As with any controversial topic, it is important to understand what the scientific research has shown. In this post I will be dealing the scientific facts about fluoride. Most people understand that fluoridation of water means that fluoride is added by the local municipal water supplier, and that’s generally correct. What most people don’t know is that in some cases, fluoridation means removing excess fluoride that occurs naturally in the water supply. Fluoride is a natural component of groundwater, and it occurs naturally everywhere in the world, in varying amounts. The process of fluoridation is to adjust the fluoride content of the water to the most healthful level.
So how did fluoridation become a normal part of municipal water supply? It all goes back to an early 20th century dentist named Dr. Frederick McKay, who practiced dentistry in Colorado, and noticed that a lot of his patients seemed to have brown teeth. In Texas, brown teeth were so prevalent that they were simply called “Texas Teeth”. Dr. McKay spent 30 years investigating the cause. Why? Because it also turned out that people with Texas Teeth also had extremely low levels of dental decay. If you had brown teeth, you were only 1/3 as likely to have cavities.
Finally, in 1931, it was determined that naturally occurring fluoride in the local drinking water was responsible for both the discoloration and the lack of decay. Texas and Colorado had extremely high levels of natural fluoride, causing the discoloration, a condition now known as dental fluorosis, which is harmless if a tad unattractive. Years of research and testing in different cities and states, conducted by the National Health Service, determined that one part per million was the ideal proportion, giving the same protection from decay, and avoiding the dental fluorosis. Ever since then, it has been the standard practice to regulate fluoride levels in municipal water supplies to one part per million. There has been broad scientific and medical consensus for decades that 0.7 to one part per million of fluoride is best for health, and exactly zero rigorously conducted scientific trials that have indicated any sign of danger. A 1999 report by the CDC concluded that studies to date have produced “no credible evidence” of an association between fluoridated drinking water and an increased risk for cancer. For all practical purposes, it is an over-and-done-with issue.
And yet, like so many advances in science or medicine, fluoridation is criticized by a small yet vocal fringe group. There is an anti-fluoridation lobby in this country. Their process is to flood the mass media with as many claims as they can invent: Claims like fluoridation causes cancer or other illnesses; that insufficient research has been done or that there is “scientific controversy” surrounding fluoridation; that fluoride is a dangerous chemical poison; that fluoridation has been banned in Europe; that it eliminates your freedom of choice; or any of a dozen other baseless and untrue statements intended to alarm and frighten the public. Alarming the public is not hard to do. There are many communities in the United States where voters have been compelled to ban fluoridation by this widespread misinformation campaign.
There are no known victims. If there was a problem with municipal fluoridation, wouldn’t we have at least a few people who showed some signs of harm after 44 years? All the anti-fluoride people could say was that the victims are “undiagnosed,” but not why. They produced no victims, just lots of dubious statistics and horror stories with no provenance.
Recommendation for Using Fluoride to Prevent and Control Dental Caries in the U.S. (Centers for Disease Control, 2001):
“Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. All U.S. residents are likely exposed to some degree of fluoride, which is available from multiple sources.” (Summary section, page 1)
“Continue and extend fluoridation of community drinking water: Community water fluoridation is a safe, effective, and inexpensive way to prevent dental caries. This modality benefits persons in all age groups and of all SES, ….” (Recommendation section, page 24)
So what does all of this mean? It means that according to our most recent scientific research, fluoride is safe and effective. There is no credible research to prove to the contrary. So keep brushing your teeth confidence!
Centers for Disease Control and Prevention. Public Health Service report on fluoride benefits and risks. JAMA 1991; 266(8):1061–1067. [PubMed Abstract]
Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: fluoridation of drinking water to prevent dental caries. Morbidity and Mortality Weekly Report 1999; 48(41):933–940.
Centers for Disease Control and Prevention (August 2010). 2008 Water Fluoridation Statistics. Retrieved August 10, 2011.
Bucher JR, Hejtmancik MR, Toft JD, et al. Results and conclusions of the National Toxicology Program’s rodent carcinogenicity studies with sodium fluoride. International Journal of Cancer 1991; 48(5):733–737. [PubMed Abstract]
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. Retrieved August 10, 2011.
Dunning, Brian. All About Flouridation (Jul 30 2007).
National Research Council, Subcommittee on Health Effects of Ingested Fluoride. Carcinogenicity of fluoride. In: Health Effects of Ingested Fluoride. Washington, DC: National Academy Press, 1993.
Kim FM, Hayes C, Williams PL, et al. An assessment of bone fluoride and osteosarcoma. Journal of Dental Research 2011; 90(10):1171–1176. [PubMed Abstract]