In an article in the January issue of the Journal of the American Dental Association (JADA) authors Armfield and Melbye indicate that “Studies of dentists’ attitudes about water fluoridation suggest that a lack of knowledge and preparedness are barriers to discussing the topic … more than one-half of the respondents believed they needed more information and training on the issue,” reports the Fluoride Action Network (FAN).

Fluoridation, touted as a decay-preventive, is the addition of fluoride compounds (mainly hydrofluosilicic acid derived from the phosphate fertilizer industry) to public water supplies.

Despite dentists’ lack of knowledge, these authors urge them to promote fluoridation, anyway.

According to Paul Connett , PhD, FAN director and lead author of the book The Case Against Fluoride ( Chelsea Green , 2010), “It is reckless to urge dentists to tell the public that fluoridation is safe when they are not on top of the literature. Their qualifications pertain to teeth. They are not qualified to assess what damage ingesting fluoride may cause to the rest of the body.”

Armfield and Melbye encourage dentists to promote the safety of fluoridation based upon this misleading assurance:

“There are no known harmful effects from ingestion of water that has had fluoride added to it at or about 0.7-1.2 milligrams/liter. No systematic reviews of the literature have shown any negative health effects from ingestion of water fluoridated in or near this therapeutic range.”

Connett says, This assertion is dangerously misleading because it:

a) Confuses the difference between concentration and dose. Harm has been found at doses that are commonly experienced in populations drinking artificially fluoridated water. For example, a child drinking 2 liters of water at 1 ppm (the average level used in fluoridation) will get a higher dose than a child drinking one liter of water at 1.9 ppm, the threshold for lowering of IQ in one published study.

b) Ignores that most basic health studies have not been conducted in countries practicing fluoridation. The absence of study is not the same as absence of harm.

c) Overlooks the serious findings reported by the US National Research Council in 2006 that subsets of the population – including bottle-fed infants – are exceeding the EPA’s safe reference dose (0.06 mg/kg bodyweight/day) drinking fluoridated water.

To compensate for dentists’ inadequate understanding of fluoride science, the JADA article encourages dentists to use “political campaigns” and their “reputation with the public” to promote fluoridation.  They write: “Advocacy through dental societies, such as participation in lobbying efforts, also may be an effective way for dentists to promote water fluoridation.”

Little seems to have changed since the ADA’s Council on Dental Health and Health Planning issued this unprofessional advice in a 1979 White paper:

“Individual dentists must be convinced that they need not be familiar with scientific reports and field investigations on fluoridation to be effective participants and that non- participation is overt neglect of professional responsibility.”

Being unfamiliar with the scientific literature is far more serious today than it was in 1979.

Connett says, “Many dentists may be shocked to find that there have been 36 studies published since 1991 that found an association between fairly modest exposure to fluoride and lowered IQ. In one of the studies (Ding et al., 2011), the researchers found IQ lowered in children drinking water ranging from 0.3 to 3 ppm and that the higher the level of fluoride in the urine (a measure of fluoride exposure) the lower the IQ. In addition, Harvard researchers in a systematic review of 27 of these IQ studies concluded that effect on children’s developing brains should be a ‘high research priority‘ especially in the US which has never investigated brain/fluoride effects.”

Armfield and Melbye postulate that: “Dentists’ lack of self-efficacy with respect to critically evaluating scientific literature may help to explain their reluctance to promote water fluoridation in their clinical practices.”

Connett says, “this reluctance in the face of lack of knowledge is to the credit of dentists. However, the efforts by Armfield and Melbye to override this reluctance on the basis of what amounts to little more than PR spin is reprehensible. It is a shabby attempt to get dentists to unwittingly betray the public’s trust. The same applies to the ADA that sanctioned the publication of this article.”