Research says it’s not a magic bullet, but if used properly, it can reduce tooth decay
Research is mixed on the effectiveness of fluoride in local water supplies for improving public health.
Conspiracies have always existed, but the internet has become a breeding ground for fluoride theories. Conspiracists online, for example, claim fluoride is the way the government dumbs down the populace through introduction of the chemical into the water supply.
While there are some risks to fluoride consumption, getting stupider is likely not one of them. The same can’t be said about spending too much time online: Despite all the information available, misinformation teems across the web.
Fluoride is the ionic form of fluorine, which is one of the most abundant elements on Earth, constituting 0.08 percent of the crust. It exists in rocks, soil, air and water across the globe. Lewiston Public Works Director Chris Davies said the city has had fluoride in the water supply since 1945. Depending on where it’s measured, fluoride is found at 0.64 to 1.12 parts per million in the water, well below the federal limit of 4 ppm.
The US National Research Council of the National Academies in a landmark 2006 report on the toxicology of fluoride stated that the Maximum Contaminant Level Goal (MCLG) of 4 ppm. The MCLG is a health goal set at a concentration at which no adverse health effects are expected to occur and the margins of safety are judged “adequate: “… the committee concluded unanimously that the present MCLG of 4 mg/L [or 4 ppm] for fluoride should be lowered. Exposure at the MCLG clearly puts children at risk of developing severe enamel fluorosis, a condition that is associated with enamel loss and pitting. In addition, the majority of the committee concluded that the MCLG is not likely to be protective against bone fractures.” Reference: Chapter 2, pages 2-3. The report also called fluoride an Endocrine Disruptor for the first time: “Fluoride is therefore an endocrine disruptor in the broad sense of altering normal endocrine function or response…” Reference: page 266.
Davies said, on average, the water supply is at about 0.96 ppm, which equates to something like 0.96 milligrams per liter of water.
Fluoride is naturally occuring in the Lewiston area. Though it could also be discharge from fertilizer.
Much of the research into fluoridation has shown it has limited beneficial effects on bone density, but does not correlate to fewer bone fractures. It mainly has some benefits in preventing dental caries, which is an infectious lesion developed in the tooth enamel causing tooth decay. Fluoride is one piece of overall oral hygiene that helps prevent and regress tooth decay, according to a 2018 National Institutes of Health study.
Fluoride has a very low retention rate. Only about one-quarter to one-third of absorbed fluoride winds up calcified into the bones. It is recommended that infants receive 0.7 milligrams of fluoride daily with 3 mg for adult women and 4 mg for adult men.
But it’s true that the chemical can have adverse effects.
Another NIH study found that fluoride can have health risks, with only modest benefits for preventing tooth decay. The 2014 paper concluded the adverse effects do not justify the limited health benefits.
“Given the questionable evidence of benefit and increasing evidence of harm, the policy of water fluoridation for the prevention of dental caries should be abandoned in favor of more effective interventions,” the study states.
But the Centers for Disease Prevention and Control lauds the introduction of fluoride to drinking water as one of the greatest public health benefits of the century. Still other studies point toward its contributions to bone density and enamel protection in youth. So which studies are to be believed? The NIH conducted an overview of the benefits and hazards of fluoride, publishing several studies. Depending on which research you consider more thorough, you could be swayed either way. What several studies conclude, however, is that fluoride is better applied topically than through a water supply, since amounts can fluctuate in the water as can the amount people drink.
Adverse effects largely stem from unmoderated amounts in drinking water above the recommended dosages. A meta-analysis of 27 studies, largely China-based, found “strong indications” that fluoride may disrupt cognitive development in children. All but one of the studies in the meta-analysis found that cognitive development was adversely affected. The effects, however, were very small, amounting to a negative difference of seven points on Intelligence Quotient scores, or a 0.45 percent reduction.
The writer wrongly stated that the effects of the loss of 7 IQ points was “very small.” This is a large and significant loss.
FYI, because of the misrepresentation in many news reports that referenced a Harvard School of Public Health news story of July 25, 2012, using the “0.45 reduction” wrongly as a reduction in IQ, a clarification was made on September 5, 2012: “The average loss in IQ was reported as a standardized weighted mean difference of 0.45, which would be approximately equivalent to seven IQ points for commonly used IQ scores with a standard deviation of 15.*” [our emphasis]
Water with fluoride in it isn’t making you dumber.
Fluoride’s efficacy in preventing tooth decay hovers around 15 percent in reducing the enamel disease, according to the 2014 study. But the 2018 study that looked at 113 other research papers found its effectiveness was between 40 percent to 50 percent.
The harm caused by ingesting too much fluoride can be minor to crippling in prolonged, excessive dosages. Extended exposure to fluoride can cause skeletal fluorosis, which leads to joint pain, numbing of the extremities and back pain. Fluoride toxicity can cause nausea, vomiting, diarrhea and even death. It is usually found in children younger than 6 and is rare for adults. Toxicity is usually a result of fluoridated water consumption paired with improper use of other heavily fluoride-infused products such as mouthwash and toothpaste.
Another debate that has arisen online regards the ethics of removing the public’s choice by adding fluoride to water systems. The other side of the debate advocates for free preventative care through water consumption to benefit low-income people with inadequate access to dental care.
Both NIH studies suggest fluoride be introduced topically instead of ingested through the water supply. The 2014 study advocates for an ideological reverse from public health organizations that promote the benefits of fluoridation but neglect to highlight the risks.
While going online to find answers about whether fluoride is dangerous can be a dubious task, some research suggests it can be beneficial if appropriately applied.