Fluoridated Water: The "Healthful" Drink that Can Damage Your Health

By The Fluoride Action Network

According to the U.S. Surgeon General, "there are profound and consequential disparities in the oral health of our citizens..." that have resulted in a "silent epidemic" of dental and oral diseases that disproportionately affects low-income and minority populations¹.

Unfortunately, not only are these groups afflicted with worse dental health, but are also suffering more extensively from the public health measure carried out under the guise of improving oral health: water fluoridation.

The Environmental Injustice of Water Fluoridation

One of the goals of the U.S. Environmental Protection Agency (EPA), and particularly of its administrator Lisa Jackson, is achieving Environmental Justice for all Americans. According to the EPA (2011):

"Environmental Justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. EPA has this goal for all communities and persons across this Nation.

It will be achieved when everyone enjoys the same degree of protection from environmental and health hazards and equal access to the decision-making process to have a healthy environment in which to live, learn, and work."

Unfortunately, the agencies and associations that continue to promote artificial water fluoridation - including the EPA's Office of Water, the U.S. Centers for Disease Control and Prevention's (CDC) Oral Health Division, the U.S. Department of Health and Human Services (HHS), and the American Dental Association (ADA) - have completely ignored racial, ethnic, and socioeconomic differences when stating that the level of fluoride used is "safe" for all Americans to consume in drinking water - on a daily basis, and over a lifetime.

A number of groups are particularly susceptible to fluoride's toxic effects.

Fluoridation proponents are finally beginning to acknowledge the susceptibility of infants and children to excessive fluoride intakes, likely because they can no longer deny the obvious effects that fluoride has on the developing teeth, in the form of dental fluorosis.

Nearly 41 percent of adolescents aged 12-15 now have some form of dental fluorosis², an outwardly visible sign of fluoride over-exposure and toxicity.

However, also included among those that are disproportionately impacted by fluoride are minorities and low-income families. The refusal by government agencies to consider these groups when determining enforceable safety standards or recommended levels for artificial fluoridation is no doubt a form of discrimination, contradicting any assertions by these agencies that they are working towards Environmental Justice for all.

Atlanta Civil Rights leaders Andrew Young and Reverend Dr. Gerald Durley recently requested that Georgia legislators repeal the state's mandatory water fluoridation law, based on the fact that fluoride can disproportionately harm poor citizens and black families.

According to a recent press release³ , the leaders "expressed concerns about the fairness, safety, and full disclosure regarding fluoridation in letters to the state's minority and majority legislative leaders." In his letter to the legislators, Rev. Dr. Durley states,

"I support the holding of Fluoridegate hearings at the state and national level so we can learn why we haven't been openly told that fluorides build up in the body over time, (and) why our government agencies haven't told the black community openly that fluorides disproportionately harm black Americans…"

Minorities Suffer Disproportionate Harm from Fluoridation

African American children have been found to consume significantly more total fluids and plain water, and thus receive more fluoride from drinking water, than white children⁴ . Additionally, African American mothers are less likely to breastfeed than most other racial groups⁵ . As breast milk contains very low levels of fluoride⁶ ), babies fed formula made with fluoridated water could receive up to 200 times more fluoride than a breast-fed baby.

Thus, African American infants and children have a higher risk of being overexposed to fluoride.

In fact, it has been known for many decades that African Americans and Hispanics are at an increased risk of developing dental fluorosis, and have a higher risk of suffering from the more severe forms of this condition⁷.

Data published in CDC's Morbidity and Mortality Weekly Report in 2005 show that Black and Mexican Americans have significantly higher levels of the worst forms of dental fluorosis than do Whites, as indicated in the following table from Beltrán-Aguilar et al. (2005; Table 23).

Table 23. Enamel fluorosis* among persons aged 6-39 years, by selected characteristics - United States, National Health and Nutrition Examination Survey, 1999-2002. Source: Beltrán-Aguilar et al., 2005.

Factors that Influence Fluoride's Toxicity

Fluoride's toxicity is exacerbated by:

Inadequate Nutrition Heightens Fluoride's Health Risks

Poor nutrition has been found to increase the incidence and severity of:

• Dental fluorosis¹³ and
• Skeletal fluorosis¹⁴. 

The dose of fluoride associated with disturbed endocrine function is also substantially lower if you're deficient in iodine (NRC, 2006). Even modest levels of fluoride in drinking water (0.88 mg/L) have been associated with reduced IQ and increased frequency of hypothyroidism when combined with low iodine, even more so than with iodine deficiency alone (Lin et al., 1991).

As poor nutrition frequently occurs among low-income families, poor children and adults are therefore far more susceptible to the detrimental effects of fluoride exposure.

Low-income families typically consume substantially less fresh fruits and vegetables, and thus more processed foods, than higher income groups. In addition to generally being less nutritious, processed foods - including those containing mechanically de-boned chicken - can also contain relatively high levels of fluoride.

Moreover, the increasing dietary intake of harmful trans fats in the United States, especially among lower income groups, may have negative repercussions in terms of fluoride metabolism. According to the U.S. Department of Health and Human Services:

"Diets high in fat have been reported to increase deposition of fluoride in bone and, thus, to enhance toxicity" (HHS, 1991).

Additionally, as with African Americans, low-income children have been found to consume significantly more total fluids and plain water - and thus receive more fluoride from drinking water - than higher-income children, putting them at greater risk for fluoride's toxic effects.

Also of concern is the inability of low-income families living in fluoridated communities to provide low-fluoride or fluoride-free water to reconstitute infant formula. Low-income families are likely not able to afford expensive filtration systems to remove fluoride from tap water, nor are they likely able to afford bottled water containing low or no fluoride.

Thus, bottle-fed infants of low-income families are at an increased risk for suffering from over-exposure to fluoride during this very sensitive developmental period.

Income Level is Strongest Indicator of Tooth Decay, Regardless of Water Fluoridation

According to the American Dental Association (ADA, 2009),

"[L]ow income is the single best predictor of high caries [cavity] experience in children. Analysis of data shows that the amount of tooth decay in children is inversely related to income level."

In 1988, an editorial published in the Journal of Dental Research (Newbrun, 1988) reported that "About 20 to 25 percent of children are at relatively high risk of caries, despite the declining caries prevalence in the 'fluoride generation'." The high-risk children included the poor.

In 1995, it was found that more than 50 percent of U.S. schoolchildren had experienced cavities (Edelstein and Douglass, 1995), when preschoolers and cavities in the primary teeth were considered. According to the authors,

"Minority, low-income and underserved groups continue to experience extensive destruction in both primary and permanent teeth."

Actually, 42 percent of five-year-olds and almost 60 percent of nine-year-olds had cavities in their primary and permanent teeth, according to National Institutes of Dental Research 1986-1987 data.

The most recent oral health statistics (1999-2004) show a direct link with tooth decay and poverty level. For example, the incidence of caries is much higher in children from families with lower income levels (HIW, Undated a-c):

In 2008, the U.S. Government Accountability Office (GAO) reported that the extent of dental disease in children has not decreased, and estimated that 6.5 million children two through 18 years of age on Medicaid suffer with untreated tooth decay (GAO, 2008). In November 2010, the GAO reported "high rates of dental disease and low utilization of dental services by children in low-income families, and the challenge of finding dentists to treat them are long-standing concerns" (GAO, 2010).

A study recently published in the Journal of Dental Research¹⁵ (also found a significant relationship between tooth loss and state income inequality among adults in the United States, with the risk for tooth loss being about 20 percent greater for those living in economically "disadvantaged" areas.

Despite claims to the contrary by promoters of fluoridation, low-income children still have high rates of tooth decay even when their drinking water is artificially fluoridated.

For example, in Georgia where fluoridation is state-mandated, 44 percent of 2 to 5-year-old Head Start children have tooth decay¹⁶ . And although fluoridation is required in North Dakota, tooth decay is present in 82 percent of Native American third grade children (who are often from very low-income families) compared to 54 percent of white children¹⁷ .

In New York City - which is 100 percent fluoridated - 56 percent of low-socioeconomic third grade children have tooth decay, compared to 38 percent of high-socioeconomic third grade children¹⁸. Likewise, in Kentucky, with a nearly 100 percent t fluoridation rate, nearly 60 percent of third grade children have experienced tooth decay, yet for nearly 35 percent of these children that decay went untreated¹⁹.

More than 60 Oral Health Care Reports from the 50 States reaffirm that low-income people have the worst dental health.

More importantly, these reports present quite an extensive array of data from examinations of school age children, yet all but one of these fail to mention rates of dental fluorosis. This is despite that each and every report strongly advocates water fluoridation²⁰.

State Dental Policies Receive Failing Grades

State dental policies fail one in five children, according to the Pew Charitable Trust²¹. Even some highly fluoridated states received a grade of "F" from Pew.

Included among these is West Virginia, which is 92 percent fluoridated. West Virginia's tooth decay rate is 66 percent for 15 year-olds. By the time these children graduate from high school, the proportion has increased to 84 percent ²².

It is reported that 80 percent of dental caries in children of West Virginia is concentrated in just 25 percent of the child population. West Virginia also ranks first in the U.S. for partial and complete tooth loss among adults²³.

The most recent national statistics show that the prevalence of dental caries in primary teeth significantly has increased for 2-5 year-olds, from approximately 24 percent to 28 percent between the 1988-1994 and 1999-2004 recording periods, and has increased from 40 percent to 42 percent for all children 2-11 years old²⁴.

Meanwhile, fluoridation rates in the United States have continued to increase, from 62 percent in 1992 (CDC, 2008) to over 72 percent in 2008!²⁵

Proponents of fluoridation would have us believe that as fluoridation rates go up, tooth decay rates will go down. But that hasn't happened.

Instead, oral health continues to decline among children - especially those from lower income families - and symptoms of fluoride overexposure and toxicity have increased to epidemic proportions, as evidenced by the 41 percent of adolescents aged 12-15 now afflicted with dental fluorosis (Beltrán-Aguilar et al., 2010).

The Role of the EPA in Fluoridation

EPA Administrator Lisa Jackson has declared that achieving Environmental Justice for all Americans is a top priority for her agency.

As fluoride has been shown to disproportionately affect poor and minority Americans, the EPA should be giving special consideration to these groups when determining the level of fluoride in drinking water that is safe for all Americans. Unfortunately, the most recent analyses of fluoride by the EPA's Office of Water (EPA, 2010a, 2010b) clearly indicate that the EPA is more concerned with protecting the fluoridation program than protecting the American people.

For example, the EPA's newly proposed reference dose for fluoride (the dose of fluoride that is supposedly safe for everyone when taken every day and over a lifetime) was based on the dietary intake of fluoride recommended by the Institute of Medicine nearly 15 years ago (IOM, 1997) to prevent dental caries.

Since that time, however, it has been well established - and is now widely accepted - that the primary action of fluoride on teeth is topical, not systemic²⁶.

As fluoride is not an essential element (i.e. not necessary for human health), any dietary recommendations for fluoride are therefore illogical and unnecessary.

Thus, EPA's newly proposed reference dose was not based on the latest scientific findings concerning the safety of this level of fluoride, but rather on outdated recommendations by those promoting artificial water fluoridation.

This reference dose will soon be translated to a new Maximum Contaminant Level Goal (MCLG) for fluoride in drinking water. If EPA were to evaluate the true science behind fluoride toxicity - free from any interference by those promoting fluoridation - the only rational outcome would be an MCLG of ZERO, effectively ending the practice of artificial water fluoridation.

What You Can Do TODAY!

The Fluoride Action Network has a game plan to END water fluoridation in both Canada and the United States. Our fluoride initiative will primarily focus on Canada since 60 percent of Canada is already non-fluoridated. If we can get Calgary and the rest of Canada to stop fluoridating their water, we believe the U.S. will be forced to follow.

Please, join the anti-fluoride movement in Canada and United States by contacting the representative for your area below.

Contact Information for Canadian Communities:

1. If you live in Ontario, Canada, please join the ongoing effort by contacting Diane Sprules at [email protected].
2. The point-of-contact for Toronto, Canada is Aliss Terpstra. You may email her at [email protected].

Contact Information for American Communities:

We're also going to address three US communities: New York City, Austin, and San Diego:

In addition, you can: