On Monday June 12, 2000, San Francisco Supervisor Mark Leno received the support he needed from other Members of the San Francisco City and County Board of Supervisors for his motion that directs the Legislative Analyst to report on research of revised American Dental Association (ADA) and American Academy of Pediatrics (AAP) recommendations for controlled-dose fluoride prescriptions for children in non fluoridated communities, and to gather information on San Francisco’s total exposure to fluoride from all sources by the end of June 2000.

San Francisco began fluoridation in 1952.

In 1995, while segments of these same trade associations simultaneously continued to lobby for fluoridation, both the ADA and the AAP created new policy recommendations for fluoride drops and tablets, which are intended to be the substitute for fluoridated water in non fluoridated communities.

The new schedules indicate that mass medication, at the claimed “optimal” level of fluoridation, exceeds the dosage that a qualified professional could prescribe, even after the professional’s individual evaluation of a child for growth and development, weight, total exposure to fluoride from all sources, and individual susceptibility.

According to these new recommendations, infants are to receive no additional fluoride, no matter what the fluoride level in the water; and it is not until a child reaches the age of 6 that the new prescription recommendations ever reach the dosage that a child consumes drinking a liter of fluoridated tap water. A child between the ages of 6 months and 3 years would be limited to a prescription containing the amount of fluoride found in one cup of water, according to the new recommendations.

U.S. Public Health Service documents show that even in 1991, non fluoridated communities were already receiving equal to and more than the targeted fluoride dosage of 1 mg per day. Fluoridated communities were receiving an estimated 3 to 7 times the “optimal” goal.

The AAP explained that their recommendations were revised because of the increased incidence of dental fluorosis (opaque white spots, striations, brown staining, mottling, and fracture prone teeth, which occur during the development of a child’s enamel, prenatal to approximately 8 years of age). The largest survey in the U.S., performed by the National Institute of Dental Research, showed in their 1986-87 survey that 66.4% of children in fluoridated communities displayed the visible signs of fluoride over-exposure on at least one tooth, and 29.9% of these same children had at least two teeth with enough severity to classify.

According to the same survey, children in non fluoridated communities are not faring well either __ 40.1% displaying overdose on at least one tooth and 13.5% on at least two teeth with enough severity to classify.

Dental fluorosis is the process by which excess fluoride exposure damages the specialized cells that lay down collagen that make up the tooth enamel. The specialized cells are only present during the child development years, thus adult over-exposure to ingested fluoride is not displayed in enamel.

Exposure to fluoride has increased since fluoridation’s inception in 1945, as fluoride is now found in sodas, fruit juices, cereals, 2% milk, concentrated soups, de-boned and ground chicken, teas, white grape juice; and lettuce, tomatoes, raisins, and other produce because of fluoride-based pesticides. Fluoride toothpastes are now required to carry a warning that children under 6 years of age should not be allowed access to fluoridated toothpaste without supervision, and to call a poison control center if a child should swallow more than an amount used for brushing.

There are no requirements for labeling fluoride contents of food that do not make specific health claims for the fluoride.