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Submission to Calgary City Council's Operations and Environment Committee (09/10/97)

New Evidence of fluoride health risks & lack of benefit to stop artificial water fluoridation in Calgary

by Health Action Network Society, Alberta Chapter Director Elke Babiuk
Revised and Updated January, 13, 1998, October 23, 1998
 
EXECUTIVE SUMMARY CONCLUSION
INTRODUCTION FLUORIDE CHRONOLOGY 1989-1997
NEW DATA -- INCREASED RISK CHRONOLOGY REFERENCES
ENVIRONMENTAL CONCERNS REFERENCES FOR OPENING REMARKS
PEOPLE AT HIGH RISK OF FLUORIDE TOXICITY APPENDIX I (people susceptible to fluoride toxicity)
DENTAL FLUOROSIS PANDEMIC APPENDIX II (scientific debate discouraged)
SYSTEMIC versus TOPICAL FLUORIDE APPENDIX III (suppression & persecution)


EXECUTIVE SUMMARY
  1. New scientific research obliged fluoride promoters to relinquish their fifty-year-old unproven hypothesis that ingesting fluoride in the early tooth-forming years provided huge benefits to teeth. A significant paradigm shift has thus occurred in dentistry over fluoride's cariostatic role.

  2. Recent large studies show little or no statistically significant and/or clinically relevant differences in decay rates of permanent teeth. According to fluoridation proponents' own literature, the impressive-sounding large percentage reductions in tooth decay that they claim for fluoridation, is a lifetime benefit of less than one tooth surface per child, or a fraction of one cavity.

  3. U.S. Environmental Protection Agency scientists take stand against fluoridation, citing the preponderance of evidence which shows increased health risks (see Chronology).

  4. Fluoride is one of the most bone-seeking elements known to man. Even "low" doses of fluoride intake is increasingly being linked to bone damage.

  • Hip fracture rates in seniors are rising in fluoridated areas and are increasing more rapidly than can be accounted for by an aging population.
  • Two studies show increased osteosarcomas in children (a rare, often fatal bone cancer).
  • New radiographic techniques show bone abnormalities in children with dental fluorosis (the teeth are a window to what is happening in the bones.
  • Bone abnormalities are seen in aborted fetuses born to mothers with dental fluorosis.
  • World Health Organization warns that ingesting 2.0 - 8.0 mg of fluoride per day (as little as 2 litres of fluoridated water) can lead to the pre-clinical stage (arthritis-like symptoms) of skeletal fluorosis (a crippling bone disease).

  1. Animal studies show that low doses of fluoride causes brain damage -- indicative of a potentialfor motor dysfunction, IQ deficits and/or learning disabilities in people. Human studies also show that fluoride has negative effects on the brain.

  2. Recently declassified information from the Manhattan Project in the U.S. revealed that scientists were aware of the adverse neurological impacts of fluoride in 1944!

  3. Seniors and people with poor nutrition or chronic illness are most susceptible to fluoride toxicity.

  4. Due to the ubiquitous nature of fluoride in an ever-increasing fluoridated society, dental fluorosis rates in children are now pandemic. Promoters claim that fluoridation is responsible for about 40% of present fluorosis levels. Foods and beverages manufactured in fluoridated areas add to fluoride intake, even in unfluoridated areas. Fluoride-containing pesticides on fruits especially, add to a child's intake as does toothpaste ingestion.

  5. U.S. Food and Drug Administration recognises increased risk to children who inadvertently swallow fluoridated toothpaste and requires all manufacturers to provide strong guidelines and poison warnings on packages.

  6. It is impossible to control the daily dose of fluoride because individual water intake varies widely. Fluoridation violates medical ethics which require informed consent before treatment and individual prescription and supervision.

  7. Studies show that fluoride may decrease birth rates in women and sperm motility in men.

  8. The fluoridating chemical is an industrial waste product contaminated with heavy metals.

INTRODUCTION

Together with increased sales for home water filters -- reverse osmosis or distillation removes fluoride -- sales for pure pristine bottled water (most don't contain fluoride) have skyrocketed in the last few years. In the province of Alberta, there are over 200 bottled water companies. A significant percentage of Calgary offices, including the Aldermanic and Mayor's offices, now provide their employees and clients with fluoride-free bottled water. Bottled water is available in almost every bar, restaurant, corner store, supermarket, etc. In Canada, sales for Spring Water (this probably doesn't include distilled or reverse-osmosis water), increased from 289 million litres in 1989 to 485 million litres in 1995. The percentage of people drinking bottled and/or home-filtered water may be significantly higher in Alberta than in a state like Pennsylvania where there are probably only five or six companies selling bottled water. It is also common knowledge that less than 1.0% of fluoridated water is ingested. The rest is flushed down the drain and used to fight fires, wash cars, fill swimming pools, etc. Ever-increasing amounts of fluoride enters our ecosystem in one way or another. If one considers increased health risks, escalating bottled and/or filtered water consumption (see footnote A), the tiny proportion of water used for drinking and cooking, and the fact that fluoride is a bioaccumulator, the following question begs an answer:

is it logical for the city of Calgary to continue dumping 755 tonnes of heavy metal-contaminated hydrofluosilicic acid (25% fluoride) into our environment every year?

The New Municipal Government Act empowers Council to stop fluoridation without plebiscite. However, if Council is reluctant to invoke that power, or if they decide not to hold a plebiscite despite the considerable new evidence presented in this submission, they have the moral obligation, and perhaps a legal duty, to issue a strongly-worded health advisory to those people who are at the greatest risk of fluoride toxicity. The most vulnerable subsets of our population at risk have been identified by the U.S. Agency for Toxic Substances and Disease Registry (ATSDR excerpt in APPENDIX I).


NEW DATA -- INCREASED RISK

BONES: the results of more than five epidemiological studies indicate increased hip fractures in both naturally and artificially fluoridated areas. The incidence of hip fracture is also increasing more rapidly than can be accounted for by aging of the population. Tragically, fluoride promoters' fervent belief in fluoridation generally precludes serious discussion when new data establishes increased risk (see Appendix II and related references). These studies are dismissed by proponents because they are ecological in design. This means that exposure and disease information is available for groups of people in specific geographical regions but not for the individuals themselves. Therefore, promoters say that study findings may be acausal (a chance occurrence, possibly due to lifestyle or environment) rather than caused by fluoride. While this is a legitimate criticism of all ecological studies, promoters forget this is a two-way street -- the many small, mostly non-randomised surveys from which they claim benefits to teeth, even if assumed valid, are also ecological studies. The fluoride-fracture link is not only plausible, but highly probable given the evidence in animal and human studies.

Many studies undeniably prove that fluoride's cumulative effect on bone is devastating. It is well known that chronic ingestion of fluoride can cause osteofluorosis or skeletal fluorosis (crippling bone disease). This evidence has been reported in at least nine studies from five countries (contrary to promoters' denials, this occurs even at relatively "low" water fluoride levels). Moreover, according to the World Health Organization, individuals consuming between 2.0 - 8.0 mg of fluoride/day (2-8 litres of fluoridated water), can develop the pre-clinical symptoms of skeletal fluorosis (arthritis-like symptoms), which is only radiographically detectable by an expert. As recently reported by the U.S. PHS, many women living in fluoridated communities are now ingesting up to 6.6 mg of fluoride per day, a crippling dose for some if maintained (see graph, Appendix III)!

It is widely recognised that fluoride "therapy" for osteoporosis adds mass to bones but produces inferior bone -- at least seven studies found structural abnormalities or mineralization defects. In short, the biomechanical competence of the skeleton may be compromised because the tensile (elasticity) strength of bone is sacrificed. These studies not only show that fluoride may cause increased skeletal fragility (more non-vertebral fractures such as hip), but that it can lead to osteomalacia (another bone disease). The relevance to fluoridation is: short-term high-dose fluoride studies show the same amount of fluoride accumulates in the bones of osteoporosis patients as would be found in some people who are chronically exposed to long-term "low" doses of fluoride (such as in fluoridated areas). People with renal insufficiency, for example, can incorporate four times more fluoride into bone than an average healthy individual.

Evidence of more bone damage is seen in a New Jersey Department of Health study, a U.S. National Cancer Institute study [see footnote B], a U.S. National Toxicology Program (NTP) rodent study (see Appendix III & Chronology), and a Polish study which examined the bones of children with dental fluorosis using new radiographic techniques. The two epidemiological studies found increased osteosarcoma rates in young men in fluoridated areas. Osteosarcoma is a rare bone cancer which mostly originates in the growing end of bones. It is more prevalent among young males 10-19 years of age and seems to occur 1.4 times more often in males than in females. Girls are at risk at an earlier age because their adolescent growth spurt occurs before that of boys. The NTP animal study found dose-related occurrences of osteosarcomas in male rats. Polish scientists discovered bone abnormalities in male children with fluorosis. How much evidence must accumulate before authorities here acknowledge what many foreign scientists have already done years ago -- fluoride is one of the most bone-seeking elements known to man and long-term ingestion is toxic to bones even in the so-called "low" doses.

NEUROLOGICAL: Phyllis Mullenix, who founded the toxicology department at Forsyth Dental Centre (an affiliate of Harvard University), and a pharmacologist and toxicologist by training, found that fluoride did not just accumulate in bones but crossed the blood-brain barrier and accumulated in the brain, once thought to be relatively impermeable to fluoride. Like Dr. Marcus, U.S. Environmental Protection Agency (EPA) toxicologist, Dr. Mullenix was fired from her position when she spoke out about fluoride's health risks (see Chronology Appendix II and Appendix III). The Mullenix study also dovetails with reports from China where skeletal fluorosis is endemic. The studies showed that fluoride negatively affects the central nervous system before skeletal fluorosis was evident (see brain.htm & Chronology for more detail). Recently declassified documents from the Manhattan Project, revealed that U.S. scientists were aware of the adverse neurological effects of fluoride in 1944!


ENVIRONMENTAL

On one summer day in Calgary, Alberta 800,000 people used 842 million litres of water. Even if one was generous in calculating average intake -- 4.0 L/person x 800,000=3.2 million litres -- over 838 kilograms of fluoride was flushed into our environment in one day! Given current regulations, no fluoride-emitting industry in Canada is allowed to pollute our ecosystem with so much fluoride.

Both the EPA and Environment Canada recognises that fluoride is a difficult-to-treat and toxic pollutant. The same concentration of fluoride added to water for "preventing" cavities (1.0 ppm=1.0 mg/L), has lethal effects on aquatic life such as salmon. More evidence of damage is given in a recent Canadian governmental review. The data contained therein, allows one to estimate the quantities of inorganic fluorides which are released by fluoridating. The amount is second to that released by phosphate fertilizer producers -- the largest fluoride polluters in Canada. It is these very industries which provide the heavy metal-contaminated (mercury, lead, etc.) industrial waste used for fluoridating. Is it reasonable to put industrial waste in drinking water?

The Canadian reviewers admit that fluorides are entering the environment in quantities harmful to aquatic and terrestrial ecosystems. Fluoride is released in sufficient amounts to damage crops, animals, plants, etc., yet according to the reviewers, it is "harmless" to humans. Common sense requires an answer: is it logical to assume that human beings are less sensitive to environmental toxins than plants, animals, or fish? A healthy immune system will protect us somewhat, but cumulative toxins like fluoride take their toll over time -- both in the environment and in our body. Despite some excellent sections on fluoride's ecotoxicity, Dr. Richard Foulkes, former special consultant to B.C.'s Minister of Health commented that once again: "...the politics of fluoridation have preempted objectivity and science."

The fluoride which still remains in sewage after treatment (about 50-75%), like heavy metals, will accumulate in farmers' fields which have the sludge applied as fertilizer. Fluoride also remains in sediments downstream from a fluoridating community for about 1-2 million years. There are a number of reasons to doubt the veracity of promoters' statements that fluoride is not a threat to aquatic life downstream from a fluoridating city. For reasons of time and space, these have not been expanded on. Please feel free to contact the author for more information.


PEOPLE AT HIGHER RISK OF FLUORIDE TOXICITY

Scientific studies have proven that fluoride allergy and/or intolerance exists. Others show that fluoride may have negative effects on the reproductive and immune systems, and the brain. Despite these new studies, many fluoridation promoters cling to the notion that indiscriminate fluoride ingestion is safe for everyone, regardless of age, nutritional status, medical conditions, or weight. The double standard is obvious -- no other drug, vitamin, herb, or mineral is privy to such a claim! Some Calgary promoters even claimed that fluoride was an "essential nutrient", a claim which is rejected by the U.S. Public Health Services, the Food and Drug Administration and the National Academy of Sciences.

In 1977, scientists at Canada's National Research Council, recognized that some people are unusually susceptible to fluoride toxicity. In a recent toxicological review of fluorides, the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) validated what our scientists said so long ago. Those people at risk from daily fluoride ingestion are individuals with cardiovascular and kidney problems, the elderly, and people with nutritional deficiencies such as calcium, magnesium and vitamin C. (ATSDR excerpt in Appendix I). The kidney is the major organ which clears fluoride from the body. Its function decreases with age and seniors thus retain more fluoride. Diabetics are also at risk. Individuals with inadequate nutrition are at risk because nutrients like calcium bind with fluoride, increasing its excretion rate and limiting its uptake into bone and teeth. Research also reveals that chronic fluoride intake creates a greater metabolic need for calcium, an element critical for healthy bones and teeth. It is ironic that the people who promoters claim will benefit the most -- poor children -- are at higher risk due to inadequate nutrition. Not surprisingly, they also have higher fluorosis rates.


DENTAL FLUOROSIS PANDEMIC

Fluorosis occurs in up to 69.2% of Canadian children, a 59.2% increase from 1945. The escalating occurrence and increased severity of fluorosis -- porous hypomineralized enamel characterized by chalky-white spots/streaks, "snow-capping", and/or brown pits -- is so serious a problem that some authorities are advocating the elimination of fluoride supplements and the use of a "pea-sized" portion of toothpaste. Less than 16% of eligible children in unfluoridated areas take supplements so this is not a significant factor in rising rates. Even if a "pea-sized" portion is used, many children cannot and/or do not spit fluoride out. Yummy-tasting bubblegum-flavoured paste is especially inviting for children. It is well known that children swallow inordinate amounts of fluoride from toothpaste, until about age five, because their spitting mechanism is not fully developed. In the 1950s when fluoridated toothpaste was marketed, authorities recognised that the simultaneous consumption of fluoride from toothpaste and water put children at risk. The following warning was printed on fluoridated paste:

"CAUTION: children under 6 should not use CREST"

This produced a problem. If the public recognised that fluoridated toothpaste put children at risk, they might think that fluoridation was risky, or, at best, redundant given the easy availability of toothpaste. Many people had staked their reputation on fluoridation's alleged safety and benefits and were not about to backtrack. Something had to be done. In the end, some individuals reversed their original opinion and started advocating fluoridated water and fluoridated toothpaste for everyone. Even though no studies had been done proving safety, the warning disappeared off tubes shortly before the American Dental Association endorsed Proctor and Gamble's (P&G) Crest toothpaste in 1960. P&G stock skyrocketed by $8 a share. Coincidence?

Almost forty years after the first warning was dropped, after much consultation, study, and thousands of reports to the U.S. Poison Control Centres involving fluoride products, the U.S. Food and Drug Administration (FDA) put manufacturers on notice. To protect children, manufacturers must now comply with stringent labelling regulations (see Chronology-Year 1997). It's noteworthy to mention that if fluoridated toothpaste was introduced today, it would never be allowed on the market by Health Canada or the FDA, because of its known toxicity and risks.

Babies should not receive fluoride supplements, according to Canadian and U.S. authorities. Those born in fluoridated areas are not so lucky and are at significant risk. Although they don't receive suppements, when powdered formula is reconstituted with fluoridated water, babies ingest more fluoride than the alleged upper "optimal" limit of 0.07 mg/kg body mass (a dose which has never been scientifically determined). Their fluoride intakes are up to 200 times that of nursing infants. They ingest an adult's equivalent of about 7.0 mg/day!

Most fluoride proponents are preoccupied with fluoride's "benefits", rather than the biological or histopathological effects. They dismiss fluorosis as a "cosmetic effect" of no consequence to health. They are oblivious to the fact that fluorosis connotes fluoride toxicity far more important than mere dental disfigurement. According to Dr. J. Colquhoun, former Chief Dental Officer of Auckland, N.Z.: "the claim that only tooth-forming cells are damaged by fluoride is extremely implausible, contrary to common sense, and can be disputed on scientific grounds. There is evidence of more general harm." Fluorosis is a frank sign of fluoride over-dose in childhood. It is an indicator that the destructive effects of fluoride are occurring in bone, connective tissue, immune and enzyme functions. Due to the porosity of moderate-to-severe fluorotic enamel, its structural integrity is compromised and post-eruptive damage ensues. The longer the tooth is in the mouth, the more severe the damage becomes. Stains increase with time. Parts of enamel often break away leaving teeth with round pits. Loss of the outermost enamel can occur and tooth surfaces rapidly wear down. Even in milder forms, fluorosed enamel is subject to surface attrition.

Fluorosis is permanent; it's often problematic for appearance-conscious teens; and, it can be expensive to fix (probably not an option for underprivileged children). Research reveals that there is no safe threshold below which the effects of fluoride will not be manifest on enamel. While fluoridated toothpaste is an important contributor to fluorosis incidence and level of severity, water-borne fluoride is a significant factor even in unfluoridated areas -- products produced in fluoridated areas (pops, juices, etc.) are sold in unfluoridated areas. To protect our children, the logical course of action should be to recommend fluoride-free toothpaste for the first 4-5 years of life, and the cessation of fluoridation -- the fastest easiest method of reaching most children at risk.


SYSTEMIC versus TOPICAL FLUORIDE

Throughout five decades, fantastic claims were made by fluoride proponents about "stronger" teeth (more acid-resistant) in fluoridated areas or in those children who took supplements. Decay was reduced by up to 70% they claimed. New analytical techniques and scientific research obliged promoters to relinquish their fifty-year-old unproven hypothesis -- that fluoride's cariostatic action was systemic (i.e., had to be incorporated into developing enamel by ingestion). Dental researchers now believe that fluoride's action is topical (i.e., acts on the surface of teeth, not from inside the body). Promoters say that by applying high concentrations of fluoride (e.g., toothpaste) to the surface of teeth when an incipient lesion is developing (initial stage of decay before enamel is breached), enamel is remineralized and lesions are "healed". In other words, according to the promoters, even topical fluoride is redundant for people not at risk of tooth decay -- the majority of us (footnote C).

This is underscored by the fact that some dental researchers now concede that a professionally- applied treatment in the dental office is superfluous unless the patient demonstrates caries activity at the time of the visit or is at high risk of decay. How many patients open their wallets twice per year for their fluoride treatment, not realizing that it's worthless? How many parents know that the fluoride treatments young children receive are potentially lethal? Why has dentistry not been more forthcoming on this? While promoters say that there is evidence to support the use of high concentrations of fluoride for some people, there is also evidence which shows that decay levels were on a downward trend globally, before fluoridated toothpaste captured the lion's share of the market. Moreover, there is sound evidence that the magnitude of benefits attributed to topical fluoride by dentistry, was vastly overblown (see references, especially the Rand Corporation reports). Finally, studies long ago revealed that enamel can remineralize without fluoride. Even in the presence of fluoride, oral hygiene must be good and saliva must be more alkaline (diet affects pH) for incipient lesions to remineralize.

When fluoride promoters themselves start to question the inadequate standards of their own dental research that, for example, led to the uncritical use and acceptance of fluoride supplements, as was recently published, it's appropriate to take a closer look at the newest unproven dental hypothesis for the "benefits" of fluoridation.. Since fluoride's cariostatic role is topical, according to the researchers, rather than systemic, the logical corollary to this would be that fluoridation is redundant. But wait, promoters now believe that fluoridation has topical benefits! Fluoridated water, they say, increases the fluoride content of saliva and plaque; thereby providing demineralizing enamel with a constant fluoride source to "heal" incipient lesions. Important omissions of fact are as follows:

  • According to the researchers themselves, the science of this theory is beset by analytical problems, confounding, lacking data on diet, plaque microbiology, individuals' oral hygiene habits and the fluctuating intra-oral conditions known to occur.

  • A recent epidemiological study of caries prediction in New York children, showed no differences between saliva fluoride levels in low or high-fluoride areas. In fact, the effect on salivary fluoride levels of drinking fluoridated water is detectable only when fluoride in water reaches about 2.0 ppm, twice the recommended level. Fluoridated toothpastes, however, elevate salivary fluoride levels to several hundred ppm for several minutes after brushing.

  • Another study measured plaque fluoride in naval recruits. No significant differences in fluoride levels were found between those coming from fluoridated or non-fluoridated areas.

  • Fluoride proponents readily admit that there are many studies on supplements, but "...few meet the standards for acceptable clinical trials." For those that allegedly do, cariostatic benefit "... is marginal at best..." Supplements are used in unfluoridated areas to mimic fluoridation, so if their own data show no relevant benefit, how is ingesting fluoridated water different?

  • Fluoridation proponents also readily admit that the little benefit they find in a few isolated studies, is a lifetime benefit of less than one tooth surface per child (a fraction of a cavity).

  • Recent Canadian studies and the1986/87 U.S. survey of 39,000 children, show no statistically significant and/or clinically relevant benefit to childrens' permanent teeth in fluoridated areas. U.S. data reveal that the children living in the least fluoridated region (Pacific) had the highest percentage of decay-free rates than those living in the most fluoridated region (Midwest).

  • Large reductions in decay rates have taken place in non-fluoridated areas world-wide. Less than 1% of Western Europe is fluoridated yet rates are comparable to ours. Less than 10% of B.C. is fluoridated, yet decay rates are impressively low.

  • Dental research shows that most tooth decay (about 83%) occurs in pits and fissures (e.g., grooves in molars). According to dental authorities, pit and fissure decay is not prevented by fluoride intake. It's prevented by sealants, a procedure now routinely performed in dental offices.

  • There are no human studies which prove that 1.0 ppm fluoridated water has topical effects.

  • There are no animal studies proving 1.0 ppm fluoridated water has systemic or topical benefits.


CONCLUSION

No other agent which is deliberately added to food or water poses the degree of risk that fluoride does. The evidence clearly shows that fluoride damages bone and that fluorosis rates are pandemic. Even if we believed the new claim that 1.0 ppm fluoridation has topical benefits, it would be minuscule compared to the claimed effects for 1,000-1500 ppm fluoridated toothpastes. The cost of implementing and/or maintaining fluoridation to maybe obtain minuscule benefit, is ludicrous. Cavities are not fatal, nor expensive to repair. Both osteosarcoma in young children and hip fracture in the elderly are potentially fatal and can significantly increase health care costs. What we don't know is the degree of risk for other health concerns such as the reproductive system (fluoride affects birth rates, sperm motility and testosterone levels), immune system, and the central nervous system (brain). Due to the fact that there are increased risks for these other health effects, albeit uncertain as to the degree, it is incumbent upon Council to protect the public. They can vote to halt fluoridation without going to the electorate; or, they can pass a by-law for another fluoridation plebiscite to be held with the 1998 election. One would think that Council has the moral obligation, and perhaps a legal duty, to issue a strongly-worded health advisory to those people who are at the greatest risk of fluoride toxicity. They have been identified by the U.S. Agency for Toxic Substances and Disease Registry (see Appendix I).

FOOTNOTE A: A recent dental survey found 26% of respondents used bottled water for their children; 11 % used water filtered with their own equipment.

FOOTNOTE B: The Surveillance, Epidemiology and End Results (SEER) by Hoover et al., showed a significant association between osteosarcoma rates and fluoridation. This finding was first discounted by the U.S. Public Health Service (USPHS) on the basis that there was an absence of a linear trend. In other words, higher cancer rates would be expected the longer the water was fluoridated. However, given the fact that rapidly growing bones in young males are most susceptible to the development of osteosarcoma, and that fluoride is a known toxin to bones, a potent enzyme inhibitor, and may act as a cancer promoter rather than an initiator, the SEER data is much more significant than first thought. If fluoride acts as a promoter (see NJ study), the duration/latency assumption is not warranted. The low-level, long term characteristics of fluoride exposure are consistent with the conditions for tumour promotion seen in other chemicals.

FOOTNOTE C: The recent large U.S. study (National Health and Nutrition Examination Survey) underscores the fact that 25% of the children examined, were responsible for about 80% of the tooth decay recorded in permanent teeth. The important factors were poverty, race, and the lack of access to dental care -- not fluoridation. Similar figures are found in the 1978 Alberta survey: 15% of children examined were responsible for 66% of decay. The most logical and economical expenditures of public funds, rather than medicating an entire population, would be to target the small percentage of children who are at higher risk of tooth decay.


FLUORIDE CHRONOLOGY 1989-1997

YEAR 1997

  • BOGUS "ADEQUATE INTAKE" (AI) published by the National Academy of Sciences is based on selected references and biased manipulations of information. Daily fluoride intake for adults in a fluoridated community is alleged to be 1.4-3.4 mg, a level not supported by a Health Canada survey or by the U.S. PHS. It's much higher. Important omissions are frequent -- recent evidence of increased bone cancers, hip fractures, neurotoxicity, etc. are not discussed.

    NAS also alleges that daily fluoride intake has not increased in the '90s from that of the '50s, a statement which defies common sense and contradicts recent research. The report alleges that .05 mg/kg fluoride is an "optimal" (a figure which has never been scientifically determined), and "AI" intake for everyone, regardless of age, weight, nutritional status or illness. They allege that this level is below the threshold for causing moderate dental fluorosis (1) -- a claim which is not accepted by knowledgable scientists familiar with the dose-response relationship and the histopathology and chemistry of fluorosed enamel. According to one prominent researcher, "...there exists no 'critical' value below which the effect of fluoride on dental enamel will not be manifest." (2) In other words, contrary to unfounded assertions by NAS, there is no "safe" level of fluoride intake.

  • FLUORIDE POISON WARNINGS, mandated by the U.S. FDA, appear on fluoridated toothpaste tubes -- "If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately." And, "Keep out of reach of children under 6 years of age." Children under two should not use fluoridated paste say the warnings. (3)

  • INFANTS & YOUNG CHILDREN SWALLOW TOO MUCH FLUORIDE from toothpaste because most don't (or can't) rinse or spit after brushing. (4), (5)

  • FLUORIDE TOXICITY INCREASED in diabetic rats. Confirms past findings in humans. (6)

  • DECREASED BONE STRENGTH found in fluoride-treated rabbits. (7)

  • EPA SCIENTISTS TAKE STAND AGAINST FLUORIDATION -- "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."(8)

  • BABIES AT INCREASED RISK -- excessive fluoride found in infant foods say researchers.(9)

  • FLUOROSIS RISK INCREASED for children when fluoride intake is coupled with low calcium intake, high protein diets, residence at high altitudes, or when they have metabolic/respiratory disorders. (10)

YEAR 1996
  • NEGLIGIBLE BENEFIT/HIGH RISK to children on fluoride supplements. The researcher questioned the standards of dental science because "...supplements have been recommended uncritically for many years on the basis of inadequate research..." (11)

  • NEGLIGIBLE BENEFIT for lifetime exposure to fluoridated water -- between 0.12 and 0.30 decayed, missing, filled, surfaces (DMFS) less per child. There are over 100 tooth surfaces in permanent teeth. (12)

  • EXCESSIVE FLUORIDE FOUND IN JUICES -- children ingest too much fluoride and are at increased risk of fluorosis say ADA researchers. (13)

  • INCREASED FLUORIDE TOXICITY/REDUCED BONE STRENGTH found in renal-deficient rats. (14)

YEAR 1995
  • DECREASED MENTAL ACUITY found in children in areas with medium or severe prevalence of dental fluorosis compared to children in areas with a low incidence. Other studies confirm that fluoride affects the central nervous system (CNS) without first causing skeletal fluorosis, and that a higher concentration of fluoride is found in embryonic brain tissue in areas where fluorosis is prevalent. (15)

  • NEUROTOXICITY FOUND in fluoride-treated rats. Fluoride penetrates the blood-brain barrier and accumulates in brain, raising new concerns about its effect on the CNS. The authors say that "...a generic behavioral pattern disruption as found in this study can be indicative of a potential for motor dysfunction, IQ deficits and/or learning disabilities in humans." (16) Earlier research showing that fluoride was associated with memory impairment and diminished mental acuity can no longer be ignored now given both the human and laboratory research. (17)

  • 86% INCREASED RISK OF HIP FRACTURES for seniors where water contained between 0.11 and 1.83 ppm fluoride, compared to those in areas with < 0.11 ppm. The results were statistically significant and were corrected for individual risk factors. (18)

  • INFANTS INGESTING TOO MUCH FLUORIDE from all sources says researcher. In a stunning admission, fluoridation proponent also admits that no one knows what the "optimal" fluoride intake is because it has never been scientifically determined. (19)

  • DECREASED BONE QUALITY found in fluoride-treated rats. (20)

  • DECREASED BONE STRENGTH found in fluoride-treated rats. (21)

  • PATHOLOGICAL BONE CHANGES found in aborted fetuses caused by maternal fluoride intake. (22)

  • DECREASED BONE STRENGTH found in fluoride-treated pigs. (23)

YEAR 1994
  • DIABETIC CHILDREN AT INCREASED RISK of developing moderate to severe dental fluorosis in "optimally" fluoridated areas. (24)

  • NO BENEFIT FOUND for fluoridated water in study of 12-year-old children. (25)

  • INTUITION USED TO PREDICT FLUORIDE BENEFITS say Health Canada's (HC) researchers (appendix III). "Predicting effectiveness of a fluoride regime" is often not used when "empirically based calculations" are available, but intuition is! They say that the high percent reductions claimed for fluoridation (mostly by Public Health officials) are frequently "misleading" and are often "...a clinically unimportant actual reduction in DMFT or DMFS saved [decayed, missing, filled teeth/surfaces]." They also admit that recent Canadian studies show no statistically significant differences in decay rates between fluoridated and unfluoridated areas. Moreover, they admit that many studies have "deficiencies" and lack "rigor". (26)

    Despite the concessions, HC's pro-fluoride researchers desperately cling to studies, with high per cent reductions, as providing "...a weight of evidence that has not been refuted for over forty years." (26) What they ignore is that many studies have been criticised by scientists (even by proponents) for methodology, overly optimistic or "intuitive" reporting, etc. Several studies show little or no statistically significant differences in decay rates; some show high fluoride intake is linked to more cavities; some show other factors may be responsible for differences, etc. (27-40)

  • REDUCED BONE QUALITY & STRENGTH in osteoporosis study. (41) Others show that bone formed with high fluoride intake is abnormal and compromises the biomechanical competence of the skeleton. (42)

  • DECREASED BIRTHS linked to fluoride levels (> or =3.0 ppm). (43) Fluoride's negative effects on the reproductive system are documented elsewhere. (44)

  • HIGH FLUORIDE -- HIGH DECAY RATES Children with low-calcium/high-fluoride intake had more decay! Largest study on decay in the world. (45)

  • EPA TOXICOLOGIST WINS COURT BATTLE after he was fired for criticised the EPA for its acceptance of a National Toxicology Program report on fluoride and cancer (see appendix III and Year 1990).

  • NEGLIGIBLE BENEFIT-HIGH RISK to children on supplements, says longtime fluoridation proponent, Dr. B. Burt. They should be eliminated because the evidence of benefit, is "marginal at best," and the risk of developing fluorosis is high. (46)

  • NO DENTAL BENEFIT FOUND The 26,000-children survey confirmed an earlier finding (47) -- "the more fluoride a child drank, the more cavities....." (48)

YEAR 1993
  • HIGH FLUORIDE -- HIGH DECAY RATES -- research collected in 1987 from World Health Organization's data banks, contradict earlier claims of a beneficial relationship between water fluoride levels and cavity prevalence. (49)

  • CHILDREN BLAMED FOR FLUOROSIS. Dental propaganda about fluorosed teeth being "aesthetically pleasing" and not noticeable by laypeople, debunked. The majority of 3,000 observers thought children with moderate to severe fluorosis neglected their teeth. This means children with fluorosis are wrongly stigmatized for their "dirty-looking" teeth. (50) Personal experience with my childrens' fluorosis also reflects this finding.

  • FLUORIDE POLLUTION HARMS WILDLIFE says Environment Canada. (51)

  • FLUORIDATION SAFE & EFFECTIVE say promoters. (52) The objectivity of the U.S. National Research Council (NRC) panel and the validity of its conclusions, especially regarding dental fluorosis, is questioned by EPA scientist Dr. William Hirzy. (53)

  • "PROPAGANDA MASQUERADING AS SCIENCE" says Dr. Bob Carton, environmental scientist and former 20-year EPA employee. He charges that both the NRC and the National Academy of Sciences, appear on fluoridation endorsement lists; and, several of its panel members received grant money from government and the fluoride industry (see political explanations-Appendix II).

  • BRAIN DAMAGE AND BEHAVIOR CHANGES found in rats exposed to aluminum and fluoride. (54)

  • FLUORIDE KILLS THREE PEOPLE. (55)

  • BAN FLUORIDE SUPPLEMENTS says U.S. Assemblyman, John Kelly, after the Food and Drug Administration admitted that they have no studies proving the drug is safe or effective for children. (56)

  • FLUORIDE SUPPLEMENTS NOT RECOMMENDED for Canadian children not at risk of tooth decay (the majority) and less than 3 years old, says Dr. Clark, a fluoride proponent. He also challenged the long-held theory that systemic fluoride prevents tooth decay. Topical fluoride (eg.. 1,000 ppm toothpaste) he said, may "remineralize" small carious lesions after they are formed. Dr. Clark admits that individuals with a low incidence of cavities, would see "...little or no additional benefits" from topical treatments. (57)

  • ABNORMAL BONE & BODY CHEMISTRY CHANGES found in boys with dental fluorosis. Could be signs of retarded growth, say Polish scientists. Boys without the fluorosis, had healthy bone structure. (58)

  • FLUORIDE IS GENOTOXIC (damaging to chromosomes) at low concentrations of 1.0-5.0 ppm. (59)

YEAR 1992
  • FLUORIDE INHIBITS LEUCOCYTES (immune system cells). The immune system is our first line of defence against bacteria, viruses, etc. (60)

  • CONGENITAL HEART DISEASE linked to fluoride in drinking water. (61)

  • INCREASED HIP FRACTURE RATES IN FLUORIDATED AREA -- "...fluoride accumulates with age and may reach toxic bone levels...." (62)

  • FLUORIDE KILLS AGAIN -- One man died and dozens fell violently ill from acute fluoride poisoning, due to malfunctioning equipment. (63)

  • EPIGASTRIC PAIN CAUSED BY FLUORIDE (64)

YEAR 1991
  • INCREASED BONE CANCER in fluoridated areas says New Jersey Department of Health study -- a 3 to 7-fold increase in young males. (65)

  • INCREASED BONE FRACTURES & BONE LOSS found in women in naturally fluoridated areas, unrelated to varying calcium levels in water. (66)

  • INCREASED HIP FRACTURES -- significant correlation found with fluoride levels in water. (67)

  • "SAFETY" AND "BENEFIT" REAFFIRMED by promotion organization. (68) Committee members were comprised of known pro-fluoridationists. (69)

  • FLUORIDE-CONTAINING PESTICIDES ADD TO INTAKE -- juices, especially grape juice contain up to 6.80 ppm fluoride. (70)

YEAR 1990
  • INCREASED SKELETAL FRAGILITY -- non-vertebral fractures up 3-fold. (71)

  • BONE CANCERS IN FLUORIDATED RATS -- classified as "equivocal" by an NTP panel. (72) However, oral tumors and a rare liver cancer were suspiciously down-graded by the panel, said Dr. Marcus, chief toxicologist, in a memo to EPA superiors. There is "...at least some evidence or clear evidence of [fluoride's] carcinogenicity." (73) A board-certified pathologist and former consultant to the EPA, agreed with the original liver cancer diagnosis. He was the first to discover, classify, and publish findings on the rare liver tumour. (73)

    In a subsequent independent evaluation, Dr. Edward Calabrese, toxicology professor, said: "the fact that fluoride is a potential mutagen/clastogen [and] concentrates in the bone...suggests that...the linkage of the site of deposition and biological activity with bone cancer outcome all speak to the plausibility issue"; therefore, the "equivocal" rating by the NTP panel is "inappropriate." (74)

  • NO STATISTICALLY SIGNIFICANT BENEFIT to fluoridation for permanent teeth. Data was presented for 39,207 children. (75)

  • INCREASED HIP FRACTURES found in fluoride-treated patients. (76)

  • INADEQUATE AND INFERIOR EVIDENCE used to justify fluoride mouthrinse program (touted as a highly effective decay preventative), say researchers. (77)

  • NO CORRELATION between the availability of fluoridated water and toothpaste and decay rates. (78)

  • INCREASED HIP FRACTURES linked to fluoridated areas (79)

YEAR 1989
  • INCREASED HIP FRACTURES found in fluoride-treated Osteoporosis patients. (80)

  • NO ASSOCIATION BETWEEN FLUORIDE AND DECAY RATES found in a 6,584 children survey. (81)

  • A request for another fluoridation plebiscite from a Calgary high school class was received by City Council. The class was coached by Calgary Health Services (CHS). Impressionable teenagers were taught that antifluoridationists are "saviours of their fellow men" who "seem motivated by distrust of government and alientation [sic] from the scientific establishment"; and, who "may also defend themselves against 'forcible entry' of any perceived 'foreign body' -- whether it [sic] fluoridation, vaccination, a mental health proposal or interracial contact."

  • Council votes to have another plebiscite (the fifth since the 1960s)

  • CHS uses $50,000 in public funds to promote the "benefits" and "safety" of fluoridation.

  • Calgarians vote in favor of fluoridation in October 1989 (implemented August 7,1991)

YEAR 1986

  • INCREASED FRACTURES/LOWER BONE MASS LINKED TO FLUORIDE IN WATER. (82) See Year 1991 and reference number 66 for pertinent information. (back to text)


CHRONOLOGY REFERENCES   (comprehensive but not inclusive)

POSTSCRIPT (11/26/97): many of the references below have been linked to the abstracts available on this web site
  1. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride by Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, National Academy of Sciences, 1997. (see published review or go back to text)
  2. Fejerskov O. et al., The Nature and Mechanisms of Dental Fluorosis in Man, J. Dent. Res., 69:Special Iss. (Feb., 1990). (back to text)
  3. Oldenburg D., Toothpaste: How Safe?, Washington Post, 06/16/97. (back to text)
  4. Adair SM, et al., Comparison of the use of a child and an adult dentifrice by a sample of preschool children, Pediatric Dent, 19:2 (March 1997), 99-103. (back to text)
  5. Levy SM, et al., Patterns of fluoride dentifrice use among infants, Pediatr Dent, 19:1 (January 1997), 50-55. (back to text)
  6. Banu Priya CAY, et al., Toxicity of Fluoride to Diabetic Rats, Fluoride, 30:1 (February, 1997), 51-58. (back to text)
    NOTE: FLUORIDE is the Journal of the International Society for Fluoride Research
  7. Turner CH, et al., Fluoride treatment increased serum igf-1, bone turnover, and bone mass, but not bone strength, in rabbits, Calcified Tissue International, 61:1, (July, 1997), 77-83.(back to text)
  8. Hirzy J.W., Ph.D., Senior V.P of the National Federation of Federal Employees (a union of scientists, lawyers, engineersand other professionals), letter, July 1997 (Washington, DC).(back to text)
  9. Hilman BS, et al., Fluoride Concentrations of Infant Foods, Journal American Dental Association (JADA), 128 (July 1997). (back to text)
  10. Whitford GM, Determinants and mechanisms of enamel fluorosis, Ciba Found Symp, 205 (1997), 226-241 (see also J. Dent Research, 69:special issue, February 1990). (back to text)
  11. Riordan PJ, The Place of Fluoride Supplements in Caries Prevention Today, Australian Dental J., 41:5 (1996), 335-343. (back to text)
  12. Spencer AJ, et al., Water fluoridation in Australia, Community Dental Health, 13:Supplement 2 (Sept. 1996), 27-37. (back to text)
  13. Kiritsy MC, et al., Assessing fluoride concentrations of juices and juice-flavored drinks, JADA, 127:7 (July 1996), 895-902. (back to text)
  14. Turner CH, et al., High fluoride intakes cause osteomalacia and diminished bone strength in rats with renal deficiency, Bone, 19:6 (December 1996), 595-601. (back to text)
  15. Li XS, Zhi JL, Gao RO, Effect of Fluoride Exposure on Intelligence in Children, Fluoride, 28:4 (Nov, 1995), pp 189-192. Others as follows: Ding LI, The nervous systemic complications of chronic fluorosis. Chinese Journal of Endemiology, 2 (1983), 97-98; Hu YH, Direct damage on nervous system by fluorosis. Compilation of First Conference on Neuropsychiatric Diseases in Xinjian, (1982), 86-88; Shung-Guan CM, et al., The non-skeletal lesions of endemic fluorosis, Chinese Journal of Internal Medicine, 21 (1982), 217-219; He H., Chen ZS, Liu XM, The influence of fluoride on the human embryo, Chinese Journal of Control of Epidemic Diseases, 4 (1989), 136-137; Du L., Wan CW, Cao XM, The influence of chronic fluorosis on the development of the brain of the human embryo, Journal of Fluorosis Research Communications, 138 (1991). (back to text)
  16. Mullenix PJ, et al., Neurotoxicity of Sodium Fluoride in Rats, Neurotoxicology and Teratology, 17:2 (1995), 169-177. (back to text)
  17. Waldbott GL, Chronic fluorine intoxication from drinking water, International Archives of Allergy and Applied Immunology, 7 (1966), 70-74; Waldbott GL, Incipient fluorine Intoxication from drinking water. Acta Medicina Scandinavica, 156 (1956), 157-158; and Waldbott GL, Fluorine intoxication from drinking water (A report of 52 cases), Wissenschafliche Zeitshrift der Ernst Mortiz-Arndt-Universitat Greifswald, 5 (3/4) 1955/1956 (500th Centennial Festschrift), 307-316. (back to text)
  18. Jacqmin-Gadda H, et al., Fluorine Concentration in Drinking Water and Fractures In the Elderly, J. of the American Medical Association (JAMA), 273:10, March, 8, 1995, 775-776. (back to text)
  19. Levy SM, Infants' fluoride ingestion from water, supplements and dentifrice, JADA, (126:12 (December 1995), 1625-1632. (back to text)
  20. Søgaard CH, et al., Effects of fluoride on rat vertebral body biomechanical competence and bone mass, Bone, 16:1 (January 1995), 163-169. (back to text)
  21. Turner CH, et al., Fluoride reduces bone strength in older rats, J. Dental Research, 74:8 (August 1995). (back to text)
  22. Shi J, et al., Relationship between bone fluoride content, pathological change in bone of aborted fetuses and maternal fluoride level, (translated from Chinese by Shi J., et al., Dept. of Epidemiology, China Medical University, Shenyang), Journal unknown, 29:2 (March 1995), 103-105. (back to text)
  23. Lafage MH et al., Comparison of alendronate and sodium fluoride effects on cancellous and cortical bone in minipigs. A one-year study, J.Clin Invest, 5 (May 1995), 2127-2133. (back to text)
  24. Seow WK, Thomsett MJ, Dental fluorosis as a complication of hereditary diabetes insipidus: studies of six affected patients, Pediatr Dent, 16:2 (March 1994), 128-132. (back to text)
  25. Downer MC, et al., Dental caries experience and defects of dental enamel among 12-year- old children in north London, Edinburgh, Glasgow and Dublin, Community Dental Oral Epidemiology, 22:5 Pt 1 (October 1994), 283-285. (back to text)
  26. Lewis, DW, et al., Investigation of Inorganic Fluoride And Its Effect On The Occurrence Of Dental Caries And Dental Fluorosis In Canada, (final report for contract #3726), Health Canada (July, 1994), unplublished. (back to text)
  27. Imai Y., Study of the relationship between fluoride ions in drinking water and dental caries in Japan, Japan J. Dental Health, 22 (1972). (back to text)
  28. Sutton, R.N., "Fluoridation: A Fifty-Year-Old Accepted but Unconfirmed Hypothesis," Med. Hypotheses, 27 (1988), 153-156.
  29. Diesendorf M.,"The mystery of declining tooth decay," Nature, 322 (July 10, 1986), 125- 129.
  30. Colquhoun J., "Child Dental Health Differences in New Zealand," Community Health Studies, XI:2 (1987), 85-90.
  31. Colquhoun J., "Influence of social class and fluoridation on child dental health, Comm. Den. Oral Epidem, 13 (1985), 37-41.
  32. Colquhoun J., "Flawed Foundation: a Re-examination Of The Scientific Basis For A Dental Benefit From Fluoridation," Community Health Studies, XIV:3 (1990), 288-296.
    NOTE: Dr. Colquhoun is an Honourary Research Fellow at the University of Auckland, former Chief Dental Officer of Auckland, NZ and former president of the Fluoridation Promotion Society.
  33. Sutton PRN, Fluoridation: errors and omissions in experimental trials, 2nd ed., Melbourne University Press, 1960), quoted in Diesendorf M., Fluoridation: Time for a Reassessment, New Doctor, 52 (Summer 1990).
  34. Diesendorf M., Anglesey Fluoridation Trials Re-Examined, Fluoride, 22:2 (April, 1989), 53-58.
  35. Ziegelbecker R, Ziegelbecker RC, WHO Data on Dental Caries and Natural Water Fluoride Levels, Fluoride, 26:4 (October, 1993), 263-266.
  36. Gray AS, Fluoridation: time for a new baseline? Journal of the Canadian Dental Association, 53 (1987), 763-765.
  37. Craig Foch, Robert Wood Johnson Foundation (a Rand Corporation report), The Costs, Effects, and Benefits of Preventive Dental Care: A Literature Review, N-1732-RWJF, December 1981. [an excerpt: "Extrapolation of treatment-effectiveness results from small-scale clinical or field trials to hypothetical situations, as widely practiced in the literature, is simply not warranted by available evidence."]
  38. Robert Wood Johnson Foundation Report 2, National Preventive Dentistry Demonstration Program 1983. Found no benefit from topical treatments tried in a four-year test in ten differing communities.
  39. Schrotenboer. Ed. review, JADA., 102 (April 1981).
  40. Tijmstra T et al., Community Dentistry and Oral Epidemiology, 6 (1978), 227-230. When children are matched by fathers' occupation, candy consumption and toothbrushing habits, the supposed reduction in caries among fluoride users vanishes. (back to text)
    NOTE: see also references 45, 75, 77, 78, 81.
  41. Søgaard CH, et al., Marked Decrease in Trabecular Bone Quality After Five Years of Sodium Fluoride Therapy -- Assessed by Biomechanical Testing of Iliac Crest Bone Biopsies in Osteoporotic Patients, Bone, 15:4 (1994), 393-399. (back to text)
  42. Turner CH, et al., The Effects Of Fluoridated Water On Bone Strength, Journal Orthopaedic Research, 10 (1992), 581-587; see also: Mosekilde L, et al., Compressive Strength, Ash Weight, And Volume Of Vertebral Trabecular Bone In Experimental Fluorosis In Pigs, Calcified Tissue International, 40 (1987), 318-322. (back to text)
  43. Freni SC, Exposure To High Fluoride Concentrations In Drinking Water Is Associated With Decreased Birth Rates, J. of Toxicology and Environmental Health, 42 (1994), 109-121. (back to text)
  44. Narayana MV, Chinoy NJ, Effect of Fluoride on Rat Testicular Steroidogenesis, Fluoride, 27:1 (Jan., 1994), 7-12.
    NOTE: see also: Susheela AK, Kumar A, A Study Of The Effect Of High Concentrations Of Fluoride On The Reproductive Organs Of Male Rabbits, Using Light And Scanning Electron Microscopy, Fluoride, 26:2 (1993) p. 148, abstracted from J. of Reproduction and Fertility, 92 (1991); Chinoy NJ Narayana MV, In Vitro, Fluoride Toxicity in Human Spermatozoa, Fluoride, 27:4 (October, 1994),231-232, abstracted from Reproductive Toxicology, 8:2 (1994). (back to text)
  45. Teotia SPS, Teotia M., Dental Caries: A Disorder of High Fluoride And Low Dietary Calcium Interactions (30 years of Personal Research), Fluoride, 27:2 (April, 1994), 59- 66. (back to text)
  46. Burt BA, The Case For Eliminating The Use Of Dietary Fluoride Supplements Among Young Children (Abstract), 1994 Jan, Presented at a Conference of the American Dental Association, (School of Public Health, U. of Michigan) (back to text)
  47. Jones T, Steelink C, Sierka J, An Analysis of the Causes of Tooth Decay in Children In Tucson, Arizona, Fluoride, 27:4 (October, 1994), p. 238; abstracted from a paper presented at the Annual Meeting of the American Association for the Advancement of Science, San Francisco USA, Feb., 22, 1994. (back to text)
  48. Steelink C, "Fluoridation controversy," Letters, Chemical and Engineering News, (July 27, 1992), p. 2. (back to text)
  49. Ziegelbecker R, Ziegelbecker RC, op cit. (back to text)
  50. Riordan PJ, Perceptions of Dental Fluorosis, Journal of Dental Research, 72:9 (September, 1993), 1268-1274. (back to text)
  51. Environment Canada and Health Canada, Priority Substances List Assessment Report, "Inorganic Fluorides," ISBN 0-662-21070-9, (1993), 1-72. (back to text) See the published review by Foulkes RG
  52. Subcommittee, National Research Council, "Health Effects of Ingested Fluoride," National Academy of Sciences (National Academy Press; Washington, DC: 1993), 1-166. (back to text)
  53. Hirzy W., president-elect, National Federation of Federal Employees, Local #2050, Press- release, August 18, 1993. (back to text)
  54. Varner JA, et al., Chronic AlF3 Administration: II. Selected Histological Observations, Neuroscience Research Communications, 13:2 (Accepted July 28, 1993), 99-104; and, Chase M., "Rat Studies Link Brain Cell Damage With Aluminum and Fluoride in Water", Wall Street Journal, October 28, 1992. (back to text)
  55. Arnow PM, et al., An Outbreak of Fatal Fluoride Intoxication in a Long-term Hemodialysis Unit, Annals of Internal Medicine, 121 (1994), 339-344; also Crimmins J., Fluoride blamed in dialysis deaths, Chicago Tribune, (July 31, 1993). (back to text)
  56. Sterling G., Kelly seeks FDA ban on fluoride supplement, The Star Ledger, June 4, 1993 (Trenton, NJ). (back to text)
  57. Clark C, Appropriate Use of Fluorides In the 1990s, J. Canadian Dental Association, 59:3 (March, 1993), 272-279. (back to text)
  58. Chlebna-Sokól D, Czerwinsk E, Bone Structure Assess-ment On Radiographs Of Distal Radial Metaphysis In Children With Dental Fluorosis, Fluoride, 26:1 (January, 1993), 37-44. (back to text)
  59. Zeiger E, et al Genetic Toxicity of Fluoride, Environmental and Molecular Mutagenesis, 21 (1993), 309-318 (Experimental Carcinogenesis and Mutagenesis Branch, National Institute of Environmental Health Sciences) (back to text)
  60. Gibson S, Effects of fluoride on immune system function, Complimentary Med. Research, 6:3 (Oct., 1992), 111-113. (back to text)
  61. Li R, et al., "Fluoride in Drinking Water and Intracardiac Blood Flow Defects in Iowa," American Journal of Epidemiology, 136 (October, 1992), p 1030. (back to text)
  62. Danielson C, et al. Hip Fractures and Fluoridation in Utah's Elderly Population, JAMA, 268:6 (August, 1992), 746-748. (back to text)
  63. Gessner BD, et al., "Acute Fluoride Poisoning From a Public Water System," New Eng. J. of Med., 330:2 (Jan. 1994), 95-99. (back to text)
  64. Gupta IP, et al., Fluoride as a Possible Etiological Factor in Non-Ulcer Dyspepsia, J. of Gastroenterology and Hepatology, 7 (1992), 355-356; see also Susheela AK, Fluoride Ingestion and Its Correlation with Gastrointestinal Discomfort, Fluoride, 25:1 (1992), 5-22. (back to text)
  65. Cohn PD, A Brief Report On The Association Of Drinking Water Fluoridation And The Incidence of Osteosarcoma Among Young Males, NJ Depart. of Health, Environ. Health Service (1992), 1-17. (back to text)
  66. Sowers MR, et al., A Prospective Study of Bone Mineral content and Fracture in Communities with Differential Fluoride Exposure, Am. J. of Epidemiology, 133:7 (1991), 649- 660. (back to text)
  67. Cooper C, et al., Water Fluoridation and Hip Fracture, JAMA (Letters), 266:4 (1991), p. 513. (back to text)
  68. Report of the AD Hoc Subcommittee on fluoride, "Review of Fluoride: Benefits and Risks," Department of Health and Human Service, Public Health Service (February, 1991), 1-134. (back to text)
  69. Yiamouyiannis J, "Fluoride The Aging Factor," 3rd edition, (Health Action Press, Delaware, Ohio: 1993), 1-292. (back to text)
  70. Stannard JG, et al., "Fluoride levels and fluoride contamination of fruit juices," J. of Clinical Pediatric Dentistry, 16:1 (1991), 38-40. (back to text)
  71. Riggs BL, et al., Effect of Fluoride Treatment on the Fracture Rate in Postmenopausal Women with Osteoporosis, New England J. of Medicine, 322:12 (March, 1990), 802-809. (back to text)
  72. "Equivocal evidence of carcinogenic activity is demonstrated by studies that are interpreted as showing a marginal increase of neoplasms that may be chemically related [NTP report TR 393]." See: National Toxicology Program Technical Report 393: "Toxicology and Carcinogenesis Studies of Sodium Fluoride (CAS No. 7681-49-4) in F344/N Rats and B6C3F1 Mice" (NIH, U.S. Department of Health and Human Services). (back to text)
  73. Marcus W, Senior Science Advisor, Criteria & Standards Division, Office of Drinking Water (ODW), United States Environmental Protection Agency, to Mr. Alan B. Hais, Acting Director, ODW (Washington, DC: May 1, 1990). (back to text)
  74. Calabrese Edward, PhD. (Environmental Health Science Program, School of Public Health; University of Massachusetts), "Evaluation of the National Toxicology Program (NTP) Cancer Bioassay on Sodium Fluoride" (Amherst: June, 1991). Commissioned by the East Bay Municipal Utility District (provides water for Oakland and area). (back to text)
  75. Yiamouyiannis JA, "Water Fluoridation And Tooth Decay: Results From The 1986-1987 National Survey of U.S. Schoolchildren," Fluoride, 23:2 (April, 1990), 55-67. (back to text)
  76. Bayley TA, et al., Fluoride-induced fractures: relation to osteogenic effect, J. Bone Mineral Research, 1:Suppl 1 (March 1990), S217-S222. (back to text)
  77. Disney JA, et al., A case study in contesting the conventional wisdom: school-based fluoride mouthrinse programs in the USA, Community Dental Oral Epidemiology, 18 (1990), 46-56. (back to text)
  78. Kalsbeek H, Verrips GHW, Dental Caries Prevalence and the Use of Fluorides in Different European Countries, J. Dental Research, 69 (Special Issue), 728-732, February, 1990. (back to text)
  79. Jacobsen S, et al., Regional Variation in the Incidence of Hip Fracture, JAMA, 264:4 (July, 1990), 500-502. (back to text)
  80. Hedlund LR & Gallagher, JC, Increased Incidence of Hip Fracture in Osteoporotic Women Treated with Sodium Fluoride, Journal Bone and Mineral Research, 4:2 (1989), 223- 225. (back to text)
  81. Hildebolt CF, et al., Caries Prevalences Among Geochemical Regions of Missouri" American Journal of Physical Anthropology, 78 (1989), 79-92. (back to text)
  82. Sowers MR et al., The relationship of bone mass and fracture history to fluoride and calcium intake: a study of three communities, Am J. Clinical Nutrition, 44:6 (December 1986), 889-898. (back to text)


REFERENCES FOR OPENING REMARKS  (most included in Chronology references)

  • Spittle B, Allergy and Hypersensitivity To Fluoride, Fluoride 26:4 (October 1993), 267-273.
  • Engman C., Water Waste, Calgary Herald, August 19, 1997.
  • Damkaer DM, Dey DB, Evidence for Fluoride Effects on Salmon Passage at John Day Dam, Columbia River, 1982-1986, North American J. of Fisheries Management, 9 (1989), 154-162.
  • Clark C, Trends in prevalence of dental fluorosis in North America, Community Den. Oral Epidem, 22 (1994), 148-152.
  • Jones CA, et al., Sodium fluoride promotes morphological transformation of Syrian hamster embryo cells, Carcinogenesis, 9:12 (1988), 2279-2284.
  • Diesendorf M, et al., New evidence on fluoridation, Australian and New Zealand J. of Public Health, 21:2 (1997).
  • Lewis DW, Banting DW, Water fluoridation: current effectiveness and dental fluorosis, Community Dentistry and Oral Epidemiology, 22 (1994), 153-158.
  • Rose D, & Marier JR., Environmental Fluoride 1977, National Research Council of Canada, NRCC 16081, 1-151
  • Liefde B de, Longitudinal survey of enamel defects in a cohort of New Zealand Children, Comm Dent Oral Epidem. 16 (1988), 218-221
  • Fejerskov O, et al., Dental tissue effects of fluoride, Adv Dental Research, 8:1 (June 1994), 15-31.
  • W.H.O., Fluorides and Human Health, 59:1970.
  • Dawes C., Weatherell J.A., Kinetics of Fluoride in the Oral Fluids, J. Dent Res., 69(Spec Iss):638-644, February, 1990.
  • Tatevossian A., Fluoride in Dental Plaque and its Effects, J. Dent Res 69(Spec Iss):645-652 February, 1990.
  • McCormack R.G., O'brien P.J., To Remain Active Until The End: The Management Of Hip Fractures In The Elderly, B.C. Medical Journal, 39:7 (July, 1997).
  • U.S. Dept. of Health and Human Services, National Institutes of Health, Dental Sealants in the Prevention of Tooth Decay, (Conference Summary, 4:11, Dec. 5-7, 1983).
  • Waldbott G. et al., op cit.
  • Toxicological Profile For Fluorides, Hydrogen Fluoride, and Fluorine (F), April 1993, Agency for Toxic Substances and Disease Registry, U.S. Dept. of Health & Human Services, p 112.
  • Mathiesen AT, Øgaard B, Rølla G, Oral Hygiene as a Variable in Dental Caries Experience in 14-Year-Olds Exposed to Fluoride, Caries Research, 1996, 30:29-33
  • Health Unit Assn. of Alberta, Report of the Second Alberta Dental Health Survey, 1985, January 1987.
  • Simard P.L., et al.,"Ingestion of Flouride [sic] from Dentifrices by Children Aged 12 to 24 Months," Clinical Pediatrics, 30:11 (November 1991), 614-617.
  • Kaste L.M., et al., Coronal Caries in the Primary and Permanent Dentition of children and Adoloescents 1-17 Years of Age: United States, 1988-1991, J. Den. Res. 75:Spec Iss (Feb/96).
  • Shannon Sutherland, Water, water...EVERYWHERE, Calgary Herald, July 2, 1997.
  • see also reference #s 2, 27-40, 57, 58, 77, 78, etc.


APPENDIX I
(excerpt below taken from: Toxicological Profile For Fluorides, Hydrogen Fluoride, and Fluorine (F), PB93-182566, April 1993, Agency for Toxic Substances and Disease Registry, U.S. Dept. of Health and Human Services, TP-91/17, p. 112).

2.7 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE

Existing data indicate that subsets of the population may be unusually susceptible to the toxic effects of fluoride and its compounds. These populations include the elderly, people with deficiencies of calcium, magnesium, and/or vitamin C, and people with cardiovascular and kidney problems.

Because fluoride is excreted through the kidney, people with renal insufficiency would have impaired renal clearance of fluoride (Juncos and Donadio 1972). Fluoride retention on a low-protein, low-calcium, and low phosphorus diet was 65% in patients with chronic renal failure, compared with 20% in normal subjects (Spencer et al. 1980a). Serum creatinine levels were weakly correlated (r=0.35-0.59) with serum fluoride levels (Hanhijarvi 1982). People on kidney dialysis are particularly susceptible to the use of fluoridated water in the dialysis machine (Anderson et al. 1980). This is due to the decreased fluoride clearance combined with the intravenous exposure to large amounts of fluoride during dialysis. Impaired renal clearance of fluoride has also been found in people with diabetes mellitus and cardiac insufficiency (Hanhijarvi 1974). People over the age of 50 often have decreased renal fluoride clearance (Hanhijarvi 1974). This may be because of the decreased rate of accumulation of fluoride in bones or decreased renal function. This decreased clearance of fluoride may indicate that elderly people are more susceptible to fluoride toxicity.

Poor nutrition increases the incidence and severity of dental fluorosis (Murray and Wilson 1948; Pandit et al. 1940) and skeletal fluorosis (Pandit et al. 1940). Comparison of dietary adequacy, water fluoride levels, and the incidence of skeletal fluorosis in several villages in India suggested that vitamin C deficiency played a major role in the disease (Pandit et al. 1940). Calcium intake met minimum standards, although the source was grains and vegetables, rather than milk, and bioavailability was not determined. Because of the role of calcium in bone formation, calcium deficiency would be expected to increase susceptibility to effects of fluoride. No studies in humans supporting this hypothesis were located. Calcium deficiency was found to increase bone fluoride levels in a two-week study in rats (Guggenheim et al. 1976) but not in a l0-day study in monkeys (Reddy and Srikantia 1971). Guinea pigs administered fluoride and a low-protein diet had larger increases in bone fluoride than those given fluoride and a control diet (Parker et al. 1979). Bone changes in monkeys following fluoride treatment appear to be more marked if the diet is deficient in protein or vitamin C, but the conclusions are not definitive because of incomplete controls and small sample size (Reddy and Srikantla 1971). Inadequate dietary levels of magnesium may affect the toxic effects of fluoride. Fluoride administered to magnesium-deficient dogs prevented soft-tissue calcification but not muscle weakness and convulsions (Chiemchaisri and Philips 1963). In rats, fluoride aggravated the hypomagnesemia condition, which produced convulsive seizures. The symptoms of magnesium deficiency are similar to those produced by fluoride toxicity. This may be because of a fluoride-induced increase in the uptake of magnesium from plasma into bone.

Some people with cardiovascular problems may be at increased risk of fluoride toxicity. Fluoride inhibits glycolysis by inhibiting enolase (Guminska and Sterkowicz 1975; Peters et al. 1964). It also inhibits energy metabolism through the tricarboxylic acid cycle by blocking the entry of pyruvate and fatty acids and by inhibiting succinic dehydrogenase (Slater and Bonner 1952).

There is evidence that daily doses of 34 mg fluoride (0.48 mg/kg/day) increases the risk of nonvertebral fractures in women with postmenopausal osteoporosis (Riggs et al. 1990). Postmenopausal women (Danielson et al. 1992; Sowers et al. 1991) and elderly men (Danielson et al. 1992) in fluoridated communities may also be at increased risk of fractures.


APPENDIX II

Artificial water fluoridation is primarily practised in English-speaking countries. About 99% of Western Continental Europe have rejected, banned, or discontinued it due to environmental, safety, and/or freedom of choice concerns. Scientists in countries like China, India, etc. have done an enormous amount of research on the biological effects of chronic fluoride exposure because fluoride toxicity is a major public health problem.

Invariably, the organizations that endorse and/or promote fluoridation in countries where fluoridation is extensively practised are the ones which review the alleged safety and benefit of the measure. There is an inherent conflict of interest which has resulted in an odd disparity. In countries where public health officials are not committed to fluoridation, much scientific research is conducted by environmental or other scientists who are interested in minimizing fluoride's detrimental biological effects.The polarized political dispute in our countries has adversely affected not only the funding which should have been devoted to studying the long-term effects of fluoride exposure, but the quality and type of research conducted. It has also affected the opportunities available for publishing in mainstream peer-reviewed scientific journals. As a result, to those not familiar with the plethora of research and with the rhetoric of the political debate that clouds this issue, science appears to be taking "sides". Science is rarely ever that clear-cut. In theory, science should be a neutral arbiter of facts, but value judgements do affect its application to the real world. Fluoridation is value-driven.

While many have questioned the impartiality of government authorities and/or professional trade agencies (medical/dental associations) that have endorsed fluoridation for decades, no one doubts the sincerity of most fluoridation promoters. After all, who wouldn't like to have strong healthy teeth with little or no effort? Unfortunately, over-zealous proponents have taken a dogmatic, authoritarian, unscientific posture that discourages open debate of valid scientific concerns. This is typified by those proponents who reject every study which casts doubt on the "safety" of fluoridation as being clinically insignificant, not attributable to fluoride, or irrelevant to fluoridation. In the rhetoric of the political debate, nonpartisan science has been obscured by socially-designated science. Professional organizations, for example, that endorse fluoridation are expressing their social preferences as citizens, not as scientists. Although these professional endorsements may appear scientific, they have no intrinsic scientific merit. This is underscored by the fact that instead of welcoming new research on the biological effects of fluoride -- as reputable scientists would -- indisputable evidence has accumulated which shows that some fluoridation proponents and their organizations have tried to suppress valid scientific research and/or have persecuted or denigrated scientists, dentists, or doctors who have spoken out against it (see censor.htm, Chronology, Appendix III, & references for Appendix II, particularly Calgary's). This negative climate poisons the atmosphere and keeps most objective scientists with true expertise, from entering the policy debate.

Despite new dental research and a new hypothesis for how high concentrations of fluoride supposedly works on the surface of teeth, some promoters persist with the tenuous arguments in favor of ingesting it. Fortunately, some of the proponents of fluoride are finally starting to recognise how inadequate and inferior their standard of dental science may have been in the past five decades of fluoride promotion. There might yet be closure to this debate on the horizon.


SOME REFERENCES -- APPENDIX II:

  1. Smith G., "Attack on a health officer," North Hill News (Calgary, AB, June 11, 1970).
  2. Diesendorf M., Diesendorf A., Suppression By Medical Journals Of A Warning About Overdosing Formula-Fed Infants With Fluoride, Fluoride, 30:2 (May, 1997), p. 125, abstracted from Accountability in Research 5, 1997, 225-237.
  3. Hileman B., "Fluoridation: Contention won't go away," Chemical & Engineering News, 66 (Aug/88)
  4. Colquhoun J., Mann R. "The Hastings Fluoridation Experiment - Science or Swindle?..." The Ecologist, 1986 16:6/1987 17:2/3.
  5. Waldbott G. et al., "Fluoridation The Great Dilemma," (Coronado Press, Kansas: 1978)
  6. Moolenburgh H., "Fluoride The Freedom Fight," (Mainstream Publishing, Edinburgh, Great Britain: 1987).
  7. Brian Martin, Scientific Knowledge in Controversy The Social Dynamics of the Fluoridation Debate, (State University of New York Press), 1991.
  8. Yiamouyiannis J., "Fluoride the Aging Factor," 3rd edition, Health Action Press, (Delaware, Ohio: 1993), 1-292.


APPENDIX III

NTP FLUORIDE/CANCER STUDY (National Toxicology Program): The bioassay was first contracted out to the Battelle Institute of Columbus, Ohio. Pathologists found significant dose-related occurrences of osteosclerosis (abnormal bone density); oral tumors; a rare bone cancer (osteosarcoma); and, a rare liver cancer called hepatocholangiocarcinoma (this diagnosis was confirmed by Dr. Reuber, the first pathologist to discover and classify the rare tumor). Battelle's results were systematically down-graded by another contractor, and then again by an NTP panel. Congress first ordered the U.S. PHS to conduct the NTP animal study in 1977.

RECENT SUPPRESSION: Recently, Dr. Phyllis Mullenix, was fired from her position at the Forsyth Dental Centre because she stepped into politically-sensitive territory with her study on fluoride. It was subsequently published in a prestigious peer-reviewed scientific journal. Meanwhile, she sued the Forsyth for wrongful dismissal and won in an out-of-court settlement.

See censor.htm for more examples.

HEALTH CANADA'S (HC) 1992 FLUORIDE "STUDY": The committee was entirely composed of fluoridation proponents. At an industry workshop in Toronto (sponsored by Proctor and Gamble-Crest, and Lederle Laboratories) in April of 1992, HC's researchers unanimously endorsed fluoridation. One dentist was known to have received funding from a fluoridated toothpaste conglomerate. How can a panel composed of people who represent one side of the fluoridation debate, render a scientifically respectable, objective opinion as to whether there are benefits or not, when they have already committed themselves publicly to the answer? (for a review, see: Foulkes RG, Review of Report: Investigation of Inorganic Fluoride and its Effect on the Occurrence of Dental Caries and Dental Fluorosis in Canada)



FLUORIDE INTAKE IN A FLUORIDATED COMMUNITY

See fluoride.htm for chart on daily fluoride intakes in mg/day & mg/kg/day
Source: U.S.P.H.S., reference 68
Max and Avg fluoride intake in mgs per day Average Maximum
20 Kg Child 0.113 - 0.18 mg/kg/day 2.25 3.6
50 Kg Adult 0.08 - 0.13 mg/kg/day 3.88 6.6
70 Kg Adult 0.08 - 0.13 mg/kg/day 5.6 9.1
Child's F intake which is eqivalent to an adult's 0.113 - 0.18 mg/kg/day 7.91 12.6

Even the maxiumum values for adult fluoride intakes will not reflect true intakes for some subsets of the population. For example, heavy tea drinkers can consume considerably more fluoride, as can athletes, diabetics, pregnant women, construction workers, etc (see fluoride.htm)