By Bill Osmunson DDS MPH, February 26, 2025
Freedom, Science, and Jurisdictional Authorities
I am a comprehensive cosmetic dentist with a master’s degree in public health. I retired after 46 years of clinical practice and teaching. For the first 25 years, I promoted fluoridation. Then, I read both sides of the science, laws, and ethics and became opposed to Community Water Fluoridation (CWF), the addition of fluoride to tap water.
Freedom of choice is fundamental and ethical, especially for a disease that is not considered highly contagious or highly lethal. Almost everyone soon after birth has the bacteria contributing to dental caries. The bacteria also need a receptive host who lacks proper hygiene and frequently eats significant amounts of sugar and refined foods.
Fluoridation is not like a vaccine intended to gain herd immunity. Public health authorities use their “police powers” to medicate each individual without the patient’s consent, individual dosage control, doctor’s prescription and oversight, Food and Drug Administration (FDA CDER NDA) approval, or pharmaceutical-grade product manufactured according to Good Manufacturing Practices for Pharmaceuticals, quality research or safety studies. Individual freedom must be protected.
The FD&C Act charges the Food and Drug Administration to regulate substances intended to treat people.
The Environmental Protection Agency (EPA) regulates substances intended to treat water.
Over the last 20 years, a great deal of science has been published and many more have spoken up against fluoridation. This is a current outline and not definitive.
Please contact me for references, bill@teachingsmiles.com
The Fetus and Infants
1. Harm to the fetus and infants from the addition of fluoride to tap water is my biggest concern. Just 0.006 ppm fluoride increase to the fetus from mother’s blood and harms the development of the fetal brain. The fetal brain appears to be ultra-sensitive to toxins, such as fluoride.
2. Infants on formula made with fluoridated water receive 175 times more fluoride than mother’s milk. The higher dosage is similar to an adult drinking a toxic concentration of water at 125 ppm fluoride. (Fluoridation is 0.7 ppm)
Freedom of Consent is violated.
3. Freedom is fundamental. Dental caries is not considered a highly contagious nor highly lethal disease. We all have opportunistic bacteria soon after birth. Fluoridation does not prevent the spread of the bacteria. The intent of fluoridation is to treat each person.
No Significant Benefit from Fluoridation
4. Only one Randomized Controlled Trial (1997) of fluoride ingestion’s alleged benefit has been published and it did not report statistical benefit. No high-quality research over 80 years has reported benefit of caries reduction from fluoride ingestion. Observational studies lack control for unknowns and have numerous problems. Without high-quality research demonstrating significant benefit and with known risks, using police powers to force treatment is unethical.
5. The Cochrane (2024) Meta-Analysis, included 157 studies since 1975, all non-randomized trials and all observational. The study reported a 3% to 4% possible benefit or no benefit. Studies had higher risk of bias: imprecision, inconsistency, confounding factors, lack of blinding (which can have a 22% to 68% effect size), and older evidence. No evidence of fluoridation’s effect for the poor. Cessation had very-low certainty of evidence. The alleged ‘benefit’ of fluoridation can be explained away by biased un-blinded examiners. Add confounders such as diet, genetics, environment, oral hygiene, and much more, provides observational data without the weight of confidence needed to determine benefit. The FDA warns the evidence is incomplete.
6. The LOTUS (2024) study of 6.4 million people in the UK, largest study ever done, reported a 2% possible benefit and no meaningful benefit for the poor.
7. The CATFISH study (2022) reported a 4% benefit for younger children and no benefit for the poor.
8. The Iowa (2018) NIH funded study reported no significant correlation of fluoridation and caries.
9. The National Health and Nutrition Evaluation Survey reported 60-70% of children ingest too much fluoride as measured with dental fluorosis, a biomarker of too much fluoride.
Do Not Swallow. Fluoridation is Not Safe
10. The National Research Council in 2006, reported risk from fluoride to teeth, skeleton, arthritis, chondrocyte metabolism, reproductive and developmental effects, neurotoxicity, neurobehavioral effects, endocrine system, thyroid, (Diabetes, Obesity) gastrointestinal, renal, hepatic, and immune systems, genotoxicity, and carcinogenicity. Research in the last 19 years has supported the NRC’s concerns on each of those risks and added more detail, confidence, and weight of evidence and added further risks of harm. Synergistic effects and a margin of safety for variation in the amount of water consumed each day, chemical sensitivities, allergies, and genetics must be included.
11. The FDA Warns, “Do Not Swallow” on the toothpaste label, referring to a 0.25 mg of fluoride, the same dose as an 11 oz glass of fluoridated water.
12.T he National Research Council (2006) reported caries benefit is topical.
13. CDC MMWR confirmed that benefit is “post-eruptive and topical,” not swallowed.
14. The Federal Court (2024) under the Toxic Substance Control Act determined that 1 liter/day of fluoridated water is an “Unreasonable Risk.”
15. The Florida Surgeon General warns, fluoridation is “Public Health Malpractice.”
16. The EPA Scientists through their Union, warned fluoridation “Boarders on Criminal Act” and the Safe Drinking Water Act prohibits the addition of anything to treat disease in humans.
17. The Washington State Board of Pharmacy determined fluoride is a “Legend Drug,” which requires a doctor’s prescription. The Idaho State Board of Pharmacy determined fluoride is a drug. The FDA testified to Congress, fluoride is a drug.
18. The Washington State Board of Health was warned by the FDA that if FDA approval was requested, fluoridation would be banned.
19. The FDA has warned that unapproved drugs are Illegal drugs
20. The Utah State Legislature (2025) banned fluoridation.
21. The U.S. National Toxicology Program reported with moderate confidence that fluoride lowers IQ at 1.5 mg/L in water, the same dose as 2 liters of fluoridated water and 10% of the public drinks 2 liters or more, some over 10 liters/day.
22. FDA, EPA, CDC & 3 of the largest raw product fluoride manufacturers under oath did not have a single safety study on fluoride for the developing brain. China does not fluoridate their water and sends some of their fluoride industrial waste product to the USA for us to drink.
23. “Endorsements” by well-meaning people or agencies do not have the scientific weight of regulatory agencies such as the Food and Drug Administration. For example, the American Dental Association endorses fluoridation; however, in court, the ADA testified that they had no duty to protect the public from harm. In contrast, the duty of regulatory agencies is to protect the public. The regulatory agencies in Austria, Belgium, Denmark, Norway, Netherlands, and Japan have rejected fluoridation. The regulatory agencies in Finland, Germany, and Hungary have suspended fluoridation. The regulatory authorities in Sweden and China have banned fluoridation. Israel suspended fluoridation.
24. The dosage for benefit is “Unknown.” We don’t know how much fluoride is needed to prevent dental caries, if any. Fluoride can not migrate through the tooth from the pulp to where the caries are forming on the outside of the tooth. Dental caries is not the result of an inadequate intake of fluoride. For example, scurvy is the result of inadequate vitamin C. Fluoride compounds added to water are EPA contaminants and do not meet the criteria of nutrients or minerals. Fluoridation is not cost-effective if damage just to the teeth are included.
25. Secretary Kennedy at HHS and Commissioner of the FDA Marty Makary MD, are opposed to adding fluoride to public water in part because chronic diseases appear to probably be related to the total toxic burden we are exposed to.
26. No Margin of Safety has been provided by the EPA or fluoridation lobby.
27. A person wanting to ingest fluoride can get a prescription from their doctor or disregard the FDA and swallow a tiny pea-sized amount of toothpaste.
28. Why did I support fluoridation? I failed to read the research for myself on both sides of the controversy. In dental school I was taught fluoridation was effective. In practice I saw patients with good dental health and some with poor dental health and assumed the difference was fluoridated water. The science convinced me I was wrong. Today, there is no reason, other than pride, saving face and failure to read and understand the science, for my professions of dentistry and public health to continue to support fluoridation.
29. When the cost to treat both cosmetic and functional dental fluorosis and lower wages from IQ loss are included in a” cost-benefit-risk analysis,” fluoridation is a net loss of over $550 per person per year.
30. We must require a higher level of scientific evidence in public health for both benefit and safety when individual freedom of choice is violated and public health’s police powers are used.
Sincerely, Bill Osmunson DDS MPH, bill@teachingsmiles.com