Florida Surgeon General, Dr. Joseph Ladapo, joined by Dr. Ashley Malin and Dr. Claire Stagg, spoke in Winter Haven, FL on Nov 22, 20224, advising that all communities statewide stop adding fluoride to drinking water.
Highlight: Water Fluoridation Is “Public Health Malpractice” – Florida Surgeon General
“It is public health malpractice and so we are issuing guidance to every community, every municipality, every county in Florida to stop adding fluoride to their community water systems. And I will tell you that the data that we have, the studies that we have, primarily are focused on pregnant women and children, thoseare clearly the most sensitive and vulnerable populations for fluoridation in terms of these adverse neuropsychiatric effects. But I personally, in my family, we’ve pulled back in terms of sources of fluoride because we’re concerned about the effects in adults also.” – Dr. Joseph Ladapo
Highlight: Safe Exposure Level For Fluoride In Drinking Water Is 0.15ppm Or Lower – Dr. Ashley Malin
“In September a federal judge in San Francisco made a ruling in the fluoride trial against the EPA that stated that fluoride and drinking water at the current recommended level of .7 milligrams per liter poses an unreasonable risk of hazard to child IQ because there is not enough of a margin of safety between the hazard level and the exposure level that is added to community drinking water. The ruling stated that the EPA’s default is for there to be factor of 10 between the hazard level and exposure level due to variability in human sensitivities. Based on the NTP’s report, the hazard to child IQ exists at 1.5 milligrams per liter. Therefore according to the EPA standard, the exposure level for fluoride in community drinking water would need to be set at 0.15 milligrams per liter or lower to create enough of a margin of safety to protect child IQ.” – Dr. Ashley Malin
Full Video: Florida Surgeon General Dr. Joseph Ladapo’s News Conference On Fluoride In Water
A transcript of the video can be found below.
Dr. Joseph Ladapo
Good morning, thank you very much for joining us here this morning. I’m Dr. Joe Ladapo, the Surgeon General of Florida, and I am joined today by Dr. Ashley Malin who is a professor at the University of Florida, and Dr Claire Stagg who is a dentist. So thank you again for joining us today.
I’d like to thank the Fairfax water treatment plant for hosting us. Water fluoridation has been in the news a lot lately and it started probably a few months ago when a judge ruled that the EPA needed to make some additional rules about safety regarding water fluoridation systems and the policies that communities in the United States follow related to water fluoridation. In the United States and in Florida, somewhere around 75 or 80% of Floridians are in communities that have water fluoridation.
As a medical physician I actually have historically supported this practice. It’s something that we’ve learned in medical school is a public health measure that, you know, is helpful and is something that as a physician we should support.
The ruling several months ago prompted me and other people to look more closely at the issue. And that ruling was based on a report that the National Toxicology Program assembled, they started actually working on it years ago reviewing data and studies of harms and benefits associated with water fluoridation and increased levels of fluoride in water. And as I started both reading this report and reading the actual studies that the report was was based on, I was appalled frankly, to be completely frank with you.
While there’s no question that fluoride is, you know, like other minerals, an important mineral, and fluoride absolutely positively can strengthen teeth, it is also the case that fluoride is neurotoxic and the effects, in terms of any neurologic effects or any behavioral effects, are actually something that have been in the literature for many years.
When this issue has arisen in the past, what you’ve typically heard from organizations like the American Dental Association and many of my colleagues, and frankly you probably would have heard it from me, if I had been asked, is that the studies that have found harms related to fluoridation were in communities that had much higher levels of fluoride than what we allow here in the United States.
Well the fact is that not only first of all did these studies find really very very bad outcomes, specifically many studies have found a relationship between fluoride and fluoride exposure and intelligence. So typically the relationship is somewhere on the order of a half a standard deviation drop in IQ in areas with higher levels of fluoridation, which is a profound effect on health and has profound implications. But there are also neuropsychiatric risks that have been raised including things like attention deficit hyperactivity disorder, including things like problems with executive function and decision making and other behavioral problems in children.
So the typical criticism has been that these studies were in countries like China or India where say the naturally occurring amounts of fluoride are much higher than what we have here in the United States. Well it turns out that in fact that wasn’t true. So in the last five or six years there have been several studies that have been published, Dr. Malin has actually published some of these studies, in communities in Canada, also in the United States, where levels of fluoride are actually quite similar to the levels that we have here in this state and in this country. And these studies have actually found the same findings – that moms and children exposed to higher levels of fluoride have experienced adverse neurologic and neuropsychiatric effects.
I mean, it’s appalling but it’s actually been documented in multiple studies now. So based on these findings and in recognition of the fact that there are other sources of fluoride that people in communities have access to, whether it’s brushing with fluoridated toothpaste, or whether it’s using a fluoride mouthwash, and there are other sources too, people go to the dentist and receive fluoride there, that it is public health malpractice, with the information that we have now, to continue adding fluoride to water systems in Florida. It is public health malpractice and so we are issuing guidance to every community, every municipality, every county in Florida to stop adding fluoride to their community water systems. And I will tell you that the data that we have, the studies that we have, primarily are focused on pregnant women and children, those are clearly the most sensitive and vulnerable populations for fluoridation in terms of these adverse neuropsychiatric effects. But I personally, in my family, we’ve pulled back in terms of sources of fluoride because we’re concerned about the effects in adults also. There’s less research there. My sense is that that research will also show adverse effects and that remains to be seen. But in this day and age, with the additional sources of fluoride that people have access to, it is public health malpractice to continue adding fluoride to community water systems that pregnant women and children have access to.
So that’s the announcement that we’re making today. We’ll be issuing formal guidance that’s going to be available for every Floridian to read and to better understand why we’re making this recommendation. And we have a tool for Floridians to look up their addresses and see whether their communities add fluoride to the water. And we encourage municipalities and counties to look at the guidance, to make the decision that is in the best interest of your communities here in Florida, of your local communities. And we encourage Floridians to look at the guidance and speak to your local leaders, because this is something that has been defended for a long time and it is public health malpractice to continue doing it.
So next we’re going to hear some words from Dr. Ashley Malin. So thank you very much again Dr. Malin for joining us.
Dr. Ashley Malin
Thank you so much Dr. Ladapo for the opportunity to be here and speak with you all today. I am an assistant professor in the department of epidemiology at University of Florida and a licensed clinical psychologist. I graduated with my PhD in 2016 and have been researching health effects of fluoride exposure for over 10 years.
Now I first want to say that although this issue has become politicized recently, I really don’t view this as a political issue. I view this as a human rights issue and a public health issue and one that is separate from other public health issues that are currently being highlighted in the media and political sphere. As Dr. Ladapo mentioned, in the last seven years there have been numerous high quality, rigorously conducted, prospective pregnancy and birth cohort studies in North America showing that chronic relatively low prenatal fluoride exposure levels are associated with poor neurodevelopmental outcomes, including reduced IQ, more symptoms of ADHD, and declines in executive function. While these studies have been conducted among populations based in Canada and Mexico, the fluoride concentrations that these pregnant women were exposed to are similar to those encountered among pregnant women in fluoridated US communities. I also led a US-based study that was published in JAMA network open last May that found that higher prenatal fluoride exposure was associated with more child neurobehavioral problems among three-year-old children in Los Angeles County. Some of these neurobehavioral problems include anxiety, headaches and stomach aches with no known medical origin, temper tantrums, and symptoms of autism.
In August a report was published by the national toxicology program that determined with moderate confidence that fluoride is inversely associated with child IQ, at a minimum, for those living in regions with water fluoride concentrations at 1.5 milligrams per liter or higher. However they expressed uncertainty about whether lower exposures could contribute to developmental neurotoxicity. In other words they may or they may not.
In September a federal judge in San Francisco made a ruling in the fluoride trial against the EPA that stated that fluoride and drinking water at the current recommended level of .7 milligrams per liter poses an unreasonable risk of hazard to child IQ because there is not enough of a margin of safety between the hazard level and the exposure level that is added to community drinking water. The ruling stated that the EPA’s default is for there to be factor of 10 between the hazard level and exposure level due to variability in human sensitivities. Based on the NTP’s report, the hazard to child IQ exists at 1.5 milligrams per liter. Therefore according to the EPA standard, the exposure level for fluoride in community drinking water would need to be set at 0.15 milligrams per liter or lower to create enough of a margin of safety to protect child IQ.
I respect any policy change that is conducive to creating such a margin of safety and protecting the brains of the next generation of children, thank you.
Thank you very much Dr Malin. Dr. Stagg, please share with us.
Dr. Claire Stagg
Right so I’m a little shorter so I’m gonna project a little bit more, can you hear me? So hi my name is Dr. Claire Stagg, I stand before you today both as a dental professional and as a mom. Regarding the widespread fluoridation of our water, that is actually a lot more harmful than the average person is aware of, that’s all of us.
I’m a dentist. In America we carry either the degree, the name, Doctor of Dental Surgery, or Doctor of Dental Medicine, but did you know that 40 to 50 years ago we were known as Dental Physicians. We bring oral and dental solutions to medical conditions. And did you also know that for eons we have been the gatekeepers of your whole health, since the mouth is actually the beginning of your second brain, the gut. It is also the amphitheater where with proper training you can connect the symptoms, and the origins or root causes, that’s a little dental humor for you, of many diseases and dysfunctions. These can be chemical, structural, mechanical, functional, emotional, and even spiritual, to name a few.
Unfortunately, with the advent of highly processed foods, poor diets, and increase in sugar consumption, and environmental pollutants, we dentists have been relegated to the domain of master craftsmen, or women, who are supposed to only drill, fill and bill. And this is what supposedly has led to the poor decision for water fluoridation to combat decay, the decay pandemic. Isn’t it interesting too that the root causes of decay, as stated previously, are still not addressed. And only the symptoms are being band-aided. Did you also know that fluoride can cause dental and bone diseases disorders in the mouth as well as in the brain, and in effect has been shown to reduce the IQ in babies. Moms, that means that you and I as well as our babies are being dumbed down.
Please also note that you use the same fluoridated water to actually bathe and shower both you and your babies on a daily basis. Remember your skin is one of the largest organs of your body, therefore you also absorb any chemicals, any chemicals added to the water. It’s very windy. Please do your research. I will not belabor the amazing scientific facts that present that have been presented by these outstanding physicians and researchers that have they shared with you already. Remember you can argue with us but you cannot, and I repeat, you cannot argue with science. And unfortunately could it be true that the true science has been pushed under the rugs because it did not suit some possibly vested interests.
Interestingly also, America is still one of the few countries that continues to fluoridate their water. Why?
The science presented is very clear. Adding fluoride to our drinking water, any water for that matter, does far more harm than good. Listen carefully now and be shocked as I was. Here in Florida specifically, the majority of local water systems do not fluoridate. However the minority of systems that do fluoridate serve more than 70% of the state’s population. That’s for Paradox right? As a clinician and as a mom I’ve have dealt with this for decades, decades. It’s been going on for a long time yes, decades. I did my research and I wanted to know why, since my goal was to properly care for my children and the families that came to me for their dental treatment. Ask yourselves too, you moms out there, why is it so important to add an industrial byproduct to our drinking and bathing water.
I end by encouraging all Floridian’s as I did to learn the facts and advocate for their own family’s health. Be active and meet with your local governments to understand that any water fluoridation is not in your best interest. Thank you.
Dr. Joseph Ladapo
Thank you Dr Stagg. So as I said we’ve we’ve put together this guidance. It’s available now, I think it’s going to be available online, and we have, you know for the folks who are more scientifically inclined and want to actually see some of the studies that support our recommendation our guidance to communities in Florida, we’ve got those available. And I think that if you look at it you’ll be as appalled as I was that you know we’ve had organizations, public health professionals, my colleagues, professional organizations like the American Dental Association, supporting the continued use of this practice in the face of very extremely concerning research. So we’re looking forward to to seeing communities in Florida make changes that are in the best interest of the people who live in their communities, and thank you all again for joining us here today. And we’re happy to answer any questions you might have. Thank you.
Q&A
Dr. Joseph Ladapo
- Q about timing with RFK Jr. –
Yeah sure the the timing is, I know, I certainly would understand the timing. I was actually chatting with the with the governor yesterday just about the fact that we’ve been actually looking at this for for months, so ever since, I’ll tell you that my wife has been asking me to look at this for a while, but we’ve had our hands full, so it’s just not something that I’ve been able to really take a deep look at. And after the federal judge made the ruling, I think it was in September, Dr. Malin was saying, we started looking much more closely at it, and then you know, everyone knows what happened in September, at the end of September and then in the beginning of October. So both hurricane Helen and hurricane Milton interrupted our progress, but it’s something that we resumed after we were able to really complete our hurricane response. I mean I’m grateful to Bobby for raising the question but it really was something that we were already looking closely at and you know again, as I learned more, it seemed more urgent and more pressing for us to really get this guidance out for Floridians.
- Q about PHS recommended .7ppm vs NTP harm at 1.5ppm –
Those are great questions so what I would suggest is this, and I’ve looked more closely at the literature this is what I’ve drawn from it. So what I would suggest is not to focus so closely on whatever the threshold is, and the reason is because the threshold, the water that we drink, is only you know maybe it’s 70%, somewhere around there, of the fluoride we consume daily. So the studies that have examined this issue have looked at cumulative fluoride exposure, so not just fluoride from water which is an important source, we also get it from food, you know we get it from toothpaste, we get it from other things that we we consume. And the important finding in these studies is that, you know, when you look at these studies, they show that what whether you’re in India, Bangladesh, Canada, or the United States, the more fluoride that people are consuming, the more fluoride from the water, from food, from other sources, the higher these risks of lower IQ, of more behavioral problems, of more ADHD. So the relationship is really the critical thing. And in terms of the level, and I think people again like to focus on the level, but in terms of the level the piece that’s important to know is not the the seven parts per million of fluoride that is currently recommended, that’s not the piece that’s important to know. What’s important to know is that these findings of the relationship between fluoride exposure and these adverse outcomes is present in communities that have levels of 0.7 parts per million of fluoride, right? So that’s the piece that’s that’s important to know, not so much to get hung up on how many parts per million is being recommended.
- Q about banning fluoridation –
So I don’t have that power. I mean I can’t imagine why anyone who was a leader in a community would not want to reduce the amount of fluoride while promoting dental health through other methods. I just can’t understand why someone would not reach that conclusion, but I’m my hope is that you know, obviously our lawmakers do have that kind of power, but I really hope our communities, our counties, our municipalities are able to reach this very sensible and very human supportive decision by themselves. I mean this is, it’s not a complex decision.
- Q about socioeconomics and access to fluoride –
It’s a great point because it’s a point that has been raised in the past to justify mass fluoridation of water. So first of all it’s important to know that at this point, so fluoride in toothpaste was started I think by Crest in the 1950s, and at this point, fluoridated toothpaste is widely available, so issues with access are really not substantive issues at this point. In terms of dental access that’s absolutely an issue and here at the Florida Department of Health we have a school-based school-based dental health programs that are very widespread in in schools in Florida. We have dental clinics in many of our County Health departments. I think that access to dental care is a very important issue. I think it’s an issue that that needs more attention. I absolutely do I think dental education, particularly with sugar consumption, which is the main reason why individuals develop cavities, and babies and children develop cavities in the first place, is a really important issue and it’s something that we care about. But the answer to that issue is not systemic dosing of the population with a neurotoxic agent. We have to find better solutions.
Dr. Claire Stagg
This is really important to me. This really irks me, the excuse of poor communities and children have issues, dental issues because they’re not taken care of and therefore we have to fluoridate. So why treat these issues when you could go to the root cause. These children are not being fed properly, there’s sodas, there’s a huge amount of consumption, their parents don’t have the means to access proper nutrition, proper education. I think as a mom, or as educators, we need to get to the root cause to help these people understand why they have decay, why they need to breathe better, why they need breast is best, why they can grow healthy babies and not just put a Band-Aid on a problem and think you’re going to solve it when in actuality you’re making the children worse because now you have to give another pill for another ill and it’s a cascading effect so everything Dr. Ladapo and Dr. Malin have said is exactly that, go to the root cause. As dentist I would like to see that change. I think it’s important that we help the children grow into healthy adults instead of trying to poison them with another issue that will make them less healthy every single which way.
Dr. Joseph Ladapo
- Q on taking a position in Trump admin –
First I I want to say that I’m very grateful to Governor DeSantis. He’s been supportive of the decisions that we’ve made over the last, now it’s been three years. You know he’s been a very strong supporter of the decisions that we’ve made. The fact that we’ve been very evidence-based and the fact that we’ve allowed the evidence to dictate which direction we go with recommendations, just like we’re doing today. So I want to thank Governor DeSantis for that. I mean I’m so appreciative of what he’s allowed us to do and he’s allowed us to do just so many important things, often unpopular things over the last few years, and today’s just another example of that in terms of his support for evidence and really what’s in the best interest of humans. And you know in that vein he’s very supportive of me having an impact. And you know obviously the governor believes in having impact in things that he cares about and I do too. And so you know I would say that I mean I’m really lucky I have an amazing job. I have a wonderful team, Florida’s a beautiful place. I think if there are opportunities, whatever those might be, that would would allow me to have even more impact, I would be interested in that. So I would certainly take that into consideration. I talk with a lot of people, you know I mean I haven’t had any public conversations, but people reach out to me all the time. I would say that.
- Q on what other cities and state are doing –
I think that this issue has been discussed in in other municipalities. I’m not sure who’s having those discussions right now but I anticipate that we’re going to see a lot more conversations happening.
- Q on any research showing fluoride is safe for brains –
I mean it’s a tough question to answer because the research that has been published it’s all on one side. I mean it’s virtually the findings are very consistent in different countries, so I I’m not sure what research would would suddenly find something different with this issue so that’s just a difficult question for me to answer.
- Q on what the EPA’s lawsuit response will be –
Yeah I mean I don’t know what the EPA… the judge has ordered them to readdress the issue, I’m not sure what they they’ll do. Frankly I’m disappointed that they’ve been aware of these issues for years and have not already made some type of policy recommendation or regulatory decision. So you know I’m actually quite disappointed in how they’ve managed this
You know I haven’t seen studies, they typically again will look at measures of total exposure, but again you know something like 60 or 70% of the fluoride exposure that people have comes from their they drinking water.
Thank you all very much again.