As the city of Davis considers whether or not to add fluoride to its water, the Vanguard is going to have a few articles that highlight arguments for and against fluoridation. We have not taken an official position on fluoridation but have received some material on it and wanted to post some of that to promote further community-based discussion.
The following is a letter from Ambassador Andrew Young, a former ambassador to the U.N., dated March 29, 2011 to the Georgia Senate and House of Representatives.
Dear Senators and Representatives:
I am writing to convey my interest in seeing that Georgia’s law mandating water fluoridation for Georgia communities be repealed.
My father was a dentist. I formerly was a strong believer in the benefits of water fluoridation for preventing cavities. But many things that we began to do 50 or more years ago we now no longer do, because we have learned further information that changes our practices and policies. So it is with fluoridation. We originally thought people needed to swallow it, so the fluoride would be incorporated into teeth before they erupted from the gums. Our belief in the need for systemic absorption was why we began adding fluoride to drinking water. But now we know that the primary, limited cavity fighting effects of fluoride are topical, when fluorides touch teeth in the mouth. We know that fluorides do little to stop cavities where they occur most often, in the pits and fissures of the back molars where food packs down into the grooves. This is why there is a big push today to use teeth sealants in the molars of children. We also have a cavity epidemic today in our inner cities that have been fluoridated for decades.
So now we know that fluoride’s impacts are primarily topical and are very limited where needed most in the teeth. And on top of this we are learning that fluorides do not simply affect teeth, but can also harm other tissues and systems in the body. So we must weigh the risks to kidney patients, to diabetics, and to babies against the small amount of cavities prevented by swallowed fluorides. The National Research Council has acknowledged that kidney patients, diabetics, seniors, and infants are susceptible groups that are especially vulnerable to harm from fluorides. There are millions of these persons who have these health conditions or who meet the criteria for concern.
The National Center for Health Statistics says that 41% of 12-15 year old adolescents now have the teeth staining called “dental fluorosis” that shows overexposure to fluorides as a child, and that 3.6% have the very visible moderate and severe forms of the condition. This translates into millions of persons with disfiguring impacts from fluorides. How many of these persons can afford the tens of thousands of dollars to have veneers or other cosmetic dental work performed?
There is growing bipartisan support across the country for halting water fluoridation. And eleven unions of EPA workers, representing 7,000 EPA lab workers, scientists, and others have called for a halt to fluoridation. The recent suggested lowering of fluoride levels in water does not address the fact that we still cannot control the amount of fluorides that sensitive individuals ingest. People are calling for investigative Fluoridegate hearings, and one can understand why, given the fact that the story about fluorides keeps changing.
I am most deeply concerned for poor families who have babies: if they cannot afford unfluoridated water for their babies’ milk formula, do their babies not count? Of course they do. This is an issue of fairness, civil rights, and compassion. We must find better ways to prevent cavities, such as helping those most at risk for cavities obtain access to the services of a dentist.
Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (2006) published in the National Academies of Science Press.
Committee on Fluoride in Drinking Water, National Research Council
Most people associate fluoride with the practice of intentionally adding fluoride to public drinking water supplies for the prevention of tooth decay. However, fluoride can also enter public water systems from natural sources, including runoff from the weathering of fluoride-containing rocks and soils and leaching from soil into groundwater. Fluoride pollution from various industrial emissions can also contaminate water supplies. In a few areas of the United States fluoride concentrations in water are much higher than normal, mostly from natural sources. Fluoride is one of the drinking water contaminants regulated by the U.S. Environmental Protection Agency (EPA) because it can occur at these toxic levels. In 1986, the EPA established a maximum allowable concentration for fluoride in drinking water of 4 milligrams per liter, a guideline designed to prevent the public from being exposed to harmful levels of fluoride. Fluoride in Drinking Water reviews research on various health effects from exposure to fluoride, including studies conducted in the last 10 years.
Here are a few of the findings in the 530-page report.
“The damage to teeth cause by severe enamel fluorosis is a toxic effect that the majority of the committee judged to be consistent with prevailing risk assessment definitions of adverse health effects.”
There was some debate among their panel as to whether fluorosis represented something “judged to be aesthetically displeasing but not adverse to health.” They write, “This view has been based largely on the absence of direct evidence that severe enamel fluorosis results in tooth loss, loss of tooth function, or psychological, behavioral, or social problems.”
They continue, “The majority of the present committee finds the rationale for considering severe fluorosis only a cosmetic effect much weaker for discrete and confluent pitting, which constitutes enamel loss… Two of the 12 members of the committee did not agree that severe enamel fluorosis should now be considered an adverse health effect. They agreed that it is an adverse dental effect but found that no new evidence has emerged to suggest a link between severe enamel fluorosis, as experienced in the United States, and person’s ability to function.”
They also find, that “Severe enamel fluorosis occurs at an appreciable frequency, approximately 10% of average, among children in US communities with water fluoride concentrations at or near the current MCLG of 4 mg/L.”