OPINION – August 27, 2012 — My personal experience with fluoridation began by growing up in Phoenix, Arizona, an area with naturally high fluoride. I noticed two consequences. First, my teeth and those of the kids I grew up with now have very few cavities. Second, almost all of us vote Republican. Both might be coincidental, however.

Like Mr. North, I too was an avid proponent of artificially fluoridated drinking water. His thoughtful, well-researched, and dispassionate analysis caused me to review his references and rethink my position. After doing so, I remain an avid proponent of artificially fluoridated drinking water. Here’s why.

1. There is no evidence any citizen has been harmed by artificially fluoridated drinking water.

We certainly have sufficient exposure. About 162 million Americans drink artificially fluoridated water. Over 40 of our largest cities fluoridate their drinking water. Over 60% of Americans drink water with detectable levels of fluoride, either natural or artificial. We have over 60 years of exposure. We still await a report of morbidity or mortality.

2. Benefits have been demonstrated.

Many studies conclude artificially fluoridated drinking water reduces the number, cost, and medical sequelae of dental cavities. A minority conclude it may not make a difference. Several professional organizations with no professional or financial interests in worsening the population’s dental health recommend artificially fluoridated drinking water. These organizations include the American Dental Association, American Medical Association, and Health Share of Oregon (the tri-county area’s largest Coordinated Care Organization). The scientific community may be divided, but organizations which experience the sequelae of poor dental health are not.

3. The report from the National Academy of Science (NAS) examined naturally fluoridated water whose fluoride levels exceed the recommended artificial level three to eight-fold.

The NAS concluded the current maximal contaminant level of 4 mg/L recommended by the FDA for naturally fluoridated water was not low enough. Their findings apply only to naturally fluoridated water, not to artificially fluoridated water. In fact, the NAS took care the evidence they considered not be applied to artificially fluoridated water: “The committee did not evaluate the risks or benefits of the lower fluoride concentrations (0.7 to 1.2 mg/L) used in water fluoridation. Therefore, the committee’s conclusions regarding the potential for adverse effects from fluoride at 2 to 4 mg/L in drinking water do not apply at the lower water fluoride levels commonly experienced by most U.S. citizens.”

The Chinese studies of the association between fluoride and IQ compared children drinking naturally fluoridated water with high levels (2.5 to 4 mg/L) to those drinking water with lower
levels (0.18 to 0.76 mg/L). This latter level is slightly lower than the target level for artificially fluoridated water in the US. The NAS did not find this association convincing. “Without detailed information about the testing conditions and the tests themselves, the committee was unable to assess the strength of the studies.” If nothing else, these studies suggest our recommended levels of artificially fluoridated water may be safe.

4. There is no evidence that water in cities with artificially fluoridation have higher levels of arsenic or lead than cities that don’t.

Fears that adding fluoride to drinking water will increase levels of other chemicals have not been validated.

Given this evidence, I respectfully disagree with Mr. North’s conclusion. Artificial fluoridation is inexpensive, has no demonstrated risk, and offers considerable financial, medical, and dental benefits.

As Mr. North noted, opposition and support for artificial fluoridation does not fall along traditional fault lines. What a curious association between liberal and conservative organizations. Does anyone remember the psychotic General Jack D. Ripper in “Dr. Strangelove”?

“Fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face… A foreign substance is introduced into our precious bodily fluids without the knowledge of the individual. Mandrake, have you ever seen a Commie drink a glass of water?

Of course, General Ripper may have been right all along.

References:

In addition to Mr. North’s excellent documentation, I found these sites helpful.

Engineering and Administrative Recommendations for Water Fluoridation, http://www.cdc.gov/mmwr/preview/mmwrhtml/00039178.htm

http://www.cancer.gov/cancertopics/factshee/Risk/fluoridated-water

Wall Street Journal, March 23, 2006. Government Panel Raises Concern About Fluoride. By Sharon Begley. http://www.healthy.net/scr/News.aspx?Id=8293

The National Academy of Science Report, 2006. http://www.nap.edu/openbook.php?record_id=11571&page=205

Dr. Samuel Metz is an anesthesiologist working at multiple sites in the Willamette Valley. He lives in Portland with his wife and daughter, and is member of Mad As Hell Doctors, Physicians for a National Health Program, and Health Care for All Oregon, all of which advocate for publicly funded universal health care.

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