Moderate to Severe Dental Fluorosis
Excessive ingestion of fluoride during the early childhood years may result in a disorder of the enamel known as dental fluorosis. In its "moderate" and severe forms, fluoride causes a marked increase in the porosity of the enamel.
After eruption into mouth, the porous enamel of moderate to severe fluorosis readily takes up stain, creating permanent brown and black discolorations of the teeth.
In addition to extensive staining, teeth with moderate to severe fluorosis are more prone to attrition and wear - leading to pitting, chipping, and decay.
As a result of the staining and crumbling of enamel, children with moderate to severe dental fluorosis can suffer a great deal of social embarrassment and pyschological stress - with a corresponding loss in self-esteem.
Recent studies in the United States have found that some cases of moderate to severe dental fluorosis can now be found in fluoridated (1 ppm) and, even, unfluoridated areas.
However, despite the obvious impact on tooth quality - and the evidence showing that teeth are not the only affected tissue - the US Environmental Protection still classifies severe dental fluorosis as a "cosmetic" effect. As a result, the federal government is not required by law to protect people from developing this condition.
EPA readily acknowledges that between 30 and 40% of children drinking water with 4 ppm fluoride (the EPA's current Maximum Contaminant Level) will develop moderate to severe fluorosis.
For over 50 years US government officials have confidently and enthusiastically claimed that fluoridation is "safe and effective". However, they are seldom prepared to defend the practice in open public debate. Actually, there are so many arguments against fluoridation that it can get overwhelming.
To simplify things it helps to separate the ethical from the scientific arguments.
Severe FluorosisPhoto by David Kennedy, DDS
Severe FluorosisPhoto by David Kennedy, DDS
Severe FluorosisPhoto by David Kennedy, DDS
Severe FluorosisPhoto by David Kennedy, DDS
For those for whom ethical concerns are paramount, the issue of fluoridation is very simple to resolve. It is simply not ethical; we simply shouldn't be forcing medication on people without their "informed consent". The bad news is that ethical arguments are not very influential in Washington, DC unless politicians are very conscious of millions of people watching them. The good news is that the ethical arguments are buttressed by solid common sense arguments and scientific studies which convincingly show that fluoridation is neither "safe and effective" nor necessary. I have summarized the arguments in several categories:
As stated by the recent recipient of the Nobel Prize for Medicine (2000), Dr. Arvid Carlsson:
Severe FluorosisPhoto by David Kennedy, DDS
Severe FluorosisPhoto by David Kennedy, DDS
"I am quite convinced that water fluoridation, in a not-too-distant future, will be consigned to medical history...Water fluoridation goes against leading principles of pharmacotherapy, which is progressing from a stereotyped medication - of the type 1 tablet 3 times a day - to a much more individualized therapy as regards both dosage and selection of drugs. The addition of drugs to the drinking water means exactly the opposite of an individualized therapy."
As stated by Dr. Peter Mansfield, a physician from the UK and advisory board member of the recent government review of fluoridation (McDonagh et al 2000):
"No physician in his right senses would prescribe for a person he has never met, whose medical history he does not know, a substance which is intended to create bodily change, with the advice: 'Take as much as you like, but you will take it for the rest of your life because some children suffer from tooth decay. ' It is a preposterous notion."
