THE STATEMENT:
We, the undersigned professionals, come from a variety of disciplines but all have an abiding interest in ensuring that government public health and environmental policies be determined honestly, with full attention paid to the latest scientific research and to ethical principles.
EIGHT recent events make action to end water fluoridation urgent.
1. The publication in 2006 of a 500-page review of fluoride’s toxicology by a distinguished panel appointed by the National Research Council of the National Academies (NRC, 2006). The NRC report concluded that the US Environmental Protection Agency’s (EPA) safe drinking water standard for fluoride (i.e. maximum contaminant level goal or MCLG) of 4 parts per million (ppm) is unsafe and should be lowered. Despite over 60 years of fluoridation, the report listed many basic research questions that have not been addressed. Still, the panel reviewed a large body of literature in which fluoride has a statistically significant association with a wide range of adverse effects. These include an increased risk of bone fractures, decreased thyroid function, lowered IQ, arthritic-like conditions, dental fluorosis and, possibly, osteosarcoma.
The average fluoride daily intakes (*) associated with many of these adverse effects are reached by some people consuming water at the concentration levels now used for fluoridation -- especially small children, above average water drinkers, diabetics, people with poor kidney function and other vulnerable sub-groups. For example, the average fluoride daily intake associated with impaired thyroid function in people with iodine deficiency (about 12% of the US population) is reached by small children with average consumption of fluoridated water at 1 ppm and by people of any age or weight with moderate to high fluoridated water consumption. Of special note among the animal studies is one in which rats fed water containing 1 ppm fluoride had an increased uptake of aluminum into the brain, with formation of beta-amyloid plaques, which is a classic marker of Alzheimer's disease pathology in humans. Considering the substantial variation in individual water intake, exposure to fluoride from many other sources, its accumulation in the bone and other calcifying tissues and the wide range of human sensitivity to any toxic substance, fluoridation provides NO margin of safety for many adverse effects, especially lowered thyroid function.
* Note: "Daily intake" takes into account the exposed individual’s bodyweight and is measured in mg. of fluoride per kilogram bodyweight.
2. The evidence provided by the US Centers for Disease Control and Prevention (CDC) in 2005 that 32% of American children have dental fluorosis – an abnormal discoloration and mottling of the enamel. This irreversible and sometimes disfiguring condition is caused by fluoride. Children are now being overdosed with fluoride, even in non-fluoridated areas, from water, swallowed toothpaste, foods and beverages processed with fluoridated water, and other sources. Fluoridated water is the easiest source to eliminate.
3. The American Dental Association’s policy change, in November 2006, recommending that only the following types of water be used for preparing infant formula during the first 12 months of life: "purified, distilled, deionized, demineralized, or produced through reverse osmosis." This new policy, which was implemented to prevent the ingestion of too much fluoride by babies and to lower the risk of dental fluorosis, clearly excludes the use of fluoridated tap water. The burden of following this recommendation, especially for low income families, is reason alone for fluoridation to be halted immediately. Formula made with fluoridated water contains 250 times more fluoride than the average 0.004 ppm concentration found in human breast milk in non-fluoridated areas (Table 2-6, NRC, 2006).
4. The CDC’s concession, in 1999 and 2001, that the predominant benefit of fluoride in reducing tooth decay is TOPICAL and not SYSTEMIC. To the extent fluoride works to reduce tooth decay, it works from the outside of the tooth, not from inside the body. It makes no sense to drink it and expose the rest of the body to the long term risks of fluoride ingestion when fluoridated toothpaste is readily available.
Fluoride’s topical mechanism probably explains the fact that, since the 1980s, there have been many research reports indicating little difference in tooth decay between fluoridated and non-fluoridated communities (Leverett, 1982; Colquhoun, 1984; 1985 and 1987; Diesendorf, 1986; Gray, 1987; Brunelle and Carlos, 1990; Spencer,1996; deLiefde, 1998; Locker, 1999; Armfield and Spencer, 2004; and Pizzo 2007 - see citations). Poverty is the clearest factor associated with tooth decay, not lack of ingested fluoride. According to the World Health Organization, dental health in 12-year olds in non-fluoridated industrialized countries is as good, if not better, than those in fluoridated countries (Neurath, 2005).
5. In 2000, the publication of the UK government sponsored “York Review,” the first systematic scientific review of fluoridation, found that NONE of the studies purporting to demonstrate the effectiveness of fluoridation to reduce tooth decay were of grade A status, i.e. “high quality, bias unlikely” (McDonagh et al., 2000).
6. The publication in May 2006 of a peer-reviewed, case-controlled study from Harvard University which found a 5-7 fold increase in osteosarcoma (a frequently fatal bone cancer) in young men associated with exposure to fluoridated water during their 6th, 7th and 8th years (Bassin et al., 2006). This study was surrounded by scandal as Elise Bassin’s PhD thesis adviser, Professor Chester Douglass, was accused by the watchdog Environmental Working Group of attempting to suppress these findings for several years (see video). While this study does not prove a relationship between fluoridation and osteosarcoma beyond any doubt, the weight of evidence and the importance of the risk call for serious consideration.
7. The admission by federal agencies, in response to questions from a Congressional subcommittee in 1999-2000, that the industrial grade waste products used to fluoridate over 90% of America's drinking water supplies (fluorosilicate compounds) have never been subjected to toxicological testing nor received FDA approval for human ingestion (Fox, 1999; Hazan, 2000; Plaisier, 2000; Thurnau, 2000).
8. The publication in 2004 of “The Fluoride Deception” by Christopher Bryson. This meticulously researched book showed that industrial interests, concerned about liabilities from fluoride pollution and health effects on workers, played a significant role in the early promotion of fluoridation. Bryson also details the harassment of scientists who expressed concerns about the safety and/or efficacy of fluoridation (see Bryson interview).
We call upon Members of Congress (and legislators in other fluoridating countries) to sponsor a new Congressional (or Parliamentary) Hearing on Fluoridation so that those in government agencies who continue to support the procedure, particularly the Oral Health Division of the CDC, be compelled to provide the scientific basis for their ongoing promotion of fluoridation. They must be cross-examined under oath if the public is ever to fully learn the truth about this outdated and harmful practice.
We call upon all medical and dental professionals, members of water departments, local officials, public health organizations, environmental groups and the media to examine for themselves the new documentation that fluoridated water is ineffective and poses serious health risks. It is no longer acceptable to simply rely on endorsements from agencies that continue to ignore the large body of scientific evidence on this matter -- especially the extensive citations in the NRC (2006) report discussed above.
The untold millions of dollars that are now spent on equipment, chemicals, monitoring, and promotion of fluoridation could be much better invested in nutrition education and targeted dental care for children from low income families. The vast majority of enlightened nations have done this (see statements).
It is time for the US, and the few remaining fluoridating countries, to recognize that fluoridation is outdated, has serious risks that far outweigh any minor benefits, violates sound medical ethics and denies freedom of choice. Fluoridation must be ended now.
References
American Dental Association (ADA). 2006. Interim Guidance on Fluoride Intake for Infants and Young Children. November 8.
www.ada.org/prof/resources/positions/sta....asp?id=egram_061109
Armfield JM, Spencer AJ. 2004. Consumption of nonpublic water: implications for children’s caries experience. Community Dent Oral Epidemiol 32:283-296.
Bassin EB, Wypij D, Davis RB, Mittleman MA. 2006. Age-specific fluoride exposure in drinking water and osteosarcoma (United States). Cancer Causes and Control 17: 421-8.
Brunelle JA, Carlos JP. 1990. Recent trends in dental caries in U.S. children and the effect of water fluoridation. J. Dent. Res 69, (Special edition), 723-727.
Centers for Disease Control and Prevention (CDC). 1999. Achievements in Public Health, 1900- 1999: Fluoridation of Drinking Water to Prevent Dental Caries. MMWR (Morbidity and Mortality Weekly Report) 48(41);933-940. October 22.
www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm
Centers for Disease Control and Prevention (CDC). 2001. Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. MMWR (Morbidity and Mortality Weekly Report) 50(RR14);1-42. August 17.
www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm
Centers for Disease Control and Prevention (CDC). 2005. Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999- 2002. MMWR (Morbidity and Mortality Weekly Report) Surveill Summ 54(3):1-43. August 26.
www.cdc.gov/mmwr/preview/mmwrhtml/ss5403a1.htm
Colquhoun J. 1984. New evidence on fluoridation. Social Science & Medicine 19:1239-46.
Colquhoun J. 1985. Influence of social class and fluoridation on child dental health. Community Dentistry and Oral Epidemiology 13:37-41.
Colquhoun J. 1987. Child dental health differences in New Zealand. Community Health Studies 11:87-104.
De Liefde B. 1998. The decline of caries in New Zealand over the past 40 years. New Zealand Dental Journal. 94: 109-113.
Diesendorf M. 1986. The mystery of declining tooth decay. Nature. 322: 125-129.
www.fluoridealert.org/health/teeth/caries/diesendorf.html
Fluoride Action Network (FAN). Online. Statements from European Health, Water, & Environment Authorities on Water Fluoridation.
fluoridealert.org/govt-statements.htm
Fox 25 News, Boston, Massachusetts. 2006. Harvard Professor: Hiding a Link? February 14. Transcript and video online at
www.fluoridealert.org/fox-transcript.html
Fox JC, (1999), Assistant Administrator, USEPA, Office of Water. Letter to Honorable Ken Calvert, Chairman, Subcommittee on Energy and Environment, Committee on Science, House of Representatives, Washington DC 20515. June 23. https://www.keepers-of-the-
well.org/gov_resp_pdfs/EPAresponse1.pdf
“Question 2. What chronic toxicity test data are there on sodium fluorosilicate? On hydrofluorosilicic acid?
[Response]: ... In collecting the data for the fact sheet, EPA was not able to identify chronic studies for these chemicals...”
Grass Roots and Global Video (GRGV). 2006. The fluoride deception. An interview with Christopher Bryson.
video.google.com/videoplay?docid=7319752...ride+deception&hl=en
Gray AS. 1987. Fluoridation: time for a new base line? Journal of the Canadian Dental Association. 53(10)763-5.
Haneke KE, Carson BL. 2001. Sodium hexafluorosilicate [CASRN 16893-85-9] and fluorosilicic acid [CASRN 16961-83-4]. Review of toxicological literature. Prepared for Scott Masten, National Institute of Environmental Health Sciences. Contract No. N01-ES-65402. October.
www.fluoridealert.org/pesticides/fluorosilicates.nih.2001.pdf
Hazan S, (2000), General Manager, Drinking Water Additives Certification Program, NSF (National Sanitation Foundation International). Letter to The Honorable Ken Calvert, Chairman, Subcommittee on Energy and Environment, Committee on Science, U.S. House of Representatives, Washington DC 20515. July 7.
https://www.keepers-of-the-
well.org/gov_resp_pdfs/NSF_response.pdf
[PAGE 6] “Question 2. Under General Requirements 3.2.1, formulation submission and review, ANSI/NSF 60 -1999, are manufacturers of hydrofluosilicic acid and silicofluorides required to “submit for each product, when available, a list of published and unpublished toxicological studies relevant to the treatment chemical and the chemicals and impurities present in the treatment chemical?”
[Response]: The standard requires that the manufacturer of a product submitted for certification provide toxicological information, if available. NSF requires that manufacturers seeking certification to the standard submit this information as part of their formulation or ingredient supplier submission.”
[PAGE 8] “Question 3. Have any studies on hydrofluosilicic acid or silicofluorides been submitted to NSF under claimed Confidential Business Information protection?
[Response] There have not been any studies on hydrofluosilicic acid or silicofluorides submitted to NSF under claimed Confidential Business Information protection.”
Leverett DH. 1982. Fluorides and the changing prevalence of dental caries. Science. 217(4554):26-30.
Locker D. 1999. Benefits and Risks of Water Fluoridation. An Update of the 1996 Federal- Provincial Sub-committee Report. Prepared for Ontario Ministry of Health and Long Term Care.
McDonagh M, Whiting PF, Wilson PM, Sutton AJ, Chestnutt, Cooper J, Misso K, Treasure E, Kleijnen J. 2000. A systematic review of public water fluoridation. British Medical Journal 321:855-859. October 7.
www.bmj.com/cgi/content/full/321/7265/855
National Research Council of the National Academies (NRC). 2006. Fluoride in drinking water: a scientific review of EPA's standards. The National Academies Press. Washington, D.C.
www.nap.edu/catalog.php?record_id=11571
Neurath C. 2005. Tooth decay trends for 12 year olds in nonfluoridated and fluoridated countries. Fluoride 38(4)324–325. November.
www.fluorideresearch.org/384/files/384324-325.pdf
Pizzo G, Piscopo MR, Pizzo I, Giuliana G. 2007. Community water fluoridation and caries prevention: a critical review. Clinical Oral Investigations. Feb 27.
Plaisier MK, (2000), Associate Commissioner for Legislation, Department of Health and Human Services, Food and Drug Administration, Richville MD 20857. Letter to Honorable Ken Calvert, Chairman, Subcommittee on Energy and Environment, Committee on Science, House of Representatives, Washington DC 20515. December 21.
keepersofthewell.org/product_pdfs/FDA_response_pt.pdf
[PAGE 1] "Fluoride, when used in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or animal, is a drug that is subject to Food and Drug Administration (FDA) regulation." and then
[PAGE 2] "No NDAs [New Drug Applications] have been approved or rejected for fluoride drugs meant for ingestion."
[PAGE 2] “Drugs in use prior to 1962 are being reviewed under a process known as the drug efficacy study implementation (DESI). The DESI review of fluoride-containing products has not been completed.”
Spencer AJ, Slade GD, Davies M. 1996. Water Fluoridation in Australia. Community Dental Health. 13(Suppl 2)27-37. September.
Thurnau RC, (2000), Chief Treatment Technology Evaluation Branch Water Supply and Water Resources Division, Office of Research and Development, USEPA National Risk Management Research Laboratory. Letter to Roger D. Masters Research Professor of Government Dartmouth College Department of Government 6108 Silsby Hall Hanover, New Hampshire 03755-3547. November 16.
keepersofthewell.org/product_pdfs/Masters-EPA-00.pdf
“To answer your first question on whether we have in our possession empirical scientific data on the effects of fluosilicic acid or sodium silicofluoride on health and behavior, our answer is no. Health effects research is primarily conducted by our National Health and Environmental Effects Research Laboratory (NHEERL). We have contacted our colleagues at NHEERL and they report that with the exception of some acute toxicity data, they were unable to find any information on the effects of silicofluorides on health and behavior...”
That's over 4,000 medical signatories. In addition here are ten reasons to oppose fluoridation, compiled by Professor Paul Connett:
1. Fluoridation is a violation of the individual's right to informed consent to medication.
2. Fluoride is not an essential nutrient. No biological process in animals or humans has been shown to depend on it. On the contrary, it is known that fluoride can interfere with many important biological processes and vital cellular constituents, such as enzymes and G-proteins. This makes fluoride potentially toxic even at low doses.
3. Children in fluoridated countries are greatly over-exposed to fluoride. When fluoridation began in 1940s, 10% of children were expected to develop dental fluorosis (damage to the enamel involving discoloration and/or mottling) in its very mild form. Today, the prevalence in fluoridated countries is much higher—41% of all American children aged 12-15 are now impacted with some form of dental fluorosis (CDC, 2010), with over 10% in categories (mild, moderate and severe) that may need expensive treatment.
4. The chemicals used to fluoridate water supplies are largely hazardous by-products of the fertilizer industry. These chemicals cannot be disposed of into the sea by international law, and have never been required to undergo randomized clinical trials for safety or effectiveness by any regulatory agency in the world. The U.S. FDA classifies fluoride as an "unapproved drug."
5. There is mounting evidence that swallowing fluoride causes harm. Fluoride has been found to damage soft tissues (brain, kidneys, and endocrine system), as well as teeth (dental fluorosis) and bones (skeletal fluorosis). There are now 24 studies that show a relationship between fairly modest exposure to fluoride and reduced IQ in children. Two of these studies suggest that the threshold for damage may be reached at fluoride levels similar to those used in water fluoridation.
6. Swallowing fluoride provides little or no benefit to the teeth. Even promoters of fluoridation agree that fluoride works topically (on the outer surface of the teeth), and not via some internal biological mechanism (CDC, 1999). A recent U.S. study found no relationship between the amount of fluoride a child ingested and level of tooth decay (Warren et al., 2009). Topical treatment in the form of fluoridated toothpaste is universally available, so it is a mistake to swallow fluoride and expose all the tissues of the body to its harmful effects.
7. Human breast milk is very low in fluoride. Breast milk averages only 0.007 ppm F (NRC, 2006). Even in areas with high fluoride levels, nursing children receive only a small fraction of the mother's fluoride intake, ensuring that the sensitive brains and bodies of breast-fed infants are protected from the developmental effects of this toxin. In contrast, a bottle-fed baby in a fluoridated area (0.7-1.2 ppm F) gets up to 200 times more fluoride than a breast-fed baby, resulting in an increased risk of dental fluorosis and other adverse effects.
8. Once fluoride is added to water, there is no way to control who gets the drug or how much is ingested. No medical follow-up or monitoring of fluoride levels in citizens' urine or bones is being carried-out by health agencies and so no record is being kept of adverse effects or daily or accumulated exposures.
9. Certain subgroups are particularly affected by fluoridation. People vary considerably in their sensitivity to any toxic substance, including fluoride. Infants, the elderly, diabetics, those with poor nutrition (e.g. low calcium and low iodine), and those with kidney disease are especially vulnerable to specific adverse effects of fluoride. Black and Mexican-Americans have a higher prevalence of the more severe forms of dental fluorosis (see Table 23, CDC, 2005).
10. Fluoridation discriminates against those with low incomes. People on low incomes are least able to afford avoidance measures (reverse osmosis or bottled water), or treatment of dental fluorosis (see Point 3) and other fluoride-related ailments (see Point 5).