The Fluoride Controversy
Fluoride is any one of a number of combinations of elements containing fluorine, a yellow, highly toxic, corrosive gas. Fluorine is apparently the most chemically active non-metallic element, and has the most reactive electro-negative ion, and thus fluorine is never found in nature in uncombined form. In compound form, as fluoride, however, it is not volatile.
Fluoride is a common topical medicine applied to strengthen teeth, but the controversy is not really about this, it's about adding fluoride to water. Calcium fluoride is found naturally in water, but since the 1940s many communities in the United States and Canada have seen their municipal water supplies fluoridated with artificially created sodium fluoride, sodium silicofluoride or hydrofluosilic acid. The American Dental Association, American Medical Association, National Institute of Dental Research, Canadian Dental Association, the Canadian Medical Association, Health Canada, Canadian Public Health Association, and World Health Organization all support the fluoridation of drinking water.
By contrast, the US Food and Drug Administration has never approved the use of fluoride for human consumption and lists it as an "unapproved new drug", and senior researchers at the US Environmental Protection Agency have come out strongly against it, though the EPA itself supports it. Many European countries - Belgium, Germany, Sweden, Denmark, Holland, France, Italy, and Norway - have rejected fluoridation, and in North America many not-so-mainstream groups strongly oppose it.
The debate is polemical and passionate, with heavy hitters and inflammatory rhetoric marshalled by both sides. So what's all the fuss about?
The Joys and Sorrows of Fluoride Consumption
The addition of fluoride to water might at first glance seem analogous to the addition of Vitamin D to milk, but the analogy is a false one. Vitamin D is an essential nutrient which can negatively impact the health of those who are deficient in it, while fluoride is not a nutrient, and lack of it cannot be labelled a deficiency. The reason fluoride is added to drinking water is because it reduces tooth decay, which explains why dental associations support fluoridation.
The seed of this idea was apparently planted by one H. Trendley Dean, a dentist working for the U.S. Public Health Service who, in 1939, examined water from 345 communities in Texas. Dean determined that in communities with about 1 part per million (ppm) fluoride in the water, people had fewer cavities and "beautiful white teeth". So the level of 1 ppm of fluoride apparently became some kind of gold standard, and fluoridation levels were set to reach this standard for the average 110 lb person drinking four cups of water a day.
The idea that there could be a magic potion that could be cheaply and safely added to water which would reduce tooth decay is undoubtedly attractive to many. It's particularly attractive because this method of delivery is universal, and reaches everyone, regardless of race, sex, age, class, sexual orientation, and all those other "us-vs-them" divisions. Though some people see fluoridation as mass medication, I believe that many who champion fluoridation have altruistic motives and are proceeding in the best spirit of public health.
But is it safe?
One problem is that too much fluoride is toxic. Which can be an issue when you consider that kids weigh less than that average 110 lbs. And that these days we're being urged to drink eight cups of water a day. And that tap water isn't our only source of fluoride - we also ingest it when consuming crops irrigated with fluoridated water (particularly tea, apparently), foods and beverages prepared in or with fluoridated water, toothpastes and mouth wash, vitamins, pesticide traces on foods, and prescription medications such as tranquilizers. In fact, it's impossible to control the amount of fluoride actually ingested by each individual by fluoridating water, so all the American Dental Association's talk of "optimally flouridated" water is smoke and mirrors. And critics charge that adding fluoride to water just ensures that people, especially children, ingest too much fluoride as a matter of course.
And then there's the fact that Dean based his findings on only 21 cities, ignoring the data from 272 other communities. In later court cases he admitted under oath that his data were invalid. Since the time of Dean's shoddy science there have been many studies done of fluoridation, and while fluoride's detractors claim that none have conclusively proved that fluoridation is effective in reducing cavities, its champions claim the opposite. The American Dental Association (ADA) points to studies which show that rates of tooth decay have declined in the US and say that this is because of fluoridation, but studies of non-fluoridated European countries apparently show similar rates of reduction. In fact, intelligent people on both sides of the debate marshall impressive scientific studies to back up their claims. What's a lay non-scientist to do?
Well, try looking at some of the other effects fluoride might have. It has been shown, apparently, that high levels of fluorine cause fluorosis, the first sign of which is mottled teeth. This mottling is most common in children who have been exposed to high levels of fluoride during the first eight years of life - as many as 10% of American children, even the ADA admits - and while it's unclear whether the mottling makes teeth more resistant or more susceptible to tooth decay, once it has occurred, it will never go away.
Fluoride was once prescribed as a treatment for osteoporosis, until it was shown to weaken bones at high dosages; the ADA is cautious here, and retreats to careful language like "According to generally accepted scientific knowledge, the ingestion of optimally fluoridated water does not have an adverse effect on bone health". Studies have linked fluoride with increased risk of hip fracture among the elderly, a potentially deadly problem for them.
Fluoride has been associated with increased bone cancer in rats, though the study that showed this was "adjusted" by the Public Health Service before the report was released for review. Every indication of cancer or other health problem was downgraded. When Dr. William Marcus, at the time the chief toxicologist for the EPA's Office of Drinking Water, questioned this "adjustment" and called for an unbiased independent evaluation of the evidence, he was fired from his job; he took his case to court, proved that his dismissal was politically motivated and eventually won reinstatement.
Fluoride has also been correlated with hyperthyroidism in humans, and the wackiest argue that it is a tool to increase susceptibility to mind control. (Remember Dr. Strangelove?) Well, that may be going a little far, but the evidence does seem rather daunting, all in all.
But Why Would They Want to Harm Us So?
It's a good question. If it's going to be argued on the basis of a conspiracy theory and massive cover-up, crackpot theories about brainwashing the populace through mass fluoride poisoning won't cut it. There must be something more compelling. And lo and behold, there actually might be!
Turns out that the sodium fluoride that finds its way into water supplies is a waste by-product of many heavy industries, and is emitted by aluminum, steel and phosphate fertilizer factories, coal-burning power plants, and producers of glass, cement and other items made from clay. If sodium fluoride were declared a toxin rather than a health boon, these industries would have to pay a lot of money to dispose of their waste fluoride. Instead, they sell it at a tidy profit to municipalities for adding to tap water.
The links between the aluminum industry and the Public Health Service are rather too close for comfort. As fluoridation began to be instituted in cities in the States, the PHS was headed by Andrew W. Mellon, one of the founders and major stockholders of the Aluminum Company of America (Alcoa). By the early fifties, when the campaign was gaining steam, another top Alcoa official, Oscar R. Ewing, was heading up the PHS, and was aided by Edward L. Bernays, the father of modern public relations and author of the book Propaganda. The happy relationship between industry and fluoridation was apparently also recognized in a memo written in 1983 by Rebecca Hammer, a deputy assistant administrator in EPA's Office of Drinking Water; she called water fluoridation "an ideal environmental solution to a long-standing problem". So someone - lots of powerful someones - stand to gain by having fluoridation continue apace.
None of this means that there is a massive fluoride conspiracy, but, let's face it, it doesn't look too good.
And then I guess it would be kind of embarrassing for national dental and public health bodies in North America to admit that they'd made a mistake and spent fifty years championing something that's actually a hazard to our health.
In the end, I have to reach some kind of personal conclusion about fluoride. It seems rather frightening to me that since 1997, American toothpaste manufacturers whose product contains fluoride - that's almost all of them - have had to put warning labels on their product advising parents to supervise their children's brushing to minimize swallowing, and to call poison control if it's eaten. *Gulp* I'm not one for paranoid fear, but that little gem gives me pause. And then there's the fact that the voices on the "con" side include some weighty scientists. Seems to me a little more scientific rigour, and dispassionate clarity, is called for in this debate.
In the meantime, I'm not taking any fluoride pills.