Fluoride Action Network

The third pillar of fluoridation promotion falls

FAN Bulletin | December 17, 2014

Dear Supporter:

The frequent claim by proponents of fluoridation that for every $ spent on fluoridation saves $38 in dental costs has just been demolished in a comprehensively documented review article by Lee Ko and Kathleen Thiessen.  Before we get to the details here is an update on our annual fundraiser.

Fundraiser update

Yesterday our fundraising efforts slowed down considerably and we are not sure why. We received 12 donations totaling $1055, but with Dr. Mercola’s doubling that added another $2110 to our total. Thus, as of Dec 16, we have raised $53,026 from 280 donors.

Thus we have reached a third of the way to our goal of $150,000 from 1,000 donors by midnight December 31 and half way to our goal of $100,000 by Christmas Eve.

By any other standards this is a lot of money, but in this case it is a very small fraction of what the other side is spending to bamboozle the public on this issue. For example, the ADA is planning to spend $500,000 just to raise the pro-fluoridation profile on social media and the CDC is planning to spend $31 million of tax-payers’ money over the next 5 years promoting this practice at the state level.

Remember, the ADA and the CDC have the money to do this but what they don’t have is the ability to reach people interested in honest science like we do. So the money we raise goes much further – but we still have to raise it and we have a long way to go to reach our goals. Will you help? Large or small every dollar raised will help. Thank you very much for the 280 supporters who have donated so far.

Don’t forget that every donation is doubled until we reach $86,000.

To make a tax-deductible donation you can either:

  • Or by check – please make checks payable to Fluoride Action Network and send to: FAN, 104 Walnut Street, Binghamton NY 13905

You can also choose one of the several premiums available at different donation levels.

The third pillar of fluoridation promotion falls

In his wonderful book, Small Is Beautiful: Economics as if People Mattered (Harper & Row, 1975) the late E.F. Schumacher wrote,

Call a thing immoral or ugly, soul-destroying or a degradation to man, a peril to the peace of the world or to the well-being of future generations: as long as you have not shown it to be “uneconomic” you have not really questioned its right to exist, grow, and prosper

So even while the mantra of fluoridation’s so-called “safety and effectiveness” has been exposed for what it is (see our book The Case Against Fluoride, Chelsea Green, 2010), many die-hard fluoridation promoters have clung to the notion that fluoridation was cost-effective. However, in a recent review article Dr. Kathleen Thiessen and her co-author Lee Ko, have demolished this third pillar of pro-fluoridation propaganda.

In a meticulously documented review (“A critique of recent economic evaluations of community water fluoridation”) recently published in the International Journal of Occupational and Environmental Health, Ko and Thiessen explained that the frequently cited claim that $38 is saved for every dollar spent on fluoridation is based on faulty assumptions. This claim from Susan Griffin (an economist working for the CDC) has been cited ad nauseam by state health officials and other promoters of fluoridation around the world.

Ko and Thiessen’s paper is thorough and accessible. The multiple tables presented for their calculations are a mathematicians delight. As you will find out, there are many, many quotable parts of this paper. Here are some:

In 2010, amid a budget crisis, the City of Sacramento, CA, instructed all departments to review programs and services. Mr. Marty Hanneman, then Director of the Department of Utilities, wrote in a memo to the City Council (18):

The City of Sacramento has been fluoridating its water supplies just over 10 years. Within that time, the actual cost of operating and maintaining the fluoridation systems has proven to be considerably more than the initial estimate. … The fluoridation infrastructure at the E.A. Fairbairn Water Treatment Plant is overdue for replacement and will be very expensive to replace. … Fluoridating water is a very costly and labor intensive process and requires constant monitoring of fluoride concentrations to ensure proper dosages. … The chemical is very corrosive, so all equipment that is used in the fluoridation process has a very short life expectancy and needs to be replaced frequently. … but also causes frequent and complex system failures.

This was echoed by Mr. Rene Fonseca of Carroll-Boone Water District in Eureka Springs, AR, which was required by a 2011 State mandate to begin CWF [community water fluoridation] (Fonseca, 2012, private communication):

All of our chemical feed systems require regular maintenance which is routine but fluoride feed equipment often requires replacement and more frequent attention. … I have toured plants and seen in trade publications deteriorating pipes, steel doors and casing, electrical components, etc. There are millions of dollars spent yearly on infrastructure damage caused by fluoride in our industry.

… Community water fluoridation proponents have a poor track record for cost estimates. For example, the county health board of Davis County, UT, provided a cost estimate of $1.38–$2 PPPY [per person per year] prior to a vote in 2000, but the true implementation cost was $4.29 PPPY (42).

This is also seen in the estimates/observed figures for the two Utah systems in Table 4. In 2001, Arkansas state legislators passed a state mandate to fluoridate community drinking water. They were partially motivated by an offer from Delta Dental of Arkansas to donate $500,000 total toward startup costs for the 32 water systems affected (42).

Later Delta Dental pledged $2 million for 34 systems and soon found itself needing to raise another $6–$10 million (43). (State mandates in California and Arkansas both require the initial implementation costs be funded by outside sources.)


For decades, the U.S. federal and state governments have promoted CWF to improve dental health of residents at low costs. Yet, in spite of the presumed savings in dental costs to Americans due to widespread use of CWF, employment of dentists is projected to grow by 16% between 2012 and 2022 (vs. 11% for all occupations) (122), and cosmetic dentistry in the U.S. has grown to be a multi-billion dollar industry (123).

We have shown that the promise of reduced dental costs was based on flawed analyses. In particular, the primary cost-benefit analysis used to support CWF in the U.S. assumes negligible adverse effects from CWF and omits the costs of treating dental fluorosis, of accidents and overfeeds, of occupational exposures to fluoride, of promoting CWF, and of avoiding fluoridated water. In assessing the benefits, it ignores important large data sets and assumes benefits to adults that are unsupported by data. Thus this analysis, as well as other economic analyses of CWF (Appendix 2), falls short of reasonable expectations for a cost-benefit analysis from a societal perspective. Minimal correction of methodological problems in this primary analysis of CWF gives results showing substantially lower benefits than typically claimed. Accounting for the expense of treating dental fluorosis eliminates any remaining benefit.
-See references below

So the science is in on this inaccurate – but widely cited claim –but how many people will hear about it? This is just another reason to help support FAN’s education efforts.

Paul Connett, PhD
Executive Director of FAN,
co-author, The Case Against Fluoride (Chelsea Green, 2010)



18. Hanneman M. Memo to the Mayor and the City Council of Sacramento regarding fluoridation of the city’s water supply. 2010 [cited 2013 Aug. 11]; Available from: http://fluoridefree sacramento.org/html/budget_for.htm

42. Crozier S. Arkansas success. State passes fluoridation law; coalition credited with victory, ADA News. 2011 [cited 2013 Aug 8]; Available from: http://www.ada.org/news/5572.aspx [link doesn’t work. This article is cited here, http://www.astdd.org/docs/02-ada-fl-toolkit.pdf ]

43. KHBS. Arkansas Foundation trying to trim fluoridation costs. KHBS-TV. 2012. [cited 2013 Aug 11]; Available from: http://www.4029tv.com/Ark-Foundation-Trying-To-Trim-Fluoridation-Costs/-/8898190/14699548/-/ryhaqx/-/index.html

122. Dentists. Job Outlook. 2014 [cited 2014 Aug 5]; Available from: http://www.bls.gov/ooh/healthcare/dentists.htm#tab-6

123. American Association of Cosmetic Dentistry. Cosmetic Dentistry Continues to Surge – Market Estimated at $2.75 Billion. 2007 [cited 2013 Aug 8]; Available from: http://www.aacd.com/index.php?module=cms&page=723

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