Debating Fluoridation
What Evidence Is There That Water Fluoridation Prevents Cavities?

By Nicholas Regush

There likely is a little warning section on the tube that suggests you keep it out of the reach of children under 6 years of age. In fact, any child between the ages of 2 and 6 should only use a pea-sized amount.

And should you be one of “those” hedonists who can’t easily control yourself and occasionally allow some of that yummy peppermint or strawberry flavor to go down the hatch, well, think again. Swallowing more than what you use for brushing is a major no-no. You may have to “seek professional assistance or contact a Poison Control Center immediately.”

That scary warning on your toothpaste which began appearing in 1997 is about fluoride. The Food and Drug Administration considers ingestion of fluoride toothpaste to be potentially poisonous. Little wonder, considering that fluoride is a by-product of aluminum and fertilizer manufacturing and contains heavy metals such as lead, arsenic and chromium. Fluoride is not a high-purity pharmaceutical, to put it conservatively.

Does Fluoridated Water Fight Cavities?

But the fluoride is in your toothpaste to fight cavities. When it comes into direct contact with teeth, fluoride appears to help. The much bigger questions are whether we need to fluoridate the entire water supply to achieve this and whether water fluoridation, an indirect method to fight cavities, actually works.

The answers don’t come easily, even though loud voices on both sides of the debate for the past 55 years have been giving the impression that scientific truth is definitely on their side.

Fierce political battles have been raging in many communities across the country about whether to fluoridate the water supply ever since Grand Rapids, Mich. took the first step in 1945. Thus far, about 60 percent of the U.S. water supply is fluoridated.

Those scientists, medical and dental organizations, consumer advocates, government officials and chemical industry representatives in favor of fluoridation insist that hundreds, if not thousands of studies, support fluoridation as a means to prevent cavities. They also claim it is safe.

On the other side, those opposing fluoridation cite a tide of research, particularly in the past decade, suggesting that long-term fluoride consumption can cause cancer, neurological problems and brittle bones, and may create a fundamental alteration of human bone architecture.

It's Better Dental Hygiene Not Fluoridation

One argument against fluoridation is that it doesn’t contribute much, if anything on average, to cavity rate reduction. Rather, the decline in cavity rates are seen as due, for example, to higher standards of living, less consumption of refined sugar and more dental flossing and brushing of teeth.

It is noteworthy that most countries in Europe have opted not to fluoridate their water supplies, contending that public dental health does not require it.

So who’s got top-notch and definitive science on their side?

No one. That’s the conclusion you must come to when reviewing the core science. Yeah, sure, there are tons of studies published but so what? We’ve unfortunately been inundated with a heap of inadequate science on water fluoridation. There is, for example, not even one randomized controlled trial on its effects.

Better Fluoridation Research Necessary

Some of the science that has accumulated over the past 55 years borders on junk because the methods used are inadequate or suspect and the rest of the research on water fluoridation is only moderately acceptable and remains inconclusive. In fact, a British government-ordered review of the published literature conducted recently by a committee of scientists at York University essentially concludes that it’s time to go back to the drawing board and do good science on this issue.

Of course, there is a lot of denial going on in the aftermath of this report. The pro-fluoridation forces have somehow managed to shamelessly interpret the report as being on their side. It’s really not on anyone’s side.

Those fighting fluoridation have attacked the report as narrow and have accused it of omitting huge volumes of data - both animal and laboratory - that would have nailed the issue down in favor of stopping fluoridation. Well, yes, the report has serious limitations because of its scope, but there will be no nailing down of anything until much more solid science is done.

What is amazing, however, is that public health policy in this country has allowed water fluoridation to continue in the absence of solid scientific evidence that its benefit is greater than its risk.

When you commit to putting a powerful chemical into the water supply, you’d better have the best of evidence that it is both safe and effective. The required level of evidence is just not there.

Nicholas Regush produces medical features for ABCNEWS. In his weekly column, published Mondays, he looks at medical trouble spots, heralds innovative achievements and analyzes health trends that may greatly influence our lives. His latest book is The Virus Within.

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