by Bill Osmunson DDS, MPH, PS (bill@teachingsmiles.com)
Aesthetic Dentistry of Bellevue and Paul G. Rubin, DDS, FIAOMT (drpaul@drpaulrubin.com)
Dentists respond to Seattle Times editorial:
The recent Seattle Times editorial on fluoridation presented one side of the fluoridation concern. Many eminent scientists, scholars and clinicians, after studied evaluation, are persuaded that fluoridation is no longer beneficial for the reduction of tooth decay (if it ever was), fluoridation is not "safe," and we are ingesting too much fluoride from all sources.
The fluoridated toothpaste label tells us fluoride is a drug: do not swallow. If more than a pea size amount (0.5 mg fluoride) is swallowed contact a poison control center. The same amount of fluoride ion, 0.5 mg, is found in two glasses of Seattle water.
The FDA's intent is correct: fluoride ingested even in small quantities can be a Public Health risk. The FDA, EPA, nor CDC regulate water fluoridation. In reality, no one monitors our total fluoride intake, and no governmental agency monitors the safety and purity of the substance used in over 90% of this country's fluoridation programs.
Infant formula mixed with fluoridated water (1 ppm), has 100 times the concentration of mother's milk, 0.01 ppm. (Levy, JADA '95) Mothers should be advised not to make baby formula with fluoridated (i.e. "Seattle") water.
Children should not use fluoridated toothpaste until they can spit without first swallowing, and only if they have decay problems. Infants, children and adults can easily ingest too much fluoride from foods and beverages. Thus, fluoridated water is excessive and serves no purpose. Labeling is non existent. Water districts do not notify their customers and ordinary home filters do not remove fluoride.
Fluoride is not a nutrient. The absence of fluoride does not cause any disease. The huge increases in fluoride based pesticides and post harvest fumigants (up to 900 ppm) and fluoride based pharmaceuticals make past estimates of total fluoride intake incomplete. The so-called "optimal" level of fluoride intake was estimated in the 1950's, long before these increased sources of fluoride intake came on the scene, and long before our increased knowledge about the mechanism of fluoride's activity and risks were explored. Mass medication of everyone with an ineffective drug which has known risks makes no sense.
Scientists at the Environmental Protection Agency, the very ones who study water safety, "hold that fluoridation is an unreasonable risk. That is, the toxicity of fluoride is so great and the purported benefits with it are so small — if there are any at all — that requiring every man, woman and child in America to ingest it borders on criminal behavior on the part of governments" (Dr. William Hirzy, EPA, 2001), and have called for a moratorium on water fluoridation in the United States.
Attempting to gain health through chemicals presents risks and side effects which must be acknowledged. A good diet and careful brushing and flossing can prevent tooth decay and improves health without adverse side effects.
Benefits: We agree, regardless of fluoridation, decay world wide in developed countries over the last 30 years has dropped to less than a third. Tremendous success in decay reduction world wide is in bold contrast to the poor dental health among some children, particularly in low-income areas. Published, peer reviewed, large-scale epidemiological studies fail to correlate this dental decay public health problem in low-income areas with the lack of fluoridation. In fact, several studies show an increase in decay with fluoridation and others show no increase in dental decay with the cessation of fluoridation. The NIH has stated the evidence for the benefits of fluoridation is "incomplete."
Risks: The CDC reports one third of American children are having dental fluorosis (a disfiguring of tooth enamel that can be very costly to repair), a significant recent increase. Several studies show increased hip fractures in the elderly, and others show an increased rate of bone cancer in young males. Evidence is mounting that fluoridation is a contributing factor in many other diseases.
The recent Seattle Times editorial on fluoridation presented one side of the fluoridation concern. Many eminent scientists, scholars and clinicians, after studied evaluation, are persuaded that fluoridation is no longer beneficial for the reduction of tooth decay (if it ever was), fluoridation is not "safe," and we are ingesting too much fluoride from all sources.
