TRUTH DECAY: Fact Checking Water Fluoridation

The latest research on the positive health impacts of water fluoridation raises many questions about its effectiveness against mounting evidence regarding its potential to actually do more harm than good. It may sound like a lot, but only 350 million people consume artificially fluoridated water, which counts for only 5% of the global population. The great majority of Europeans consume non-fluoridated water with several countries strongly promoting preventative treatments against tooth decay. What’s surprising is that when one compares countries with and without fluoridated water, one finds there is very little difference in the rate of reduction or level of dental caries. In fact, other studies show a decline in caries after water fluoridation is ceased and other fluoride application programs have taken hold. 

Of course, here in the United States, water fluoridation is common practice with nearly 200 million Americans ingesting artificially increased levels of the inorganic anion. The US Department of Health Human Services cites the low levels of fluoride flowing through American taps to be both safe and effective – but that is beginning to contrast with the latest findings pointing to the potentially harmful effects of fluoride exposure such as low IQ, neurobehavioral deficits, and endocrine dysfunction. And while the Centers for Disease Control and Prevention, the American Dental Association and other major public health organizations share an endorsement for water fluoridation, some studies clearly assert that any benefits to added fluoride must be weighed against its potential adverse health impacts. 

Several studies—including one from Harvard dating back to 2012—highlight neurotoxic effects of fluoride in children and from fetal exposures. And as far back as 2006 it was found that repeated exposure to fluoride caused enamel fluorosis and bone fracturing, but the studies lacked the amount of detail that would allow for conclusive certainty. However, more recently, the U.S. Department of Health and Human Services concluded that fluoride is presumed to be a cognitive neurodevelopmental hazard based on a consistent pattern across an array of populations, and that higher exposure could lead to decreased IQ in children, although a review of the draft supported further analysis. 

Also brewing is a debate around the ethical issue of the addition of any type of medicine to public water supplies without consent. US citizens have the right to elect to receive or not receive medications, but many Americans have no choice at all in the matter of fluoridated or non-fluoridated water. For many, the benefits seem sensible and clear. For the most part, fluoride prevents and occasionally reverses the formation of tooth cavities. It has also been proven to strengthen enamel which helps teeth resist the bacteria that causes tooth decay. However, fluoride that is consumed and ingested into the body can also accumulate in the bones, which raises concerns about how drinking fluoridated water might increase the risk of diseases like bone cancer. This has caused a flourishing debate between individual rights and societal health, and while there are several methods for reducing or eliminating fluoride exposure through drinking water, it’s important to consider how dosages of fluoride in water fluoridation is identical for all ages and body types, raising more ethical concerns. What is safe for one, may not be safe for all. 

The prevailing opinion among researchers appears to be that tooth decay is without question a serious health issue that should be addressed with a combination of healthy care habits, fluoride products and access to dental care. But as for all practices that affect the public health, new studies should be carefully considered when evaluating the positive and negative impacts of water fluoridation. 

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