Compiled by Michael F. Dolan, PhD
Hu and Birnbaum Make Powerful Public Health Statement on Fluoride
Two of the leading experts on the health effects of exposure to fluoride–including the former director of the National Toxicology Program (NTP)–have called on their colleagues in the public health profession to form a consensus to protect mothers and infants from fluoride.
In a commentary published in the July issue of the American Journal of Public Health, Prof. Howard Hu of the University of Southern California and Dr. Linda Birnbaum, retired director of the National Institute of Environmental Health Sciences write, “Policies regarding fluoridation have enormous implications for the 209 million Americans whose drinking water undergoes community fluoridation, as well as the many people whose tap water is naturally fluoridated (11 million whose fluoride concentration exceeds the current public health service recommendation of 0.7 milligrams per liter [mg/L]).”
Hu and Birnbaum give central importance to the ruling of Federal District Judge Edward Chen, a crucial judgment that has gone largely unreported by newspapers and television news broadcasts. Chen wrote, “Plaintiffs have proven, by a preponderance of the evidence, that water fluoridation at the level of 0.7 mg/L— the prescribed optimal level of fluoridation in the United States—presents an unreasonable risk of injury to health or the environment, without consideration of costs or other non-risk factors, including an unreasonable risk to a potentially exposed or susceptible subpopulation under the conditions of use.”
The essay contains a succinct and strongly worded summary of the evidence of fluoride’s neurotoxicity and notes, “From a policy perspective regarding risk, EPA [Environmental Protection Agency] is required to consider setting standards that provide a margin of safety, currently dramatically exceeded by EPA’s regulatory limit of 4 mg/L, to protect potentially susceptible individuals. This includes pregnant women and children and, arguably, individuals who may be genetically susceptible (such as those recently found to have variants related to dopamine metabolism that are associated with amplified fluoride neurotoxicity effects).”
“[W]e believe that the time has come for dental, medical, public health, environmental health, health policy, epidemiology, and risk assessment professionals to come together, weigh the evidence, and arrive at a consensus on policy recommendations and steps,” conclude the authors.
While the authors do not ask that fluoridation be ended, it is impossible to meet their goal of protecting pregnant women and children while leaving the failed policy in place.
Source: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2025.308166
Fluoride Exposure a Hazard for Orthodontic Patients’ Mouth Cells
Dental researchers from the All India Institute of Medical Sciences report that mouth buccal mucosa cells are damaged when fluoride toothpaste or mouthwash is used by orthodontic patients who have nickel-titanium archwires. The fluoride corrodes the wires, releasing metals onto the cell surfaces.
The buccal mucosa consists of the epithelium cells lining the inside of the cheeks and lips. Writing in the Journal of Oral Biology and Craniofacial Research on June 3rd, the scientists report, “The use of fluoride mouthwash and toothpaste in the presence of stainless-steel attachments and nickel-titanium archwire decreased the buccal cell viability by 8.51% and increased the micronucleus score by 3.03%. The use of fluoride toothpaste and mouthwash had a significant cytotoxicity effect on buccal mucosa cells in the presence of nickel-titanium archwire during comprehensive orthodontic treatment.”
The micronucleus score is a measurement of improper cell division that may be due to a substance’s genotoxicity or ability to cause damage to DNA.
After examining seventy-five healthy patients who had been given fluoridated toothpaste and mouthwash, and collecting their cells for analysis, the authors report a significant adverse effect on those who had the nickel-titanium (NiTi) archwires compared to those with only stainless-steel wires or none at all.
They had been concerned over this toxic exposure, as they write, “[F]luoride has been implicated in corrosion processes, particularly by degrading the protective titanium oxide layer on NiTi archwires, potentially leading to increased metal ion leaching. The continuous release of metal ions from corroded orthodontic materials can result in various health concerns. The nickel in the corrosion product has been shown to exhibit cytotoxic effects in the oral cavity. Even in non-toxic amounts, nickel exposure can cause DNA damage.”
Source: https://doi.org/10.1016/j.jobcr.2025.06.007
Pasco, WA Heading Toward Removal of Fluoridation Chemicals
Five of the seven City Councilors in Pasco, WA, want to end water fluoridation there due to the health risks associated with the practice. In early July, the council voted 5-2 to initiate the process to end fluoridation, which requires a 90-day notice to residents and an opportunity for public feedback.
According to KEPR News, “Councilman Charles Grimm expressed optimism about the community’s engagement on the issue. ‘I am so encouraged that people on both sides of the fluoridation issue are coming from the perspective of wanting to do what’s best for the children,’ he said. Grimm noted that constituents have been asking for fluoride removal, as Pasco is the only city in the Tri-Cities area that adds it to the water. Grimm referenced a report from The Journal of the American Medical Association, which he said connects higher fluoride levels to lower IQ scores in children.”
Two public feedback sessions are scheduled for August 5th and September 17th at City Hall, with online comment options also available.
Pasco, WA is a city of 80,000 in Franklin County on the Columbia River in southeastern Washington. Nearby Kennewick and Richland do not fluoridate their water, according to the report.
In Washington, the state Department of Health must be notified 90 days before a city makes a decision to start or discontinue fluoridation.
Council members in favor of ending fluoridation are Mayor Pete Serrano, Mayor Pro Tem David Milne, Charles Grimm, Peter Harpster and Leo Perales.
Communities Ending Fluoridation Since FAN’s Fluoridation Court Ruling: https://fluoridealert.org/content/communities-that-have-ended-fluoridation-since-the-fluoride-lawsuit-ruling/
‘Much of life on Earth, including plants, fungi, and bacteria, evolved to resist toxic environmental fluoride’
In a new study that describes the biochemical structure of membrane proteins that expel fluoride ions from cells, researchers at the University of Michigan and the University of Texas at Dallas leave little doubt that life on Earth sees fluoride as a toxin to be avoided.
“Much of life on Earth, including plants, fungi, and bacteria, evolved to resist toxic environmental fluoride. In eukaryotes, the major resistance mechanism is fluoride export by FEX [fluoride export] proteins,” write the authors.
“Fluoride (F-) is present at biologically relevant concentrations throughout the natural environment, including soil, water, and certain minerals. Human use of fluoride and fluorine-containing molecules has further compounded fluoride levels in some niches. Intracellular fluoride accumulation inhibits multiple enzymes that are essential in multiple biological pathways, including glycolysis, ATP synthesis, phosphorylation, nucleotide synthesis, and other processes catalyzed by metalloenzymes. As a result, most microorganisms, fungi, and plants possess mechanisms to avoid fluoride toxicity,” they note in presenting their paper.
In conclusion to their detailed, technical discussion of the fluoride export protein’s molecular structure, and the contrast between prokaryotic (bacterial) fluoride export proteins and those of eukaryotes (including plants and fungi) the authors note, “In summary, our findings establish a foundation for understanding fluoride physiology and transport in eukaryotes, and provide a unique perspective on the evolution of structural and mechanistic complexity in membrane transport proteins.”
Source: https://doi.org/10.1101/2025.06.25.661560
Water Hardness and Fluoride Level Have Negative Synergistic Effect on Zebrafish Embryos
In an effort to investigate the factors involved in chronic kidney disease of unknown cause (CKDu), researchers from the University of Sri Jayewardenepura in Sri Lanka collected 60 well samples from regions of CKDu across the country, used zebrafish embryos to test for toxicity, and found that the combined adverse effect on the embryos of water hardness and higher fluoride concentration was greater than the effect of either exposure alone.
Writing for the March 2026 issue of Nature Environment & Pollution Technology, the authors report the highest level of water hardness they found was 285.2 parts per million of calcium carbonate, considered very hard, while the highest fluoride level was 2.33 ppm, a level of fluoride the US Environmental Protection Agency currently considers safe.
Each batch of fish embryos were exposed to the chemical concentration for 96 hours. The highest levels of hardness and fluoride resulted in 16.7% and 18.8 percent mortality respectively while exposure to the combined chemical solutions killed nearly half of the fish. Such combined exposures led to widespread developmental delays and morphological abnormalities.
Zebrafish are widely used as model organisms in toxicological studies due to their rapid growth and development and the fact that they are translucent, so they can be stained and examined under a microscope.
The authors also note, “Zebrafish share around 70% of their genes with humans, and their nephron structures (the basic functional unit of the kidney) are remarkably similar, making them a good model for studying renal diseases.”
Source: https://doi.org/10.46488/NEPT.2026.v25i01.D1787
Modern Anesthetics Still Contain Risk of Fluoride-Induced Kidney Damage
Writing in the journal Toxics published on June 19th, scientists from several Belgian universities have painted a grim picture of potential kidney damage from widely used fluoride-containing anesthetics such as sevoflurane. While some types of fluoride-induced damage are reversible, others “may result in irreversible renal impairment.”
The authors note, “Volatile anesthetics are known to induce significant renal adverse effects and are widely used in both operating rooms (ORs) and intensive care units (ICUs). This review aims to elucidate their nephrotoxic potential, underlying mechanisms, reversibility of renal injury, and possible therapeutic interventions—including the existence of a therapeutic window.”
They report that modern anesthetics are more potent and effective, adding, “Historically, methoxyflurane was associated with significant nephrotoxicity due to excessive fluoride ion production, ultimately leading to its withdrawal from clinical use. Although newer agents were initially considered renally safe, contemporary anesthetics—particularly sevoflurane—can still produce nephrotoxic fluoride concentrations. Recent reports have documented renal adverse effects associated with sevoflurane and other modern volatile agents. Currently, commonly used volatile anesthetics include fluorinated liquids such as isoflurane, desflurane, and sevoflurane. Fluoride inhibits several enzyme systems, impairing tissue respiration and anaerobic glycolysis. In the kidneys, fluoride disrupts sodium transport in the proximal convoluted tubule, inhibits adenylate cyclase, and diminishes the action of antidiuretic hormone.”
Highlighting recent developments that have improved understanding of fluoride toxicity from volatile anesthetics, the authors also point out areas that need further study as is the case with the yet to be characterized sevoflurane metabolite, simply called “compound A.”
In their review the scientists note regarding this compound, “Additionally, the sevoflurane degradation product “compound A” has been implicated in direct renal tubuar and glomerular toxicity. Specifically, exposure has been correlated with glomerular damage, evidenced by albuminuria, as well as injury to both proximal and distal tubules, indicated by elevated levels of ?-glutathione-S-transferase. Postprandial glycosuria may also be observed. Unlike nephrogenic diabetes insipidus, the structural damage induced by compound A may result in irreversible renal impairment.”
Source: https://doi.org/10.3390/toxics13060514
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