The Case Against Water Fluoridation

The Case Against Water The Case Against Water Fluoridation Fluoridation

Paul Connett, PhDPaul Connett, PhDDirector, Fluoride Action NetworkDirector, Fluoride Action Network

FluorideFluorideALERTALERT.org.orgHartford, CT, June 26, 2013Hartford, CT, June 26, 2013

IntroductionIntroduction

I have spent 17 years researching the I have spent 17 years researching the fluoridation issue, first as a professor fluoridation issue, first as a professor of chemistry specializing in of chemistry specializing in environmental chemistry and environmental chemistry and toxicology, and now as director of the toxicology, and now as director of the Fluoride Action Network.Fluoride Action Network.

Outline of my presentationOutline of my presentation

1. Why fluoridation should not have started.1. Why fluoridation should not have started.2. Key moments since 1990 that should have 2. Key moments since 1990 that should have

ended fluoridation.ended fluoridation.3. The very poor science underpinning the 3. The very poor science underpinning the

case for fluoridation.case for fluoridation.4. Better alternatives to fight tooth decay4. Better alternatives to fight tooth decay

Part 1.Part 1.Why Fluoridation shouldWhy Fluoridation should

never have started never have started

1. We should never use the public water 1. We should never use the public water supply to deliver medicinesupply to deliver medicine. WHY?. WHY?

2. You can’t control who gets the medicine.2. You can’t control who gets the medicine. 3. You can’t control the DOSE people get.3. You can’t control the DOSE people get.4. It violates the individual’s right to 4. It violates the individual’s right to

informed consent to medicine.informed consent to medicine.

5) Fluoride is NOT a nutrient. 5) Fluoride is NOT a nutrient. There is not a single process inside the There is not a single process inside the

body that needs fluoride to function body that needs fluoride to function properly, howeverproperly, however

6) Fluoride is a known toxic substance that 6) Fluoride is a known toxic substance that interferes with many fundamental interferes with many fundamental biochemical functions biochemical functions

In other words: In other words: it doesn’t do any good to it doesn’t do any good to swallow fluoride and it has the potential to swallow fluoride and it has the potential to cause harmcause harm

7) 1 ppm fluoride (1 mg/liter) is NOT small. 7) 1 ppm fluoride (1 mg/liter) is NOT small. It is 250 times the level in mothers milk in It is 250 times the level in mothers milk in a non-fluoridated community (0.004 ppm, a non-fluoridated community (0.004 ppm, NRC , 2006, p. 40)NRC , 2006, p. 40)

8) A bottle-fed baby in a fluoridated 8) A bottle-fed baby in a fluoridated community is getting 250 times the community is getting 250 times the fluoride dose that nature intended. Who fluoride dose that nature intended. Who knows more about what the baby needs – knows more about what the baby needs – nature or a bunch of dentists from Chicago nature or a bunch of dentists from Chicago (ADA)?(ADA)?

9) The fluoridating chemicals used are not the 9) The fluoridating chemicals used are not the pharmaceutical grade chemicals used in pharmaceutical grade chemicals used in dental products, but are dental products, but are arsenic-arsenic-contaminated contaminated industrial waste products industrial waste products obtained from the fertilizer industry.obtained from the fertilizer industry.

10) The dental lobby has controlled this 10) The dental lobby has controlled this debate for far too long. There are more debate for far too long. There are more tissues in the body than teeth. It is time to tissues in the body than teeth. It is time to get dentistry out of the public water supply get dentistry out of the public water supply and back into the dental office.and back into the dental office.

The vast majority of The vast majority of countries do NOT countries do NOT

fluoridate their waterfluoridate their water

97% of Western European population now drinks Non-Fluoridated Water

AustriaBelgiumDenmarkFinlandFrance

GermanyGreeceIceland

ItalyLuxembourgNetherlands

Northern IrelandNorwayScotlandSweden

Switzerland

Austria*BelgiumDenmarkFinlandFrance*

Germany*GreeceIceland

ItalyLuxembourgNetherlands

Northern IrelandNorwayScotlandSweden

Switzerland*

*Some fluoridate their salt

97% of Western European population now drinks Non-Fluoridated Water

According to WHO data According to WHO data tooth decay in 12-year-olds tooth decay in 12-year-olds

is coming down as fast is coming down as fast in F as NF countries in F as NF countries

SOURCE: World Health Organization. (Data online)

Supporting documents:Supporting documents:Neurath, 2005*Neurath, 2005*Cheng, 2007*Cheng, 2007*

Part 2Part 2 Some of the events since 1990 Some of the events since 1990

which should have forced an which should have forced an end to water fluoridationend to water fluoridation

(An ugly fact can destroy a (An ugly fact can destroy a beautiful theory)beautiful theory)

Ugly Fact # 1Ugly Fact # 1 A series of studies since A series of studies since

1980 indicate that the 1980 indicate that the notion that swallowing notion that swallowing

fluoride reduces tooth decay fluoride reduces tooth decay is very weakis very weak

Between 1980 and 1990Between 1980 and 1990 A number of articles began to A number of articles began to

appear in major journals indicating appear in major journals indicating that there was very little difference that there was very little difference in tooth decay between fluoridated in tooth decay between fluoridated and non-fluoridated communitiesand non-fluoridated communities

Leverett in Leverett in ScienceScience, 1982, 1982Diesendorf in Diesendorf in NatureNature, 1986*, 1986*

Gray, 1987Gray, 1987Colquhoun* Colquhoun*

This prompted the NIDR to conduct This prompted the NIDR to conduct the largest survey of tooth decay the largest survey of tooth decay

ever carried out in the US.ever carried out in the US.

NIDR surveyNIDR survey

The teeth of over 39,000 The teeth of over 39,000 children in 84 communities children in 84 communities were examined.were examined.

YiamouyiannisYiamouyiannis

Using the FOIA Dr. John Yiamouyiannis obtained Using the FOIA Dr. John Yiamouyiannis obtained the the DMFTDMFT (= decayed, missing and filled permanent (= decayed, missing and filled permanent TEETH),TEETH), data for children aged 5-17 data for children aged 5-17

His plot of the data showed no statistical difference His plot of the data showed no statistical difference between children from N-F and F communitiesbetween children from N-F and F communities

NIDR - Yiamouyiannis, 1990

NIDR - Brunelle and Carlos (1990)NIDR - Brunelle and Carlos (1990)

Brunelle and Carlos increased Brunelle and Carlos increased sensitivity by factor of five sensitivity by factor of five (approximately) by comparing (approximately) by comparing DMFS DMFS ((= decayed, missing and filled = decayed, missing and filled permanent permanent SURFACESSURFACES - 5 surfaces to - 5 surfaces to most teeth, 4 in the cutting teeth)most teeth, 4 in the cutting teeth)

They measured tooth decay as Decayed Missing and Filled Tooth Surfaces

(DMFS). There are 4 or 5 surfaces per tooth.

Decayed Missing and Filled surfaces (DMFS)

There are 4 surfaces to the top six and bottom six cutting teeth and 5 surfaces on all the other teeth.

128 tooth surfaces in all.

Brunelle and Carlos (1990) measured tooth decay as Decayed Missing and

Filled Tooth Surfaces (DMFS)See Table 6 in their paper.

2.8DMFS

F

The largest US survey of tooth decay

3.4 DMFSNF

2.8DMFS

F

Brunelle and Carlos, 1990

Average difference (for 5 - 17 year olds) in DMFS = 0.6 tooth surfaces (5 surfaces to a tooth)

3.4 DMFSNF

2.8DMFS

F

Not only was this saving very Not only was this saving very

small (small (0.6 of one tooth 0.6 of one tooth surface) surface) but it was not even but it was not even

shown to be statistically shown to be statistically significant!significant!

Supporting documents:Supporting documents:Yiamouyiannis, 1990*Yiamouyiannis, 1990*

Brunelle and Carlos, 1990* Brunelle and Carlos, 1990* (see Table 6)(see Table 6)

Warren et al. (2009)Warren et al. (2009)(the “Iowa” study)(the “Iowa” study)

Warren et al., 2009, Warren et al., 2009, measured measured tooth decay as a function of tooth decay as a function of individual exposure to fluoride. individual exposure to fluoride.

They found no relation between They found no relation between tooth decay and amount of fluoride tooth decay and amount of fluoride ingested.ingested.

““These findings suggest that These findings suggest that achieving a caries-free statusachieving a caries-free status

may have relatively little to do may have relatively little to do with fluoride intake…with fluoride intake…””

  Supporting document Warren et Supporting document Warren et al., 2009*al., 2009*

Ugly Fact # 2Ugly Fact # 2

CDC (1999)CDC (1999)Fluoride’s predominant Fluoride’s predominant benefit is TOPICAL not benefit is TOPICAL not

systemicsystemic

CDC, MMWR, 48(41); 933-940, CDC, MMWR, 48(41); 933-940, Oct 22, 1999Oct 22, 1999**

““Fluoride’s caries-preventive Fluoride’s caries-preventive properties initially were attributed to properties initially were attributed to changes in enamel during tooth changes in enamel during tooth developmentdevelopment..... . However, laboratory However, laboratory and epidemiologic research suggest and epidemiologic research suggest that fluoride prevents dental caries that fluoride prevents dental caries predominantly after eruption of the predominantly after eruption of the tooth into the mouth, and its actions tooth into the mouth, and its actions primarily are topical…”primarily are topical…”

If fluoride works on the outside of If fluoride works on the outside of the tooth not from inside the bodythe tooth not from inside the body

Why Why swallow fluoride and expose every swallow fluoride and expose every tissue of the body to a toxic substance, tissue of the body to a toxic substance, when you can brush it on your teeth and when you can brush it on your teeth and spit it out? spit it out?

And why put it in the drinking water and And why put it in the drinking water and force it on people who don’t want it?force it on people who don’t want it?

Ugly Fact # 3Ugly Fact # 3 The U.S. National Research The U.S. National Research

Council published the Council published the results of its 3-year review results of its 3-year review

of fluoride’s toxicityof fluoride’s toxicity(NRC, 2006)(NRC, 2006)

National Research Council (2006)

NRC found that fluoride could NRC found that fluoride could cause many harmful effects in cause many harmful effects in the body in countries with high the body in countries with high natural levels of fluoride in natural levels of fluoride in their water.their water.

Independent scientists have Independent scientists have argued that there is NO argued that there is NO ADEQUATE MARGIN OF ADEQUATE MARGIN OF SAFETY to protect SAFETY to protect everyoneeveryone drinking fluoridated water from drinking fluoridated water from some of these harmful effects.some of these harmful effects.

An exposure analysis in Chapter 2 An exposure analysis in Chapter 2 of the NRC report shows that of the NRC report shows that subsets of population drinking F -subsets of population drinking F -water (including bottle-fed water (including bottle-fed infants) are exceeding EPA’s safe infants) are exceeding EPA’s safe reference dose (0.06 mg/kg/day)reference dose (0.06 mg/kg/day)

See supporting document*See supporting document*

John Doull (chairman, NRC, 2006 Review)John Doull (chairman, NRC, 2006 Review)

““What the committee found is that we’ve gone with the status What the committee found is that we’ve gone with the status quo regarding fluoride for many years—for too long really—quo regarding fluoride for many years—for too long really—and now we need to take a fresh look . . . In the scientific and now we need to take a fresh look . . . In the scientific community people tend to think this is settled. I mean, when community people tend to think this is settled. I mean, when the U.S. surgeon general comes out and says this is one of the the U.S. surgeon general comes out and says this is one of the top 10 greatest achievements of the 20th century, that’s a hard top 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have hurdle to get over. But when we looked at the studies that have been done, been done, we found that many of these questions are unsettled we found that many of these questions are unsettled and we have much less information than we should, and we have much less information than we should, considering how long this [fluoridation] has been going on.”considering how long this [fluoridation] has been going on.”

Scientific American, Jan 2008.Scientific American, Jan 2008.

Ugly Fact # 4Ugly Fact # 4Fluoridation may actually be Fluoridation may actually be

killing a few young boys killing a few young boys each yeareach year

Bassin et al., 2006Bassin et al., 2006

OsteosarcomaOsteosarcoma

Bassin found that young boys exposed to Bassin found that young boys exposed to fluoridated water fluoridated water in their 6th,7th or 8th in their 6th,7th or 8th yearsyears, had a 5-7 fold increase in , had a 5-7 fold increase in developing osteosarcoma by the age of developing osteosarcoma by the age of 20, compared to non-exposed boys. 20, compared to non-exposed boys.

Her 2006 study has never been refuted.Her 2006 study has never been refuted. The study promised by Douglass (Kim et The study promised by Douglass (Kim et

al., 2011) failed to do so.al., 2011) failed to do so.

Supporting documents:Supporting documents:Bassin et al., 2006*Bassin et al., 2006*Kim et al., 2011*Kim et al., 2011*

Ugly Fact # 5Ugly Fact # 5 CDC (2010)CDC (2010)

Confirms that American kids Confirms that American kids are being hugely over-are being hugely over-

exposed to fluorideexposed to fluoride

Dental FluorosisDental Fluorosis

Early promoters thought that at 1 ppm F Early promoters thought that at 1 ppm F they could reduce tooth decay and limit they could reduce tooth decay and limit dental fluorosis to dental fluorosis to 10%10% of children in of children in itsits very mild very mild form.form.

Prevalence and Severity of Dental Fluorosis Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004in the United States, 1999-2004

November 2010: CDCNovember 2010: CDC update on fluorosis update on fluorosis by Beltrán-Aguilar et al.by Beltrán-Aguilar et al.

See supporting document*See supporting document*

CDC, 2010CDC, 2010

CDC, 2010CDC, 2010

41%

Very Mild Dental Fluorosis

Impacts up to 25% of tooth surface

CDC, 2010CDC, 2010

41%

Mild Dental Fluorosis

Impacts up to 50% of tooth surface

CDC, 2010CDC, 2010

41%

Moderate- Severe Dental Fluorosis

Impacts 100% of tooth surface

See also CDC (2005)See also CDC (2005)

An earlier report from the CDC had An earlier report from the CDC had found that Black and Hispanic found that Black and Hispanic Americans had higher rates of Americans had higher rates of dental fluorosis (especially the more dental fluorosis (especially the more serious categories) than White serious categories) than White Americans. See supporting Americans. See supporting document CDC, 2005, Table 23.*document CDC, 2005, Table 23.*

A KEY QUESTIONA KEY QUESTION

When fluoride is damaging the When fluoride is damaging the baby’s growing tooth cells baby’s growing tooth cells (causing dental fluorosis)(causing dental fluorosis) what is it what is it doing to its other developing doing to its other developing tissues?tissues?

Ugly Fact # 6Ugly Fact # 6There is extensive evidence There is extensive evidence

that fluoride damages the that fluoride damages the brains of animals and brains of animals and

humanshumans

Over 40 animal studies Over 40 animal studies show that prolonged exposure to show that prolonged exposure to

fluoride can damage the brain. fluoride can damage the brain. 19 animal studies 19 animal studies report that mice or rats ingesting report that mice or rats ingesting

fluoride have an impaired capacity to learn and fluoride have an impaired capacity to learn and remember. remember.

12 studies 12 studies (7 human, 5 animal) link fluoride with (7 human, 5 animal) link fluoride with neurobehavioral deficitsneurobehavioral deficits

3 human studies 3 human studies link fluoride exposure with impaired link fluoride exposure with impaired fetal brain developmentfetal brain development

37 out of 43 published studies show that fluoride 37 out of 43 published studies show that fluoride lowers IQlowers IQ

To access any of these brain studiesTo access any of these brain studies1) Go to FluorideALERT.org1) Go to FluorideALERT.org2) Click on RESEARCHERS2) Click on RESEARCHERS3) Click on Health Data Base3) Click on Health Data Base4) Click on Brain Effects 4) Click on Brain Effects Or go direct toOr go direct toFluorideALERT.org/issues/FluorideALERT.org/issues/

health/health/brainbrain

Varner et al. (1998)Varner et al. (1998)

Gave rodents Gave rodents 1 ppm1 ppm fluoride in their water fluoride in their water for one year. The exposed rodents hadfor one year. The exposed rodents had

kidney damage, kidney damage, brain damage, brain damage, A greater uptake of aluminum into the brain A greater uptake of aluminum into the brain

and and beta amyloid deposits which are beta amyloid deposits which are

characteristic of Alzheimer’s disease.characteristic of Alzheimer’s disease.

Xiang et al. (2003 a,b)Xiang et al. (2003 a,b) Compared children in two villages ( <0.7 ppm Compared children in two villages ( <0.7 ppm

versus 2.5 - 4.5 ppm F in water)versus 2.5 - 4.5 ppm F in water) Controlled for lead exposure and iodine intake, Controlled for lead exposure and iodine intake,

and other key variables (NOTE: both lead and other key variables (NOTE: both lead exposure and low iodine also lower IQ).exposure and low iodine also lower IQ).

Found a drop of 5-10 IQ points across the whole Found a drop of 5-10 IQ points across the whole age rangeage range

The whole IQ curve shifted for both males and The whole IQ curve shifted for both males and femalesfemales

Xiang et al. (2003 a,b)Xiang et al. (2003 a,b) MALES

Xiang estimated that the Xiang estimated that the thresholdthreshold for lowering IQ was at for lowering IQ was at 1.91.9 ppm fluoride in the water ppm fluoride in the water

This offers no adequate margin of This offers no adequate margin of safety to protect safety to protect all all American American children from 1) the large range of children from 1) the large range of doses and 2) large range of doses and 2) large range of sensitivity expected in a large sensitivity expected in a large population population

No protection for range of exposureNo protection for range of exposure

A child drinking TWO liters of A child drinking TWO liters of water at 1 ppm would get a higher water at 1 ppm would get a higher DOSE DOSE (2 mg/day) (2 mg/day) thanthan

one of the Chinese children one of the Chinese children drinking ONE liter of water at 1.9 drinking ONE liter of water at 1.9 ppm ppm (1.9 mg/day)(1.9 mg/day)

To protect for the full range of To protect for the full range of sensitivity in a large populationsensitivity in a large population

To protect the most sensitive person in a large To protect the most sensitive person in a large populationpopulation

We normally divide the DOSE that causes harm by We normally divide the DOSE that causes harm by TEN (intra-species variation).TEN (intra-species variation).

What dose were the Chinese children getting at 1.9 What dose were the Chinese children getting at 1.9 ppm? Estimating a RANGE of dose:ppm? Estimating a RANGE of dose:

If they drank 0.5 liters/day = 1 mg/dayIf they drank 0.5 liters/day = 1 mg/day If they drank 1.0 liter/day = 1.9 mg/dayIf they drank 1.0 liter/day = 1.9 mg/day If they drank 2.0 liters/day = 3.8 mg/dayIf they drank 2.0 liters/day = 3.8 mg/day

To protect for the full range of To protect for the full range of sensitivity in a large populationsensitivity in a large population

Chinese childrenChinese children Range of dose = 1- 4 mg/dayRange of dose = 1- 4 mg/dayTo protect all of American children To protect all of American children

divide by 10divide by 10 SafeSafe dose would range from dose would range from 0.1 to 0.4 0.1 to 0.4 mg/day. Even if we use the mg/day. Even if we use the

higher number this dose would be exceeded higher number this dose would be exceeded by children drinking 0.4 liter (400 ml) of by children drinking 0.4 liter (400 ml) of water at 1 ppmwater at 1 ppm

Supporting documents:Supporting documents:Xiang et al., 2003a*Xiang et al., 2003a*Xiang et al., 2003b*Xiang et al., 2003b*

11 of the 37 IQ studies found an 11 of the 37 IQ studies found an association between lowered IQ and association between lowered IQ and

fluoride levels in the urinefluoride levels in the urine

Ding et al. 2011* Ding et al. 2011* (J. Hazardous (J. Hazardous Materials)Materials)

“ “Mean value of fluoride in drinking water was Mean value of fluoride in drinking water was 1.31 ±1.05mg/L (range 1.31 ±1.05mg/L (range 0.24–2.840.24–2.84).” ).”

“ “ ConclusionsConclusions Overall, our study suggested that low levels of Overall, our study suggested that low levels of

fluoride exposure in drinking water had negative fluoride exposure in drinking water had negative effects on children’s intelligence... effects on children’s intelligence...

The results also confirmed the dose–response The results also confirmed the dose–response relationships between urine fluoride concentrations relationships between urine fluoride concentrations and IQ scores…and IQ scores…””

Xiang finds an association between Xiang finds an association between lowered IQ and PLASMA fluoride lowered IQ and PLASMA fluoride

levelslevelsXiang et al., 2011*Xiang et al., 2011*

Xiang et al. 2010Xiang et al. 2010 Xiang et al., 2012

Ding et al. 2011Ding et al. 2011

Xiang (2012). Children’s IQ versus Levels of fluoride in the serum (children from both villages combined, personal communication with Paul Connett) . Thehigher the levels of fluoride in the plasma the lower the levels of IQ.

Ugly Fact # 7Ugly Fact # 7Choi et al. (2012)*Choi et al. (2012)*

The Harvard review of IQ The Harvard review of IQ studiesstudies

Harvard meta-analysis of 27 studiesHarvard meta-analysis of 27 studies Choi et al (the team included Philippe Choi et al (the team included Philippe

Grandjean) did a meta-analysis of Grandjean) did a meta-analysis of 2727 studies comparing IQ in “high” versus studies comparing IQ in “high” versus “low” fluoride villages .“low” fluoride villages .

The study was published in The study was published in Environmental Environmental Health Perspectives Health Perspectives (published by NIEHS)(published by NIEHS)

They acknowledge that there were They acknowledge that there were weaknesses in many of the studies, weaknesses in many of the studies, however…however…

the results were remarkably the results were remarkably consistentconsistent

In In 26 of the 27 studies 26 of the 27 studies there was there was lower average IQ in the “high” lower average IQ in the “high” versus low-fluoride villages.versus low-fluoride villages.

Average IQ lowering was Average IQ lowering was about 7 about 7 IQ pointsIQ points..

Choi et al. 2012Choi et al. 2012The Harvard scientists concluded The Harvard scientists concluded

that further investigation of that further investigation of fluoride’s lowering of IQ should fluoride’s lowering of IQ should be a be a “high research priority”“high research priority”

Promoters claim that the fluoride levels in the Promoters claim that the fluoride levels in the “High Fluoride” villages were so high that they “High Fluoride” villages were so high that they

are not relevant to fluoridation programs?are not relevant to fluoridation programs? THIS IS NOT TRUE. In 8 of the studies the “high fluoride THIS IS NOT TRUE. In 8 of the studies the “high fluoride

village” had concentrations less than 3 ppmvillage” had concentrations less than 3 ppm In one “high fluoride village” the concentration was only 0.88 In one “high fluoride village” the concentration was only 0.88

ppmppm And one study (Xiang et al., 2003 a and b) found a threshold at And one study (Xiang et al., 2003 a and b) found a threshold at

1.9 ppm.1.9 ppm. These studies offer These studies offer no adequate margin of safety no adequate margin of safety to protect to protect

all children drinking uncontrolled amounts of fluoridated waterall children drinking uncontrolled amounts of fluoridated water

Dr. Philippe GrandjeanDr. Philippe Grandjean

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

IQ and populationIQ and population

100

Number of KidsWith a

Specific IQ

IQ

IQ and populationIQ and population

Very BrightMentallyhandicapped

100

Number of KidsWith a

Specific IQ

IQ

IQ and populationIQ and population

95 100

Number of KidsWith a

Specific IQ

IQ

IQ and populationIQ and population

Very BrightMentallyhandicapped

95 100

Number of KidsWith a

Specific IQ

IQ

Other health concernsOther health concerns1)1) First symptoms of fluoride’s poisoning of the bone are identical First symptoms of fluoride’s poisoning of the bone are identical

to arthritis. No investigation in any fluoridated country.to arthritis. No investigation in any fluoridated country.2)2) Li et al (2001).* Doubling of hip fracture at 1.5 ppm?Li et al (2001).* Doubling of hip fracture at 1.5 ppm?3)3) Fluoride used to lower thyroid function in hyperthyroid patients Fluoride used to lower thyroid function in hyperthyroid patients

Galletti and Joyet (1958)*Galletti and Joyet (1958)*4)4) Bachinskii et al (1985) Thyroid function lowered at 2.3 ppm.Bachinskii et al (1985) Thyroid function lowered at 2.3 ppm.5)5) Fluoride accumulates in human pineal gland. Lowers melatonin Fluoride accumulates in human pineal gland. Lowers melatonin

levels in animals and shortens time to puberty (Luke 1997, levels in animals and shortens time to puberty (Luke 1997, 2001*). No attempt to reproduce these findings in any 2001*). No attempt to reproduce these findings in any fluoridated country.fluoridated country.

Supporting documents:Supporting documents:Li et al, 2001*Li et al, 2001*Luke, 2001*Luke, 2001*

Galletti and Joyet, 1958*Galletti and Joyet, 1958*

SummarySummary 1) Most countries don’t fluoridate their water 1) Most countries don’t fluoridate their water

but there is no difference in tooth decay in 12-but there is no difference in tooth decay in 12-year-olds between those that do and those that year-olds between those that do and those that don’t (WHO figures) don’t (WHO figures)

2) Fluoridation is a clumsy form of medicine (you 2) Fluoridation is a clumsy form of medicine (you can’t control the dose or who gets it).can’t control the dose or who gets it).

3) It violates the individual’s right to informed 3) It violates the individual’s right to informed consent to medicineconsent to medicine

SummarySummary 4) The evidence that swallowing fluoride actually 4) The evidence that swallowing fluoride actually

reduces tooth decay is very weak. Warren et al reduces tooth decay is very weak. Warren et al (2009) could find no relationship between the (2009) could find no relationship between the amount of fluoride swallowed by children and amount of fluoride swallowed by children and tooth decay.tooth decay.

5) Even major promoters of fluoridation (e.g. 5) Even major promoters of fluoridation (e.g. CDC) admit that fluoride’s predominant action CDC) admit that fluoride’s predominant action is TOPICAL not SYSTEMIC, i.e. it works on is TOPICAL not SYSTEMIC, i.e. it works on the outside of the tooth not from inside the bodythe outside of the tooth not from inside the body

SummarySummary 6) For those who want fluoride fluoridated toothpaste is 6) For those who want fluoride fluoridated toothpaste is

readily available. readily available. There is no need to swallow it and There is no need to swallow it and there is no need to force there is no need to force it on people that don’t want it.it on people that don’t want it.

7) American kids are being over-exposed to fluoride. 41% 7) American kids are being over-exposed to fluoride. 41% of American children aged 12-15 have some form of dental of American children aged 12-15 have some form of dental fluorosis (CDC, 2010).fluorosis (CDC, 2010).

8) It is reckless to assume – without very careful study – 8) It is reckless to assume – without very careful study – that while fluoride is damaging the growing tooth cells it is that while fluoride is damaging the growing tooth cells it is not harming other tissues in the child’s developing body.not harming other tissues in the child’s developing body.

SummarySummary 9) Nature has given us a very good idea about 9) Nature has given us a very good idea about

how much fluoride the baby should get. The level how much fluoride the baby should get. The level of fluoride in mothers milk is EXTREMELY of fluoride in mothers milk is EXTREMELY LOW : 0.004 ppm (NRC, 2006, p.40)LOW : 0.004 ppm (NRC, 2006, p.40)

10) It is reckless to give a bottle-fed baby about 10) It is reckless to give a bottle-fed baby about 200 times the level of fluoride that nature 200 times the level of fluoride that nature intended.intended.

11) The evidence that fluoride can damage the 11) The evidence that fluoride can damage the developing brain is extensivedeveloping brain is extensive

SummarySummary 9) Nature has given us a very good idea about 9) Nature has given us a very good idea about

how much fluoride the baby should get. The level how much fluoride the baby should get. The level of fluoride in mothers milk is EXTREMELY of fluoride in mothers milk is EXTREMELY LOW : 0.004 ppm (NRC, 2006, p.40)LOW : 0.004 ppm (NRC, 2006, p.40)

10) It is reckless to give a bottle-fed baby about 10) It is reckless to give a bottle-fed baby about 200 times the level of fluoride that nature 200 times the level of fluoride that nature intended.intended.

11) The evidence that fluoride can damage the 11) The evidence that fluoride can damage the developing brain is extensive.developing brain is extensive.

SummarySummary 12) Studies from China indicate that lower IQs are 12) Studies from China indicate that lower IQs are

associated with a) levels of fluoride in water b) level of associated with a) levels of fluoride in water b) level of fluoride in their urine and c) levels of fluoride in their fluoride in their urine and c) levels of fluoride in their plasmaplasma

13) One estimate of the threshold for this effcct (1.9 13) One estimate of the threshold for this effcct (1.9 ppm) offers no adequate margin of safety to protect all ppm) offers no adequate margin of safety to protect all our children from either the range of doses or the our children from either the range of doses or the range of sensitivity expected in a large population.range of sensitivity expected in a large population.

14) A small shift in IQ can have devastating 14) A small shift in IQ can have devastating consequences at the population level. consequences at the population level.

SummarySummary 15) There is no question that given a sufficient dose 15) There is no question that given a sufficient dose

fluoride can harm many human tissues (brain, fluoride can harm many human tissues (brain, bone, teeth, thyroid, kidney etc.) (NRC, 2006).bone, teeth, thyroid, kidney etc.) (NRC, 2006).

16) There is no adequate margin of safety to protect 16) There is no adequate margin of safety to protect all our citizens drinking uncontrolled amounts of all our citizens drinking uncontrolled amounts of fluoridated water and getting fluoride from many fluoridated water and getting fluoride from many other sources.other sources.

17) It is reckless to expose our population in this 17) It is reckless to expose our population in this way, when alternatives are readily available.way, when alternatives are readily available.

SummarySummary 18) It is arrogant in the extreme for the dental lobby 18) It is arrogant in the extreme for the dental lobby

(with little training in toxicology) to be forcing this (with little training in toxicology) to be forcing this practice on individuals who do not want it practice on individuals who do not want it (especially those of low-income who cannot afford (especially those of low-income who cannot afford alternative water supplies).alternative water supplies).

19) It is utterly irresponsible that this practice has 19) It is utterly irresponsible that this practice has gone on for over 65 years a) without approval of the gone on for over 65 years a) without approval of the FDA, b) without a single randomized clinical trial to FDA, b) without a single randomized clinical trial to demonstrate effectiveness and c) with so many demonstrate effectiveness and c) with so many crucial health questions unanswered.crucial health questions unanswered.

SummarySummary 20) It is bad enough when this decision is made 20) It is bad enough when this decision is made

via local referendum but it is even worse when via local referendum but it is even worse when Connecticut forces this practice on the whole Connecticut forces this practice on the whole state.state.

I applaud Senator Markley for taking this I applaud Senator Markley for taking this initiative and hope he will succeed in lifting this initiative and hope he will succeed in lifting this state mandate and go on to make CT the first state mandate and go on to make CT the first state to outlaw this practice completely.state to outlaw this practice completely.

1. Nov 2012, 1. Nov 2012, QueenslandQueensland lifted mandatory requirementlifted mandatory requirement

2. April 2013, 2. April 2013, Israel Israel MOH MOH announces lifting of announces lifting of mandatory requirement in one mandatory requirement in one yearyear

Part 3Part 3Science supporting Science supporting

fluoridation has been fluoridation has been pitifulpitiful

Basic science has not been done. There have been Basic science has not been done. There have been 1) No randomized clinical trials to demonstrate either 1) No randomized clinical trials to demonstrate either

effectiveness or safetyeffectiveness or safety 2) No systematic monitoring of fluoride in urine, blood or bones2) No systematic monitoring of fluoride in urine, blood or bones 3) No investigation of a possible relationship between fluoridation 3) No investigation of a possible relationship between fluoridation

and 1) Arthritis; 2) Hypo-thyroidism; 3) Alzheimer’s disease; 4) and 1) Arthritis; 2) Hypo-thyroidism; 3) Alzheimer’s disease; 4) lowered IQ; 5) behavioral problems in children; 5) earlier onset of lowered IQ; 5) behavioral problems in children; 5) earlier onset of puberty and 6) bone fractures in childrenpuberty and 6) bone fractures in children

The science supporting The science supporting fluoridation has been pitifulfluoridation has been pitiful

The science supporting The science supporting fluoridation has been pitifulfluoridation has been pitiful

5) No attempt to reproduce studies of harm found in 5) No attempt to reproduce studies of harm found in countries with high natural levels of fluoridecountries with high natural levels of fluoride

6) No attempt to use the severity of dental fluorosis as a 6) No attempt to use the severity of dental fluorosis as a biomarker of exposure to fluoride in children to biomarker of exposure to fluoride in children to investigate many childhood problems.investigate many childhood problems.

7) If you don’t look you don’t find!7) If you don’t look you don’t find! 8) But the absence of studies is not the same as absence 8) But the absence of studies is not the same as absence

of harm!of harm!

Dr. Peter CooneyDr. Peter Cooney

Dr. Peter Cooney, the Chief Dental Dr. Peter Cooney, the Chief Dental Officer of Canada, told an audience Officer of Canada, told an audience in Dryden, Ontario (April 1, 2008),in Dryden, Ontario (April 1, 2008),

““I walked down your High Street I walked down your High Street today, and I didn’t see anyone today, and I didn’t see anyone growing horns, and you have been growing horns, and you have been fluoridated for 40 years!”fluoridated for 40 years!”

Supporting documents:Supporting documents:Professor Trevor Sheldon’s letter to Professor Trevor Sheldon’s letter to

the House of Lords on York the House of Lords on York Review*Review*

Also John Doull*Also John Doull*

Fluoridation is a “belief” systemFluoridation is a “belief” system Fluoridation has never been a “science-based” Fluoridation has never been a “science-based”

practice (certainly not good science). practice (certainly not good science). The tactics of promoters reveal this: The tactics of promoters reveal this:

a) they use “endorsements” (i.e. authority) in place of a) they use “endorsements” (i.e. authority) in place of primary scienceprimary science

and and b) they attack the credibility of opponents with many b) they attack the credibility of opponents with many personal attacks.personal attacks.

Such tactics would not be necessary if the primary Such tactics would not be necessary if the primary science was on their side.science was on their side.

EndorsementsEndorsements 1) The first critical endorsement came in 1950 from 1) The first critical endorsement came in 1950 from

the US Public Health Service. This was made the US Public Health Service. This was made before any trial had been completed and before any before any trial had been completed and before any significant health studies had been published. significant health studies had been published.

2) Other endorsements quickly followed, ADA, 2) Other endorsements quickly followed, ADA, APHA, etc.APHA, etc.

3) These endorsements are very effective with the 3) These endorsements are very effective with the general public and busy legislators, but are less general public and busy legislators, but are less impressive to independent researchers.impressive to independent researchers.

Some examples of unprofessional tactics, Some examples of unprofessional tactics, poor science and biased reviewspoor science and biased reviews

1) ADA White paper (1979)1) ADA White paper (1979) 2) CDC (1999)2) CDC (1999) 3) Queensland Health (2007) promotion3) Queensland Health (2007) promotion 4) WHO (2004) used biased panel4) WHO (2004) used biased panel 5) Health Canada (2007) expert panel biased5) Health Canada (2007) expert panel biased 6) NHMRC (Australia) 2007 review very poor6) NHMRC (Australia) 2007 review very poor

ADA White Paper (1979)ADA White Paper (1979)

““Individual dentists must be convinced that Individual dentists must be convinced that they need not be familiar with scientific they need not be familiar with scientific reports and field investigations on reports and field investigations on fluoridation to be effective participants fluoridation to be effective participants and that and that non- participation is overt non- participation is overt neglect of professional responsibilityneglect of professional responsibility.”.”

CDC (1999)*CDC (1999)*

In October 1999, the CDC claimed that In October 1999, the CDC claimed that fluoridation was “one of the great public health fluoridation was “one of the great public health achievements of the 20achievements of the 20thth century.” century.”

But this statement (and all statements on But this statement (and all statements on fluoridation from the CDC) comes from the fluoridation from the CDC) comes from the Oral Health Division – consisting of about 30 – Oral Health Division – consisting of about 30 – largely dentally trained personnel – whose largely dentally trained personnel – whose mission is to promote fluoridation.mission is to promote fluoridation.

CDC (1999)*CDC (1999)*

This claim was based on a report written by two people. This claim was based on a report written by two people. One a dentist who had not published anything on One a dentist who had not published anything on fluoridation before and the other an economist.fluoridation before and the other an economist.

This report was not externally peer-reviewed.This report was not externally peer-reviewed.It was six years out of date on the health studies cited It was six years out of date on the health studies cited

for safety for safety (see marked passage*)(see marked passage*)..The evidence cited to demonstrate effectiveness was The evidence cited to demonstrate effectiveness was

trivial and embarrassing (see Figure 1).trivial and embarrassing (see Figure 1).

CDC MMWR, October 22, 1999

SOURCE: World Health Organization. (Data online)

Queensland Health’s Queensland Health’s promotion of “mandatory” promotion of “mandatory”

statewide fluoridation) statewide fluoridation) (2007)(2007)

Queenslanders were toldQueenslanders were toldFluoridated Townsville hasFluoridated Townsville has65% less tooth decay than65% less tooth decay thanNon-Fluoridated BrisbaneNon-Fluoridated Brisbane

Qld Health “results - Qld Health “results - 65 % less tooth decay65 % less tooth decay””

“ “ In Townsville, water In Townsville, water supplies have been supplies have been fluoridated since 1964, fluoridated since 1964, resulting in 65% less resulting in 65% less tooth decay in tooth decay in children children than those in Brisbane”than those in Brisbane”

“ “ fluoride, which is fluoride, which is proven to be safe proven to be safe and and effectiveeffective ” ”

Qld Health newspaper ads Dec 2007Qld Health newspaper ads Dec 2007

How did they get the 65% less decay ?How did they get the 65% less decay ?

0.26 – 0.09 = 0.26 – 0.09 = 0.17 DMFS0.17 DMFS0.17/0.26 x 100 0.17/0.26 x 100 = 65% = 65%

fewer tooth surfaces decayed fewer tooth surfaces decayedAn absolute saving of 0.17 of An absolute saving of 0.17 of

one tooth surface in 7 year one tooth surface in 7 year olds!olds!

This was an atrocious This was an atrocious example of “cherry picking” example of “cherry picking”

the datathe data

“ Teeth exposed to fluoridated water” Qld Health 2007

“ Teeth exposed to fluoridated water” Qld Health 2007

“ Teeth without exposure to fluoridated water” Qld Health 2007

Does this look like a difference in 0.17 of one tooth surface?

“ Teeth exposed to fluoridated water” Qld Health 2007

“ Teeth without exposure to fluoridated water” Qld Health 2007

Does this look like a difference in 0.17 of one tooth surface?

Or is this fraudulent promotion?

“ Teeth exposed to fluoridated water” Qld Health 2007

“ Teeth without exposure to fluoridated water” Qld Health 2007

WHO (2004)WHO (2004)Fluoride Fluoride M A Lennon, H Whelton, D O'Mullane, J M A Lennon, H Whelton, D O'Mullane, J

Ekstrand.Ekstrand.http://www.who.int/water_sanitation_health/dwq/nutfluoride.pdfMA Lennon, is chairman of the British Fluoridation SocietyMA Lennon, is chairman of the British Fluoridation SocietyH. Whelton and D. O’Mullane are both dental researchers H. Whelton and D. O’Mullane are both dental researchers

from the University of Cork and are both pro-from the University of Cork and are both pro-fluoridation (Ireland has mandatory fluoridation)fluoridation (Ireland has mandatory fluoridation)

Health Canada’s expert panel (2007)Health Canada’s expert panel (2007)

In 2007 Health Canada selected a panel of six In 2007 Health Canada selected a panel of six experts to review the literature of experts to review the literature of fluoridation’s safety and effectivenessfluoridation’s safety and effectiveness

Of the 6 panelists chosen FOUR were dentists Of the 6 panelists chosen FOUR were dentists well-known for their promotion of well-known for their promotion of fluoridation.fluoridation.

The review was a self-fulfilling prophecy.The review was a self-fulfilling prophecy.

The NHMRC (Australia) 2007 reviewThe NHMRC (Australia) 2007 review The panel dismissed the relevance of the The panel dismissed the relevance of the

massive NRC (2006) review (500 pages, massive NRC (2006) review (500 pages, 1100 references) in one sentence.1100 references) in one sentence.

““The NAS report refers to the adverse health The NAS report refers to the adverse health effects from fluoride at 2-4 mg/L, the reader is effects from fluoride at 2-4 mg/L, the reader is alerted to the fact that fluoridation of alerted to the fact that fluoridation of Australia’s drinking water occurs in the range Australia’s drinking water occurs in the range of 0.6 to 1.1 mg/L.” (p.16)of 0.6 to 1.1 mg/L.” (p.16)

Part 4Part 4Better AlternativesBetter Alternatives

Better AlternativesBetter AlternativesIf you want fluoride use fluoridated If you want fluoride use fluoridated

toothpaste (96% toothpaste sold in US is toothpaste (96% toothpaste sold in US is fluoridated) fluoridated)

Better still use XYLITOL toothpaste. Xylitol Better still use XYLITOL toothpaste. Xylitol toothpaste has been used for over 30 years toothpaste has been used for over 30 years in Finlandin Finland

Give Xylitol mints (not chewing gum) to kids Give Xylitol mints (not chewing gum) to kids in school (e.g. Wichita, Kansas). in school (e.g. Wichita, Kansas).

Give free toothbrushes and free toothpaste to Give free toothbrushes and free toothpaste to low-income families (e.g. Scotland)low-income families (e.g. Scotland)

Better AlternativesBetter Alternatives Most of tooth decay is concentrated in low-Most of tooth decay is concentrated in low-

income familiesincome families Most distressing tooth decay is baby bottle Most distressing tooth decay is baby bottle

tooth decaytooth decay Low-income families need better diet and Low-income families need better diet and

better dental educationbetter dental education LESS SUGAR! MORE BRUSHING!LESS SUGAR! MORE BRUSHING! Less sugar means less tooth decay and less Less sugar means less tooth decay and less

OBESITY…less diabetes, fewer heart OBESITY…less diabetes, fewer heart attacks (education = a good investment!)attacks (education = a good investment!)

Modern studies show that Modern studies show that tooth decay does NOT go up tooth decay does NOT go up

when fluoridation stoppedwhen fluoridation stopped

Recent studies indicate that Dental Caries has Recent studies indicate that Dental Caries has not gone upnot gone up after Fluoridation Stoppedafter Fluoridation Stopped

1. 1. Former East GermanyFormer East Germany Kunzel, W. & Fischer, T. (1997).Kunzel, W. & Fischer, T. (1997). Rise and fall Rise and fall of caries prevalence in German towns with different F concentrations in of caries prevalence in German towns with different F concentrations in drinking water.drinking water.

Caries ResCaries Res 31(3): 166-73 31(3): 166-73

2. 2. CubaCuba Kunzel, W. & Fischer, T. (2000).Kunzel, W. & Fischer, T. (2000). Caries prevalence after cessation of Caries prevalence after cessation of water fluoridation in La Salud, Cuba. water fluoridation in La Salud, Cuba. Caries ResCaries Res 34(1): 20-5. 34(1): 20-5.

3. 3. CanadaCanada Maupome, G. Maupome, G. et. alet. al (2001). (2001). Patterns of dental caries following the Patterns of dental caries following the cessation of water fluoridation. cessation of water fluoridation. Community Dent Oral EpidemiolCommunity Dent Oral Epidemiol 29(1): 37- 29(1): 37-47.47.

4. 4. FinlandFinland Seppa, L. Seppa, L. et. al et. al (2000).(2000). Caries trends 1992-98 in two low-fluoride Caries trends 1992-98 in two low-fluoride Finnish towns formerly with and without fluoride. Finnish towns formerly with and without fluoride. Caries ResCaries Res 34(6): 462-8. 34(6): 462-8.

EXTRA SLIDESEXTRA SLIDES

More on IQ studiesMore on IQ studies

RESOURCES

If you have several If you have several weeks to spendweeks to spend

National Research Council (2006)

If you have severalIf you have several days to spend days to spend

Book published by Chelsea Green

October, 2010

Can be ordered on Amazon.com

Contains 80 pages

of references to the

Scientific literature

If you have onlyIf you have onlyhalf an hour to spendhalf an hour to spend

Please watch the Please watch the 29 minute DVD29 minute DVD

“Professional Perspectives“Professional Perspectiveson Fluoridation”on Fluoridation”

Can be viewed ONLINE atCan be viewed ONLINE atwww.Fluoridewww.FluorideALERTALERT.org.org

If you have onlyIf you have only20 minutes to spend20 minutes to spend

Please watch the Please watch the 20 minute DVD20 minute DVD

“TEN FACTS on FLUORIDE”“TEN FACTS on FLUORIDE”PLUS BOOKLET PLUS BOOKLET

atatwww.Fluoridewww.FluorideALERTALERT.org.org

Fluoridation violates Fluoridation violates the Precautionary Principle the Precautionary Principle

If PP doesn’t apply to fluoridation If PP doesn’t apply to fluoridation then you might as well get rid of it!then you might as well get rid of it!

See Chapter 21 in See Chapter 21 in The Case Against The Case Against FluorideFluoride

Precautionary Principle: Criteria for application.Precautionary Principle: Criteria for application.

1. Is there published evidence of harm? 1. Is there published evidence of harm? YES – 36 IQ studiesYES – 36 IQ studies2. Is this effect serious? 2. Is this effect serious? YESYES3. Is the benefit being pursued very significant?3. Is the benefit being pursued very significant? NO. A fraction of one permanent tooth NO. A fraction of one permanent tooth

surface saved ?surface saved ?4. Are there alternative cost-effective solutions 4. Are there alternative cost-effective solutions

available?available? YES. Fluoridated toothpaste. XylitolYES. Fluoridated toothpaste. Xylitol