Editor’s note: This commentary is by Jack Crowther, of Rutland, who is retired. He worked as a journalist and in corporate communications. Graphs 1-3 and 5 are from the Fluoride Action Network website; Graph 4 is from the CDC website.
Proponents of community water fluoridation use a kind of mantra, “safe and effective, safe and effective,” to convince the public that there is little to debate on the subject. They, meaning especially the dental profession and public health bureaucracy, act as if the science of fluoridation has been settled.
Unfortunately and surprisingly, for the 200 million Americans on fluoridated water and a lesser number elsewhere in the world, the claim of safety and effectiveness remains unproven to this day. This is especially unfortunate because fluoridation is mass medication administered without informed consent. (The U.S. Food and Drug Administration considers fluoride a drug when used in the treatment of disease, tooth decay being a disease.)
Regardless of the other objections to fluoridation, if it’s not effective, why do it? The graphs that follow are only part of the evidence showing fluoridation’s effectiveness is in doubt.
Here are five graphs. Together they strongly suggest that something other than fluoridation is responsible for the decline in tooth decay in developed countries. Better nutrition, better oral health habits and dental care, and fluoride toothpaste are among the possibilities. We need to admit the likelihood that, on the question of effectiveness alone, fluoridation is neither necessary nor desirable.
These three graphs were prepared by the Fluoride Action Network, the leader in the campaign against fluoridation. The graphs are based on data from the World Health Organization. Since WHO supports fluoridation, there is no reason to suspect the data.
The graphs show the change in the numbers of damaged, missing and filled teeth (DMFT) in countries with no fluoridation of either water or salt (top graph); in countries that fluoridate most of their water (middle graph); and in countries with some water or salt fluoridation (bottom graph). Notably, the graphs all show similar rates of decline in tooth decay, regardless of fluoride in the water.
Graph 4 was presented by the Centers for Disease Control and Prevention in 1999 when it made the claim that fluoridation was “one of 10 great public health achievements of the 20th century.” The statement appeared in the CDC’s own publication without benefit of scientific peer review. Yet it is today treated not as a self-congratulatory pat on the back (the CDC being a leading promoter of fluoridation) but as a fact beyond questioning.
Graph 4 shows that, yes, the rate of decayed, missing and filled teeth declined as fluoridation increased. Does that prove fluoridation was the cause? No, association does not prove cause and effect, as discussed above. In fact, Graph 4 raises the following question: Why did the rate of tooth decay continue to decline sharply as the prevalence of fluoridation leveled off?
This graph comes from the work of the late Dr. John Colquhoun, a dentist in New Zealand who went from being a leading proponent of fluoridation to a forceful opponent. He switched sides when his own research showed fluoridation was not the benefit he had thought it was and caused the harmful side effect of dental fluorosis.
Colquhoun (pronounced kuh-hoon), went on an international study tour in 1980 to verify the benefits of fluoridation. Instead he found that studies in the countries he visited showed decay in non-fluoridated areas to be like that in fluoridated locations. He returned only to find that New Zealand data collected in his absence reinforced the evidence from other countries: There was similar, or even less, decay in non-fluoridated areas as in fluoridated areas.
Confronted by the evidence, Colquhoun admitted the mistake at the heart of the fluoridation program and became a dedicated opponent. This put him at odds with the New Zealand dental health bureaucracy which had by then signed on to the fluoride bandwagon. For the remainder of his life, Colquhoun sought to end fluoridation, a program he had helped create.
The New Zealand graph, like Graph 4, shows that the number of decayed teeth continued to decline even after the level of fluoridation stabilized. An interesting line in Colquhoun’s graph is the purple one showing the increase in the use of fluoridated toothpaste. As mentioned above, fluoride toothpaste, diet, better oral health habits, and improved dental care are plausible explanations for the continuing decline in tooth decay, with and without fluoridation.
An interview with Dr. Colquhoun, well worth watching, can be found at: https://youtu.be/e8th-Bbb0LQ.