Compiled by Michael F. Dolan, PhD
Review of Equity in Dental Research Shows No Interest in Water Fluoridation
A new review that explores the limitations of equitable practices and outcomes of dental research in relation to economic status makes no mention of water fluoridation, and reveals that much of dental research today violates the principle of equity by looking at impoverished populations as groups that should be acted upon rather than invited to share in oral health decision making.
The “socioeconomic gradient,” plays a central role in this discussion.
As the authors note, “One of the most well-documented phenomena in oral health literature is the socioeconomic gradient phenomenon, whereby the prevalence and severity of oral diseases tend to rise as people’s socioeconomic standing becomes lower. According to the World Health Organization (WHO), there exists an exceptionally strong and clear link between socioeconomic standing, determined using income, occupation, and educational attainment variables, and the prevalence and severity of oral diseases, regardless of the age group under study (children through elderly individuals) and irrespective of whether it is high-, middle-, or low-income countries [4]. This is not simply a statistical correlation, but a reflection of how socioeconomic stratification influences biological outcomes.”
The current spate of research reports on how to convince people to accept fluoridation, on how to overcome so-called “misinformation” circulating on social media and in text messages, and how fluoridation benefits all people equally are revealed in this review to be the opposite of what equitable practices would require in that people would be invited to help design the research, both its purpose and methods, and then use the research to build up their own oral health infrastructure, whether in impoverished sections of wealthy countries or in underdeveloped nations.
The authors, dental researchers from India, are particularly critical of dental researchers’ failure to address what they call the “corporate architecture of oral disease.”
They write, “The most critical yet poorly studied determinants of oral health inequalities include the role played by the corporate sector in creating and influencing the environmental conditions that shape risks of oral diseases on the population level.”
“Corporate lobbying against policies that would decrease caries by reducing the consumption of cariogenic foods such as sugar taxes or advertising bans is a clear obstruction to the creation of a positive policy environment for dental research. Research focused strictly on the behavior-based factors affecting caries risk but failing to explore the commercial determinants behind dietary conditions will inevitably misidentify causality and misguide intervention efforts,” they write.
As recently publicized by Prof. by Philippe P. Hujoel of the University of Washington, Seattle, the dental guild in the USA, in developing its water fluoridation advocacy, was greatly influenced by an agent of the Kellogg Foundation, a major producer of sugar cereal for children.
Sources:
https://doi.org/10.7759/cureus.108931
https://doi.org/10.3390/nu14204263
Scholars Find More Evidence of Fluoride’s Neurotoxicity as They Call for Stricter Regulations
A study of mental state among adults in a fluorosis-affected region of Shanxi Province in China has found that at least 10 years of consumption of fluoride-contaminated water leading to a urinary fluoride concentration of just 0.24 milligrams per liter (mg/L) is associated with a one percent increased rate of cognitive decline. This is a concentration of the toxin in urine quite similar to the 0.3 mg/L previously proposed as the benchmark level associated with a decline of one IQ point.
Writing in Environment International‘s March 6th edition, the authors from the Chinese Center for Disease Control and Prevention note that, “[M]ounting evidence indicates that fluoride possesses systemic toxicity that transcends the skeletal and dental systems, adversely affecting several soft organs, including the neurological system, musculature, kidneys, liver, blood vessels, and endocrine glands.”
They add, “[T]he established guideline values for fluoride in drinking water and urinary were primarily designed to avert skeletal and dental issues and have not adequately considered the potential neurotoxicity of fluoride; neurobehavioral endpoints and data on cognitive impairment have largely been omitted from the current risk assessment framework. …Considering the heightened sensitivity of neurological system to environmental toxicants, it is plausible to hypothesize that fluoride concentrations in drinking water or urine within the scope of current regulatory limits may nevertheless induce neurotoxic consequences and cognitive deficits. This raises critical concerns regarding the inadequacy of existing guidelines in safeguarding against fluoride-induced neurotoxicity and underscores the urgent necessity to reassess and potentially amend these standards to strengthen neurological health protection.”
The authors recommend the adoption of a “neuroprotection-oriented revision” of fluoride exposure regulations, particularly focusing on elderly patients.
They write, “[E]xtra safeguards for vulnerable populations, especially the elderly, should be taken into account. Due to age-related deterioration of blood–brain barrier integrity, the elderly may exhibit increased vulnerability to fluoride-associated neurotoxicity effects.”
Having found that a urinary fluoride level of 0.83 mg/L was associated with a 5% increase in cognitive decline in subjects older than 60 years, the authors recommend that a urinary level of not more than 0.8 mg/L, half the current Chinese regulatory level, be adopted.
In China the maximum contaminant level for fluoride in drinking water is 1.0 mg/L while in the USA it is 4.0 mg/L.
Source: https://doi.org/10.1016/j.envint.2026.110190
Moldovan Professors Seek to Lessen “Social Burden” of Dental Fluorosis
While the dental guild has long downplayed the impact of dental fluorosis, a disorder of the teeth caused by drinking fluoridated water, as a “cosmetic” concern, some dental and health investigators have noted that the bright white opacities or pitted and stained appearance of teeth caused by exposure to fluoride can damage a person’s quality of life.
A group of professors at Nicolae Testemitanu State University of Medicine and Pharmacy in Moldova, reporting at a recent meeting entitled “Yesterday’s cultural heritage – implications in the development of tomorrow’s society,” have called for improved dental management that takes into account oral health-related quality of life (OHRQoL).
“Dental fluorosis is a developmental enamel anomaly resulting from excessive fluoride exposure during odontogenesis, with clinical manifestations ranging from discrete opacities to pitting and brown-yellow discolouration. Beyond structural involvement, lesion severity influences aesthetic perception, social adaptation, and oral health-related quality of life (OHRQoL),” they write in the conference document.
Their review of the evidence found that the impact of dental fluorosis on quality of life increases with the severity of enamel defects. In the more severe cases it is “associated with impaired self-image, emotional discomfort, social avoidance, and limitations in daily activities, including smiling, speech, and school or professional interactions.”
They conclude, “Dental fluorosis should be approached not merely as a structural enamel defect, but as a condition with clinical, aesthetic, and psychosocial implications. Integrating patient perception and OHRQoL assessment into the treatment plan can improve individualised management and reduce the social burden of the condition.”
Source: https://ibn.idsi.md/vizualizare_articol/250435
Arsenic and Fluoride Levels in Groundwater an Extensive Problem in Mexico
A large segment of Mexico’s population is consuming drinking water from aquifers that contain hazardous levels of arsenic and fluoride, according to a new model of contamination of groundwater there.
Writing May 11 in the Journal of Hazardous Materials, researchers from Mexico, Switzerland, Korea and the USA used thousands of measurements to develop a model for detecting the likelihood of these chemicals in Mexican groundwater.
Their new model to find arsenic and fluoride in drinking water derived from aquifers in Mexico has led the investigators to conclude that 10.4 million people there may be exposed to arsenic levels exceeding the World Health Organization’s (WHO) recommended upper limit of 10 micrograms per liter, 9.4 million drink water exceeding the WHO’s maximum level of 1.5 milligrams per liter, and 7.2 million are exposed to hazardous levels of both toxins.
They report that more than 15% of the national land is suspected to harbor excessive levels of arsenic, 13.5% contain high levels of fluoride in the water, and nearly 9% of the land mass contains aquifers with hazardous levels of both toxins, with hotspots concentrated in north-central Mexico.
The authors conclude, “Nationwide, single- and co-contamination footprints are large and spatially coherent, implying that monitoring, mitigation, and communication should be planned regionally rather than site-by-site. At an operational level, these hazard maps can guide (i) placement of new monitoring wells and confirmatory sampling in high-probability corridors, (ii) well-management actions such as well switching, blending, and deployment of centralized or point-of-use treatment where exceedances are likely, and (iii) risk communication and health-surveillance efforts in densely populated hotspots.”
Source: https://doi.org/10.1016/j.jhazmat.2026.142383
Skeletal Fluorosis Case Highlights Unknown Extent of This Disorder
A case of skeletal fluorosis from the southwestern USA suggests the prevalence of this disorder may be more greater than widely appreciated.
In a report entitled “Skeletal fluorosis mimicking rheumatologic disease: a case report,” that was published April 8 in Clinical Rheumatology, researchers from the Mayo Clinic Arizona note that a physical examination, laboratory tests, X-ray examinations, and a review of medical records did not lead specifically to a diagnosis of skeletal fluorosis.
Only a consideration of the patient’s water supply provided the conclusive result.
They wrote, “Further investigation revealed municipal drinking water in his hometown in the southwestern United States contained fluoride concentrations of 6.5 mg/L (recommended level: 0.7 mg/L). The patient reported drinking this water for multiple years, suggesting significant cumulative exposure.”
The authors acknowledged that people who have developed skeletal fluorosis could show no sign of it, writing “Manifestations range from asymptomatic disease to diffuse musculoskeletal pain, limited mobility, and increased fracture risk.”
Google summarized the literature on skeletal fluorosis in the USA by writing, “There is no exact national total, but skeletal fluorosis is considered extremely rare in the United States. Only a handful of medically documented cases (roughly 20 to 30) have ever been officially reported in medical literature, usually stemming from extreme, uncommon behaviors rather than public drinking water.”
For forty years the US Environmental Protection Agency’s Safe Drinking Water Act maximum contaminant level for fluoride in drinking water has been 4 parts per million. It is based on the need to avoid skeletal fluorosis, but with cases of the disease being asymptomatic it remains to be seen how prevalent the disease is in the USA, and at what concentration of fluoride in drinking water it develops.
Source: https://doi.org/10.1007/s10067-026-08123-w
Canadian Groups Petition Auditor General’s Office to End Water Fluoridation
On March 20, five environmental groups from Québec and Ontario used the Auditor General’s Act to request that the Commissioner of the Environment and Sustainable Development of the Office of the Auditor General of Canada end the addition of inorganic fluorides to drinking water.
The five groups – Fluoride Free Canada, Eau Secours of Montréal, Citizens Environmental Alliance of Southwest Ontario of Windsor, Watershed Watcher Environmental Network of Windsor, and Windsor Essex on Watch of Tecumseh, Ontario, petitioned the Commissioner, “To stop the injection of toxic substances into drinking water, namely anthropogenic inorganic fluorides (hexafluorosilicic acid, sodium fluorosilicate and sodium fluoride), contaminated with toxic metals (arsenic, lead, aluminum), for therapeutic purposes, recommended by Health Canada but in violation of the Fisheries Act.”
The petition also asks Health Canada to define the legal classification of chemicals used in fluoridation, and to state that by labelling the fluorides “water treatment additives” Health Canada “in no way guarantees the effectiveness, safety and sanitary quality of these products.”
The petition includes extensive, detailed discussion of how fluoridation violates the Fisheries Act and how Health Canada has failed to protect public health as required by law.
The text includes discussion of the Auditor General’s response to past petitions, the problems associated with labelling the fluoride products “water treatment additives,” and a summary of evidence that fluoridation is neither safe nor effective.
Source: https://www.fluoridefreecanada.ca/news
Cause of Multigenerational, Cumulative Fluoride Neurotoxicity Found in Roundworm
Concerned that the neurotoxic effects of fluoride could accumulate across generations, researchers from two institutions in Lanzhou, China have used the roundworm, Caenorhabditis elegans, which is a leading model organism for studying development in animals, to show that fluoride-induced neurotoxicity can accumulate over generations. They also found the biochemical pathway that causes it.
Writing in the Journal of Hazardous Materials March 6, the authors from the Northwest Normal University and the Gansu Provincial Hospital note, “Fluoride is recognized as a developmental neurotoxicant. Epidemiological studies consistently associate early-life exposure with cognitive deficits and reduced IQ in children, a concern exacerbated by fluoride’s ability to cross the placental and blood-brain barriers.”
They added, “Evidence from mammalian models further suggests a potential multi-generational dimension to its neurotoxicity, with prenatal or multi-generational exposure leading to impaired neurodevelopment and progressive cognitive decline. However, the molecular mechanisms underlying these effects, particularly their persistence across generations, remain poorly understood.”
They chose the roundworm because, “The nematode Caenorhabditis elegans provides a powerful model to dissect multi-generational toxicity, given its established utility in documenting rapid, non-genetic inheritance of stress responses from diverse environmental insults.”
They justified the use of a roundworm for this study, writing, “Despite the significant morphological differences between nematodes and humans, many key cellular and molecular pathways are highly conserved across evolution, including stress response pathways…neuronal development and function… and epigenetic regulatory mechanisms.”
“These are the core mediators through which transgenerational effects occur,” they note.
The authors reported, “Continuous exposure at environmentally relevant concentrations (20–50 mg/L) resulted in cumulative deficits in locomotion, feeding, and learning memory across four generations,” of the roundworm.
They went on to find that the neurotoxic effect was due to dysregulation of the kynurenine pathway, that breaks down the amino acid tryptophan. Specifically, they found that the toxic fluoride exposure caused an increase in production of a certain enzyme that led to the overproduction of the neurotoxic metabolite 3-hydroxykynurenine.
They also used a genetic technique to block the production of this enzyme, and found the neurotoxic effect eliminated. Also, the administration of glutathione, a peptide of three amino acids, blocked the neurotoxicity.
They conclude, “The identification of this specific metabolic pathway has significant implications for risk assessment in fluorosis-endemic regions. Populations experiencing multi-route exposure—from both aqueous sources and atmospheric deposition—may be particularly vulnerable to the multi-generational effects described here. Our findings suggest that regulatory frameworks should consider aggregate exposure pathways when establishing safety thresholds.”
Source: https://doi.org/10.1016/j.jhazmat.2026.141676
•• Michael Dolan can be contacted at <mdolan.ecsn@outlook.com>