brunei (95%), Chile (70%), Guyana (62%), Hong Kong (100%), Ireland (73%), Israel (70%), Malaysia (75%), New Zealand (62%), and Singapore (100%). However, Israel has recently announced that fluoridation will end by 2014 due to health concerns.
Most of mainland Europe, except Ireland, is not fluoridated; England fluoridates 10%. Japan is not fluoridated. Canada fluoridates 40%, but the number has declined by 25% in the last five years as more and more cities voted not to fluoridate.
Fluoridation Linked To Reduced IQ In Children
Recently, the Harvard School of Public Health published a meta-analysis that reviewed fluoride’s effects on the brains of children. Most of the fluoride studies in the report were based on research from China, India, Iran, and Mexico conducted over the last two decades.
The Harvard review reported that children who had higher exposures to fluoride in the communities where they lived had lower IQ levels than those exposed to much less fluoride. A rise in fluoride levels from 0.3 ppm (parts per million) to 3.0 ppm was associated with a 5-point drop in IQ. In addition, dental fluorosis occurs much more commonly in China where high fluoride exposure occurs from increased amounts in groundwater and from the use of coal in industrialized areas.
Fluoride is toxic to brain cells in developing children. Many parents, not aware of the adverse effects of fluoride, reconstitute infant formula with fluoridated water. In amounts as low as 1 ppm, the average concentration of fluoridated water in the U.S., fluoride can potentially damage the brain, as it readily crosses the blood-brain barrier, leading to brain and mental health issues. The scary part is that some of these changes may not be observed for 20 years or more after exposure. Various studies compared some of the brain changes seen as similar to those observed in Alzheimer’s disease.
The truth is that 1 ppm is only the amount said to be added to drinking water. Given that many products such as fluoridated toothpastes and mouth rinses, black and green teas, pesticides used to treat food crops, and Teflon-coated pans also contain fluoride, the actual exposure is much higher.
To date, more than 42 studies have looked into this association between fluoride and low IQ, with no less than 36 strongly supporting these findings. In the end, even if fluoride is highly effective against tooth decay, most parents would surely choose to protect their children’s brains instead, especially when there is a proven, effective alternative to fluoride in preventing cavities (see below).
Fluoridation Linked To Hypothyroidism
Fluoride is a very small, chemically reactive particle that tends to displace other minerals in certain storage sites within the body. In the thyroid gland, fluoride can prevent iodine from playing its proper role in the production of two thyroid hormones, T3 and T4, that are critical for controlling the body’s metabolism. Without sufficient iodine, the manufacture of thyroid hormones is compromised, resulting in hypothyroidism, an under-active thyroid. Historically, up till the 1970s, fluoride was used to suppress an overactive thyroid (Grave’s disease) before anti-thyroid drugs were developed.
As many as 25 million Americans have hypothyroidism and half of them have no idea that they do. Symptoms of hypothyroidism are numerous and may include:
- fatigue after sleeping 8-10 hours, need to take a nap daily,
- mood swings, anxiety, depression,
- decreased appetite, weight gain, inability to lose weight,
- forgetfulness, inability to concentrate,
- dry skin/hair, excessive hair loss, brittle nails,
- muscle/joint pain, carpal tunnel syndrome, tendonitis,
- menstrual disturbances, impaired fertility,
- neck swelling, snoring, hoarse voice,
- increased LDL (bad) cholesterol,
- cold hands and feet, and consistently low body temperature below 98 degrees.
Surprisingly tiny amounts of fluoride can change thyroid function. Studies show that for a 150-pound adult, ingesting 3.5 mg fluoride per day is enough to result in thyroid dysfunction. The most recent exposure analysis by the U.S. Environmental Protection Agency (EPA) estimates that the average American adult is consuming nearly 3 mg fluoride on a daily basis, and some are routinely ingesting 6 mg per day or more!
For a 30-pound child, fluoride intakes greater than 0.7 mg per day put the child at risk for hormonal dysfunction. The EPA estimates children within this weight range consume over 1.5 mg fluoride each day, more than twice the level that causes altered thyroid function. Such chronically high exposures may have profound and life-long effects on the intellectual and physical development of children.
Fluorides are cumulative and build up steadily. The body can only eliminate half of the total intake, which means that the older you are the more fluoride will have accumulated in the body. This is probably one of the reasons why hypothyroidism is pervasive among people over the age of 50. One study estimates that up to 20% of the older age groups have some degree of hypothyroidism.
In Canada, the rate of hypothyroidism has also exploded alongside with low rates of dental decay. This has led to University of Toronto professor and head of preventive dentistry, Dr. Hardy Limeback, retracting his professional endorsement of fluoride as a benign cavity-prevention tool in 1999. Since then, the rate of fluoridation in Canada has dropped significantly to the current 40% and the trend is continuing.
Fluoridation Linked To Skeletal Fluorosis
Prolonged, excessive exposure to fluoride can cause a debilitating bone disease known as skeletal fluorosis. Fluoride accumulates in the body and causes bone-forming cells to lay down extra skeletal tissue, which increases bone density. However, while bones become more dense, they are also hardened and thus less elastic, making them more brittle and susceptible to fractures.
In the initial stages of skeletal fluorosis, a patient may suffer a variety of symptoms in the absence of any detectable bone changes, including ruptures of the stomach lining, nausea, bone, muscle, and joint pain, as well as joint stiffness. Some of these symptoms are indistinguishable from common forms of arthritis like osteoarthritis and rheumatoid arthritis.
In the U.S., there has always been the notion that skeletal fluorosis does not occur at water fluoride levels below 8 ppm. However, studies in India and China have repeatedly documented skeletal fluorosis at levels as low as 0.7 to 1.5 ppm fluoride. In the U.S. the average concentration is 1 ppm. At present, there are no established treatments for skeletal fluorosis.
Fluoride & Adverse Effects On The Kidney
Kidney patients are particularly vulnerable to fluoride exposure because when the kidneys are damaged they are unable to efficiently excrete fluoride from the body. As a result, kidney patients accumulate up to four times more fluoride in their bones and blood than healthy people.
Kidney patients have a higher risk of bone and thyroid gland damage, as well as developing hyperparathyroidism, the uncontrolled secretion of parathyroid hormones. These hormones regulate calcium concentration in the body. An elevated parathyroid hormone concentration results in a depletion of calcium in bone structures and thus a higher calcium concentration in the blood. As bone flexibility decreases, the bone becomes more susceptible to fractures.
How To Reduce Your Fluoride Exposure
Given the adverse effects of fluoride, you may want to consciously reduce your exposure. The following includes some likely sources of fluoride in your daily lives:
1. If you live in an area which fluoridates its water, you can avoid drinking the fluoride by either buying spring water or filtering it out with one of the methods below:
Spring water. Most brands of spring water contain very low levels of fluoride. However, before consuming any bottled water on a consistent basis, you should verify that the fluoride content is less than 0.2 ppm, and ideally less than 0.1 ppm.
Water filters. There are 5 ways to remove over 90% of the fluoride – distillation, reverse osmosis, deionization using ion exchange resins, activated alumina, and bone char. (Note that activated carbon filters do not remove fluoride.)
The main disadvantage of distillation, reverse osmosis, and deionization is that the water is stripped of all the minerals, which is not healthy for drinking.
The main disadvantage of activated alumina is that aluminum can leach into the water. Aluminum is toxic to the brain and is linked to degenerative brain diseases like Alzheimer’s and Parkinson’s diseases.
Bone char filters do not have the drawbacks of the other methods. However, you need to make sure that the bone is of medical grade. Bone char also removes chlorine, lead, mercury, arsenic, heavy metals, radioactive isotopes, and pesticides.
2. Switch to non-fluoridated toothpastes and mouth rinses. Never get fluoride gel treatments at the dentist.
3. Avoid reconstituting infant formula with fluoridated tap water. Infant formula produced with fluoridated water contains 100 to 200 times more fluoride than is found naturally in breast milk.
4. Minimize consumption of processed foods and beverages, such as soda and reconstituted juice, which are often manufactured with fluoridated tap water.
5. Avoid produce sprayed with pesticides. If you regularly drink non-organic grape juice or wine, consider buying organic varieties. Many commercially-grown grapes are sprayed with a fluoride pesticide.
6. Limit your consumption of black, green, and oolong tea as the more mature leaves can absorb up to 20 times more fluoride from the soil than the younger leaves used in white tea. Mature tea leaves also contain less of the powerful anti-oxidant EGCG than the younger leaves. Favor purchasing organic teas over conventional. Although organic teas may still contain fluoride, the methods for cultivation are generally better than conventional ones.
7. Reduce eating chicken that is pulverized into a pulp form, such as chicken fingers and chicken nuggets. The mechanical deboning process increases the quantity of bone particles in the meat. Since bone is the main site of fluoride accumulation in animals, the higher levels of bone particles in mechanically deboned meats results in significantly elevated fluoride levels.
8. Avoid fluoridated salt which is sold in countries such as Austria, Bolivia, Columbia, Costa Rica, Dominican Republic, France, Germany, Honduras, Nicaragua, Panama, Switzerland, and Venezuela.
9. Beware that some pharmaceuticals may be fluorinated. These include Cipro, fluorinated anesthetics (Isoflurane and Sevoflurane), Niflumic acid, Flecainide, and Voriconazole.
10. Avoid using teflon-coated pans which may increase the fluoride content of food.
An Alternative To Fluoride In Preventing Cavities
Tooth decay is caused by the bacteria called Streptococcus mutans. This bacteria lives in the mouth and thrives on sugar and other carbohydrates. In the presence of carbohydrates, S. mutans produces acids that dissolve the enamel of the teeth, causing cavities.
Many studies have found that the natural sugar alcohol xylitol prevents, and in some cases, reverses tooth decay. Xylitol stops the bacteria from producing tooth-eating acid, reduces the plaque they create, and promotes tooth remineralization. Xylitol also stimulates saliva, the body’s natural way to protect the teeth.
According to the studies, best results are seen when xylitol is used throughout the day, with at least 5 exposures. Therefore, consider using toothpastes, mouth rinses, mints, and gum that contain xylitol. Xylitol is generally safe although at high doses, it may cause stomach discomfort and possibly diarrhea. Xylitol has minimal effect on blood sugar and can be used by diabetics.