Fluoride, Fluoride, Fluoride…

 
children's toothpasteWe all want the best for our kids, and like everything in life, there are different opinions on how to get there.

Maybe you go out of your way to read labels in your attempt to give your family the best quality products you can. But there’s one label you might have missed: the one on your family’s toothpaste.

warning on children's toothpasteBuying that bright, candy-esque packaged toothpaste because it might encourage brushing is naturally based on the best of intentions for the child.

But if it’s fluoridated, you’ll notice a poison control warning.

 

Seek first to understand, then to be understood.
– Dr. Stephen Covey

The Fluoridated Party Line

In January, a Norwegian study on oral health messages was published in the International Journal of Dental Hygiene. The aim was to investigate recommendations given to the general public by dentists, dental hygienists, dental nurses, and public health nurses on preventing caries (tooth decay).

More than 800 health professionals answered the authors’ questionnaire.

  • 59-71% judged oral hygiene education to be the most important part of preventing caries.
  • 84-98% recommended that all children use fluoride toothpaste.
  • Half recommended fluoride lozenges for 50% or more of children.

The message is clear: Fluoride, fluoride, fluoride. But does that make it right? Accurate? Effective?

It’s Too Much Sugar, NOT too little Fluoride

Frankly, it’s distressing to realize that diet seems not to have been mentioned at all – or not by enough to merit highlighting.

In terms of prevention, fluoride is, at best, a stop-gap measure – an attempt to minimize damage rather than keep it from happening in the first place. It’s a point that was made nicely in a paper published last year in the Journal of Dental Research.

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause—sugars. [emphasis added]

Instead, preventive self-care for children gets reduced to a “how-to” message for parents: fluoridate. This is concerning.

Education as a Foundation of Health

When it comes to families with young children, the emphasis on fluoride is a culturally ingrained message that supersedes parental control. As a parent, you can regulate the cookie jar, but, how do you regulate, much less know, the quantity of fluoride your child ingests from toothpaste? Fluoridated water? Juices? Soft drinks? Processed meat? Other sources?

You can’t.

If you’ve ever left a dental office feeling shamed because you didn’t embrace fluoride for your kids, you should know there are alternatives. In biological dentistry, generally speaking, oral health care isn’t so much a “message” as it is a holistic philosophy.

Rather than just throwing fluoride recommendations at you, we seek to understand the desires and goals you have for your family’s dental care. Once we understand, we work to identify individual habits that may influence health outcomes and emphasize education regarding diet and effective cleaning techniques rather than fluoride.

We believe this approach not only empowers you and your family to achieve your health goals, but employs the truest sense of “self-care for children” in the prevention of tooth decay.

Research Group Finds Evidence for Fluoridation Wanting

It was a little shocking and very gratifying to see the headline in such a major media outlet at the start of this week:

Newsweek headline on fluoridation review

The review in question is the latest from the Cochrane Collaboration, which Newsweek described as “the gold standard of scientific rigor in assessing effectiveness of public health policies.” Cochrane’s Oral Health Group analyzed the data in 155 studies on fluoridation, caries (tooth decay) and fluorosis.

Overall, they found very little good quality evidence supporting the practice today.

At best, they found some evidence that fluoridation reduces cavities in children – but with some important caveats. As described in the plain language summary of the review,

Although these results indicate that water fluoridation is effective at reducing levels of tooth decay in children’s baby and permanent teeth, the applicability of the results to current lifestyles is unclear because the majority of the studies were conducted before fluoride toothpastes and the other preventative measures were widely used in many communities around the world.

Most of the research – 97% – was also deemed at high risk of bias.

Does fluoridation benefit adults? Evidence was found wanting. Would caries rates jump if fluoridation were stopped? Again, evidence was found wanting. In the end, wrote the authors,

There is very little contemporary evidence, meeting the review’s inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.

The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. [emphasis added]

Despite all this, fluoride remains the only medication added to public water. It’s considered good “prevention.” Yet there are more effective and far less toxic things we can do to prevent caries, starting with good hygiene and healthful, nutrient-dense diets.

For every medication – every health intervention – carries some degree of risk, and when it comes to fluoride, the more we learn about its risks, the more they exceed any theoretical benefit. While the current review didn’t consider the systemic effects of swallowing fluoride, it did consider fluorosis – the mottling of tooth enamel due to excess fluoride exposure.

The researchers calculated that, in areas with a fluoride level of 0.7 ppm in the water, approximately 12% of the people evaluated had fluorosis that could cause concern about their appearance. This increases to 40% when considering fluorosis of any level .

It’s interesting to note that the level mentioned – 0.7 ppm – is the recently revised recommendation of the US Department of Health and Human Services. One of the reasons they lowered the level was concern about too much fluoride in the modern environment. Some of it may be naturally occurring. Most is manufactured – typically byproduct of the phosphate fertilizer industry. It’s available in toothpastes and rinses. You can even find fluoridated floss! Conventional dentistry has its fluoride treatments and supplements, as well.

And then there’s the stuff in water.

Documented health risks from chronic fluoride exposure include thyroid problems and cognitive delays, as well as cardiovascular disease, diabetes and other conditions.

No evidence of benefit, yet good evidence of risk? It’s time to finally and for good “Get the F Out of Texas” and end this practice. We deserve clean, pure water.

Activists Fighting to “Get the F Out of Texas”

fluoride free logoNext Wednesday, activists will gather outside Dallas City Hall in protest of the city council’s decision to keep on fluoridating city water. “On March 25,” declares Fluoride Action North Texas in a press release on the event,

our large and diverse group will stand together to voice; we are outraged the council ignored the science that shows fluoridation is not safe and effective for everyone. We are livid the Council did not take advantage of the many opportunities at their disposal to have open debates or conversation with the experts about fluoridation. We are appalled at the blatant disregard for the voice of the people and the Council’s lack of informing the public. This group of thirteen voted to continue a program that the risks far outweigh the supposed benefits. We assert The Dallas City Council’s action of purchasing the Hydrofluorosilicic Acid to be added to the Dallas Water Supply as a willful disregard for the health of the public. This action cannot go unchallenged.

Of course, Dallas isn’t the only city in Texas where concerned citizens are making a difference. Down in Austin, activists believe this is the year in which change may finally be possible. After all, their city council is almost entirely new, and their new mayor “has expressed a willingness to take a fresh and impartial look at fluoridation.” What’s more,

Even the staunchest local supporters of fluoride—after years of labelling us fringe, weird, tin foil hat and the like, have been slowly forced to acknowledge the fact and adapt their tactics accordingly. Key to the sea change was likely a survey conducted by KEYE-TV in mid-2012 in which roughly half (49%) of those polled called fluoridation as a waste of money… Since it’s now impossible to insult fluoride opponents without insulting about half of Austin’s population, the politically-motivated pushers of fluoridation have backed off a bit and directed their scientifically-bankrupt ire elsewhere.

One of their actions has been to secure airtime for an excellent PSA to “Get the F Out of Austin”:

Since the study mentioned in the PSA was done, others have continued to confirm that fluoride is not something we should be ingesting so much of. (Even conventional dentists and public health advocates have noted that we’re all getting far too much fluoride.) A study published earlier this year in the journal Environmental Health, for instance, found that ADHD rates are higher in states where a larger proportion of people get fluoridated drinking water. Obviously, more study is needed to determine if there’s a causal link. Yet in light of past research – such as last year’s neurotoxins study in Lancet Neurology – the new data does suggest continued caution.

Another recent study – this, in the Journal of Epidemiology and Community Health – showed a link between excess fluoride consumption and underactive thyroid. Simply, fluoride blocks your thyroid’s natural ability to produce iodine. Hypothyroidism, in turn, can cause other problems, such as depression, weight gain, fatigue and muscle pain.

Fluoridated water has proven to be no panacea. The risks it has been shown to carry far outweigh any modest benefits it may confer. As Paul Connett has said, “It is time to get dentistry out of the public water supply and back into the dental office.”

To voice your concern about fluoride to the Austin City Council, visit Fluoride Free Austin’s “Take Action” page.

To make a donation to help Fluoride Free Austin keep their PSA on the air, visit their project page at Indiegogo.

Yesterday’s Fluoride Vote in Dallas

Despite a valiant grassroots effort to get the city to change its fluoridated course,

Dallas Morning News screenshot

Only [Sheffie] Kadane and Adam Medrano voted against the $1,060,800 contract with Mosaic Crop Nutrition to fluoridate Dallas’ water supply for the next three years.

Kadane tried to kill the deal. He insisted that “you ingest that fluid, you take it into your belly, you eliminate it,” so clearly fluoride in the water supply does nothing. “Unless you spread it on,” he insisted, “it’s not helping in any way shape or form.” Said Kadane, “Dental hygiene is the way to prevent cavities … it’s not by using flouride.”

Not to mention things like diet, exercise, sufficient rest and sleep, and all else that goes with making a healthful mouth, body and life.

Unfortunately, addressing those kinds of issues as a matter of public health is much more difficult, expensive and time-consuming than just adding fluoride to the water supply.

That aside, Kadane made an important point that often gets lost in the sometimes outrageous rhetoric thrown around this issue: Even if you accept that any topical benefit is worth the risks of regular ingestion, fluoridation is no “substitute for dental care”.

After all, even though more than 2/3 of the population have fluoridated water, youth tooth decay in this country continues to be described as an “epidemic.”

But though fluoridation remains Dallas policy for the time being, the fight for a fluoride-free future will, no doubt, continue.

 

Fluoride Awareness Week 2014

water faucetAs we previously noted, less than half of all dentists think that fluoridation is a good idea. Most oppose it, for a variety of reasons.

An excellent collection of those reasons in the video Professional Perspectives on Fluoride, which we share this Fluoride Awareness Week, a joint campaign by Dr. Mercola and the Fluoride Action Network. Featuring leading authorities and advocates against water fluoridation, this film explores the social, ethical, and medical implications of “a practice that has been proven neither safe nor effective.”

 

  

 

You can buy a DVD of the film here – specially priced this week at just $10.

To learn even more about the science, ethics and politics of fluoridation – and efforts toward a fluoride-free future – be sure to check out these recent articles on Dr. Mercola’s site:

Also worth browsing is FAN’s video library, which you can view here.

Previous posts on fluoride

Image by Jenn Durfey

Fluoride Policy & Mythology in Dallas

Dallas City HallThere was quite a commotion over in Dallas early this month after three City Council members showed signs that they were aware of the ineffectiveness and costliness of fluoridating water – a program that may be wasting up to $1,000,000 annually.

Supporters of the policy seemed aghast, and invective came fast and furious. Dallas News’ columnist Jacquielynn Floyd called anti-fluoride activists “anti-science crackpots.” Her premise and support of fluoride can be summed up by one sentence:

Ever since scientists realized that a modest supplement to drinking water supplies could help keep people’s teeth from rotting out of their heads, suspicious dissenters have viewed community water fluoridation… as a sinister plot.

Floyd and other pro-fluoride supporters cling to early findings that suggested fluoride’s benefit to oral health and overlooked the dangers of uncontrolled exposure. Yet in the words of one of the most recent critical reviews of fluoridation research – published earlier this year in the Scientific World Journal

Available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environment.

The following month, research published in Lancet Neurology included fluoride among 6 industrial chemicals found to cause problems in the brain development of millions of children around the globe.

Still, fluoridation advocates point to the generally improved dental health of people — as if dental health were about nothing but fluoride; as if brushing, flossing, a healthful diet, regular dental visits and the rest had nothing to do with it; as if all but fluoride is just for show, right?

Fluoridation was again on the agenda at this week’s Council meeting, but no action was taken, leaving Dallas’ nearly 50 year old fluoridation policy intact – for now, anyway. But you can be sure that anti-fluoridation activists will be continuing to do all they can to press for change.

For time after time, research suggests that the world needs to find another away to reduce the number of dental carries.

Throughout all the commentary about Dallas’ fluoridation fight, we have noticed two persistent myths out there. It’s high time to debunk them, so let’s take a look at some misinformation:

Myth #1: Including fluoride in water is “proven” to reduce cavities and tooth decay.

Many who disagreed with the City Council’s decision expressed concern that citizens, especially those in lower income brackets, would face greater dental issues without fluoridated water. Yet even though about 3/4 of all Americans already receive fluoridated water, we face an epidemic of tooth decay – especially among children – that shows no signs of abating. What improvements we have seen in oral health status may actually stem from other health improvements, including improved oral hygiene education, improved dietary education and a greater number of people regularly visiting a dentist.

Myth #2: Swallowing fluoride is safe and does not lead to long-term health issues.

If you drink unfiltered, public water, think about how much fluoride you swallow with each gulp. How much do you accidentally swallow when you brush your teeth? How much has stayed in your body throughout your lifetime?

The accumulation of fluoride in your body can lead to other health conditions. Children who are exposed to fluoride even in small dosages are at risk of developing fluorosis, also known as mottling of tooth enamel. What’s worse, as a neurotoxin, fluoride has been linked to cognitive delay.

As of May 2013, a total of 43 studies have investigated the relationship between fluoride and human intelligence, and a total of 31 studies have investigated the relationship fluoride and learning/memory in animals. Of these investigations, 37 of the 43 human studies have found that elevated fluoride exposure is associated with reduced IQ, while 29 of the 31 animal studies have found that fluoride exposure impairs the learning and/or memory capacity of animals. The human studies, which are based on IQ examinations of over 11,000 children, provide compelling evidence that fluoride exposure during the early years of life can damage a child’s developing brain.

Other problems from swallowing too much fluoride include but are not limited to arthritis, diabetes, cardiovascular disease, and kidney disease.

Despite myths like these two, however, progress is being made. Dr. Mercola recently noted that

since 2009, about 130 communities have stopped water fluoridation. Canada has dropped from about 60 percent of the population drinking fluoridated water down to about 32-33 percent. Victories have also been logged in Australia, Israel, New Zealand, and across the US.

The more we talk about mandatory fluoridation and its flaws, the more likely change will come. If you’re interested in reading more on the issues, check out “20 Points Against Fluoridated Water.”

Image by Mariano Mantel, via Flickr

20 Points Against Fluoridated Water

 

running_faucetThe Arrogance of Fluoridation

Via Fluoride Action Network
By Paul Connett, PhD
FAN Director

Organized dentistry, which includes the American Dental Association [ADA], the Oral Health Division of the Centers for Disease Control and Prevention [OHD] and state dental directors, is the only health profession that seeks to deliver its services via the public’s water supply.

The practice of artificial water fluoridation is the height of arrogance when one considers the following undisputed facts and scientifically supported arguments:

  1. Fluoride is not a nutrient. Not one biochemical process in the human body has been shown to need fluoride.
  2. The level of fluoride in mother’s milk is exceedingly low (0.004 ppm, NRC, 2006, p.40). Formula-fed infants receive up to 175 to 250 times more fluoride than a breast-fed infant if using water fluoridated with .7 or 1 ppm of fluoride. Does the dental community really know more than nature about what the baby needs?
  3. Fluoride accumulates in the bone and in other calcified tissues over a lifetime. It is still not known what the true half-life of fluoride is in the human bone, but an estimate of 20 years has been made (NRC, 2006, p 92). This means that some of the fluoride absorbed by infants will be retained for a lifetime in their bones. Early symptoms of fluoride poisoning of the bones are identical to arthritis. Lifelong accumulation of fluoride in bones can also make them brittle and more prone to fracture.
  4. Once fluoride is added to the water supply, there is no way of controlling the dose people get daily or over a lifetime and there is no way of controlling who gets the fluoride – it goes to everyone regardless of age, weight, health, need or nutritional status.
  5. The addition of fluoride to the public water supply violates the individual’s right to informed consent to medical or human treatment. The community is doing to everyone what a doctor can do to no single patient.
  6. Fluoride is known to have toxic properties at low doses (Barbier et al, 2010).
  7. Children in fluoridated countries are being over-exposed to fluoride as demonstrated by the very high prevalence of dental fluorosis. According to the CDC (2010) 41% of American children aged 12-15 have some form of dental fluorosis. Black and Mexican American children have significantly higher rates (CDC, 2005, Table 23).
  8. A 500-page review by the National Research Council in 2006 revealed that several subsets of the population (including bottle-fed babies) are exceeding the EPA’s safe reference dose (0.06 mg/kilogram bodyweight/day) when drinking fluoridated water at 1 ppm (NRC, 2006, p85). The NRC panel also indicated that fluoride causes many health problems at levels close to the exposure levels in fluoridated communities (NRC, 2006).
  9. An unrefuted study conducted at Harvard University shows that fluoride may cause osteosarcoma (a frequently fatal bone cancer) in young men when boys are exposed to fluoridated water in their 6th, 7th and 8th years (Bassin et al., 2006). Despite promises by Bassin’s thesis advisor (Chester Douglass), a subsequent study by Kim et al. (2011) did not refute Bassin’s key finding of the age-window of vulnerability.
  10. There are many animal and human studies which indicate that fluoride is a neurotoxin and 37 studies that show an association between fairly modest exposure to fluoride and lowered IQ in children. Twenty-seven of these studies were reviewed by a team from Harvard University (Choi et al., 2012). In an article in Lancet Neurology, Grandjean and Landrigan (2014) have since classified fluoride as a developmental neurotoxicant. All these papers can be accessed at www.FluorideAlert.org/issues/health/brain.
  11. For many decades no health agency in any fluoridated country has made any serious attempt to monitor side effects (other than dental fluorosis). Nor have they investigated reports of citizens who claim to be sensitive to fluoride’s toxic effects at low doses.
  12. No U.S. doctors are being trained to recognize fluoride’s toxic effects, including low dose-reversible effects in sensitive individuals.
  13. Dental caries is a disease, according to the ADA, CDC’s OHD, and the American Association of Pediatric Dentistry, and others. Fluoridation is designed to treat this disease but it has never been approved by the FDA. The FDA has never performed any trial to ascertain the safety of fluoride. FDA classifies fluoride as an “unapproved drug.”
  14. The effectiveness of swallowing fluoride to reduce tooth decay has never been demonstrated by a randomized control trial (RCT) the gold standard of epidemiology (McDonagh et al., 2000).
  15. The evidence that fluoridation or swallowing fluoride reduces tooth decay is very weak (Brunelle and Carlos, 1990 and Warren et al., 2009).
  16. The vast majority of countries neither fluoridate their water nor their salt. But, according to WHO figures, tooth decay in 12-year olds is coming down as fast – if not faster – in non-fluoridated countries as fluoridated ones.
  17. Most dental authorities now agree that the predominant benefit of fluoride is TOPICAL not SYSTEMIC (CDC, 1999, 2001) – i.e., it works on the outside of the tooth not from inside the body, thus there is no need to swallow fluoride to achieve its claimed benefit and no justification for forcing it on people who do not want it.
  18. Many countries (e.g. Scotland) have been able to reduce tooth decay in low-income families using cost-effective programs without forcing fluoride on people via the water supply (BBC Scotland, 2013).
  19. While organized dentistry (i.e. the ADA/OHD) claims that fluoridation is designed to help low-income families, it is hard to take such sentiments seriously when,
    1. 80% of American dentists refuse to treat children on Medicaid.
    2. The ADA opposes the use of dental therapists to provide some basic services in low-income areas.

    Moreover, such a practice can hardly be considered equitable when low-income families are less able to afford fluoride avoidance strategies and it is well-established that fluoride’s toxic effects are made worse by poor diet, which is more likely to occur in low-income families.

  20. Compounding the arrogance of this practice, neither the ADA, nor the OHD will deign to defend their position in open public debate nor provide a scientific response in writing to science-based critiques (e.g. The Case Against Fluoride by Connett, Beck and Micklem).

Conclusion: It is time to get dentistry out of the public water supply and back into the dental office. It is also time the U.S. media did its homework on this issue instead of simply parroting the self-serving spin of the dental lobby.

Complete references available here

Image by Steve Johnson, via Flickr

56% of Dentists Say “No” to Fluoridation

The official pro-fluoridation position is unambiguous:

The American Dental Association unreservedly endorses the fluoridation of community water supplies as safe, effective and necessary in preventing tooth decay. This support has been the Association’s position since policy was first adopted in 1950.

fluoride_comic_cropConsidering itself to be the voice of dentists as a whole, however, the organization might want to start rethinking their position.

Recently, The Wealthy Dentist – a marketing website for dental practices – conducted a survey that included a very simple question: Do you support water fluoridation?

Overall, 70% said no. Counting only responses from dentists, a clear majority still said no – 56%, to be exact.

Here’s what some of those dentists had to say when asked if they “see fluoride as a wonder drug or deadly chemical” (all emphases in the original):

  • Fluoride belongs in toothpaste, not water. That way, those who want it can have it. Besides, fluoride is only effective topically, not systemically.”
  • Fluoride should not be added to the water supply as its effects on individuals cannot be monitored and the dose cannot be controlled. Treatments may be indicated in the dental office and people can choose to use fluoride toothpaste and rinses as well.”
  • “I think the classification of it as a toxic waste is pretty self explanatory.”

Yet, as the Fluoride Action Network notes,

Despite this, many in the public health community continue to advocate for fluoridating water supplies. Unlike their predecessors, today’s advocates insist that fluoridated water provides an effective source of topical fluoride by increasing the fluoride content in both saliva and plaque. Even if true, however, recent studies show that there is virtually no practical difference in tooth decay rates between fluoridated and non-fluoridated areas. Accordingly, if fluoridated water does have a topical effect on teeth, it appears sufficiently miniscule that use of topical fluoride products can readily replace it.

It certainly doesn’t seem enough to justify the real, documented health risks of ingesting fluoride, from fluorosis to developmental problems to cancer.

There is also growing concern that we are getting too much of the stuff, which has lead the Department of Health and Human Services, among others, to recommend that EPA lower the levels allowed in water. Those who want fluoride are welcome to it and can easily get it through toothpastes and rinses. (Indeed, in some stores, it’s impossible to find toothpaste that does not contain fluoride – even “natural” products such as some varieties of Tom’s of Maine.)

Besides, there is a better way.

“The commendable goal of prevention,” says the International Academy of Biological Dentistry and Medicine,

should be advanced by effective routes, not by fluoride. When the public water supply is fluoridated, fluoride is taken into the body systemically when people drink water. Fluoride taken systemically has little to no effect in decreasing tooth decay.

As health professionals, we favor effective national and community efforts for cavity prevention; for example, a campaign for children to reduce sugar intake would have demonstrable effects on cavity reduction.

Fluoride just isn’t necessary for good dental health – but other things are. Proper nutrition and hygiene, for instance, are vital.Teeth need minerals such as calcium, magnesium and phosphorus ; vitamins such as D and K. They need to be cleaned regularly and well, not just with brushing but flossing, too. (Brushing alone cleans only about 60% of your total tooth surface.) They need to be spared added sugars and refined carbs, which serve mainly to feed the bacteria that form biofilm (plaque) and acidify the oral cavity.

Not only are such steps are more effective than fluoride, they have the bonus of contributing to whole body health, as well.