Wednesday night the city of Cambridge held a community forum to discuss the risks and benefits of its public water fluoridation program. And activists in other cities, like Newburyport and Gloucester, are organizing to get town ballot measures to stop water fluoridation. There are about 140 Massachusetts cities and towns that add fluoride to the drinking water.

For about seven decades, communities in America have been adding it to the water in an effort to prevent tooth decay in adults and children. And by many accounts it’s been wildly successful: The Centers for Disease Control labels fluoridation of water as one of the 10 great public health achievements of the last century.

Yet in the face of widespread support from the dental and health communities, the American Dental Association and the World Health Organization in recent years a number of Massachusetts towns have turned back the clock on water fluoridation.

Two Views On Water Fluoridation

Dr. Philippe Grandjean, adjunct professor of environmental health at Harvard’s School of Public Health on water fluoridation and the developing brain:

Just because we did studies over the last 70 years, it doesn’t mean that we did everything that is necessary to know for sure that fluoridation is not toxic to some processes in the body or development of the brain. Those studies have actually not been done.

I’ve been studying human brain development in regard to exposures to lead, mercury, pesticides, solvents and when I started looking at the fluoride literature, in connection with the National Research Council’s report on fluoride a few years ago, I thought that there was a stone that we hadn’t turned. I worked with the most prominent scientist in China, where 27 studies had been done looking at communities where children have lived all their lives, actually before conception, and were exposed to the same amounts of fluoride in drinking water at different levels. They suggested that children exposed to higher levels were losing an average of 7 IQ points compared to those exposed to low amounts of fluoride.

We know very well that the dose makes the poison, but the point is that the lowest of the highly exposed children, were quite similar to our fluoridation levels, so we are in that range.

I know that Health and Human Services in Washington has recommended that we decrease the level of fluoride in water from 1 part per million to 0.7 parts per million. I think we ought to do that right away, because it’s recognized by the experts around the world that we don’t need as much as Cambridge adds to the water. And then we’ve got to follow this very carefully with CDC hopefully doing studies that can calm down our worries.

I really hope that we’re right and that it’s safe, but I want to be sure. Because I’ve worked in this field long enough to know that with time, we have always found that lead, mercury and pesticides were more toxic than we originally thought. I am not willing to sit here and say, OK, let’s expose the next generation’s brains and just hope for the best.

Toothpaste is the perfect way of exposing the teeth to fluoride is needed. We don’t need to absorb fluoride into our bloodstream where it can be carried to the brain. I look at this as “mega dosing,” it is like aerial spraying of huge amounts of fluoride, where just a tiny bit is reaching the target.

Howard Pollick, professor of health sciences at the University of California School of Dentistry and the chair of the Fluoridation Advisory Committee at the California Dental Association Foundation on the science behind fluoridation’s safety:

There have been 70 years of experience since the initial community trials in 1945 in Grand Rapids, MI,  Newburgh, NY and other places. They were trying to simulate what naturally occurs in some communities, that is, an optimal concentration of fluoride in the water. At that time it was considered to be about 1 part per million, a milligram per liter, a very small concentration.

What they found was it had a profound effect on reducing the severity and burden of tooth decay for the community, so that was simulated in these community trials, and found to be very effective, without any consequences to health. That practice now occurs with about 3/4 of the American public that’s served by public water systems. That’s over 200 million people in this country.

I think that people are getting a lot of information on the internet and from the Fluoride Action Network, which is dedicated to opposing fluoridation. But there’s also a lot of authoritative resources on the internet, including the Centers for Disease Control, the World Health Organization and the American Dental Association, and when they look at the safety, and the potential risks at that concentration, there really really isn’t a risk to health. This has been confirmed with a report in 2006 that looked at fluoride in water from the National Research Council at the request of the Environmental Protection Agency, and they did not find any health concerns at the level that we’re talking about.  It is very important to consider levels, the concentration. Certainly, if there’s a very high concentrations of fluoride in water, you can maybe have some problems, but the way it’s controlled with water fluoridation systems, there are no problems.

The studies that Professor Grandjean got from China and elsewhere showed that at higher levels, there might have been a problem, compared to lower levels of fluoride. In fact, the lower levels, where we are sort of comparable in terms of what we have in the united states in fluoridation, actually showed that IQ was not changed by those lower levels. It’s a basic tautological principle that it’s not the substance that causes the problem, but it’s the dose or concentration, we’ve known this for centuries. That’s why we control the concentration of fluoride in water, because every water system has some naturally occurring fluoride, and we want to make sure that it’s at the optimum concentration for the benefit of dental health.

One point that I think Professor Grandjean and I agree on is the proposed recommendation by HHS to go to .7 parts per million. Young children, unfortunately, tend to swallow fluoride toothpaste — fluoride toothpaste is 1000 parts per million of fluoride. And the recommendation is to spit it out. Well young children can’t do that very well, they can’t spit, so we recommend a very small, pea sized or even a smear of fluoride on the child’s toothbrush when they are very young.

Click to listen to radio debate: The Fluoride Debate Rages On In Some Massachusetts Cities

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