Fluoride Action Network

Pew’s promotion of water fluoridation undermines science and the democratic process

Source: Fluoride Action Network press release | November 21st, 2011

Current science indicates that water fluoridation is not only ineffective at reducing tooth decay, but is also harmful to health. Despite this knowledge, The Pew Charitable Trusts continues to promote fluoridation by using inaccurate information, and by lobbying legislators to conceal vital information on fluoride‘s adverse effects, reports The Fluoride Action Network (FAN).

Pew Using Propaganda Instead of Science

Pew has alleged that those opposing water fluoridation are misrepresenting the research (1). FAN Executive Director Paul Connett, Ph.D., strongly disagrees with this claim. Connett points out that current scientific research reveals certain groups are at an elevated risk for adverse effects from fluoridated water—including babies, kidney patients, and above average water consumers (2). According to the National Research Council’s landmark review, Fluoride in Drinking Water, “Fluoride is an endocrine disruptor” (2), with altered thyroid function observed at fluoride levels commonly consumed by many Americans on a daily basis. Additionally, African Americans and Mexican Americans are more likely to suffer more often, and from the more severe forms of dental fluorosis—a discoloration of the teeth indicating fluoride overexposure during childhood—than are Caucasians (3), making fluoridation an Environmental Justice issue.

Pew Children’s Dental Campaign Director Shelly Gehshan recently accused fluoridation opponents of trying to “raise fears about fluoridation’s safety by citing foreign studies of fluoride levels that were at least two or three times higher than the level used to fluoridate U.S. public water systems” (1). According to Dr. Connett, “The foreign studies Gehshan alludes to are likely the 25 studies linking fluoride to reduced IQ. Several of these studies were not high dose studies. For example, Ding et al. (4) found a lowering of IQ in children drinking water with 0.3 to 3 ppm fluoride. This covers the range of that used in the U.S. fluoridation program (0.7-1.2 ppm). The threshold level in the Xiang et al. study (5a,5b) was 1.9 ppm. Clearly there is no margin of safety for this very serious end point.”

Dr. Connett continues, “Furthermore, by claiming that there is no problem with fluoridation simply because the concentrations of fluoride found to cause harm in some published studies were higher than used in artificial fluoridation, indicates that Ms. Gehshan has no understanding of toxicology. There is an important difference between concentration and dose. For example, someone drinking two liters of water at 1 ppm would get more fluoride than someone drinking one liter of water at 1.9 ppm. Moreover, when extrapolating from a study that finds harm in a small group, a margin of safety (usually a safety factor of 10) must be applied to account for the large range in sensitivity expected for any toxic substance, and thus to more adequately protect everyone in a larger population.”

Another issue of concern is that, immediately following publication of a study by Kim et al. (6) that found no association between bone fluoride levels and osteosarcoma (a frequently fatal form of bone cancer), Pew issued talking points (7,8) aimed at promoting this study while discrediting an earlier Harvard study by Bassin et al. (9). Pew’s misleading talking points inaccurately stated that the Kim et al. study had successfully refuted the study by Bassin and colleagues, which had found that boys exposed to fluoridated water in their 6th-8th years had a 5-7 fold increased incidence of osteosarcoma.

Dr. Connett says, “The study by Kim et al. had been promised for five years by Chester Douglass, Bassin’s thesis adviser at Harvard (10). When it finally appeared, it proved to be a very poorly designed study, and failed miserably to refute Bassin’s findings. Bone fluoride levels measured at diagnosis or autopsy give no indication of the fluoride exposure during the critical period, as found by Bassin. It’s incredible that Pew should stoop to what amounts to outright propaganda. It is also revealing that the Kim et al. study was not published in the journal where Bassin published her article (Cancer Causes and Control)—or in any other cancer or medical journal—but rather in a dental journal (Journal of Dental Research).

Pew Undermining the Democratic Process

At the top of their homepage, Pew states that the organization “applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life” (11). However, instead of stimulating civic life, Pew has dampened it by paying for lobbyists (12) to convince Arkansas legislators—behind closed doors and without citizen input—to quickly pass a statewide mandatory fluoridation law, over-riding citizen referenda in many Arkansas cities that had rejected fluoridation on several occasions.

Mixing infant formula with fluoridated water puts babies at unnecessary risk of developing discolored or pitted teeth (dental fluorosis), without any proven benefit. This is acknowledged by federal government agencies, health departments and organized dentistry (e.g. 13-15). Despite this, Pew recently urged the Austin City Council to conceal this information from water customers, and to ignore science-based requests from Austin residents to put such warnings on water bills (16). “Pew has decided that protecting fluoridation is more important that protecting babies,” says Dr. Connett.

A Positive Path Forward

Pew claims that the foundation uses expertise “valued for its nonpartisan balance and grounding in sound science.” FAN therefore challenges Pew to hire a team of independent experts in toxicology and epidemiology to carefully review the book “The Case Against Fluoride” (17), and respond in kind to all of the carefully documented and referenced arguments therein. If Pew is indeed grounded in “sound science,” we believe the results of this honest inquiry will lead Pew to abandon its relentless promotion of artificial fluoridation.


1. The Pew Charitable Trusts. 2011. Pew applauds California vote to fluoridate, urges policy makers to be guided by sound science. News Release. November 15. http://www.prnewswire.com/news-releases/pew-applauds-california-vote-to-fluoridate-urges-policy-makers-to-be-guided-by-sound-science-133911828.html

2. National Research Council. 2006. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. http://www.nap.edu/openbook.php?record_id=11571

3. Beltran-Aguilar ED, Barker LK, Canto MT, et al. 2005. Surveillance for dental caries, dental sealants, tooth retention, endentulism, and enamel fluorosis—United States, 1988- 1994 and 1999-2002. CDC, MMWR, Surveillance Summaries, August 26, 2005, vol. 54, No SS-3, pp. 1-44. See Table 23 online at http://www.fluoridealert.org/table23.html

4. Ding Y, Gao Y, Sun H, Han H, Wang W, Ji X, Liu X, Sun D. 2010. The relationships between low levels of urine fluoride on children’s intelligence, dental fluorosis in ?endemic fluorosis areas in Hulunbuir, Inner Mongolia, China. Journal of Hazardous Materials doi:10.1016/j.jhazmat.2010.12.097.

5a. Xiang Q, Liang Y, Chen L, Wang C, Chen B, Chen X, Zhou M. 2003a. Effect of fluoride in drinking water on children’s intelligence. Fluoride 36(2):84-94. Full study at http://www.fluoridealert.org/scher/xiang-2003a.pdf

5b. Xiang Q, Zhou M, Zang H. 2003b. Blood lead of children in Wamiao-Xinhuai intelligence study. Fluoride 36(3):198-199. Full study at http://www.fluoridealert.org/scher/xiang-2003b.pdf

6. Kim FM, Hayes C, Williams PL, Whitford GM, Joshipura KJ, Hoover RN, Douglass CW. 2011. An assessment of bone fluoride and osteosarcoma. Journal of Dental Research 90(10):1171-6.

7. Kincade K. 2011. Study finds no link between fluoride and osteosarcoma. DrBicuspid.com. July 28. Shelly Gehshan, Director of Pew Children’s Dental Campaign: “I would say that this [Kim et al., 2011] study can put peoples’ fears to rest because it shows no correlation between fluoride and osteosarcoma. In 2006, the National Research Council said that if fluoride might be linked to cancer, osteosarcoma would be the most plausible form of cancer. But now that’s been ruled out. We can now say that fluoride does not cause any kind of cancer.” http://www.drbicuspid.com/index.aspx?sec=sup&sub=orc&pag=dis&ItemID=308238

8. American Water Works Association. 2011. Suggested Talking Points for the Harvard-Douglass Study from the Pew Center on the States. August 1. http://www.awwa.org/files/GovtPublicAffairs/AdvisoriesAlerts/080111FluorideBoneCancer.pdf

9. Bassin EB, Wypij D, Davis RB, Mittleman MA. 2006. Age-specific fluoride exposure in drinking water and osteosarcoma (United States). Cancer Causes Control 17(4):421-8.

10. Douglass CW, Joshipura K. 2006. Caution needed in fluoride and osteosarcoma study (Comment). Cancer Causes Control 17(4):481-2.

11. The Pew Charitable Trusts. http://www.pewtrusts.org/

12. Nathe C. 2011. Water fluoridation in Arkansas. RDH 31 (7). http://www.rdhmag.com/index/display/article-display/3187095135/articles/rdh/volume-31/issue-7/columns/water-fluoridation-in-arkansas.html

13. CDC (U.S. Centers for Disease Control and Prevention). 2011. Overview: Infant formula and fluorosis. http://www.cdc.gov/FLUORIDATION/safety/infant_formula.htm – 1

14. Mayo Clinic. 2010. Infant formula: 7 steps to prepare it safely. http://www.mayoclinic.com/health/infant-formula/MY00193/NSECTIONGROUP=2

15. Delta Dental. 2010. Fluoride in infant formulas. http://oralhealth.deltadental.com/Children/Infant/22,DD63

16. Doggett, Libby. 2011. Email to PHHSC Committee Chair Martinez. 12 October. Available at http://fluoridefreeaustin.com/handouts.html

17. Connett P, Beck J, Micklem HS. 2010. The Case Against Fluoride: How Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep It There. Chelsea Green: White River Junction, VT. 372 Pp.