Return to Fluoride Page

<--Return to Right To Know Main Page


From: "Arthur M. Strauss"
Date: Tue, 17 Sep 2002 19:42:23 -0400

I encourage you to selectively pass this on appropriately.

50 Reasons to Oppose Fluoridation
by Paul Connett, Ph.D.

March 6, 2001

Dr. Paul Connett
Professor of Chemistry
St. Lawrence University, NY 13617

with assistance from:

Michael Connett
Fluoride Action Network

50 Reasons to Oppose Fluoridation

1) Fluoride is not an essential nutrient. No disease has ever been linked
to a fluoride deficiency. Humans can have perfectly good teeth without

2) Fluoridation is not necessary. Most Western European countries are not
fluoridated and have experienced the same decline in dental decay as the US
(see data from World Health Organization on levels of tooth decay in
Europe, US, New Zealand, and Australia in Appendix 1).

3) Fluoridation's role in the decline of tooth decay is in serious doubt.
The largest survey ever conducted in the US (over 39,000 children from 84
communities) by the National Institute of Dental Research showed little
difference in tooth decay among children in fluoridated and non-fluoridated
communities (Hileman, 1989 and Yiamouyiannis, 1990). According to the
NIDR's statisticians, the study found an average difference of only 0.6
DMFS (Decayed Missing and Filled Surfaces) in the permanent teeth of
children aged 5-17 residing in either fluoridated or unfluoridated areas
(Brunelle and Carlos, 1990). This difference is less than one tooth
surface! There are 128 tooth surfaces in a child's mouth.

4) Where fluoridation has been discontinued in communities from Canada, the
former East Germany, Cuba and Finland, dental decay has not increased but
has actually decreased (Maupome et al, 2001; Kunzel and Fischer,1997,2000;
Kunzel et al, 2000 and Seppa et al, 2000).

5) One of the early trials which helped to launch fluoridation took place
in Newburgh, NY, with Kingston, NY as the control community. After 10 years
of this trial (which was methodologically flawed), it looked as if there
was a large decrease in dental caries in the fluoridated community compared
to the non-fluoridated community. However, when children were re-examined
in these two cities in 1995 (50 years after the trial began) there was
practically no difference in the dental decay in the two communities. If
anything, the teeth in unfluoridated Kingston were slightly better (Kumar
and Green 1998).

6) Modern research (e.g. Diesendorf, 1986; Colquhoun, 1997, and De Liefde,
1998) shows that decay rates were coming down before fluoridation was
introduced and have continued to decline even after its benefits would have
been maximized. Many other factors influence tooth decay. Studies in India
(Teotia and Teotia, 1994) and Tuczon, Arizona (Steelink, 1992) have shown
that tooth decay actually increases as the fluoride concentration in the
water increases.

7) Leading dental researchers (Levine, 1976; Fejerskov, Thylstrup and
Larsen, 1981; Carlos, 1983; Featherstone, 1987, 1999, 2000; Margolis and
Moreno, 1990; Clark, 1993; Burt, 1994; Shellis and Duckworth, 1994 and
Limeback, 1999, 2000), and the Centers for Disease Control and Prevention
(CDC, 1999) are now acknowledging that the mechanism of fluoride's benefits
are mainly TOPICAL not SYSTEMIC. Thus, you don't have to swallow fluoride
to protect teeth. As the benefits of fluoride (if they exist) are topical,
and the risks are systemic, it makes more sense, for those who want to take
the risks, to deliver the fluoride directly to the tooth in the form of
toothpaste. Since swallowing fluoride is unnecessary, there is no reason to
force people (against their will) to drink fluoride in their water suppy.
(All the referencs for "topical versus systemic benefits" are listed as a
group in the reference section).

8) The US fluoridation program has massively failed to achieve one of its
key objectives, i.e. to lower dental decay rates while minimizing dental
fluorosis (mottled and discolored enamel). The goal of the early promoters
of fluoridation was to limit dental fluorosis (in its mildest form) to 10%
of children (NRC, 1993, pp. 6-7). The percentage of children with dental
fluorosis in optimally fluoridated areas is up to EIGHT TIMES this goal
(Williams, 1990; Lalumandier, 1995; Heller, 1997 and Morgan, 1998). The
York Review estimates that up to 48% of children in optimally fluoridated
areas have dental fluorosis in all forms and up to 12.5% in the mild to
severe forms (McDonagh, 2000).

9) Dental fluorosis means that a child has been overdosed on fluoride.
While the mechanism by which the enamel is damaged is not definitively
known, it appears fluorosis may be a result of either inhibited enzymes in
the growing teeth (Dan Besten 1999), or through fluoride's interference
with the thyroid gland.

10) The level of fluoride put into water (1 ppm) is 100 times higher than
normally found in mothers' milk (0.01 ppm) (Institute of Medicine, 1997).
There are no benefits, only risks, for infants ingesting this heightened
level of fluoride at such an early age (this is an age where susceptibility
to environmental toxins is particularly high).

11) Fluoride is a cumulative poison. Only 50% of the fluoride we ingest
each day is excreted through the kidneys, the remainder accumulates in our
bones, pineal gland, and other tissues. If the kidney is damaged, fluoride
accumulation will increase.

12) Fluoride is very biologically active even at low concentrations. It
interferes with hydrogen bonding which is central to the structure and
function of proteins and nucleic acids. Thus, fluoride has the potential to
disrupt events at the very heart of living things (Emsley, 1981).

13) Fluoride inhibits enzymes in test tubes (Waldbott, 1978), in bacteria
in the oral cavity (Featherstone, 2000), in the growing tooth (DenBesten,
1999), in bone (Krook and Minor, 1998) and in other tissues (Luke, 1998).

14) Fluoride has been shown to be mutagenic, cause chromosome damage and
interfere with the enzymes involved with DNA repair in a variety of insect,
tissue culture and animal studies (DHSS, 1991, Mihashi and Tsutsui, 1996).

15) Fluoride administered to animals at high doses wreaks havoc on the
reproductive system - it renders sperm non-functional and increases the
rate of infertility (Chinoy, et al, 1995; Kumar & Susheela, 1994; Chinoy &
Narayana, 1994; Chinoy & Sequeira, 1989). A recent study from the US found
increased rates of infertility among women living in areas with 3 or more
ppm fluoride in the water. According to this latter study, which was
published in the Journal of Toxicology and Environmental Health, "Most
regions showed an association of decreasing TFR [Total Fertility Rate] with
increasing fluoride levels" (Freni 1994).

16) Fluoride forms complexes with a large number of metals, which include
metals which are needed in the body (like calcium and magnesium) and metals
(like lead and aluminum) which are toxic to the body. This can cause a
variety of problems. For example, fluoride interferes with enzymes where
magnesium is an important co-factor, and it can help facilitate the uptake
of aluminum into tissues where the aluminum wouldn't otherwise go.

17) Rats fed for one year with 1 ppm fluoride in doubly distilled and
de-ionized water, using either sodium fluoride or aluminum fluoride, had
morphological changes to their kidneys and brains and had an increased
level of aluminum present in their brain (Varner et al, 1998). Aluminum in
the brain is associated with Alzheimers disease.

18) Fluoride and aluminum fluoride complexes interact with G-proteins and
thus have the potential to interfere with many hormonal and some
neurochemical signals (Struneka and Patocka, 1999).

19) Aluminum fluoride was recently nominated by the Environmental
Protection Agency and National Institute of Environmental Health Sciences
for testing by the National Toxicology Program. According to the EPA and
NIEHS, aluminum fluoride currently has a "high health research priority"
due to its "known neurotoxicity" (BNA, 2000). If fluoride is added to water
which contains aluminum, than aluminum fluoride complexes will form.

20) Animal experiments show that fluoride exposure alters mental behavior
(Mullenix et al, 1995). Rats dosed prenatally demonstrated hyperactive
behavior. Those dosed postnatally demonstrated hypoactivity (i.e. under
activity or "couch potato" syndrome).

21) Studies by Jennifer Luke (1997) showed that fluoride accumulates in the
human pineal gland to very high levels. In her Ph.D thesis Luke has also
shown in animal studies that fluoride reduces melatonin production and
leads to an earlier onset of puberty.

22) Three studies from China show a lowering of IQ in children associated
with fluoride exposure (Li et al, 1995; Zhao et al, 1996 and Lu et al,
2000). Another study (Lin et al, 1991) indicates that even just moderate
levels of fluoride exposure (e.g. 0.9 ppm in the water) can exacerbate the
neurological defects of iodine deficiency, which include decreased IQ and
retardation. (According to the CDC, iodine deficiency has nearly quadrupled
in the US since the 1970's, with nearly 12% of the population now iodine

23) Earlier in the 20th century, fluoride was prescribed by a number of
European doctors to reduce the activity of the thyroid gland for those
suffering from hyperthyroidism (over active thyroid) (Merck Index, 1960, p.
952; Waldbott, et al., 1978, p. 163). With water fluoridation, we are
forcing people to drink a thyroid-depressing medication which could serve
to promote higher levels of hypothyroidism (underactive thyroid) in the
population, and all the subsequent problems related to this disorder. Such
problems include depression, fatigue, weight gain, muscle and joint pains,
increased cholesterol levels, and heart disease.

It bears noting that according to the Department of Health and Human
Services (1991) fluoride exposure in fluoridated communities is estimated
to range from 1.58 to 6.6 mg/day, which is a range that actually overlaps
the dose (2.3 - 4.5 mg/day) shown to decrease the functioning of the human
thyroid (Galletti & Joyet, 1958). This is a remarkable fact, and certainly
deserves greater attention considering the rampant and increasing problem
of hypothyroidism in the United States. (In 1999, the second most
prescribed drug of the year was Synthroid, which is a hormone replacement
drug used to treat an underactive thyroid).

24) Some of the early symptoms of skeletal fluorosis, a fluoride-induced
bone and joint disease that impacts millions of people in India, China, and
Africa , mimic the symptoms of arthritis. According to a review on
fluoridation by the journal of the American Chemical Society, "Because some
of the clinical symptoms mimic arthritis, the first two clinical phases of
skeletal fluorosis could be easily misdiagnosed" (Hileman, 1988). Few if
any studies have been done to determine the extent of this misdiagnosis,
and whether the high prevalence of arthritis in America (over 42 million
Americans have it) is related to our growing fluoride exposure, which is
highly plausible. The causes of most forms of arthritis (e.g.
osteoarthritis) are unknown.

25) In some studies, when high doses of fluoride were used in trials to
treat patients with osteoporosis in an effort to harden their bones and
reduce fracture rates, it actually led to a HIGHER number of hip fractures
(Hedlund and Gallagher, 1989; Riggs et al, 1990).

26) Eighteen studies (four unpublished, including one abstract) since 1990
have examined the possible relationship of fluoridation and an increase in
hip fracture among the elderly. Ten of these studies found an association,
eight did not. One study found a dose-related increase in hip fracture as
the concentration of fluoride rose from 1 ppm to 8 ppm (Li et al, 1999, to
be published). Hip fracture is a very serious issue for the elderly, as a
quarter of those who have a hip fracture die within a year of the
operation, while 50 percent never regain an independent existence. (All 18
of these studies are referenced as a group in the reference section).

27) One animal study (National Toxicology Program, 1990) shows a
dose-related increase in osteosarcoma (bone cancer) in male rats. The
initial finding of this study was of "clear evidence of carcinogenicity" a
finding which was soon conspicuously downgraded to "equivocal evidence"
(Marcus, 1990). EPA Professional Headquarters Union has requested that
Congress establish an independent review of this study's results (Hirzy

28) Two epidemiological studies show a possible association (which some
have discounted: Hoover, 1990 and 1991) between osteosarcoma in young men
and living in fluoridated areas (National Cancer Institute, 1989 and Cohn,
1992). Other studies have not found this association.

29) Fluoridation is unethical because individuals are not being asked for
their informed consent prior to medication. This is standard practice for
all medication.

30) While referenda are preferential to imposed policies from central
government, it still leaves the problem of individual rights versus
majority rule. Put another way -- does a voter have the right to require
that their neighbor ingest a certain medication (even if it's against that
neighbor's will)?

31) Some people appear to be highly sensitive to fluoride as shown by case
studies and double blind studies (Waldbott, 1978 and Moolenburg, 1987).
This may relate to fluoride interfering with their hormone levels including
those produced by their thyroid gland. Can we as a society force these
people to drink fluoride?

32) According to the Agency for Toxic Substances and Disease Registry
(ATSDR, 1993) some people are particularly vulnerable to fluoride's toxic
effects; these include: the elderly, diabetics and people with poor kidney
function. Again, can we in good conscience force these people to ingest
fluoride on a daily basis?

33) Also vulnerable are those who suffer from malnutrition (e.g. calcium,
magnesium, vitamin C, vitamin D and iodide deficiencies and protein poor
diets). Those most likely to suffer from poor nutrition are the poor, who
are precisely the people being targeted by new fluoridation proposals (Oral
Health in America, May 2000). While being at heightened risk, poor families
are less able to afford avoidance measures (e.g. bottled water or removal

34) Since dental decay is most concentrated in poor communities, we should
be spending our efforts trying to increase the access to dental care for
poor families. The real "Oral Health Crisis" that exists today in the
United States, is not a lack of fluoride but poverty and lack of dental

35) Fluoridation has been found to be ineffective at preventing one of the
most serious oral health problems facing poor children, namely, baby bottle
tooth decay, otherwise known as early childhood caries (Jones, 2000).

36) Once fluoride is put in the water it is impossible to control the dose
each individual receives. This is because, one, some people (e.g. manual
laborers, athletes and diabetics) drink more water than others, and
because, two, we receive fluoride from sources other than the water supply.
Other sources of fluoride include food and beverages processed with
fluoridated water; fluoridated dental products, and pesticide residues on

As one doctor has aptly stated, "No physician in his right senses would
prescribe for a person he has never met, whose medical history he does not
know, a substance which is intended to create bodily change, with the
advice: 'Take as much as you like, but you will take it for the rest of
your life because some children suffer from tooth decay. ' It is a
preposterous notion."

37) Despite the fact that it is recognized that we are ingesting too much
fluoride, and despite the fact that we are exposed to far more fluoride in
2000 than we were in 1945 (when fluoridation began), the "optimal"
fluoridation level is still 1 part per million, the same level deemed
optimal in 1945!

38) The early studies conducted in 1945 -1955 in the US, which helped to
launch fluoridation, have been heavily criticized for their poor
methodology and poor choice of control communities (De Stefano, 1954;
Sutton 1959, 1960 and 1996). According to Dr. Hubert Arnold, a statisician
from the University of California at Davis, the early fluoridation trials
"are especially rich in fallacies, improper design, invalid use of
statistical methods, omissions of contrary data, and just plain
muddleheadedness and hebetude."

39) The US Public Health Service first endorsed fluoridation in 1950,
before one single trial had been completed (McClure, 1970)! It may not be
coincidental that in the same year of the US PHS endorsement, the Sugar
Research Foundation, Inc. (supported by 130 corporations) expressed its aim
in dental research as, "To discover effective means of controlling tooth
decay by methods other than restricting carbohydrate (sugar) intake"
(Waldbott, 1965, p.131).

40) The fluoridation program has been very poorly monitored. There has
never been a comprehensive analysis of the fluoride levels in the bones of
the American people. US Health authorities have no idea how close we are
getting to levels which will cause subtle or even serious bone and joint

41) According to a letter received by New Jersey Assemblyman John Kelly,
the Food and Drug Administration (FDA) has never approved the fluoride
supplements given to children, which are designed to deliver the same
amount of fluoride as fluoridated water.

42) The chemicals used to fluoridate water in the US are not pharmaceutical
grade. Instead, they come from the wet scrubbing systems of the
superphosphate fertilizer industry. These chemicals (90% of which are
sodium fluorosilicate and fluorosilicic acid), are classified hazardous
wastes contaminated with toxic metals and trace amounts of radioactive
isotopes. Recent testing by the National Sanitation Foundation suggest that
the levels of arsenic in these chemicals are high and of significant

43) These hazardous wastes have not been tested comprehensively. The
chemical usually tested in animal studies is pharmaceutical grade sodium
fluoride, not industrial grade fluorosilicic acid. The assumption being
made is that by the time this waste product has been diluted down, all the
fluorosilicic acid will have been converted into free fluoride ion, and the
other toxics and radioactive isotopes will be so dilute that they will not
cause any harm, even with lifetime exposure. These assumptions have not
been examined carefully by scientists, independent of the fluoridation

44) Studies by Masters and Coplan (1999) show an association between the
use of fluorosilicic acid (and its sodium salt) to fluoridate water and an
increased uptake of lead into children's blood.

45) Sodium fluoride is an extremely toxic substance -- just 3 to 5 grams,
or about one teaspoon, is enough to kill a human being. Both children
(swallowing gels) and adults (accidents involving malfunctioning of
fluoride delivery equipment and filters on dialysis machines) have died
from excess exposure.

46) Some of the earliest opponents of fluoridation were biochemists and at
least 14 Nobel Prize winners are among numerous scientists who have
expressed their reservations about the practice of fluoridation (see
appendix 4 for list). Dr. James Sumner, who won the Nobel Prize for his
work on enzyme chemistry, had this to say about fluoridation: "We ought to
go slowly. Everybody knows fluorine and fluoride are very poisonous
substances.We use them in enzyme chemistry to poison enzymes, those vital
agents in the body. That is the reason things are poisoned; because the
enzymes are poisoned and that is why animals and plants die" (Connett,

Last year's (2000) recipient of the Noble Prize for Medicine and
Physiology, was Dr. Arvid Carlsson of Sweden. Dr. Carlsson was one of the
leading opponents of fluoridation in Sweden. He was part of the panel that
recommended that the Swedish government reject the practice, which they did
in 1971. In her book "The Fluoride Question: Panacea or Poison" Anne-lise
Gotzsche quotes Carlsson as follows: "It is not worthwhile to conceal the
fact that it is a question of applying a pharmacologically active substance
to an entire population" (p.69).

47) The Union representing the scientists at the US EPA headquarters in DC
is on record as opposing water fluoridation (Hirzy, 1999) and rejects the
US EPA's approval of the use of hazardous industrial waste products to
fluoridate the public water supply.

48) Many scientists, doctors and dentists who have spoken out publicly on
this issue have been subjected to censorship and intimidation (Martin
1991). Tactics like this would not be necessary if those promoting
fluoridation were on secure scientific ground.

49) Promoters of fluoridation refuse to recognize that there is any
scientific debate on this issue, despite the concerns listed above and
objective reviews of the controversy (Hileman, 1988). Dr. Michael Easley,
one of the most vocal proponents, goes so far as to say that there is no
legitimate debate, whatsoever, concerning fluoridation. According to
Easley, who works closely with the CDC and ADA, "Debates give the illusion
that a scientific controversy exists when no credible people support the
fluorophobics' view." Easley adds that
"a most flagrant abuse of the public trust occasionally occurs when a
physician or a dentist, for whatever personal reason, uses their
professional standing in the community to argue against fluoridation, a
clear violation of professional ethics, the principles of science and
community standards of practice" (Easley, 1999).

Comments like these led the associate technical director for Consumers
Union, Dr. Edward Groth, to conclude that "the political profluoridation
stance has evolved into a dogmatic, authoritarian, essentially
antiscientific posture, one that discourages open debate of scientific
issues" (Martin, 1991).

50) When it comes to controversies surrounding toxic chemicals, invested
interests traditionally do their very best to discount animal studies and
quibble with epidemiological findings. In the past, political pressures
have led government agencies to drag their feet on regulating asbestos,
benzene, DDT, PCBs, tetraethyl lead, tobacco and dioxins. With fluoridation
we have had a fifty year delay. Unfortunately, because government officials
have put so much of their credibility on the line defending fluoridation,
and because of the huge liabilities waiting in the wings if they admit that
fluoridation has caused an increase in hip fracture, arthritis, bone
cancer, brain disorders or thyroid problems, it will be very difficult for
them to speak honestly and openly about the issue. But they must, not only
to protect millions of people from unnecessary harm, but to protect the
notion that, at its core, public health policy must be based on sound
science not political pressure. They have a tool with which to do this:
it's called the Precautionary Principle. Simply put, this says: if in doubt
leave it out. This is what most European countries have done and their
children's teeth have not suffered, while their public's trust has been

It is like a question from a Kafka play. Just how much doubt is needed on
just one of the health concerns identified above, to override a benefit,
which when quantified in the largest survey ever conducted in the US,
amounts to less than one tooth surface (out of 128) in a child's mouth?

For those who would call for further studies, we say fine. Take the
fluoride out of the water first and then conduct all the studies you want.
This folly must end without further delay.

APPENDIX 1. World Health Organization Data

Table: DMFT Status (Decayed, Missing & Filled Teeth) for 12 year olds.
Organized by Country.
   DMFTs Year Status
Australia 0.8 1998 fluoridated
Zurich, Switzerland 0.84 1998 unfluoridated
Netherlands 0.9 1992-93 unfluoridated
Sweden 0.9 1999 unfluoridated
Denmark 0.9 2001 unfluoridated
UK (England, Scotland, N. Ire) 1.1 1996-97 10% fluoridated
Ireland 1.1 1997 fluoridated
Finland 1.1 1997 unfluoridated
US 1.4 1988-91 fluoridated
Norway 1.5 1998 unfluoridated
Iceland 1.5 1996 unfluoridated
New Zealand 1.5 1993 fluoridated
Belgium 1.6 1998 unfluoridated
Germany 1.7 1997 unfluoridated
Austria 1.7 1997 unfluoridated
France 1.9 1998 unfluoridated

Data from: WHO Oral Health Country/Area Profile Programme Department of
Noncommunicable Diseases Surveillance/Oral Health WHO Collaborating Centre,
Malmö University, Sweden


Statements on fluoridation by governmental officials from several countries:



"Generally, in Germany fluoridation of drinking water is forbidden. The
relevant German law allows exceptions to the fluoridation ban on
application. The argumentation of the Federal Ministry of Health against a
general permission of fluoridation of drinking water is the problematic
nature of compuls[ory] medication." (Gerda Hankel-Khan, Embassy of Federal
Republic of Germany, September 16, 1999).



"Fluoride chemicals are not included in the list [of 'chemicals for
drinking water treatment']. This is due to ethical as well as medical
considerations." (Louis Sanchez, Directeur de la Protection de
l'Environment, August 25, 2000).



"This water treatment has never been of use in Belgium and will never be
(we hope so) into the future. The main reason for that is the fundamental
position of the drinking water sector that it is not its task to deliver
medicinal treatment to people. This is the sole responsibility of health
services." (Chr. Legros, Directeur, Belgaqua, Brussels, Belgium, February
28, 2000).



"Fluoride has never been added to the public water supplies in Luxembourg.
In our views, the drinking water isn't the suitable way for medicinal
treatment and that people needing an addition of fluoride can decide by
their own to use the most appropriate way, like the intake of fluoride
tablets, to cover their [daily] needs." (Jean-Marie RIES, Head, Water
Department, Administration De L'Environment, May 3, 2000).



"We do not favor or recommend fluoridation of drinking water. There are
better ways of providing the fluoride our teeth need." (Paavo Poteri,
Acting Managing Director, Helsinki Water, Finland, February 7, 2000).

"Artificial fluoridation of drinking water supplies has been practiced in
Finland only in one town, Kuopio, situated in eastern Finland and with a
population of about 80,000 people (1.6% of the Finnish population).
Fluoridation started in 1959 and finished in 1992 as a result of the
resistance of local population. The most usual grounds for the resistance
presented in this context were an individual's right to drinking water
without additional chemicals used for the medication of limited population
groups. A concept of "force-feeding" was also mentioned.

Drinking water fluoridation is not prohibited in Finland but no
municipalities have turned out to be willing to practice it. Water
suppliers, naturally, have always been against dosing of fluoride chemicals
into water." (Leena Hiisvirta, M.Sc., Chief Engineer, Ministry of Social
Affairs and Health, Finland, January 12, 1996.)



"We are pleased to inform you that according to the Danish Ministry of
Environment and Energy, toxic fluorides have never been added to the public
water supplies. Consequently, no Danish city has ever been fluoridated."
(Klaus Werner, Royal Danish Embassy, Washington DC, December 22, 1999).



"In Norway we had a rather intense discussion on this subject some 20 years
ago, and the conclusion was that drinking water should not be fluoridated."
(Truls Krogh & Toril Hofshagen, Folkehelsa Statens institutt for folkeheise
(National Institute of Public Health) Oslo, Norway, March 1, 2000).



"Drinking water fluoridation is not allowed in Sweden...New scientific
documentation or changes in dental health situation that could alter the
conclusions of the Commission have not been shown." (Gunnar Guzikowski,
Chief Government Inspector, Livsmedels Verket -- National Food
Administration Drinking Water Division, Sweden, February 28, 2000).



"From the end of the 1960s until the beginning of the 1970s drinking water
in various places in the Netherlands was fluoridated to prevent caries.
However, in its judgement of 22 June 1973 in case No. 10683 (Budding and
co. versus the City of Amsterdam) the Supreme Court (Hoge Road) ruled there
was no legal basis for fluoridation. After that judgement, amendment to the
Water Supply Act was prepared to provide a legal basis for fluoridation.
During the process it became clear that there was not enough support from
Parlement [sic] for this amendment and the proposal was withdrawn."
(Wilfred Reinhold, Legal Advisor, Directorate Drinking Water, Netherlands,
January 15, 2000).


Northern Ireland:

"The water supply in Northern Ireland has never been artificially
fluoridated except in 2 small localities where fluoride was added to the
water for about 30 years up to last year. Fluoridation ceased at these
locations for operational reasons. At this time, there are no plans to
commence fluoridation of water supplies in Northern Ireland." (C.J. Grimes,
Department for Regional Development, Belfast, November 6, 2000).



"Toxic fluorides have never been added to the public water supplies in
Austria." (M. Eisenhut, Head of Water Department, Osterreichische
Yereinigung fur das Gas-und Wasserfach Schubertring 14, A-1015 Wien,
Austria, February 17, 2000).


Czech Republic:

"Since 1993, drinking water has not been treated with fluoride in public
water supplies throughout the Czech Republic. Although fluoridation of
drinking water has not actually been proscribed it is not under
consideration because this form of supplementation is considered:

     * uneconomical (only 0.54% of water suitable for drinking is used as
such; the remainder is employed for hygiene etc. Furthermore, an increasing
amount of consumers (particularly children) are using bottled water for
drinking (underground water usually with fluor)
     * unecological (environmental load by a foreign substance)
     * unethical ("forced medication")
     * toxicologically and phyiologically debateable (fluoridation
represents an untargeted form of supplementation which disregards actual
individual intake and requirements and may lead to excessive
health-threatening intake in certain population groups; [and] complexation
of fluor in water into non biological active forms of fluor." (Dr. B.
Havlik, Ministerstvo Zdravotnictvi Ceske Republiky, October 14, 1999).


Statement of Douglas Carnall, Associate Editor of the British Medical
Journal, published on the BMJ website ( ) on the day
that they published the York Review on Fluoridation.

See this review on the web at

British Medical Journal

October 7, 2000


Website of the week

Water fluoridation

Fluoridation was a controversial topic even before Kubrick's Base Commander
Ripper railed against "the international communist conspiracy to sap and
impurify all of our precious bodily fluids" in the 1964 film Dr
Strangelove. This week's BMJ shouldn't precipitate a global holocaust, but
it does seem that Base Commander Ripper may have had a point. The
systematic review published this week (p 855) shows that much of the
evidence for fluoridation was derived from low quality studies, that its
benefits may have been overstated, and that the risk to benefit ratio for
the development of the commonest side effect (dental fluorosis, or mottling
of the teeth) is rather high.

Supplementary materials are available on the BMJ 's website and on that of
the review's authors, enhancing the validity of the conclusions through
transparency of process. For example, the "frequently asked questions" page
of the site explains who comprised the advisory panel and how they were
chosen ("balanced to include those for and against, as well as those who
are neutral"), and the site includes the minutes of their meetings. You can
also pick up all 279 references in Word97 format, and tables of data in
PDF. Such transparency is admirable and can only encourage rationality of

Professionals who propose compulsory preventive measures for a whole
population have a different weight of responsibility on their shoulders
than those who respond to the requests of individuals for help. Previously
neutral on the issue, I am now persuaded by the arguments that those who
wish to take fluoride (like me) had better get it from toothpaste rather
than the water supply (see and for the two viewpoints).

Douglas Carnall
Associate Editor
British Medical Journal


List of 14 Noble Prize winners who have opposed or expressed reservations
about fluoridation.

1) Adolf Butenandt (Chemistry, 1939)
2) Arvid Carlsson (Medicine, 2000)
3) Hans von Euler-Chelpin (Chemistry, 1929).
4) Walter Rudolf Hess (Medicine, 1949)
5) Corneille Jean-François Heymans (Medicine, 1938)
6) Sir Cyril Norman Hinshelwood (Chemistry, 1956)
7) Joshua Lederberg (Medicine, 1958)
8) William P. Murphy (Medicine, 1934)
8) Giulio Natta (1963 Nobel Prize in Chemistry)
10) Sir Robert Robinson (Chemistry, 1947)
11) Nikolai Semenov (Chemistry, 1956)
12) James B. Sumner (Chemistry, 1946)
13) Hugo Theorell (Medicine, 1955)
14) Artturi Virtanen (Chemistry, 1945)


Agency for Toxic Substances and Disease Registry (ATSDR) (1993).
Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine (F).
U.S. Department of Health & Human Services, Public Health Service.

Arnold HA. (1980). Letter to Dr. Ernest Newbrun. May 28, 1980.

Brunelle JA, Carlos JP. (1990). Recent trends in dental caries in U.S.
children and the effect of water fluoridation. J. Dent. Res 69, (Special
edition), 723-727.

Centers for Disease Control and Prevention (CDC). (1999). Achievements in
Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental
Caries. Mortality and Morbidity Weekly Review. (MMWR). 48(41): 933-940
October 22, 1999.

Chinoy NJ, et al. (2000). Presentation at the XXIII International
Conference of the International Society for Fluoride Research, Szczecin,
Poland, June, 2000.

Chinoy NJ, et al. (1995). Microdose vasal injection of sodium fluoride in
the rat. Reprod Toxicol. 5(6): 505-12.

Chinoy NJ, Narayana MV. (1994). In vitro fluoride toxicity in human
spermatozoa. Reprod Toxicol. 8(2):155-9.

Chinoy NJ, et al. (1994). Transient and reversible fluoride toxicity in
some soft tissues of female mice. Fluoride. 27:205-214.

Chinoy NJ, Sequeira E. (1989). Effects of fluoride on the histoarchitecture
of reproductive organs of the male mouse. Reprod Toxicol. 3(4):261-7.

Cohn PD. (1992). A Brief Report On The Association Of Drinking Water
Fluoridation And The Incidence of Osteosarcoma Among Young Males. New
Jersey Department of Health Environ. Health Service: 1- 17.

Colquhoun J. (1997) Why I changed my mind about Fluoridation. Perspectives
in Biology and Medicine 41: 29-44.

Connett, M. (2000). How Much Arsenic is Fluoridation Adding to the Public
Water Supply? Fluoride Action Network

Connett M. (2000). Interview w/ Dr. William Hirzy. July 3, 2000.

Connett, P. (2000). Fluoride: A Statement of Concern. Waste Not #459.
January 2000. Waste Not, 82 Judson Street, Canton, NY 13617.

Connett P, Connett M. (2000). The Emperor Has No Clothes: A Critique of the
CDC's Promotion of Fluoridation. Waste Not #468. September. Waste Not, 82
Judson Street, Canton, NY 13617.

De Liefde B. (1998). The Decline of Caries in New Zealand Over the past 40
Years. New Zealand Dental Journal. 94:109-113.

Department of Health & Human Services. (U.S. DHHS) (2000). Oral health in
America: A Report of the Surgeon General. Rockville, MD: U.S. Department of
Health & Human Services. National Institute of Dental and Craniofacial
Research, National Institutes of Health. httm://

Department of Health & Human Services. (U.S. DHHS) (1991). Review of
Fluoride: Benefits and Risks, Report of the Ad Hoc Committee on Fluoride of
the Committee to Coordinate Environmental Health and Related Programs.
Department of Health and Human Services, USA.

DenBesten, P (1999). Biological mechanism of dental fluorosis relevant to
the use of fluoride supplements. Community Dent. Oral Epidemiol., 27, 41-7.

De Stefano TM. (1954). The fluoridation research studies and the general
practitioner. Bulletin of Hudson County Dental Society. February, 1954.

Diesendorf M.(1986). The Mystery of Declining Tooth Decay. Nature. 322:

Ditkoff BA, Lo Gerfo P. (2000). The Thyroid Guide. Harper-Collins. New York.

Easley, M. (1999). Community fluoridation in America: the unprincipled
opposition. Unpublished.

Emsley J, et al (1981). An Unexpectedly Strong Hydrogen Bond: Ab Initio
Calculations and Spectroscopic Studies of Amide-Fluoride Systems. Journal
of the American Chemical Society. 103: 24-28.

Freni SC. (1994). Exposure to high fluoride concentrations in drinking
water is associated with decreased birth rates. J Toxicology and
Environmental Health. 42: 109-121.

Galletti P, Joyet G. (1958). Effect of Fluorine on Thyroidal Iodine
Metabolism in Hyperthyroidism. Journal of Clinical Endocrinology.

Glasser G. (1999). "It's Pollution Stupid!"

Gotzsche A. (1975). The Fluoride Question: Panacea or Poison? New York:
Stein and Day Publishers.

Hanmer R. (1983). Letter to Leslie A. Russell, D.M.D, from Rebecca Hanmer,
Deputy Assistant Administrator for Water, US EPA. Mar 30, 1983.

Heller KE, et al (1997). Dental Caries and Dental Fluorosis at Varying
Water Fluoride Concentrations. J Pub Health Dent. 57(3): 136-143.

Hileman B. (1988). Fluoridation of water: Questions about health risks and
benefits remain after more than 40 years. Chemical and Engineering News.
August 1: 26-42.

Hileman B. (1989). New Studies Cast Doubt on Fluoridation Benefits.
Chemical and Engineering News. May 8.

Hirzy JW. (1999). Why the EPA's Headquarters Union of Scientists Opposes
Fluoridation. Press release from National Treasury Employees Union. May 1.

Hoover, R.N. et al (1990). Fluoridation of Drinking Water and Subsequent
Cancer Incidence and Mortality. Report to the Director of the National
Cancer Institute.

Hoover RN, et al. (1991). Time trends for bone and joint cancers and
osteosarcomas in the Surveillance, Epidemiology and End Results (SEER)
Program. National Cancer Institute In: Review of Fluoride: Benefits and
Risks Report of the Ad Hoc Committee on Fluoride of the Committee to
Coordinate Environmental Health and Related Programs US Public Health
Service. pp F1 -F7.

Institute of Medicine. (1997). Dietary Reference Intakes for Calcium,
Phosphorus, Magnesium, Vitamin D, and Fluoride. Standing Committee on the
Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition
Board. National Academy Press.

Jolly SS, et al. (1971). Human intoxication in Punjab. Fluoride. 4(2):

Kelly JV. (2000). Letter to Senator Robert Smith, Chairman of Environment
and Public Works Committee, U.S. Senate, August 14, 2000.

Krook L, Minor RR. (1998). Fluoride and Alkaline Phosphatase. Fluoride. 31:

Kumar A, Susheela AK. (1994). Ultrastructural studies of spermiogenesis in
rabbit exposed to chronic fluoride toxicity. Int J Fertil Menopausal Stud.

Kumar JV, Green EL. (1998). Recommendations for Fluoride Use in Children.
NY State Dental Journal. 64(2):40-7.

Kunzel W, Fischer T. (2000). Caries prevalence after cessation of water
fluoridation in La Salud, Cuba. Caries Res 34(1): 20-5.

Kunzel W, et al. (2000). Decline in caries prevalence after the cessation
of water fluoridation in former East Germany. Community Dent. Oral
Epidemiol. 28(5): 382-389.

Kunzel W, Fischer T. (1997). Rise and fall of caries prevalence in German
towns with different F concentrations in drinking water. Caries Res 31(3):

Lalumandier JA, et al. (1995). The prevalence and risk factors of fluorosis
among patients in a pediatric dental practice. Pediatric Dentistry. 17(1):

Li XS. (1995). Effect of Fluoride Exposure on Intelligence in Children.
Fluoride. 28(4): 189-192.

Limeback H. (2000). Leading Dental Researcher Speaks Out Against
Fluoridation. A videotaped interview available from Grass Roots & Global
Video. 82 Judson Street, Canton, NY 13617. email

Lin FF, et al. (1991). The relationship of a low-iodine and high-fluoride
environment to subclinical cretinism in Xinjiang. Iodine Deficiency
Disorder Newsletter. Vol. 7. No. 3.

Luke J. (2001). Fluoride Deposition in the Aged Human Pineal Gland. Caries
Res. 35: 125-128.

Luke J. (1997). The Effect of Fluoride on the Physiology of the Pineal
Gland. Ph.D. Thesis. University of Surrey, Guildord.

Marcus W. (1990). Memorandum from Dr. William Marcus, to Alan B. Hais,
Acting Director Criteria & Standards Division ODW, US EPA. May 1, 1990.

Martin B. (1991). Scientific Knowledge in Controversy: The Social Dynamics
of the Fluoridation Debate. SUNY Press, Albany NY

Masters RD, Coplan M. (1999). Water treatment with Silicofluorides and Lead
Toxicity. International Journal of Environmental Studies. 56: 435-449.

Maupome G, et al. (2001). Patterns of dental caries following the cessation
of water fluoridation. Community Dent Oral Epidemiol. 29(1): 37-47.

McDonagh M, et al. (2000). A Systematic Review of Public Water
Fluoridation. NHS Center for Reviews and Dissemination,. University of
York, September 2000.

Mihashi,M. and Tsutsui,T.(1996). Clastogenic activity of sodium fluoride to
rat vertebral body-derived cells in culture. Mutat Res, 368(1):7-13.

Morgan L, et al. (1998). Investigation of the possible associations between
fluorosis, fluoride exposure, and childhood behavior problems. Pediatric
Dentistry. 20(4): 244-252.

Mullenix P, et al. (1995). Neurotoxicity of Sodium Fluoride in Rats.
Neurotoxicology and Teratology. 17: 169-177.

National Cancer Institute. (1989). Cancer Statistics Review, 1973-1987.
Bethesda, MD: National Institutes of Health. Publication No.90-2789.

National Research Council. (1993). Health Effects of Ingested Fluoride.
National Academy Press, Washington DC.

National Toxicology Program [NTP] (1990). Toxicology and Carcinogenesis
Studies of Sodium Fluoride in F344/N Rats and B6C3f1 Mice. Technical report
Series No. 393. NIH Publ. No 91-2848. National Institute of Environmental
Health Sciences, Research Triangle Park, N.C. The results of this study are
summarized in the Department of Health and Human Services report
(DHHS,1991) op cit.

Nesin BC. (1956). A water supply perspective of the fluoridation
discussion. J Maine Water Utilities Association.

Riggs BL, et al. (1990). Effect of Fluoride treatment on the Fracture Rates
in Postmenopausal Women with Osteoporosis. N Eng J Med. 322: 802-809.

Seppa L, et al. (2000). Caries trends 1992-98 in two low-fluoride Finnish
towns formerly with and without fluoride. Caries Res. 34(6): 462-8.

Stecher P, et al. (1960). The Merck Index of Chemicals and Drugs. Merck &
Co., Inc, Rathway NJ.

Steelink C. (1992). Fluoridation Controversy. Chemical & Engineering News.
(Letter). July 27: 2-3.

Strunecka A, Patocka J. (1999). Pharmacological and toxicological effects
of aluminofluoride complexes. Fluoride. 32: 230-242.

Susheela AK. (1998). Scientific Evidence on Adverse Effects of Fluoride.
Presented to Members of Parliament & LORDS, House of Commons, Westminister,
London, October 20, 1998.

Susheela AK. (1993). Prevalence of endemic fluorosis with gastrointestinal
manifestations in people living in some North-Indian villages. Fluoride.
26: 97-104.

Sutton P. (1996). The Greatest Fraud: Fluoridation. Lorne, Australia:
Kurunda Pty, Ltd.

Sutton P. (1960) Fluoridation: Errors and Omissions in Experimental Trials.
Melbourne University Press. Second Edition.

Sutton, P. (1959). Fluoridation: Errors and Omissions in Experimental
Trials. Melbourne University Press. First Edition.

Teotia M, et al. (1998). Endemic chronic fluoride toxicity and dietary
calcium deficiency interaction syndromes of metabolic bone disease and
deformities in India: year 2000. Indian J Pediatr. 65(3):371-81.

Teotia SPS, Teotia M. (1994). Dental caries: a disorder of high fluoride
and low dietary calcium interactions (30 years of personal research).
Fluoride. 27(2): 59-66.

Waldbott GL, et al. (1978). Fluoridation: The Great Dilemma. Coronado
Press, Inc., Lawrence, Kansas.

Waldbott GL. (1965). A Battle with Titans. Carlton Press, NY.

WHO (Online). WHO Oral Health Country/Area Profile Programme. Department of
Noncommunicable Diseases Surveillance/Oral Health. WHO Collaborating
Centre, Malmö University, Sweden.

Williams JE, et al. (1990). Community Water Fluoride Levels, Preschool
Dietary Patterns, and The Occurrence of Fluoride Enamel Opacities. J of Pub
Health Dent. 50:276-81.

Yiamouyiannis JA. (1990). Water Fluoridation and Tooth decay: Results from
the 1986-87 National Survey of U.S. Schoolchildren. Fluoride. 23: 55-67.

Zhao LB, et al (1996). Effect of high-fluoride water supply on children's
intelligence. Fluoride. 29: 190-192.


a) Studies Reporting an Association between fluoridated water (1 ppm
fluoride) & hip fracture.
1 a) Cooper C, et al. (1990). Water fluoride concentration and fracture of
the proximal femur. J Epidemiol Community Health 44: 17-19.

1 b) Cooper C, et al. (1991). Water fluoridation and hip fracture. JAMA
266: 513-514 (letter, a reanalysis of data presented in 1990 paper).

2) Danielson C, et al. (1992). Hip fractures and fluoridation in Utah's
elderly population. Journal of the American Medical Association 268(6):

3) Hegmann KT, et al. (2000). The Effects of Fluoridation on Degenerative
Joint Disease (DJD) and Hip Fractures. Abstract #71, of the 33rd Annual
Meeting of the Society For Epidemiological research, June 15-17, 2000.
Published in a Supplement of Am. J. Epid. P. S18.

4) Jacobsen SJ, et al. (1992). The association between water fluoridation
and hip fracture among white women and men aged 65 years and older; a
national ecologic study." Annals of Epidemiology 2: 617-626.

5) Jacobsen SJ, et al. (1990). Regional variation in the incidence of hip
fracture: US white women aged 65 years and olders. J Am Med Assoc 264(4):

6 a) Jacqmin-Gadda H, et al. (1995). Fluorine concentration in drinking
water and fractures in the elderly. JAMA 273: 775-776 (letter).

6 b) Jacqmin-Gadda H, et al. (1998). Risk factors for fractures in the
elderly. Epidemiology 9(4): 417-423. (An elaboration of the 1995 study
referred to in the JAMA letter).

7) Keller C. (1991) Fluorides in drinking water. Unpublished results.
Discussed in Gordon, S.L. and Corbin, S.B,(1992) Summary of Workshop on
Drinking Water Fluoride Influence on Hip Fracture on Bone Health.
Osteoporosis Int. 2, 109-117.

8) Kurttio PN, et al. (1999). Exposure to natural fluoride in well water
and hip fracture: A cohort analysis in Finland. American Journal of
Epidemiology 150(8): 817-824.

9) May DS, Wilson MG. (1992). Hip fractures in relation to water
fluoridation: an ecologic analysis. Unpublished data, discussed in Gordon
SL, and Corbin SB. (1992). Summary of Workshop on Drinking Water Fluoride
Inflruenbce on Hip Fracture on Bone Health. Osteoporosis Int. 2:109-117.

b) Studies reporting an association between water-fluoride levels higher
than fluoridated water (2 to 4 ppm) & hip fracture.
Li Y, et al. (2001). Effect of long-term exposure to fluoride in drinking
water on risks of bone fractures. J Bone Miner Res.16(5):932-9.

Sowers M, et al. (1991). A prospective study of bone mineral content and
fracture in communities with differential fluoride exposure. American
Journal of Epidemiology 133: 649-660.

c) Studies Reporting No Association between water fluoride & hip fracture:

(Note that in 4 of these 8 studies, an association was actually found
between fluoride and some form of fracture - distal forearm, wrist, even
hip. See notes and quotes below.)
Cauley J. et al. (1995). Effects of fluoridated drinking water on bone mass
and fractures: the study of osteoporotic fractures. J Bone Min Res 10(7):

Feskanich D, et al. (1998). Use of toenail fluoride levels as an indicator
for the risk of hip and forearm fractures in women. Epidemiology 9(4):

While this study didn't find an association between water fluoride and hip
fracture, it did find an association - albeit non-significant 1.6 (0.8-3.1)
- between fluoride exposure and elevated rates of forearm fracture.

Hillier S, et al. (2000). Fluoride in drinking water and risk of hip
fracture in the UK: a case control study. The Lancet 335: 265-2690.

Jacobsen SJ, et al. (1993). Hip Fracture Incidence Before and After the
Fluoridation of the Public Water Supply, Rochester, Minnesota. American
Journal of Public Health, 83, 743-745.

Karagas MR, et al. (1996). Patterns of Fracture among the United States
Elderly: Geographic and Fluoride Effects. Ann. Epidemiol. 6 (3), 209-216.

As with Feskanich (1998) this study didn't find an association between
fluoridation & hip fracture, but it did find an association between
fluoridation and distal forearm fracture, as well as proximal humerus
fracture. "Independent of geographic effects, men in fluoridated areas had
modestly higher rates of fractures of the distal forearm and proximal
humerus than did men in nonfluoridated areas."

Lehmann R, et al. (1998). Drinking Water Fluoridation: Bone Mineral Density
and Hip Fracture Incidence. Bone, 22, 273-278.

Phipps KR, et al. (2000). Community water fluoridation, bone mineral
density and fractures: prospective study of effects in older women. British
Medical Journal, 321: 860-4.

As with Feskanich (1998) and Karagas (1996), this study didn't find an
association between water fluoride & hip fracture, but it did find an
association between water fluoride and other types of fracture - in this
case, wrist fracture. "There was a non-significant trend toward an
increased risk of wrist fracture."

Suarez-Almazor M, et al. (1993). The fluoridation of drinking water and hip
fracture hospitalization rates in two Canadian communities. Am J Public
Health 83: 689-693.

While the authors of this study conclude there is no association between
fluoridation and hip fracture, their own data reveals a statistically
significant increase in hip fracture for men living in the fluoridated
area. According to the authors, "although a statistically significant
increase in the risk of hip fracture was observed among Edmonton men, this
increase was relatively small (RR=1.12)."


a) Burt, B.A. (1994). Letter. Fluoride. 27: 180-181.

b) Carlos JP. (1983). Comments on Fluoride. J.Pedodontics. Winter: 135-136.

c) CDC. (2001). Recommendations for Using Fluoride to Prevent and Control
Dental Caries in the United States. Mortality and Morbidity Weekly Review.
August 17, 50(RR14):1-42.

d) CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of
Drinking Water to Prevent Dental Caries. Mortality and Morbidity Weekly
Review (MMWR), 48(41);933-940 October 22, 1999.

e) Featherstone JDB. (1987). The Mechanism of dental decay. Nutrition
Today. May/June: 10.

f) Featherstone JDB. (1999). Prevention and reversal of dental caries: role
of low level fluoride. Community Dent Oral Epidemiol. 27:31-40.

g) Featherstone JDB. (2000). The Science and Practice of Caries Prevention.
Journal of the American Dental Association. 131: 887-899.

g) Fejerskov O, et al. (1981). Rational use of fluorides in caries
prevention. Acta Odontol Scand. 39(4): 241-249.

h) Levine RS. (1976). The action of fluoride in caries prevention: a review
of current concepts. Brit Dent J. 140: 9-14.

i) Locker D. (1999). Benefits and Risks of Water Fluoridation. An Update of
the 1996 Federal-Provincial Sub-committee Report. Prepared for Ontario
Ministry of Health and Long Term Care.

j) Limeback H. (1999). A re-examination of the pre-eruptive and
post-eruptive mechanism of the anti-caries effects of fluoride: is there
any caries benefit from swallowing fluoride? Community Dent Oral Epidemiol.
27: 62-71.

 Fluoride Information Page

for toothpaste without flouride or harmful ingredients

top of page


Copyright All rights reserved.

Telephone: 310-457-5176 | For General Information:

Webmaster for Shelley R. Kramer