BONING
UP ON
FLUORIDE
The EPA sets a “maximum contaminant
level” of fluoride at 4 ppm, warning that chil-
dren exposed to this amount are at increased
risk of bone disease and severe dental fluo-
rosis. Canada has set its optimum fluoride
level for water at 0.6 ppm, and most Western
European countries — including those with
government-subsidized dentistry — have
rejected fluoridation outright. (See sidebar
for more dosage info.)
The FDA regulates fluoride as a drug
when it is administered topically to prevent
tooth decay (as in fluoridated toothpaste). But
fluoride in the water supply is officially clas-
sified as a contaminant rather than a drug, and
the EPA regulates it. Agency managers have
remained largely mum on the subject, but
unionized EPA scientists voted against fluori-
dation in 1997. “We hold that fluoridation is
an unreasonable risk,” union senior Vice
President Dr. J. William Hirzy testified. “The
toxicity of fluoride is so great and the pur-
ported benefits associated with it are so small
— if there are any at all — that requiring
every man, woman and child in America to
ingest it borders on criminal behavior on the
part of the local governments.”
Contradictory
science on water
flouridation
baffles decision-
makers.
BY KERA ABRAHAM
FLUORIDE’S FRIENDS
I
n Stanley Kubrick’s classic 1964 movie, Dr. Strangelove, the deranged General Jack D.
Ripper thinks he knows a secret communist plot to destroy Americans from within. “A for-
eign substance is introduced into our precious bodily fluids without the knowledge of the
individual. Certainly without any choice,” he says ominously. He’s referring to water fluor-
idation, “the most monstrously conceived and dangerous communist plot we have ever had
to face.” Kubrick seems to be mocking the anti-fluoridation activists of his day.
Forty years later, some Americans still view fluoride as a threat — though not a Soviet one, and
probably not dangerous to our precious bodily fluids so much as to our solid parts. Fluoridation’s
opponents are fighting against momentum; three in five Americans now drink fluoridated water, and
that number is growing as more cities fluoridate their water supplies. But the movement against fluori-
dation, buoyed by new studies and the Internet, is amassing credible ammunition in its favor.
THE SCIENCE
Fluoride is a natural substance that exists
in all water at some level. The gaseous ele-
ment fluorine combines with other elements
to form fluoride compounds in rocks and
soil, which dissolve into flowing water. Most
groundwater contains trace levels of fluoride,
and ocean water contains about 1.3 parts per
million (ppm) flouride.
Public water fluoridation actually means
“adjusting to the optimum” — adding or
removing fluoride to achieve a level of about
1 ppm, which the Center for Disease Control
(CDC) has determined as the optimum con-
centration for strengthening teeth without
causing serious dental fluorosis (or tooth
mottling, a funky cosmetic effect). In places
with high levels of naturally occurring fluo-
ride, adjusting to the optimum means
removing fluoride from the water supply.
In most places, though, it means adding
fluoride.
Governments fluoridate water as a means
to prevent tooth decay. When we eat sugar or
other refined carbohydrates, oral bacteria
10 JULY 21, 2005
BONES ABOUT FLUORIDE
produce acid that erodes minerals on the sur-
face of teeth. Our saliva attempts to reverse
this process by re-building the tooth’s miner-
al shield with a bath of calcium and phos-
phate. But a high-sugar diet produces acidic
bacteria faster than mineral-rich saliva can
repair the damage, causing cavities over
time.
When we ingest fluoride in water, it
replaces calcium and phosphate on the
tooth’s surface, resulting in enamel that is
about 10 times more acid-resistant than teeth
that have not been exposed to fluoride. That
helps to prevent cavities, but it also makes
teeth more brittle. Teeth that have been
exposed to fluoride tend to break more easi-
ly than those that have not.
What happens to teeth often happens to
bone. According to fluoride critic Dr. Hardy
Limeback, head of preventative dentistry at
the University of Toronto, 95 percent of
ingested fluoride ends up in bones, not teeth.
And what happens there worries some scien-
tists and doctors.
In the past five years, scientists have pro-
duced an influx of peer-reviewed research
linking fluoride consumption with bone
damage. In a recent study, 96 percent of
Tibetan children with dental fluorosis
(caused by high fluoride intake from brick
tea) exhibited developmental skeletal abnor-
malities in wrist x-rays. A May 2003 study in
the journal Fluoride links increased fluoride
consumption with lower IQs in Chinese chil-
dren. A study in Rheumatology Journal
reports that moderate levels of fluoride
intake (1.9-3.6 ppm) correlates to knee
osteoarthritis. And a 2001 Harvard doctoral
thesis links fluoridated water to an increase
in young boys’ risk of developing osteosar-
coma, a rare form of childhood bone cancer.
Proponents are quick to point out that
high doses of fluoride may be toxic, but
water supplies are fluoridated to a relatively
low dose. The Environmental Protection
Agency (EPA), however, reports that even at
1 ppm, fluoride can cause moderate dental
fluorosis in a small percentage of people.
Despite the concerns about fluoride, the
CDC calls fluoridation one of the 10 greatest
public health achievements of the 21st centu-
ry, and the American Dental Hygienists’
Association credits it with a 50-60 percent
reduction in tooth decay since World War II.
The American Dental Association, the
American Medical Association, the U.S.
Public Health Service and the American
Water Works Association all endorse it.
Jane Myers, director of the Oregon
Dental Association’s public affairs depart-
ment, believes that the mainstream majority
supports fluoridation. She says that if local
jurisdictions won’t fluoridate their water sup-
plies, the state should mandate it. “The world
abounds in junk science,” she says. “We
require seat belts and motorcycle helmets
and inoculations and a number of things, and
they’re frequently met with resistance by
vocal minorities.”
In addition to improving the state’s teeth,
Myers says, water fluoridation is good for
the economy. She claims that every $1 spent
on fluoridation yields about $38 in saved
dental costs, which could make a big dent in
the state’s annual $70 million Medicaid den-
tal bill.
Myers, admitting that she’s not an MD,
has nothing to say about fluoride’s potential
threats to the body — but she suspects that
they’re overblown. “They’ve been doing this
for 60 years in the United States,” she says.
“It comes down to who you’re gonna
believe. Are you gonna believe the
Department of Health, which has our well
being at stake, or the opponents? Who are
they, and what are their credentials?”
FLUORIDE’S FOES
Lynne Campbell, director of the anti-
fluoridation group Oregon Citizens for Safe
Drinking Water, suspects that something
fishy is going on with fluoridation, though
she doesn’t know the details. She notes that
the Public Health Service, the agency in
charge of fluoridation research, is also fluori-
dation’s primary endorser. In her view, that
conflict of interest has created skewed poli-