As you scrub the tiny remnants of your last meal from in between your back molars, before the last swish of fluoridated toothpaste is spat out, you aren’t likely to give too much thought to that important, active ingredient. Fluoride, we’re told, is used to strengthen the enamel in our teeth and for those who are intolerant or sensitive to fluoride, there are unfluoridated toothpastes available, not to mention good ol’ fashioned baking soda. While we can choose our dental products, the fluoride debate has mostly focused on public water fluoridation due to the lack of choice citizens are given about what comes out of their own kitchen faucets. What many Americans don’t know, despite the claim that extremely small amounts of sodium fluoride may help some people in preventing dental decay, fluoride has been proven to be toxic in large amounts and harmful in small amounts over time.
So, what exactly is fluoride? According to a chemical element encyclopedia, fluorides are compounds of fluorine, a pale yellow gas, and other elements (Newton 190). Never found alone in nature, fluorine is one of the most chemically and biologically reactive elements, and though “the [soluble] fluorides it forms with metals (such as sodium, calcium, magnesium, aluminum) are not very chemically reactive…[they are still] very active biologically” (Connett et al. 116). It seems that such an obviously dangerous chemical, placed near the top of the periodic table of the elements, couldn’t possibly be considered for human consumption, but as we’ll find out, fluoride wastes are abundant and there must be some way to dispose of it.
Fluorides must be mined and processed to extract pure fluorine, which is then cooled to its liquid state and has many industrial uses. One major use for fluorine during the Cold War era was in the production of uranium hexafluoride, used to enrich uranium for nuclear weapons (Smith 15). There are also several other valuable elements found within the same rock mined for fluorine, such as phosphate, which is produced in mass quantities for fertilizer in Florida. Up until the late 1960’s, the smelting process in phosphate manufacturing plants released known toxic gases, hydrogen fluoride (Hf) and silicon tetrafluoride (SiF4) into the air through smokestacks, killing local crops and livestock. Aluminum, phosphate, cement, steel and uranium enrichment through the use of fluorine, of course, also produces dangerous fluoride emissions (Null 64). Farmers near a “secret DuPont-run weapons plant in Deepwater, New Jersey” filed lawsuits in 1946 after an accident at the plant. These lawsuits prompted the Pentagon to “redefine fluoride emissions as ‘benign’” in order to continue weapons manufacturing (Smith 15). However, according to U.S. National Academy of Sciences member Edward Groth, “fluoride was responsible for more damage claims than all twenty other major air pollutants combined” (as cited in Bryson xv). The mining and manufacturing industries’ solution to this problem is a simple device called a “wet scrubber” that sprays water to capture toxic gases inside the smokestacks, creating a solution called hexafluorosilicic acid (H2SiF6) that is captured as waste (Connett et al.16). It is important to note that, while this “waste” is a fluoride (a compound of fluorine), it is not the same as fluorides that naturally exist in minerals like fluorspar, fluorapatite and cryolite (“Fluorine”).
The fluoride known as hexafluorosilicic acid, as it turns out, has uses. “At first, industry could dispose of fluoride legally only in small amounts by selling it to insecticide and rat-poison manufacturers” until the idea of water fluoridation came about (Null 65). Water fluoridation is the adding of supplemental fluorides to public drinking water for the purpose of decreasing dental caries (decay). Early studies were done in areas where there are higher concentrations of natural fluorides found in groundwater. In these areas, experts like H. Trendley Dean noticed severe teeth staining and abnormal tooth surfaces, he called “mottling,” but reported that “fluoride levels of up to 1.0 ppm in drinking water did not cause mottled enamel; if the fluoride exceeded this level, however, fluorosis would occur” (as cited in Null 65). Dental fluorosis is caused by overexposure to fluoride and cases can range from mild, or hardly noticeable, medium fluorosis (as illustrated in fig. 1) to severe, which can involve a total disfigurement of the teeth. According to an encyclopedic entry as recent as 2008, “Fluoride protection appears to result from the formation of a fluorophosphate complex in the outer tooth layers, making them resistant to penetration by acids made by mouth bacteria” [emphasis mine] (“Fluoride”). Studies performed by Dean as well as biochemist Gerald J. Cox were funded by, and had close ties to, a lawsuit-threatened industry, possibly influencing their findings that fluoride, in such small levels, was not only safe, but beneficial for teeth, since teeth with dental fluorosis seemed to resist decay. These findings launched a fluoride promotion campaign with Grand Rapids, MI being the first town to fluoridate their municipal water supplies (Null 65). From that point on, public water fluoridation has been considered a great modern medical acheivement by many, but it seems the greatest acheivement might be in convincing citizens that these industrial fluorides, formerly considered toxic waste that was costly, or nearly impossible, to dispose of safely, was now considered a dental medicine. Now, at a concentration of 23 percent, hexafluorosilicic acid is transported to chemical companies who distribute it around the country, untreated, as a fluoridating agent for public water supplies in communities where naturally occurring fluorides in groundwater are “deficient” (Connett et al. 16). Fluoridated counties throughout the US as of 2008 are illustrated in fig. 2.
Pharmaceutical grade sodium fluoride, which is somewhat safer, is what you can find in toothpaste, mouthwash and dental floss, though they are not to be swallowed as the warning on the packaging of these products makes clear. The glaring question is: why is it recommended we drink eight 8-ounce glasses of fluoridated water a day, but if a child swallows more than a pea-sized glob of fluoridated toothpaste, the Poison Control Center may need to get involved? Do we need the same warning label on our kitchen sinks? It seems, even having these questions places me firmly in the “anti-fluoridation” group.
The impression that water and toothpastes are just not delivering enough fluoride to the public seems to come from the realization that fluoride is also found in certain foods like “canned juices, carbonated beverages, infant formulas, commercially prepared infant food, and milk” (Lui et al. 14). In a study of 42 popular brands and types of milk found in American supermarkets, expert Cuifeng Liu headed a research team that determined a probable connection between fluoridated milk and dental fluorosis (Liu et al. 10). Liu reports the earlier well-documented observed prevalence of dental fluorosis cases in fluoridated communities–which is very likely due to fluoride exposure from several, unnatural, sources (Liu et al. 11). A seldom recognized yet common problem of dental fluorosis (the pitting, mottling, and staining of the teeth) in communities, that are more likely to consume higher levels of fluorides, needs to be looked into much further.
The Centers for Disease Control and Prevention (CDC) seems to have a limited understanding of how much fluoride Americans are actually consuming and as the ADA, the CDC and many other medical and dental opinion makers still firmly believe that fluoridation of the water supply is the most democratic and cost-effective way of reducing inequities in oral health,” and “although other fluoride-containing products are available, water fluoridation remains the most equitable… method of delivering fluoride to all members of most communities” (“Fluoridation of Drinking Water to Prevent Dental Caries” 347, 350). While water fluoridation is certainly a cost-effective public source of fluoride, there are several studies which reveal that unfluoridated communities boast similar, if not identical, improvements in dental health over time (Connett et al. 31-63). Many fluoridated communities, while considered to enjoy improved dental health, instead have not only similar dental health to unfluoridated communities, but also have the worst cases of dental fluorosis.
While fluorosis-infected teeth are more resistant to decay, the condition has been feared to indicate elevated levels of toxicity that may be affecting internal organs. However, fluoridationsists fondly quote a study led by the U.S. Public Health Service; “scientists from the FDA’s National Center for Toxicological Research, including researchers from more than a dozen federal research agencies, found that the benefits of fluoridated water outweigh any risks” though the study provides mostly inconclusive evidence to back this claim (“Government assesses fluoride” 4). Reports like this from government agencies are abundant, and they reinforce a pro-fluoride attitude amongst the public and dental professionals, with little or no real proof that fluorides are safe or beneficial; while numerous reports have documented various negative effects of fluoride overexposure in countries around the world. For example, eighty experiments showing animal brain damage due to fluoride ingestion and twenty-three studies find a link between higher levels of fluoride and lowered IQ in children (Connett et al. 121). Similar fluoride studies have been conducted to determine potential damage “to the endocrine system, including the thyroid and pineal glands… bone (including fractures, arthritis, and osteosarcoma… and the kidney and other tissues” (Connett et al. 107). While many of these studies do not conclusively prove such effects will occur from exposure to fluoride through drinking water, dental products, or foods individually—collectively–it is easy to determine that many Americans are overexposed to fluoride and may develop certain illnesses.
The very idea of “mass-medicating” the teeth of large populations drew sharp public criticism 60 years ago, during an era when the fears of the people were easily manipulated and exaggerated:
“…during the McCarthy era, some antifluoridationists believed that fluoridation was part of a Communist plot to destroy the United States… some believed the Nazis in 1930s Germany had discovered that fluoridation made those drinking it docile and easily controlled. [Some believed] that once the federal government won public acceptance of treating tooth decay through chemicals in the water supply, the next step would be birth control or psychiatric medication administered to the entire population through the public drinking water, or forcing exercise and diet regimes on the entire population to control obesity… [or that] the force behind the promotion of fluoridation was the sugar industry, which wanted to find an easy way to prevent tooth decay so that it could encourage consumption of sugar” (“Fluoridation”).
It is easy to see that outrageous, and outspoken claims like these from a small percentage of anti-fluoridationists painted all those who opposed fluoride as antagonistic conspiracy theorists. The public perception has since been that opposing water fluoridation is absurd and those who do are a probably a little strange. The American Dental Association (ADA) along with Government agencies like the EPA, FDA and the CDC still suggest a 2 parts per million (ppm) ratio of fluoride in public drinking water and a limit of 4 ppm (“Government Assesses Fluoride 4”) despite all the evidence uncovered and studies that reveal serious potential for harm.
While there are fluoridationists and anti-fluoridationists, it seems many Americans fall into a third category of unknowing indifference. Much of the research on this topic is not publicly recognized; even the supposed benefits of fluoride don’t seem to be common knowledge–most just think it helps their teeth–somehow. Most like to assume, for sanity’s sake, that government agencies and medical professionals do their utmost to ensure the safety of the people, but imperfect and susceptible to human error, laws based on old science and those in authority should be investigated and improved, if possible. Among the local residents of North East England, where water fluoridation varies between the smaller communities, a study was conducted to determine the public knowledge and opinions about water fluoridation. Interviewing members of the general population, a group moderator gathered qualitative information concerning water quality, dental health and fluoridation from those who agreed to participate. The study found what is a likely similarity between average English and American citizens: “variable knowledge of fluoride in relation to dental and general health” yet “confirmed public support for water fluoridation but highlighted the place of public health professionals in championing water fluoridation because of public apathy” (Hasting et al. 39). Many people with a limited understanding of the legitimacy of the anti-fluoride argument easily dismiss many factual evidences of harmful fluoride-related effect.
Those criticized for speaking out against it is not only a few scientists, other experts, or conspiracy theorists who oppose and speak out about fluoride these days. Some organizations dedicated to public education about fluoride, and reversing EPA laws allowing fluoride into public drinking water are: The Fluoride Action Network, The International Society for Fluoride research, Oregon Toxics Alliance, Clean Water Action Alliance of MA, and the Institute for Natural Dentistry, to name just a few. In one famous lawsuit from 1990 “the American Dental Association was sued by 40 of its members for misleading the public about the health effects of fluoride” (Kleiner 30). While most citizens might not be in a position (or even have a desire) to take that kind of legal action, contacting your local utility company to learn whether your water is fluoridated is a first step to ending fluoridation if it is. You can educate friends and family about the risks of ingesting fluoride and organizing with your city council to present them with the studies, experiments, and information about the origins of the fluorides used in public drinking water. In the meantime, while you can certainly choose your own toothpaste, it’s not practical to use unfluoridated bottled water for all your cooking and drinking so, a fluoride water filter might be a great investment. As hard as it may be, avoiding processed foods and carbonated drinks that may contain fluoride, is another way to lower your daily fluoride intake.
We should be able to make informed choices about what we put into our bodies as a fundamental human liberty, so that if we fall ill or develop any medical condition or injury because of choices we have made, we are responsible instead of others in authority who often make mistakes, are often blamed, but assume no responsibility. With a whole host of government-related problems that Americans love to complain about, policies regarding something as close to home as our own tap water should be a top priority and people with knowledge of this legitimate public health risk need to continue speaking out in order to eliminate it. As the stigma surrounding American anti-fluoridationists continues to dissolve, it is my hope that water fluoridation will end in the near future or that, at least, people will be able to opt out of using such a dangerous chemical.
Connett, Paul, et al. The Case Against Fluoride. White River Junction, VT: Chelsea Green Publishing Company, 2010. Print.
“Fluoridation of Drinking Water to Prevent Dental Caries.” Medicine, Health, and Bioethics: Essential Primary Sources. Ed. K. Lee Lerner and Brenda Wilmoth Lerner. Detroit: Gale, 2006. 347-351. Gale Opposing Viewpoints In Context. Web. 22 Nov. 2011.
“Fluoridation.” Conspiracy Theories in American History: An Encyclopedia. Ed. Peter Knight. Santa Barbara: ABC-CLIO, 2003. Credo Reference. Web. 18 Oct. 2011.
Newton, David E. “Fluorine.” Chemical Elements. Ed. Kathleen J. Edgar. 2nd ed. Vol. 1. Detroit: UXL, 2010. 189-197. Gale Virtual Reference Library. Web. 18 Oct. 2011.
“Government Assesses Fluoride” FDA Consumer. 25.4 (May, 1991) 4. Health and Wellness Resource Center. Web. 11 Nov. 2011.
Hastings, G.B. et al. “The Role of the Public in Water Fluoridation: Public Health Champions or Anti-Fluoridation Freedom Fighters?” British Dental Journal 184.1 (1998) Print.
Kleiner, Ellen. “Fluoride Bites The Cusp.” Mothering 74 (1995): 30. Health Source – Consumer Edition. Web. 22 Nov. 2011.
Liu, Cuifeng et al. “Fluoride Content of Dairy Milk from Supermarket a Possible Contributing Factor to Dental Fluorosis” International Society for Fluoride Research. 28.1 (1995) 10-16. Print.
Null, Gary PhD. “Fluoridation: Medicating Our Water.” Townsend Letter Group. (Nov. 2010): 64-70. Print.
Smith, Gar. “Fluoride, Toothpaste, and the A-Bomb.” Earth Island Journal. 26.1 (Spring, 2011.) 15-16. Web. 12 Nov. 2011.