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City Council to Hear Anti-Fluoride Arguments

fluoridation Tonight the Raleigh City Council will hear a challenge to the current community water fluoridation (CWF) standards. Likely the request will be to adjust the water fluoridation to levels below the optimal level to prevent tooth decay.

Water fluoridation was introduced in Grand Rapids, Michigan in 1945, and since then the use of CWF has been the primary factor in saving some $40 billion in oral health care costs in the United States. While behavioral patterns have changed in that period, CWF is the the chief reason that half of all children under 18 have never had a cavity in a permanent tooth.

If you talk to any dentist above 70 years of age in the area, to a man, they can attest to the marked improvement in children’s oral health they’ve seen first-hand throughout their careers; and, to a man, they will all tell you that CWF has been a good decision.

There are dangers of having too much fluoride, however. Fluorosis is the overuse of fluoride and produces mottled teeth. In mild to moderate cases the mottling is strictly an aesthetic problem. In severe cases the enamel in mottled teeth is not as strong, and is difficult to treat. Studies have been done and concluded that below a certain point (just greater than 1 part-per-million (ppm) of fluoride), the rate of fluorosis rises constantly and slowly, and is a flatter curve than the falling rate of decay. Beyond that certain point, however, fluorosis dramatically increases while decay flattens out. It is for this reason that the recommended water dosage point is 1.0ppm. There is no doubt that a decrease in the amount of fluoride intake from this level will result in many more cavities for children in Raleigh, and therefore, a lifetime of weaker teeth.

According to the Centers for Disease Control:

The Division of Oral Health salutes the dedication and perseverance of fluoridation pioneers. Because of their efforts and continued support from generations of dentists and other health care providers, health care and public health organizations, community leaders, water plant operators, and untold others, the prevention of tooth decay through community water fluoridation is recognized by the DC as one of 10 great achievements in public health of the 20th century. This simple, safe, and inexpensive public health intervention has contributed to a remarkable decline in tooth decay in the United States, with each generation enjoying better oral health than the previous generation.

According to Former Surgeon General Richard H. Carmona:

… Fluoridation is the single most effective public health measure to prevent tooth decay and improve oral health over a lifetime, for both children and adults … Policymakers, community leaders, private industry, health professionals, the media, and the public should affirm that oral health is essential to general health and well-being and take action to make ourselves, our families, and our communities healthier. I join previous Surgeons General in acknowledging the continuing public health role for community water fluoridation in enhancing the oral health of all Americans.

We are in a two week stretch of speeches about some big decisions in America. However none of those will impact our children’s health as much as what will be said tonight to the Raleigh City Council.

The meeting will take place in the Raleigh City Council Chamber at 7:00pm.

  • John

    Did anyone stand up and neurotically claim that flouridating water is part of Obama’s “nanny state”?

  • Anonymous

    No, John, and given the way these people presented themselves, they were anything but right-wingers…maybe Occupy people, but definitely not staunch Conservatives.

  • Rob

    The reason that I want fluoride out of the water is that is a known neurotoxin that crosses the blood-brain barrier and has been tied to lowered IQ’s in children. I hate that my children are routinely drinking it. If I had to choose between cavities and neurological disorders, you can easily guess what I’d do. I’m sure many others would feel the same. I’d rather people be responsible for putting in their own water if they still want it.


  • Anonymous

    I appreciate your concern, Rob, but the effect mentioned in that article seem to be occurring at way, WAY higher levels of fluoride intake than we currently put in our water supply. These studies, especially the one comparing two villages, don’t account for vast differences between the tribes, and vast differences between the the environmental and genetic differences between them and citizens in the United States. Also, the article operates under the assumption that the dose/response curve is straight, which is not remotely accurate. In fact, straight lines are a rarety in pharmacologic studies.

    The article also somehow links mottling of teeth as proof of toxicity. Nobody will argue that fluoride is not toxic at high doses, however at mildly high doses, we see fluorosis, which is an interruption of the laying down of the enamel matrix. These interruptions reflect light differently, and give an ugly, uneven appearance to the enamel. However this does not necessarily mean that the child has other morphological abnormalities. It’s really not more devastating that Julien’s green hair was in 6th grade from swimming in the pool every day.

    We surely should continue the investigation of fluoride. At this point, howeverm there is not ample evidence of danger compared to the enormous benefits gained, especially for the poor. Early childhood decay is costly, and treatment is poorly received, often causing psychological barriers to all forms of healthcare, and prevention by the patient for the rest of their lives.

    • guest

      Ingestion of fluoride has little benefit, but many risks.

      Whereas fluoride’s benefits come from topical contact with teeth, its risks to health (which involve many more tissues than the teeth) result from being swallowed.

      Adverse effects from fluoride ingestion have been associated with doses attainable by people living in fluoridated areas. For example:

      Risk to the brain. According to the National Research Council (NRC), fluoride can damage the brain. Animal studies conducted in the 1990s by EPA scientists found dementia-like effects at the same concentration (1 ppm) used to fluoridate water, while human studies have found adverse effects on IQ at levels as low as 0.9 ppm among children with nutrient deficiencies, and 1.8 ppm among children with adequate nutrient intake. (10-13)

      Risk to the thyroid gland. According to the NRC, fluoride is an “endocrine disrupter.” Most notably, the NRC has warned that doses of fluoride (0.01-0.03 mg/kg/day) achievable by drinking fluoridated water, may reduce the function of the thyroid among individuals with low-iodine intake. Reduction of thyroid activity can lead to loss of mental acuity, depression and weight gain (14)

      Risk to bones. According to the NRC, fluoride can diminish bone strength and increase the risk for bone fracture. While the NRC was unable to determine what level of fluoride is safe for bones, it noted that the best available information suggests that fracture risk may be increased at levels as low 1.5 ppm, which is only slightly higher than the concentration (0.7-1.2 ppm) added to water for fluoridation. (15)

      Risk for bone cancer. Animal and human studies – including a recent study from a team of Harvard scientists – have found a connection between fluoride and a serious form of bone cancer (osteosarcoma) in males under the age of 20. The connection between fluoride and osteosarcoma has been described by the National Toxicology Program as “biologically plausible.” Up to half of adolescents who develop osteosarcoma die within a few years of diagnosis. (16-19)

      Risk to kidney patients. People with kidney disease have a heightened susceptibility to fluoride toxicity. The heightened risk stems from an impaired ability to excrete fluoride from the body. As a result, toxic levels of fluoride can accumulate in the bones, intensify the toxicity of aluminum build-up, and cause or exacerbate a painful bone disease known as renal osteodystrophy. (20-23)

      Water fluoridation’s benefits to teeth have been exaggerated.

      Even proponents of water fluoridation admit that it is not as effective as it was once claimed to be. While proponents still believe in its effectiveness, a growing number of studies strongly question this assessment. (29-54) According to a systematic review published by the Ontario Ministry of Health and Long Term Care, “The magnitude of [fluoridation’s] effect is not large in absolute terms, is often not statistically significant and may not be of clinical significance.” (41) For example:

      No difference exists in tooth decay between fluoridated & unfluoridated countries. While water fluoridation is often credited with causing the reduction in tooth decay that has occurred in the US over the past 50 years, the same reductions in tooth decay have occurred in all western countries, most of which have never added fluoride to their water. The vast majority of western Europe has rejected water fluoridation. Yet, according to comprehensive data from the World Health Organization, their tooth decay rates are just as low, and, in fact, often lower than the tooth decay rates in the US. (30, 40, 49)

      Cavities do not increase when fluoridation stops. In contrast to earlier findings, five studies published since 2000 have reported no increase in tooth decay in communities which have ended fluoridation. (42-46)

      Fluoridation does not prevent oral health crises in low-income areas. While some allege that fluoridation is especially effective for low-income communities, there is very little evidence to support this claim. According to a recent systematic review from the British government, “The evidence about [fluoridation] reducing inequalities in dental health was of poor quality, contradictory and unreliable.” (53) In the United States, severe dental crises are occurring in low-income areas irrespective of whether the community has fluoride added to its water supply. (54) In addition, several studies have confirmed that the incidence of severe tooth decay in children (“baby bottle tooth decay”) is not significantly different in fluoridated vs unfluoridated areas. (32, 37, 47) Thus, despite some emotionally-based claims to the contrary, water fluoridation does not prevent the oral health problems related to poverty and lack of dental-care access.

      • Anonymous

        If there is validity in the articles which you have cited (and probably not reviewed individually, right?), then you will need to take this up with the CDC and Surgeon General:

        I’ll warn you, though, that phrases like “ingestion of fluoride has little benefit”, “no difference exists in tooth decay between fluoridated & unfluoridated countries.” and “fluoridation does not prevent oral health crises in low-income areas” shows little experience in the field. There is overwhelming evidence in the peer-reviewed, double-blind literature that refutes these claims.

  • guest

    “The prevalence of dental caries in a population is not inversely related to the concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not necessarily more efficacious in preventing dental caries.”
    SOURCE: CDC (2001). Recommendations for using fluoride to prevent and control dental caries in the United States. Mortality and Morbidity Weekly Review 50(RR14):1-42.

    Harvard University Environmental Health Professor Dr. Phillipe Grandjean: “Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain. The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.”

    It doesn’t seem a wise policy to create the potential for such brain drain in a city Forbes magazine calls a “brain magnet.”

  • Anonymous

    Nobody is contesting the concept that a toxic dose of fluoride exists. However AT THESE LEVELS, there are no peer-reviewed, double-blind trials that demonstrate any of these toxic effects. Dr. Grandjean could be an excellent in vitro researcher, however his paper doesn’t remotely begin to refute the meta analysese of 1000s of articles published by the international dental ecology community that demonstrate, in vivo, the benefits that appropriate fluoride dosing provides to a community.

    Isn’t it interesting that nobody has pondered the irony of the dental community’s steadfast support for community water fluoridation? This is the very group that stands to gain the most, financially, from the cessation of this practice.

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