I am writing in response to your article, Lack of fluoride in drinking water causes health concerns (Jul. 2, 2013). I understand you are currently an Intern at the Shawnee News-Star (based on your Linkedin profile). In light of this fact, I will hold your Editor responsible for your work. However, this letter is for you, written in the hope that it is not too late to save you from the pro-fluoridation zealots you have already encountered. For this reason, I shall offer a brief, point-by-point critique of your article. I hope this critique will prompt you to, in the future, be more critical of your pro-fluoridation sources.
“The lack of fluoride in community water sources may be detrimental to overall dental health of the county’s residents, according to concerns from Pottawatomie County healthcare professionals.”
Fluoride is not an essential nutrient. The human body does not need fluoride for any biological process, including the development of healthy teeth. Moreover, people can have perfectly good teeth without having access to artificially fluoridated water. As noted by Cheng et al. (2007), “Although the prevalence of caries varies between countries, levels everywhere have fallen greatly in the past three decades, and national rates of caries are now universally low. This trend has occurred regardless of the concentration of fluoride in water or the use of fluoridated salt, and it probably reflects use of fluoridated toothpastes and other factors, including perhaps aspects of nutrition.” The same trend was noticed by Diesendorf (1986), when he wrote in the journal Nature, “Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries over the past thirty years. It is now time for a scientific re-examination of the alleged enormous benefits of fluoridation.” Learn more.
“Fluoride is a naturally occurring mineral that prevents tooth decay.”
As explained by Connett et al. (2010), “Natural does not necessarily mean good. Arsenic, like ﬂuoride, leaches naturally from rocks into groundwater, but no one suggests topping that up. Besides, there is nothing “natural” about the ﬂuoridating chemicals, as they are obtained largely from the wet scrubbers of the phosphate fertilizer industry. The chemicals used in most ﬂuoridation programs are either hexaﬂuorosilicic acid or its sodium salt, and those silicon ﬂuorides do not occur in nature.”
“Water fluoridation has been shown to reduce dental decay in children’s teeth by 18 to 40 percent, according to the CDC.”
Firstly, there is something you should know about the CDC, in relation to fluoridation (watch this video, time-code 1:16:43 –). Secondly, “we have to remember that percentages can give a very misleading picture. For example, if an average of two decayed tooth surfaces are found in a non-ﬂuoridated group and one decayed surface in a ﬂuoridated group, that would amount to an impressive 50 percent reduction. But when we consider the total of 128 surfaces on a complete set of teeth, the picture—which amounts to an absolute saving in tooth decay of a mere 0.8 percent—does not look so impressive” (Connett et al. 2010, p. 251).
“The CDC recommends between 0.7 and 1.2 ppm of fluoride in the water to have a significant impact on the reduction of dental decay.”
By now, I assume you will have watched the aforementioned video (1:16:43 –) relating to the CDC’s Oral Health Division. If so, you will know they are far too ‘dentally biased’ to be giving out recommendations that will/may have long-term systemic toxicological implications. However, consider the following words, from risk assessment expert and former National Research Council expert Panelist, Dr. Kathleen Thiessen: “Water fluoridation at 0.7 mg/L is not adequate to protect against known or anticipated adverse effects and does not allow an adequate margin of safety to protect young children, people with high water consumption, people with kidney disease (resulting in reduced excretion of fluoride), and other potentially sensitive population subgroups” (Thiessen 2011, p. 5). Dr. Thiessen was a Panelist for the 2006 report, Fluoride in Drinking Water: A Scientific Review of EPA’s Standards, which you can learn more about here.
“Dr. Nan Shadid, who has been a dentist in Shawnee for 28 years, said she has noticed a significant increase in the number of children with cavities since Shawnee ceased water fluoridation.”
Dr. Shadid’s comments are anecdotal/subjective. The data, on the other hand, shows that tooth decay does not go up when fluoridation is stopped. Furthermore, think about all the famous cities of world that do not fluoridate their water (watch this video, time code 03:04 –), yet whose people maintain equal if not better oral health than those in fluoridated cities. With this in mind, consider the words of Carlsson (2010), “Sweden rejected fluoridation in the 1970s… Our children have not suffered greater tooth decay, as World Health Organization figures attest, and in turn our citizens have not borne the other hazards fluoride may cause. In any case, since fluoride is readily available in toothpaste, you don’t have to force it on people.” As a journalist, you would do well to thoroughly interrogate your source (in this case, Dr. Shadid) before letting her spout out her subjective views, whilst failing to offer any counter-information for your readers to consider. Watch this video (time code 0:46:11 –).
“There’s two ways to get fluoride in your system,” Shadid said. “One way is topical using mouthwashes or toothpaste. The other way is systemic where it gets in through your bloodstream.”
“The only way babies are going to get enough fluoride to help them develop healthy teeth is by drinking fluoridated water.”
Madi, this is where your article goes right off the rails. If there was ever a prime example of dangerous liaisons between media interns and fluoride zealots, this is it. I highly recommend you read this page and watch this video. Hopefully, that will set your alarm bells ringing as a journalist.
“Infants need to ingest the fluoride to help develop healthy teeth, she said.”
Madi, here are some key critical questions you can ask next time.
“Drinking fluoridated water and brushing with fluoridated toothpaste is the best way to combat decay.”
This is not supported by the comparative data. To quote Cheng et al. (2007) once again, “Although the prevalence of caries varies between countries, levels everywhere have fallen greatly in the past three decades, and national rates of caries are now universally low. This trend has occurred regardless of the concentration of fluoride in water or the use of fluoridated salt, and it probably reflects use of fluoridated toothpastes and other factors, including perhaps aspects of nutrition.” Thiessen (2013) discusses this matter further.
“Adding fluoride to water can help reduce plaque buildup in the heart.”
The evidence for ‘benefit‘ from fluoridated water is very weak, therefore, any attempt to move beyond this point into claiming additional ‘health benefits,’ is reprehensibly desperate, at best. “Most studies of benefits of fluoride intake or fluoridation have failed to account for a number of important variables, including individual fluoride intakes (as opposed to fluoride concentrations in the local water supplies), sugar intake, socioeconomic variables, and the general decline in caries rates over the last several decades, independent of water fluoridation status. When World Health Organization data on oral health of children in various countries are compared, similar declines in caries over time are seen in all developed countries, regardless of fluoridation status (Cheng et al. 2007; Neurath 2005). The only peer-reviewed paper to be published from California’s major oral health survey in the 1990s reported no association between fluoridation status and risk of early childhood caries (Shiboski et al. 2003). Several studies show differences in caries rates with socioeconomic status or dietary factors but not with fluoridation status (e.g., Adair et al. 1999; Hamasha et al. 2006)” (Thiessen 2011, p. 2). As an aside, it may be worth noting this paper (see: Conclusion); and consulting this database.
Madi, the next time someone like a local dentist tries to convince you that fluoridation is completely “safe and effective,” don’t be afraid to interrogate them – rigorously, if need be. I hope some of the above has assisted towards giving you the confidence to do this.
Recommended reading / viewing
AFAM Research Division