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Below is a Letter
to the Editor that my Associate Editor, Cory, and I had
published on the website of the British Medical Journal this
past week.
When "programmed cell death"
was first identified as a cellular function in 1972, water
fluoridation in the United States had already been around
for over two decades.
Several years ago, fluoride was
found to induce apoptosis (1), joining a list of other apoptosis
inducing substances, such as radiation, mercury and anti-cancer
drugs. The mechanism of action is likely through activation
of the enzyme caspase-3 (2). Although these discoveries may
be important in the development of pharmacological agents
to treat cancer or other diseases, it should cause a great
deal of concern regarding current levels of fluoride exposure.
While fluoride has long been known to be highly
toxic, we find it most disturbing that it acts
through apoptosis rather than necrosis, since the former requires
genetic interference.
As researchers stated last year "Even though fluoride
toxicity is increasingly being considered to be important,
very little information is available on the mechanism of action
of fluoride." (2)
Since apoptosis is potentially implicated in the development
of neurological disorders such as autism, Alzheimer's, and
schizophrenia (3, 4), this lack of understanding is concerning.
A logical question would be if pregnant women consuming large
amounts of fluoride be increasing their unborn child's risk
of autism? While this is unproven, it is biologically possible,
especially considering the vital role of apoptosis in embryogenesis.
This is especially relevant when one
considers the fact that any benefit of water fluoridation
in the reduction of dental caries is miniscule at best.
In 1990, researchers from the National Institute of Dental
Research in the US performed an epidemiological study and
declared "The results suggest that water fluoridation
has played a dominant role in the decline in caries and must
continue to be a major prevention methodology." (5)
However, a closer look at the study shows that the conclusion
is not supported by the actual data.
The difference in tooth decay was actually found to be 0.6
DMFS (Decayed, Missing, or Filled Surfaces). In other words,
the tremendous benefit of fluoridation amounted to about one
half of a single tooth surface, out of a total number of tooth
surfaces of 128 (less than 0.5% difference). In addition,
it is doubtful whether such a small difference is even statistically
significant.
The medical community really
needs to ask itself exactly what their priorities should be.
Considering the fact that apoptosis "sculpts
the developing brain", as a review in Nature describes
it (6), it needs to determined if we are willing to continue
to recommend that children be subjected to the potential risk
of water fluoridation for the meager benefits, if any, described
above.
How can we assure the public that it is perfectly safe, when
the biological effects of fluoride are still in the process
of being unraveled, even today?
British
Medical Journal July 20, 2001
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