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A Medical Doctor's Opposition to Fluoridation

A Medical Doctor's Opposition to Fluoridation

People have often asked me why I oppose fluoridation of our drinking water. They often say, "Well, you know, it's been in our water for over 70 years." I used to be reassured by this as well, so I understand their reasoning.

With this blog, I hope to address the growing list of specific concerns regarding the safety of adding fluoride to our drinking water. Dozens of studies over the last twenty or more years have highlighted the need for caution, and they have not been adequately addressed with the necessary follow up studies by those who reassure us that it is safe, but, rather, those authorities offer little more foundation to their reassurances than "it's been done for the last 70 years". Fluoridation of our water supplies did begin 70 years ago, a time when we didn't even know the structure of DNA. There is no comparison between the science of the 1940s and today's. Today's science is based on tools that couldn't even have been imagined in the ‘40s. Of course, these tools are much better at assessing fluoride's potential risks and benefits. Indeed, despite the reassuring statements of the CDC, ADA, the EPA, the American Academy of Pediatrics and others, many studies raise serious concerns about fluoride's safety. The institutions mentioned seem to think since fluoride is an existing public health policy, that fluoride is "innocent until proven guilty." Without this "tradition", I think few would overlook these disturbing studies to approve swallowing fluoride whose efficacy, incidentally, is by topical contact to the teeth as it passes through the mouth (more about such issues in future posts).

The practice of good medicine requires regular evaluation of the safety and the benefits of a medical treatment that we recommend for our patients. Indeed, this reevaluation raises questions about this 70 year old public health policy and the risk versus benefit ratio that made fluoride appear safe back in the day of DDT (when we were also assured of its safety), of cigarettes and the use of X-rays for treating acne that resulted in thyroid cancer.

When we swallow fluoride, it goes to every cell in our body, so we are talking about a medical and not a dental issue. The department of the CDC that makes this public health policy is composed almost entirely of dentists; the ADA is of course primarily dentists. The American Academy of Pediatrics? The AMA? I'm confused about their stance since their training, like mine, makes it unethical to do harm to patients and nobody can deny that fluoridation of our water supply results in harm to people that would otherwise not have been afflicted. (Almost everyone has heard our caveat, "First do no harm.") Public health policy, of which fluoridation of our water supply is an example, doesn't seem to have a problem with "collateral damage" of innocent people "for the greater good", but the practice of medicine, as I was taught it, most definitely does.

All studies, including the ones that raise concern about fluoride's safety, were reviewed by the National Research Council (NRC) in 2006 and I summarize by quoting their conclusions and recommendations at the end of this blog. Two points need to be made. One is telling you who the NRC is. The NRC is a committee of experts from diverse areas of science that review the existing medical literature on a particular issue. It is created by the National Academies of Sciences and the Institute of Medicine. The Academies exist to make recommendations to the government and its NRC is the Gold Standard for the objective review of the medical literature. The other point to be made is that the NRC after a 3 year review of the fluoride literature concluded that many areas investigated lack sufficient data to allow us to be assured of fluoride's safety. Nevertheless, it appears that the dental societies, including the dentists at the CDC, prefer to stick to its "innocent until proven guilty" policy with fluoride despite the NRC's conclusions and recommendations.

Congratulations for having read this far. This first blog has a wider area of focus than will future blogs which will focus on more specific issues, but I think this "Bigger Picture" overview is a good way to get started in helping you gain confidence that, indeed, the Emperor is wearing no clothes and that it is time for a bottom up (no pun intended, Emperor) approach to addressing this issue that may adversely affect a very large number of people.

Here is a summary of the recommendations of the NRC report on fluoride from 2006 (their full report can be downloaded free at:
http://www.nap.edu/catalog/11571/fluoride-in-drinking-water-a-scientific...
There's some medical mumbo jumbo in the recommendations, but I think you can get the idea. If just of couple of these dozen plus suggested studies demonstrate adverse effects, I would think large numbers of us would choose not to swallow fluoride, especially when its efficacy, if any, is topical. (Page numbers are noted, eg. Pharmacodynamics and recommendations for further study can be found on page 101 in the above report.)

p101 Pharmacodynamics: Recommendations

• "Additional research is needed on fluoride concentrations in human bone as a function of magnitude and duration of exposure, age, gender and health status..."

• "Thus, more studies are needed on fluoride concentrations in soft tissues (e.g., brain, thyroid, kidney) following chronic exposure."

p180 Musculoskeletal

• "more data are needed on concentration gradients during active remodeling ."

• "More research is needed on bone concentrations of fluoride in people with altered renal function, as well as other potentially sensitive populations..."

p222 Neurotoxicity and neurobehavioral effects

• "To determine the possible adverse effects of fluoride, additional data from both the experimental and the clinical sciences are needed."

• "Studies of populations exposed to different concentrations of fluoride should be undertaken to evaluate neurochemical changes that my be associated with dementia. Consideration should be given to assessing effects from chronic exposure."

• "At the present time, questions about the effects of the many histological, biochemical and molecular changes caused by fluorides cannot be related to specific alterations in behavior or to known diseases. Additional studies of the relationship of the changes in the brain as they affect the hormonal and neuropeptide status of the body are needed."

• Most of the studies ...have tested NaF. It is important to determine whether other forms of fluoride (e.g.. silicofluorides) produce the same effects in animal models."

p267 Effects on Endocrine System

• "further effort is necessary to characterize the direct and indirect mechanisms of fluoride's action on the endocrine system and the factors that determine the response, if any, in a given individual. Such studies would address the following:

o the in vivo effects of fluoride on second messenger function

o the in vivo effects of fluoride on various enzymes

o the integration of the endocrine system (both internally and with other

o identification of those factors, endogenous (eg. age, sex, genetic factors systems such a the neurological system) or preexisting disease) or exogenous (e.g.., dietary calcium or iodine concentrations, malnutrition), associated with increased likelihood of effects of fluoride exposures in individuals. perchlorate) that affect the same endocrine system or mechanism identify any transient, reversible, or adaptive responses to fluoride

o consideration of the impact of multiple contaminants (e.g., fluoride and perchlorate) that affect the same endocrine system or mechanism

o examination of effects at several time points in the same individuals to identify any transient, reversible, or adaptive responses to fluoride

• "Better...epidemiology studies....Important ...studies would include the following:

o "...data on general dietary status...such as calcium, iodine, selenium, and

o characterizing and grouping individuals by estimated (total) exposure

o examining a range of exposures with normal or control groups having very

• The effects of fluoride on various aspects of endocrine function should be examined further, particularly with respect to a possible role in the development of several diseases of mental states in the US. Major areas of investigation include ...:

o Thyroid disease....

o nutritional (Ca deficiency) rickets

o calcium metabolism....

o pineal function...

o development of glucose intolerance and diabetes."

P303 Gastrointestinal, renal, hepatic and immune systems

• Renal and hepatic

o Additional studies...to determine...the incidence of renal

o The effect of low doses of fluoride on kidney and liver enzyme function in aluminum intakes rather than by ...fluoride concentration in drinking water..." low fluoride exposures (below those associated with 1 mg/L in drinking water for humans). osteodystrophy....humans needs to be carefully documented....

• Immune response

o Epidemiologic studies should be carried out to determine whether there is

o More research is needed on the immunotoxic effects of fluoride in animals

o It is paramount that careful biochemical studies be conducted to determine a higher prevalence of hypersensitivity reactions in areas where there is elevated fluoride in the drinking water...[and] which fluoride chemicals can cause hypersensitivity.... In addition, studies...percentage of immuncompromised subjects who have adverse reactions....and humans to determine if fluoride accumulation can influence immune function. what fluoride concentrations occur in the bone and surrounding interstitial fluids from exposure to function in drinking water at up to 4mg/L, because bone marrow is the source of the progenitors that produced the immune system cells."