If the benefits to teeth from fluoridated water are hard to find, the damage done to teeth by fluoridated water is easy to see – literally.

Dental fluorosis is a mottling of the tooth surface that can range from mild discoloration of the tooth surface to severe staining and pitting. The condition is permanent after it forms in children during tooth formation.

Back at the 1965 trial in Columbia, the court was repeatedly assured by pro-fluoridation witnesses that fluoridation at one part per million would not produce dental fluorosis, first by Dr. William Draffin, former president of the South Carolina Dental Association, and later by Dr. Fred Lewis, Director of the Division of Dental Health at the State Board of Health.

Yet today in the U.S. the prevalence of dental fluorosis is surprisingly high, and increasing. The Centers for Disease Control in 2005 released a survey of American children showing an overall dental fluorosis rate of 32 percent in U.S. school children aged 8-19. This represents a 40 percent increase in the incidence of dental fluorosis since the previous survey done 15 years earlier. This increase in dental fluorosis provides a biomarker of overexposure to fluoride in U.S. children. While, as expected, the incidence of dental fluorosis is 2 and a half times higher where drinking water is either fluoridated or naturally high in fluoride, many children even in localities without significant fluoride in the water now show signs of dental fluorosis. How can this be?

A ubiquitous toxin

It turns out that drinking fluoridated water is only one of a number of sources of exposure to fluoride. Children in unfluoridated localities consume sodas and other beverages manufactured in fluoridated localities using fluoridated water. This is known as “the halo effect.” In addition, grape products, tea, and processed chicken can be high in fluoride apart from water used in processing and preparation. (The fluoride in grape products is due to residues of the pesticide, Cryolite, which is widely used on grapes.)

A major source of fluoride intake for children in particular is swallowed toothpaste. Fluoride toothpaste contains about 1000 ppm fluoride. While adults on average ingest 3 percent of the toothpaste they use for brushing, 2 year old children in one study swallowed a mean of 65 percent of the toothpaste they brushed with. It was found that many small children don’t even rinse after brushing. You can confirm what a bad idea this is by examining the warning label on your tube of fluoride toothpaste:

“Keep out of reach of children under 6 years of age. If you accidentally swallow more than used for brushing, get medical help or contact a poison control center right away.”

Fluoride intake from swallowed toothpaste can easily surpass that from fluoridated water for many small children.

High-dose groups

Non-nursing infants can also receive a surprisingly high exposure to fluoride when fluoridated water is used to reconstitute their infant formula. The NRC Review lists average fluoride intake for this group at 0.87 – 1.15 mg/kg of body weight/day – about 3 times the dose in mg/kg/day received by the average adult drinking the same fluoridated water.

Of course, anyone drinking fluoridated water who drinks more water than average will receive a higher than average exposure to fluoride. While the EPA estimates average water consumption for adults at l.l5 liters per day, the Centers for Disease Control recommends that anyone exercising heavily in hot weather consume 0.5 – l liters of fluids per hour. There are also between 5 and 10 million people in the U.S. with undiagnosed or poorly controlled diabetes, which is characterized by high water intake. People with renal insufficiency also receive a higher effective dose of fluoride due to their kidneys’ impaired ability to remove fluoride that they ingest.

Fluoridation’s collapsing margin of safety

This relatively uncontrolled exposure to fluoride resulting from water fluoridation at one ppm was justified back in 1965 by claims of a wide margin of safety between expected exposures from fluoridation and the dose of fluoride required to produce deleterious health effects. By contrast, the 2006 National Research Council review of fluoride standards found that 4 ppm of fluoride in drinking water is not protective of public health, and did not assert that a standard of 2 ppm is protective of public health either. The wide margin of safety claimed in 1965 had officially collapsed, replaced by uncertainty as to what exactly constitutes a safe level of fluoride in drinking water, and by the realization of how little is actually known about the effects of fluoridation after 40 years of what amounts to the intentional contamination of our water supply.

At the 1965 trial in Columbia, the star witness in opposition to fluoridation was Dr. George Waldbott, a leading fluoride researcher who had come all the way from Michigan to testify. Dr. Waldbott described his research on hypersensitivity to fluoridated water, and refuted claims that there was a wide margin of safety between exposures from fluoridation and negative health effects. He said that physicians and dentists testifying in support of fluoridation “testify in good faith and they are honest and sincere, but they are simply not aware of what is going on,” since research unfavorable to fluoridation could not get published in the U.S.

On August 17, 1965, Judge John Grimball ruled that “The city has a right to place fluoride in the water and require its citizens to drink it whether they wish to or not, because it is a well thought out plan supported by excellent medical authorities.” Fluoride opponents appealed the judge’s ruling to the S.C. Supreme Court, where it was upheld 4 to 1 on May 11, 1966. On July 6, 1967 the fluoridation of Columbia’s water supply began, and has continued ever since.

CDC still promoting fluoridation despite evidence

Today 152 million Americans receive artificially fluoridated water and another 10 million receive water from groundwater sources with fluoride levels of at least 1 ppm. Fluoridation continues to be actively promoted by the U.S. Centers for Disease Control. The CDC has declared that fluoridation of drinking water in the U.S. is “the major factor responsible for the decline in dental caries (tooth decay) during the second half of the 20th Century,” ignoring the evidence that non-fluoridated localities have experienced similar declines. According to the CDC, “extensive research conducted over the past 60 years has shown that the fluoridation of public water supplies is safe and effective.” The CDC dismisses the recent NRC review of fluoride standards, claiming that “the NRC committee did not examine the health risks of water at the levels recommended for fluoridation.”

Citing the findings of the National Research Council review, the Georgia-based Lillie Center on August 7, 2007 filed an ethics complaint against the CDC Division of Oral Health. In its complaint the Lillie Center charged the CDC with “mislead[ing] the public concerning the results of studies about harm from ingesting fluoride,” and “omit[ting] vital information in its information disseminated to the public concerning vulnerable population groups that are particularly susceptible to harm from fluoride.”

In fact, the CDC’s active support and promotion of fluoridation is critical in providing this intentional contamination of our water supply with political cover from questions about its safety and effectiveness. In its ethics complaint, the Lillie Center describes how the system works:

“Water districts and cities adopt the position [that fluoridation is safe] by deferring to … the opinion of state health departments, and state health departments defer to CDC’s Oral Health division.”

That is indeed how it works here in South Carolina. In response to my inquiry about the safety and effectiveness of fluoridation, Columbia Utilities Director John Dooley stated that in fluoridating our water the city of Columbia is only following the advice of DHEC, whose goal, according to Dooley, “is to increase the number of South Carolinians receiving the oral health benefits of optimally fluoridated drinking water.” When I wrote him again, Dooley responded, “We advise you to contact DHEC regarding fluoridation practices.”

DHEC Oral Health Director Christine Veschusio told me that in deciding to endorse fluoridation, “We base our decision on organizations such as the CDC.” Paul Connett, director of Fluoride Action Network, describes the relationship between the CDC and state health departments more bluntly:

“Policy is determined from the top [by the U.S. Surgeon General] and sent down to the state health departments just like the military. If you are in this bureaucratic chain of command, you do not challenge policy without risking your job and your pension. In the case of fluoridation, this policy is orchestrated by the Oral Health Division of the CDC …State health departments throughout the 50 states promote the practice [of fluoridation] faithful to the chain of command.”

As much as Columbia city officials would like to pretend that the decision to fluoridate our water is DHEC’s, it was a vote by Columbia city council that started fluoridation forty years ago, and it would only take a vote by Columbia city council to end it. Over the past 2 years I have sent letters, e-mails, and information packets to city council members in an attempt to inform them about fluoridation, with absolutely no response. Ultimately it will require political pressure, not pleas for the protection of public health, to motivate our city council to close the fluoridation valves at the city water plants, and end the intentional contamination of our water supply that their predecessors mistakenly approved in 1965. Given the current level of public ignorance, and the unwillingness of the mass media to examine this issue critically, I am not holding my breath.

For more information on water fluoridation, see the Fluoride Action Network website, http://www.fluorideaction.net

Additional Fluoride Facts:

Easy to Add, Hard to remove – Ordinary water filters do not remove fluoride, and boiling fluoridated water only concentrates the fluoride. Effectively removing fluoride from water requires distillation, high-quality reverse osmosis, or a special activated alumina filter.

Natural fluoride levels – The water that enters Columbia’s water plants has fluoride levels of about 0.1ppm. In general, unpolluted surface waters have fluoride levels below 0.2 ppm, with the majority below 0.1 ppm. However, in some places groundwater contains much higher levels of fluoride. At last count, 105,618 people in South Carolina (mostly in the low country) received public water supplies from groundwater with more that 4ppm fluoride, more people than in all other states combined.

Natural does not mean safe – The fact that groundwater in some places has high levels of fluoride is used by fluoridation proponents to imply that fluoride is safe because it is “natural.” But some groundwater also has naturally high levels of arsenic, a known carcinogen. Would anyone claim that this makes water tainted with arsenic safe?

One man’s trash … – Fluoridation provides a tremendous financial windfall to the phosphate fertilizer industry. The chemical used to fluoridate Columbia’s water (as well as most fluoridated water in the U.S.) is produced mainly from the volatile fluorosilicates caught by the phosphate fertilizer industry’s pollution control scrubbers. This byproduct would otherwise be classified as hazardous waste.

A tale of two toxins – In Clinical Toxicology of Commercial Products (5th edition, 1984), fluoride is rated as slightly more toxic than lead (fluoride is rated as very toxic; lead is rated as moderately to very toxic). Yet the permissible level of lead in drinking water is 0.015 ppm, while for fluoride it is 4 ppm – 250 times higher. In fact, fluoride is intentionally added to drinking water at a rate 66 times higher than the allowable level for lead.