“Recent high-quality UK studies show how limited the benefits to dental decay are. Oral health in Scotland has significantly improved without fluoridation. The Government and dental lobby are wrong to keep overstating the benefit and saying fluoridation is safe and effective.”
Fears over fluoride have reached a head in San Francisco, where the US Environmental Protection Agency (EPA) is being taken to court by the Fluoride Action Network over claims the mineral is damaging the neurodevelopment of foetuses and children.
It was sparked by a draft report from the US Department of Health’s National Toxicology Programme which looked at 55 studies and found: “When compared to children exposed to lower levels of fluoride, children exposed to higher fluoride levels had statistically significantly lower IQ scores.”
The report, which took three years to complete, has proved controversial and been subject to two reviews by the National Academies of Sciences, Engineering, and Medicine, who claim the authors failed to provide adequate support for their conclusions and asked for a substantial rewrite.
The amended version has yet to be formally released, although it was signed off by the National Toxicology Programme in May 2023 and sent to NTP leadership for approval, with the authors largely sticking to their guns.
‘If it was toxic, the Russians would be using it’
Barry Crockroft, the former chief dental officer for England, and now chairman of the British Fluoridation Society, remains unconvinced.
“If it was toxic, the Russians would be using it,” he said. “There is a health monitoring programme carried out on a rolling basis and there has never been any disease which has shown up as linked.
“You can never prove a negative. I could suggest that chocolate biscuits cause dementia, God forbid, but nobody has done the research to show it is not true.”
As with all medicines or interventions, the dose makes the poison, and there is great uncertainty about the level at which fluoride may become harmful.
Some areas of the world naturally have very high levels of fluoride, and it is known to lead to dental fluorosis or crippling skeletal fluorosis, which can lead to calcification of tendons and ligaments, and bone deformities
The World Health Organisation currently recommends a limit of fluoride in drinking water at 1.5 mg/L, but it is impossible to know how much extra fluoride people are consuming through other means.
Coffee, tea, wine, grapes, potatoes and seafood are all known to be high in fluoride, and any food prepared in fluoridated water will also pick up traces of the mineral.
Fluoride is also present in baby formula, which could explain why bottle-fed babies in fluoridated areas of Canada suffered bigger drops in IQ than breast-fed youngsters.
Low-IQ could be related to other factors
But the low-IQ effect could also be an artefact of other issues. Areas chosen for fluoridation are often the most deprived, and so it is difficult to tease apart the reasons for low-educational achievement, or illness.
The North East and the West Midlands already have some of the lowest IQ scores in the country and the worst health.
And research has been conflicting. A study published by the University of Queensland in October 2022 found that children who grew up drinking fluoridated water had no worse emotional, behavioural or executive functioning issues by the time they reached adolescence than other youngsters.
In 2023, the California Department of Public Health carried out a meta-analysis and concluded water fluoridation was not associated with lower IQ scores in children.
Critics argue that studies showing a link to neurodevelopmental problems have failed to take into account other water-borne contaminants, such as arsenic, or fluoride taken in from coal used in indoor fires.
The San Francisco court case may be the best chance of coming to a consensus on the issue and over the next fortnight, Judge Edward Chen will be hearing the views of seven experts on the subject.
Judge Chen has already said that the EPA will be forced to regulate fluoride if the court case proves an “unreasonable risk” to children and pregnant women.
But the case has been rumbling on since June 2020 with little progress, and the court is unlikely to rule before Britain rolls out further fluoridation.
For now, all we can do is sip it and see.