Dear Honorable Minister German,
We applaud your decision to end mandatory fluoridation in Israel and we look forward to the time that there is an outright ban on this reckless practice.
Your position is a model for the public health community both in Israel and in our respective communities. It is sound, based on the current literature and the need to protect the health of citizens from unnecessary ingestion of fluoride.
It is unfortunate that in making the best decision for the health and welfare of your citizens that you have been subjected to criticism and bullying as noted in the June 22rd article, Backlash against Health Minister Yael German for her decision to stop fluoridation, published in The Jerusalem Post (Siegel-Itzkovich).
Professor Paul Connett, co-author of The Case Against Fluoride (Chelsea Green, 2010), is willing to travel to Israel and publicly debate any of those who are organizing against you. However, in our experience the pro-fluoridation advocates are unable to defend their position in open public debate. This is not through a lack of debating skills on their part but rather the fact that science simply does not support their claims that swallowing fluoride is safe or that it dramatically reduces tooth decay.
The following facts and arguments underline the inappropriateness of this outdated practice:
Delivering any medicine via the water supply is reckless
Fluoridation violates all principles of modern pharmacology. Once added to water there is no way of controlling the dose or the people who get the medicine – it goes to everyone regardless of age, weight, health, need or nutritional status. Moreover, it violates the individual’s right to informed consent to medical treatment. (http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000445.htm).
Swallowing fluoride is particularly inappropriate
Fluoride is not a nutrient. Not one biochemical process in the body needs fluoride. Underlining this fact is the exceedingly low level of fluoride in mother’s milk (0.004 ppm, NRC, 2006, p.40). Formula-fed infants in fluoridated communities (at 0.7 to 1.2 ppm) receive 175 to 300 times more fluoride than a breast-fed infant.
Making matters worse is the fact that fluoride is known to have toxic properties at low doses (NRC 2006, Barbier et al., 2010; Varner et al., 1998). It also accumulates in the bone and builds up there over a lifetime. Early signs of fluoride poisoning of the bone (skeletal fluorosis) are identical to arthritis and lifelong accumulation can make bones brittle and more prone to fracture.
Dental fluorosis
While we do not see the crippling effects of skeletal fluorosis observed in countries like India and China, which have areas of high natural levels of fluoride, children in fluoridated countries are experiencing a very high prevalence of dental fluorosis. According to the CDC (2010) 41% of American children aged 12-15 have dental fluorosis. Black and Mexican American children have significantly higher rates of the more severe forms of dental fluorosis (CDC, 2005, Table 23).
Fluoridation promoters acknowledge that dental fluorosis indicates over-exposure to fluoride but refuse to admit other harm. A review of the toxicology of fluoride by the U.S. National Research Council of the National Academies in 2006 revealed that fluoride is an endocrine disruptor and causes many health problems at levels close to the exposure levels in fluoridated communities. This panel also reported that bottle-fed babies are exceeding the EPA’s safe reference dose when drinking fluoridated water (NRC, 2006, p85).
Fluoride impacts the brain
Many animal and human studies indicate that fluoride is a neurotoxin (www.FluorideAlert.org/issues/health/brain). In 2012, a team that included Harvard University researchers reviewed 27 studies that showed an association between fairly modest exposure to fluoride and lowered IQ in children (Choi et al., 2012). In nine of these studies the so-called “high fluoride” village had fluoride levels less than 3 ppm. Such levels provide no adequate margin of safety to protect all children –especially the most vulnerable- from lowered IQ when drinking fluoridated water.
An incredible lack of oversight
Fluoridation is designed to treat a disease but has never been approved by the Food and Drug Administration (FDA); it classifies fluoride as an “unapproved drug.”
How strong is the evidence that swallowing fluoride reduces tooth decay?
Fluoridation advocates claim that it is very strong. However, if you look at the actual science it is a different story. The effectiveness of swallowing fluoride to reduce tooth decay has never been demonstrated via a randomized controlled trial (RCT), the gold standard of epidemiology (McDonagh et al., 2000). Two key U.S. studies – both government funded and by pro-fluoridation researchers – have failed to produce convincing evidence of benefit.
A very large study, administered by the U.S. National Institute for Dental Research, examined the permanent teeth of 39,000 children (aged 5-17) from 84 communities. The average saving in Decayed Missing and Filled Surfaces (DMFS) when comparing children in fluoridated and non-fluoridated communities was 0.6 of a tooth surface out of 128 tooth surfaces, and this was not shown to be statistically significant (Brunelle and Carlos, 1990). Even if it were, the average saving is remarkably small considering what risks are being taken to achieve this result.
As part of the “Iowa Fluoride Study,” where children’s tooth decay and fluoride intake has been tracked from birth, researchers examined the relationship between tooth decay and individual exposure to fluoride from all sources, including water, food and dental products. They were attempting to find the so-called “optimal dose” needed to reduce tooth decay, however they concluded that, “achieving a caries-free status may have relatively little to do with fluoride intake…” (Warren et al., 2009).
The most likely explanation for the weak evidence of benefit
Even fluoridation advocates have acknowledged that the predominant benefit of fluoride is topical, not systemic (CDC, 1999). In other words, fluoride works on the outside of the tooth not from inside the body. This acknowledgement removes the whole rationale for fluoridating water and forcing people who don’t want it to ingest it.
Most countries don’t fluoridate their water
The vast majority of countries (including 97% of Europe) neither fluoridate their water nor their salt. However, WHO figures indicate that tooth decay in 12-year-olds is coming down as fast in non-fluoridated countries as fluoridated ones (http://fluoridealert.org/issues/caries/who-data/ ).
Tooth decay in low-income families can be reduced by safer means
Many countries have been able to reduce tooth decay in low-income families using cost-effective programs without water fluoridation. The Scottish Childsmile program involves a) teaching tooth-brushing in nursery schools; b) advising parents on better diets; c) annual check-ups and d) fluoride varnishes where necessary. The number of 12-year-olds without caries has increased to over 70% using these methods and in the process costs have been cut by half (BBC Scotland, 2013).
Added benefit of emphasizing education
Making education, not fluoridation, the center of the fight against tooth decay has the added advantage of attacking the cause of obesity, an issue which threatens to cost health services billions of dollars over coming decades.
References after signatures
Sincerely,
Paul Connett, PhD, Director, Fluoride Action Network, USA
Mary Lou Andersen, MS, Bellingham, Washington
Eve-Marie Arcand, DMD, Sherbrooke, Québec, Canada
Douglas Amell, ND, Moose Jaw, Saskatchewan, Canada
Alexander J. Audette, R.Ac., TCMP, B.Eng.(Chem), Guelph, Ontario, Canada
David M. Augenstein, MSc, PEng, Akron/Canton, Ohio
John Bain, DDS, Farmington, Arkansas
Kellie Barnes, MOMT, MPT, Portland, Oregon
Jane Beck, BSc, MBBS, Thames, New Zealand
James S. Beck, MD, PhD, Professor Emeritus of Medical Biophysics, University of Calgary, Canada; Co-author, Case Against Fluoride (Chelsea Green, 2010)
Bobbie Beckman, DDS, Bassano del Grappa, Italy
Kathleen Bernardi, RDH, King City, Ontario, Canada
Jo Thomas Blaine, L.Ac, San Diego, California
Zuzka Borovjakova, CNP (Certified Nutritional Practitioner), Toronto, Ontario
Barry Breger, MD, Montreal, Québec, Canada
Gene Burke, BA, Woodland Hills, California
Roger Burt, MS (psychology), Portland, Oregon
Robert Button BScPharm, RPh, CDE, CRE, Dryden, Ontario, Canada
David Buttorff, Louisville, Kentucky
Elizabeth Caliva, PE, MS, Encinitas, California
Neil J. Carman, PhD, Austin, Texas
Leo Cashman, MA, Executive Director of DAMS Inc. (Dental Amalgam Mercury Solutions), USA
Anthony Cipolla, DDS, Williamsport, Pennsylvania
Griffin Cole, DDS, President, International Academy of Oral Medicine & Toxicology, Austin, Texas
John J. Collins, DC, Newberg, Oregon
Michael Connett, JD, Los Angeles, California
Gerald W Cooper, PENG, B Eng, MBA, Toronto, Canada
Karl Cox, PhD, Brighton, Sussex, UK
Michael Czajka, PhD candidate (Chemistry), Melbourne, Victoria, Australia
Lady Carla Davis, MPH, Queensland, Australia
Catherine L. Deptula, DVM, BS, Brandon, Florida
Robert C Dickson, MD, CCFP, FCFP, Calgary, Alberta, Canada
Michael F. Dolan, PhD, Amherst, Massachusetts
Dr Jayne LM Donegan, MBBS DRCOG DCH DFFP MRCGP MFHom, London, UK
Aviva (Zack) Dycian, DMD, Ramat HaSharon, Israel
Irucka Embry, M.Eng., BS, Nashville, Tennessee
Hart Nadav Feuer, PhD, Agricultural Sciences, University of Bonn, Germany
Gerald A Fillmore, DDS, MS, Orthodontist (retired), Gridley, California
Laurence Fisher, BDS, Wellington, New Zealand
Naomi H. Flack, BS, EdM, Palm Beach Gardens, Florida
Gary Fortinsky, DDS, Toronto, Ontario, Canada
Matt Freedman, Chiropractic Physician, Eugene, Oregon
Brenda L. Gallie, Professor, University of Toronto, Ontario, Canada
Elsa Noeline Gannaway, MA. Dip Ed., Wellington, New Zealand
Michael Godfrey, MBBS, Tauranga, New Zealand
Sara Gold, DAMS International (Dental Amalgam Mercury Solutions) – Israel Activist, Certified Energy Health Practitioner, Betar Illit, Israel
Dorothy Goldin Rosenberg, MES, PhD, Toronto, Canada
Yarden Goldstein, DDS, Tel Aviv, Israel
Anna Goodwin, MD (Medical Oncologist), Hamilton, New Zealand
Michael Gossweiler, DDS Indianapolis, Indiana
Stephanie Grootendorst, DC, DACNB, Chiropractic Physician, Diplomate Chiropractic Neurology, Portland, Oregon
Ian Gregson, Wellington Chapter, Weston A Price Foundation, New Zealand
Ronald A. Greinke, PhD, Medina, Ohio
Sophie Guellati-Salcedo, PhD, Miami, Florida
Chris Gupta, P.Eng., London, Ontario, Canada
MC Hagerty, RN, BSN, MA, Carlsbad, California
Merilyn Haines, B App Sc Med Lab Tech, Brisbane, Queensland, Australia
Kathryn Hall, RN, Berkeley, California
Gerald F Harris BSc, BEd, Peterborough, Ontario, Canada
William Harris, MD, Honolulu, Hawaii
Leslie C. Hatcher RN, BSN, Southlake, Texas
Simeon Hein, PhD, Institute for Resonance, Boulder, Colorado
James M. Heltzel, DMD, Las Vegas, Nevada
Nancy R. Heltzel, RDH, KOHP, Las Vegas, Nevada
David R. Hill, PEng, CEng, FBCS, Professor Emeritus, Calgary, Alberta, Canada
J. William Hirzy, PhD, Washington, DC
Vic Hummert, Author, Lafayette, Louisiana
David W Horwood, MAgSc, Melbourne, Victoria, Australia
Professor C. Vyvyan Howard, MD, PhD, University of Ulster, Northern Ireland; Past President, International Society of Doctors for the Environment
Cheryl Hughes, RN, Cove, Texas
Ann Huntsman, RN, MS, Cupertino, California
April Hurley, MD, Santa Rosa, California
Lisa Intemann, PhD, BA, BAppSc, DipSocSc, Port Macquarie, NSW, Australia
Bo H Jonsson, MD, PhD, Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden
Susan Kanen, BS (Whistleblower to lead in drinking water Washington DC), Anchorage, Alaska
Barry S. Kendler, PhD, FACN, CNS, Professor of Nutrition, University of Bridgeport, Connecticut
David Kennedy, DDS, Past President, International Academy of Oral Medicine and Toxicology, San Diego, California
George Knorr, Professor of Physics Emeritus, University of Iowa, Iowa
Robert Kopitzke, PhD (Statistics), Fort Collins, Colorado
Stephen M. Koral, DMD, Boulder, Colorado
Deborah Landowne, CCH, RSHom(NA) Classical Homeopathy, San Rafael, California
Neima Langner, MD, FRCP(C) Community Medicine and Public Health, Ottawa, Ontario, Canada
Isabella Leviyev, Physician Assistant, Queens, New York
Louisa Liberman, PhD, Hillsborough, North Carolina
Hardy Limeback, PhD, DDS, Former Head, Preventive Dentistry, University of Toronto; Past President, Canadian Association for Dental Research; Member of the 2006 National Research Council panel which reviewed the toxicology of fluoride; Mississauga, Ontario, Canada
Mel Litman, MD and Maya Litman, BA, B.Ed, Metar, Israel
Dennis Lobstein, MTCM, PhD, Los Angeles, California
Theresa Lynch, Ed. D., Charlottesville, Virginia
Douglas J. Mackenzie, MD, Santa Barbara, California
Peter Mackinlay, Dip Arch, A G Inst Tech, B Arch, Geelong, Victoria, Australia
Joy Margulies, RN, BS (community health), Arverne, New York
Elizabeth McDonagh BSc(Hons), Cert. Ed., Doncaster, South Yorkshire, UK
Lisa McLaurin, RN, CCRN, Castaic, California
James D. McNabb, MD, CNS, Austin, Texas
Philip Michael, MB, BCh, DCH, DRCOG, MICGP, Hon Sec IDEA, Bandon, Co Cork, Ireland
Spedding Micklem, D.Phil (Oxon), Edinburgh, Scotland; Co-author, Case Against Fluoride (Chelsea Green, 2010)
Howard W. Mielke, PhD (Environmental Pharmacology), New Orleans, Louisiana
Deborah E. Moore, PhD, Executive Director, Second Look, Worcester, Massachusetts
Tatyana Moore, CPA, Syracuse, New York
John J Mulrooney DC, Portland, Oregon
Janet Nagel, Ed.D (Public health educator, ret.), Greensboro, North Carolina
Ted Ninnes, MA, MSc, PhD, Kawhia, New Zealand
Bill Osmunson DDS, MPH, Portland, Oregon
Eugene L. Packer, DC, N.Easton, Massachusetts
Ian E Packington MA (Oxon) Cert Tox (Barts), York, UK
Dr Geoff Pain, Monbulk, Victoria, Australia
Gilles Parent, ND, Co-author, Fluoridation: Autopsy of a Scientific Error, 2010. Québec, Canada
Professor Stephen Peckham, BSc, MA(Econ), University of Kent; Director, Centre for Health Services Studies, Canterbury, UK
Doug Piltingsrud, PhD (Inorganic chemistry), Eyota, Minnesota
Michael Pinkerton, Doctor of Chiropractic, Petaluma, California
Christian Pires, Systems Engineer, Portalegre, Portugal
Betsy Ramsay, Journalist, Teacher, Author, Jerusalem, Israel
Hagen Rampes, BSc MBChB FRCPsych, London, UK
Elizabeth W. Reed, PhD, Oak Ridge, Tennessee
James W. Reeves, PhD, Lafayette, Louisiana
David W Regiani, DDS, MIAOMT, Founding member, Past president of the International Academy of Oral Medicine and Toxicology, Ortonville, Michigan
Curtis Rexroth MA, DC, CCN, Moline, Illinois
Robert H Riffenburgh, PhD, MS, PStat, FASA, FRSS, San Diego, California; Author, Statistics in Medicine, 3rd Edition (Elsevier, 2012).
Cynthia L. Rochen, BSN, BSAg, Silver Spring, Maryland
Terry Rose, BSc., BDS, Otago New Zealand
Michael Ross, LHP, Toronto, Ontario, Canada
Troy Ross, MD, MPH, Reno, Nevada
Teresa Rouse, BSN, RN, CRRN, Green City, Missouri
Jean Ryan, BSc, Nutrition and Dietetics, RN, Brisbane, Queensland, Australia
John A. Ryan, MBBS, MSc, Nutrition, FRACGP, DCH, FAMAC (Acupuncture), FACNEM, Brisbane, Queensland, Australia
Holly Satvika, RN, FNP-BC, Asheville, North Carolina
Andrew W. Saul, PhD, Editor, Orthomolecular Medicine News Service, Rochester, New York
Michael B Schachter, MD, Certified Nutrition Specialist (CNS), Suffern, New York
Judy Schriebman, Certified Classical Homeopath, RSHom(NA), San Rafael, California
Karilee Shames PhD, RN, Sebastopol, California
Richard Shames, MD, Sebastopol, California
Nestor B Shapka, DDS, Bonnyville, Alberta, Canada
Ruth W. Shearer, PhD (toxicologist, retired), Lacey, Washington
Davorin K. Skender, BSE, Bloomington, Indiana
Rick Smith, Network Manager (CAAS), Providence, Rhode Island
Kristine L. Soly, MD, FACC, Holistic Cardiologist, Crossville, Tennessee
Joerg Spitz, MD, PhD, Schlangenbad, Germany
Carol Vander Stoep, RDH, BSDH, OMT, Austin, Texas
Kathleen Thiessen, PhD, Senior Scientist, Oak Ridge Center for Risk Analysis, Tennessee
Sheldon Thomas, Director ‘Clear Water Legacy’, Retired Manager of Water Distribution, Hamilton, Ontario, Canada
William Thornton, ND, DC, Santa Monica, California
Eric Turk, PhD (Neuroscience), North Hills, California
Shimon Tsuk, M.Sc., Kiryat Ono, Israel
Ruth Tudor, RN, Olympia, Washington
Hilary C. Walton, PhD in Evolutionary Behavioral Ecology, Cleveland OH
Barbara Warren, RN, MS, Albany, New York
Joy Warren, BSc. (Hons, Env. Sc.), Certificate in Health and Nutrition, West Midlands, UK
Declan Waugh, Environmental Scientist, Cork, Ireland
Charles Weber, MS (soil science), Hendersonville, North Carolina
John J. West, CET, LAFT, Wallingford, Vermont
Donna Westfall, Former Councilmember, Crescent City, California
Raymond R. White, PhD (Biology), San Francisco, California
Shirley Williams, RN, Bellingham, Washington
Mae W. Woo, DDS, Billings, Montana
Loty Zilberman, Chemical Engineer, MSc, Ghivataiim, Israel
References:
Barbier O, Arreola-Mendoza L, Del Razo LM. 2010. Molecular mechanisms of fluoride toxicity. Chemico-Biological Interactions, 188(2):319-33.
BBC News Scotland. 2013. Nursery toothbrushing saves £6m in dental costs. November 9.
Brunelle JA, Carlos JP. 1990. Recent trends in dental caries in U.S. children and the effect of water fluoridation. Journal of Dental Research, 69(Special edition):723-727. Excerpts at http://fluoridealert.org/studies/nidr-dmfs/
CDC 1999 (Centers for Disease Control and Prevention). Achievements in public health, 1900- 1999: Fluoridation of drinking water to prevent dental caries. Mortality and Morbidity Weekly Review (MMWR) 48(41): 933-940. October 22.
CDC 2005 (Centers for Disease Control and Prevention). Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis–United States, 1988-1994 and 1999-2002. MMWR Surveillance Summaries, 54(3):1-43.
CDC 2010 (Centers for Disease Control and Prevention). Beltrán-Aguilar, Barker L, Dye BA. 2010. Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004. NCHS Data Brief Number 53. November.
Choi AL, Sun G, Zhang Y, Grandjean P. 2012. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environmental Health Perspectives, 120(10):1362–1368.
Connett P, Beck J and Micklem S. 2010. The Case Against Fluoride. White River Junction, Vermont: Chelsea Green Publishing.
McDonagh MS, Whiting PF, Wilson PM, et al. 2000. Systematic Review of Water Fluoridation. British Medical Journal, 321(7265):855–59. Note: The full report that this paper summarizes is commonly known as the York Review and is available at http://www.york.ac.uk/inst/crd/fluorid.htm
NRC 2006 (National Research Council of the National Academies). Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. Washington, DC: The National Academies Press.
Siegel-Itzkovich J 2014. Backlash against Health Minister Yael German for her decision to stop fluoridation. The Jerusalem Post. June 22.
Varner JA, Jensen KF, Horvath W, Isaacson RL. 1998. Chronic administration of aluminum-fluoride or sodium-fluoride to rats in drinking water: alterations in neuronal and cerebrovascular integrity. Brain Research, Feb 16;784(1-2):284-98.
Warren JJ, Levy SM, Broffitt B, et al. 2009. Considerations on optimal fluoride intake using dental fluorosis and dental caries outcomes – a longitudinal study. Journal of Public Health Dentistry, 69(2):111-5.
Print 
PDF