Glaring examples of anti-fluoride paranoia have recently made the news. An outfit called FAN (Fluoride Action Network), another called the Lillie Center, and the EWG (Environmental Working Group) have weighed in with media releases that demonstrate quack modus operandi: misstatements of fact, half-truths, and dubious, cherry-picked, non-contextual data. They use a November 2006 statement by the American Dental Association as a jumping-off point, mischaracterizing the ADA recommendation to generate false implications.

Environmental Working Group

This from the EWG: “Even the American Dental Association has changed its tune and tells parents to avoid fluoridated water…It’s troubling that children across the country are drinking fluoridated water in spite of serious health concerns.” And the FAN letter asserts that the ADA recommendation “clearly excludes the use of fluoridated tap water” for preparing infant formula. Both the EWG and FAN cite a recent paper from Harvard that reportedly suggests a link between fluoridated water and the development of osteosarcoma, a rare bone cancer.

But the authors of the Harvard paper, which is a limited part of a larger fifteen-year study scheduled by the Harvard School of Dental Medicine, note that their work constitutes an “exploratory analysis” that will require scientific confirmation to substantiate or refute the findings. Moreover, the principal investigator of the larger study states that the full study will not suggest an overall association between fluoride and osteosarcoma.

And the assertions about the ADA’s position are false: the ADA clearly states that infant formula prepared with fluoridated water presents no health risk but may create an increased risk of fluorosis, which is not a disease but can affect the way teeth look. ADA’s November recommendations on simple ways to reduce fluoride intake for infants and young children relate to fluorosis, not to any health risks. The most common type of tooth fluorosis is barely detectable except by an expert eye (in a half-century of active dental practice in fluoridated New York City, I can’t recall any patients complaining of noticeable fluorosis). That the EWG cites a questionable study and a small chance of a cosmetic flaw as evidence of “serious health concerns” casts further doubt on their pretense to be reliable environmental advocates.

To feature such dubious risks against the undeniably demonstrated benefits of fluoridation flies in the face of the risk-benefit principle and is characteristic of quackery. For the hundreds of millions of people who drink fluoridated water, the demonstrated protection from dental caries is overwhelming, there are no known health risks, and the risk of fluorosis very small, if not non-existent.

Fluoride Action Network

FAN states that the U.S. is “one of the few remaining fluoridating countries.” But over 405 million people in over sixty countries worldwide enjoy the benefits of fluoridated water. These countries include Canada, Australia, the United Kingdom, Brazil, Chile, Israel, Singapore, and New Zealand. Some other countries, because of water supply problems, have instituted programs of fluoride supplements and fluoridated salt. The oft-repeated assertion that Europe has banned fluoridation is false.

FAN, referring to a report by the National Research Council, misleadingly states that the National Research Council says that the Environmental Protection Agency safe drinking water standard for fluoride is unsafe and should be lowered. But the NRC report refers only to naturally occurring fluoridated water, not to the water fluoridation program, and the EPA water standard is four times the amount of fluoride used in fluoridation — this has nothing to do with community water fluoridation, and FAN’S juxtaposition of the allegation with their implications about fluoridation is deceitful. As a matter of fact, the NRC report itself states: “The report does not examine the health risks or benefits of the artificially fluoridated water that millions of Americans drink, which contains 0.7 to 1.2 mg/L of fluoride.”

FAN falsely claims that the anti-caries activity of fluoride is only topical, and that therefore drinking fluoridated water is not useful. Topical fluoride is indeed effective, but fluorides ingested regularly during tooth formation (preeruptively) are integrated into the enamel and provide longer-lasting protection than topical fluoride. Also, fluoridated water enhances the topical effect: ingested fluoride is incorporated in saliva that continually bathes the teeth.

FAN’s release is signed by a list of “600 professionals,” but their cited credentials do not inspire confidence. A quick look shows a glut of pseudo-science buzz-words: Natural, Holistic, Chiropractic, Organic, Oriental Medicine, Acupuncture, Environmental Health, Orthomolecular Health-Medicine, Integrative Medicine, Biological Dentistry, Environmental Medicine. Certain organizations, like the “International Academy of Oral Medicine and Toxicology,” keep popping up. It claims as “professionals” self-styled nutritionists, authors of half-baked books, and even the folk singer Pete Seeger. (Seeger is a legendary entertainer who in the past has given significant support to important environmental programs. It is sad to see him, at the twilight of his career, lending his name to anti-fluoridation quackery, with the implication that he’s a science “professional.”)

After all the noise, one solid fact remains: fluoridation is safe, effective, and essential. No valid health risk has ever been demonstrated.

See also: ACSH’s full report, A Primer on Dental Care: Quality and Quackery.

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