The Centers for Disease Control and Prevention (CDC) considers fluoridation of water one of the ten greatest achievements in public health in the 20th century (Centers for Disease Control and Prevention, 2010). The first known use of fluoride in water occurred in Grand Rapids, Michigan on January 25th, 1945 (Bull World Health Organization, 2006). It wasn’t until the 1950’s that public water fluoridation really hit the mainstream, becoming official policy of the U.S. Public Health Service and being widely promoted among dental health authorities. Today, the American Dental Association claims that the fluoridation of public water has improved the dental health of over 200 million American citizens (National Institute of Dental and Craniofacial Research, 2011).
Since the introduction of public water fluoridation there have been numerous studies which have sought to discover the effects of fluoride on tooth decay levels among different communities across the nation. The results showed a substantial reduction in tooth decay among fluoridated communities when compared against those who do not have fluoride added to their water supply. The addition of fluoride was found to coat the enamel of the teeth while also deterring bacterial growth (MMWR Fluoride Report, August 17th 2001). There are Federal guidelines in place which dictate the amount of fluoride that can be safely used in the public drinking water. These limitations exist because fluoride in concentrated doses can cause permanent staining of the teeth, while still making them stronger and more resistant to decay.
The benefits of water fluoridation are well documented and accepted among those in the dental profession. The American Dental Health Association has been promoting the use of fluoride in water supplies, as well as dental hygiene products such as toothpaste and mouth rinse, for decades. A 13 year trial study conducted among 26 states concluded with a confirmed reduction of tooth decay among the population. Early studies showed a 50% to 70% reduction in dental caries among adolescents, while later studies conducted in the 1980’s produced a mean reduction of only 18% (CDC, unpublished data, 1999).
There are many proponents of fluoride, both in public and private sectors that take the stance that water fluoridation is a very necessary health measure which provides low barrier access to preventive health care. This cost effective prevention measure is able to be distributed widely to communities regardless of their socioeconomic status, which in turn reduces national spending on dental care. Dental care also happens to be the fourth most expensive health cost in the United States. When comparing the cost of fluoride medication as a preventive health measure against the costs of reactive care as a result of dental cavities, it is easy to see the cost savings. The average cost of water fluoridation is around $1 per person annually, compared to the typical $400 that can be charged for one emergency extraction caused by tooth decay. “ One economic analysis estimated that prevention of dental caries, largely attributed to fluoridation and fluoride-containing products, saved $39 billion dollars in dental-care expenditures in the United States during 1979-1989” (CDC, unpublished data, 1999).
There is an often overlooked benefit of water fluoridation which is the reduction in costs for Medicare recipients who are already stretched thin financially. Since healthcare policy rates are set on a cumulative scale based on the frequency of services, the reduction in dental health expenditures among the general population helps to keep group healthcare rates lower as a whole. This benefit is paralleled by the cost savings for those individuals in low socio-economic brackets, particularly children. Children in low income families tend to have less access to regular dental checkups and are less likely to practice daily personal dental care (MMWR Fluoride Report, August 17th 2001). It is generally agreed upon that affordable healthcare costs for low or fixed income individuals provides a positive effect on society as a whole because those people are the least likely to obtain adequate care. Healthy people generate countless benefits within society. “The health of the people is really the foundation upon which all their happiness and all their powers as a state depend. “ (Benjamin Disraeli, 1877)
Water fluoridation is a highly controversial issue that has been debated for decades. From the time that fluoride was first introduced in America, various non-profit organizations and public health “watchdog” groups have been blowing the whistle on the safety and effectiveness of this practice. In recent years, many serious diseases have been linked to fluoride exposure ranging from bone cancer and melanoma to mental health disorders like Alzheimers and down syndrome. The effects of such wide scale, unmeasured public medication are far reaching and have yet to be fully understood.
Fluoride is a highly toxic substance. Consider, for example, the poison warning that the Food and Drug Administration (FDA) now requires on all fluoride toothpaste sold in the United States (American Dental Association, 2002). Unlike naturally occurring fluorine found in the ground, the fluoride compounds added to public water supplies and toothpastes are industrial waste by-products of the phosphate fertilizer and aluminum industry. These compounds are known to be contaminated with heavy metals and carcinogens, including lead, arsenic, cadmium, and mercury. Although proponents of fluoride claim that the levels are too small for concern, fluoride levels exceed the EPA’s health based Maximum Contaminant Levels (MCL’s), which for lead and arsenic are set at zero.
One of the most perplexing concerns about fluoride is the fact that even though this highly toxic chemical is being added to drinking water, exposure can lead to serious injury or even death. Individuals who work in close proximity to this substance are required to take classes that inform them of the dangers of a fluoride leak and the health effects that can occur as a result of exposure. Due to the toxic nature of fluoride, the amount that is added to the water system is regulated at very small percentages because it has to be highly diluted to prevent the risk of being fatal. This fact alone has many in the water cleaning industry asking why this dangerous chemical is being added to our public water supply. This is the same water supply that we spend millions of taxpayer dollars to remove pollutants and toxins from.
Ironically, proponents of fluoride often tout the cost savings of public water fluoridation. Assuming that this is a necessary health expenditure which many would argue that it most definitely is not, the undocumented wastefulness of this practice is not being considered. Not only humans but all creatures on this earth are being exposed. Therefore, when it comes to the overall cost savings only human consumption is being considered in those estimates. What about all the money that is wasted fluoridating the household pets, lawns and gardens of 70% of American households? Not to mention that which is wasted in other capacities, down the drains of sewers, etc.
A possible relationship between fluoridated water and cancer risk has been debated for years. When fluoride was first introduced to American households back in 1945, it was touted as an amazing public health accomplishment. Unfortunately, as the years passed and tooth decay was on the decline, other more serious and fatal conditions like prostate cancer and bone tumors were on the rise (Cancer Trends Progress Report, 2011/2012). Many recent studies show evidence of the cancer-causing potential of fluoridated drinking water in humans and animals. A partial study from Harvard, published in 2006, confirmed that exposure to higher levels of fluoride in drinking water was linked to higher risk of a rare form of bone cancer in adolescent boys called osteosarcoma. Another study from the US National Toxicology Program found higher rates of the exact same type of cancer in a study involving male rats that were given fluoridated drinking water for two years (National Toxicology Program, 1990). Also, the NRC recommends that further research should be conducted on the effects of fluoride on the risk of bladder cancer.
Beyond the physical health concerns, research suggests that fluoride has adverse effects on human neurological development as well. In a telling review of a variety of studies that have demonstrated just how significantly fluoride can damage the brain and subsequently your IQ, Harvard University scientists stated “our results support the possibility of adverse effects of fluoride exposures on children’s neurodevelopment.” New studies from China show that children whose mothers were exposed to fluoridated water while they were pregnant had lower I.Q. scores than those whose mothers lived in non-fluoridated areas during pregnancy.
Since it has been acknowledged that fluoride can be toxic to humans at high levels, many are concerned about inadvertent consumption through alternative sources. Intake, absorption and retention will vary among each individual and since too much fluoride can be hazardous to your health, exposure levels need to be exact. Several different factors determine the level of individual fluoride absorption and retention. Even if you are able to control your water intake by drinking bottled water, other sources of fluoride exist from toothpaste, soft drinks, and food. Therefore intake levels cannot be measured accurately to determine proper dosage amounts.
While there has been a great deal of controversy surrounding this topic, one might question whether the concern is due to a genuine public health concern or simply an overall lack of evidence to support the safety of fluoride ingestion over an extended period of time. While fluoride use may in fact reduce tooth decay, there is a strong possibility that the risks outweigh the benefits. Ultimately, many reputable sources agree that the use of fluoride as an accepted method of dental health promotion is a very misunderstood practice that deserves a more in depth look. In the meantime, I think I’ll stick with bottled water.
- Hodge HC. Evaluation of some objections to water fluoridation. In: Newbrun E, ed. Fluorides and dental caries. 3rd ed. Springfield, Illinois: Charles C. Thomas, 1986:221-55.
- National Research Council. Health effects of ingested fluoride. Washington, DC: National Academy Press, 1993.
- Committee to Coordinate Environmental Health and Related Programs, Ad Hoc Subcommittee on Fluoride (February 1991). Review of Fluoride: Benefits and Risks. Public Health Service, Department of Health and Human Services. n.d. Web. 10 Nov. 2012.
- “Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries” CDC.GOV. Centers for Disease Control and Prevention. 22. Oct. 1999. Web. 10. Nov. 2012. [C1]
- Ringelberg ML, Allen SJ, Brown LJ. Cost of fluoridation: 44 Florida communities. J Public Health Dent 1992;52:75-80
- Fluoride Recommendations Work Group. “Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States.” CDC.GOV. n.d. Web. 10 November. 2012.
- “The Story of Fluoridation” NIDCR.NIH.GOV. National Institute of Dental and Craniofacial Research. n.d. Web. 10 Nov. 2012.
- “Ten Great Public Health Achievements in the 20th Century” CDC.GOV. Center for Disease Control. n.d. Web. 10 Nov. 2012.
Cancer Trends Progress Report, 2011/2012
***This article was contributed by Chrystle Poss a.k.a. “Survival Girl”, Owner of this Survival Blog and devoted Prepper. She has been writing articles on survival and emergency preparedness since 2006. You can find her work on various websites and publications.***