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I. QUESTIONS about FLUORIDE/FLUORIDATION:
II. QUESTIONS about REDUCING FLUORIDE EXPOSURE:
III. QUESTIONS about FLUORIDE/PERSONAL HEALTH:
I. QUESTIONS about FLUORIDE/FLUORIDATION:
Why is fluoride added to water?
Fluoride is added to water in an attempt to prevent tooth decay.
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Is fluoridated water necessary for healthy teeth?
NO. Most recent, large-scale studies have found that fluoridated water
provides only a minor benefit to teeth, or no demonstrable benefit at
all. According to a recent Canadian government review: "The magnitude
of fluoridation's effect is not large in absolute terms, is often not
statistically significant and may not be of clinical significance."
Moreover, according to the National Academy of Sciences, fluoride is not an essential nutrient. This
means that no human disease - including tooth decay - will result
from a "deficiency" of fluoride. Thus, unlike real nutrients like calcium and magnesium, the human body does not
need fluoride for any physiological process.
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What makes fluoride different from other chemicals added to water?
In contrast to other chemicals added to water, fluoride does not treat
the water, or make the water safer to drink. Fluoride is the only
chemical added to water for the sole purpose of medication (to prevent
tooth decay -- a non-waterborne disease).
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Does fluoride need to be swallowed in order to prevent tooth decay?
NO. Most dental researchers now concede that fluoride’s main benefit
comes from direct contact with the outside of teeth (a "topical" effect), and not from ingestion (a "systemic" effect). There is no need to swallow fluoride to prevent tooth decay.
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Doesn’t everyone fluoridate their water?
NO. While most water supplies in the United States are artificially
fluoridated, most water supplies in other western countries are not. In
western Europe,
most countries have rejected water fluoridation, including: Austria,
Belgium, Denmark, Finland, France, Germany, Italy, Luxembourg,
Netherlands, Norway, Scotland, Sweden, and Switzerland.
Less than 10 countries in the world fluoridate more than 50% of their
water supplies, while almost half of the world’s population drinking
fluoridated water reside in North America (Canada & US).
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Where does the fluoride added to water come from?
The main fluoride chemical added to water (hydrofluorosilicic acid) is
an industrial by-product from the phosphate fertilizer industry. Unlike
the fluoride used in toothpaste, hydrofluorosilicic acid is not
pharmaceutical-grade quality. It is an unpurified, industrial-grade,
corrosive acid which has been linked, in several recent studies, to
increased levels of lead in children’s blood.
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Does fluoride occur naturally in water?
Like arsenic and lead, very small amounts of fluoride can be found in
most water supplies. However, the level of fluoride that
naturally-occurs in water is usually much lower than the level
artificially added in water fluoridation programs.
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What are potential risks from consuming fluoridated water?
Recent studies in the peer-reviewed medical literature
indicate that fluoridated water can have detrimental side effects.
Health risks associated with low-to-moderate doses of fluoride include:
dental fluorosis; bone fracture; bone cancer; joint pain; skin rash,
reduced thyroid activity; and IQ deficits.
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Is fluoridated water safe for babies?
NO. According to the American Dental Association
(ADA), children under 1 year of age should not receive infant formula
made with fluoridated water. Babies exposed to fluoridated water are at
high risk of developing dental fluorosis
- a tooth defect caused by fluoride-induced cell damage within the
teeth. Other harm is also likely. According, for example, to the US
National Research Council, “it is apparent that fluorides can interfere
with the functions of the brain.”
The danger that fluoride poses to the brain is likely greatest during
fetal and infant development, as during this time the barrier which
protects the child’s brain from environmental toxins is not yet fully
formed. Thus, chemicals that find their way into a baby’s bloodstream
can penetrate into the brain.
According to the Greater Boston Physicians for Social Responsibility:
“fluoride exposure, at levels that are experienced by a significant
proportion of the population whose drinking water is fluoridated, may
have adverse impacts on the developing brain. Though no final
conclusions may be reached from available data, the findings are
provocative and of significant public health concern."
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Is fluoridated water safe for people with kidney disease?
NO. Recent research has found that fluoridated water can contribute to
the development of painful bone disorders in people with advanced kidney disease.
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II. QUESTIONS about REDUCING FLUORIDE EXPOSURE:
How do I avoid fluoride from my tap
water?
WATER FILTERS:
One way to avoid fluoride from the tap is to purchase a water
filter. However, most water filters will not effectively remove
fluoride. For instance, Brita filters will NOT remove fluoride.
The two types of filters which will reliably remove more than 90% of the
fluoride are reverse-osmosis
filters and activated alumina filters. Thus, if you are looking for a filter to remove fluoride, make sure
it uses "reverse-osmosis" or "activated alumina" technology.
SPRING WATER: Another
way to avoid fluoride from the tap is to drink spring water. Most
spring water has less than 0.1 ppm fluoride, which is 10 times
less than added for fluoridation. If you regularly consume a particular
brand of spring water, call the telephone number on the label
and ask the company how much fluoride is in their water. (This
information will be readily available to them.) We recommend water
with less than 0.1 ppm fluoride.
If you decide to use spring water as your main source of water,
you might consider (for convenience purposes) buying or renting
a water
cooler/dispenser that holds 5 gallon jugs of water. In addition,
you might want to contact a bottled water company in your area
and have them deliver water (in 5 gallon jugs) to
your door on a recurring basis. This cuts down on the need to
continually buy smaller plastic bottles from the store.
WATER DISTILLATION:
A third way to avoid fluoride from the tap, is to distill the
water. Water
distillation will remove most, if not all, of the fluoride. The price for
distillation units varies widely depending on the size. While
small (counter-top) units cost as little as $200, large units cost as much as
$1600+.
AVOID "TRINITY SPRINGS"
WATER: One brand of spring water to avoid, if
you are looking to cut down on your fluoride exposure, is "Trinity
Springs." Trinity Springs is based in Idaho, USA and has
very high levels of naturally-occurring fluoride
(about 4 ppm) in its water.
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What else can I do to minimize fluoride
exposure for myself and my family?
1) If you're using a fluoridated
toothpaste, consider switching to a non-fluoridated
alternative (which you can find at most health food stores). Young
children, who don't have well developed swallowing-reflexes, often
swallow a lot of toothpaste when brushing,
which can cause disfiguring dental
fluorosis and contribute greatly to total systemic intake.
Also, even when the toothpaste is not swallowed, the fluoride
may cross the gum membrane and enter the bloodstream.
2) If your child is using infant
formula, it is imperative to avoid making
the formula with fluoridated tap water. Infant formula reconstituted
with fluoridated water delivers a very high dose of fluoride to
a young baby. For instance, infant formula produced with fluoridated
water contains 100 to 200 times more fluoride (1,000 ppb) than
is found naturally in breast milk (5-10 ppb). In fact, while breast-fed
infants receive the LOWEST body burden (mg/kg/day) in the population,
they receive the HIGHEST body burden if they receive fluoridated
formula.
3) Minimize consumption of processed
beverages (e.g. soda
and reconstituted juice).
Soda and juice made from concentrate are often manufactured with
fluoridated tap water, and hence, have fluoride levels similar
to fluoridated water.
4) If you regularly drink non-organic
wine or grape juice consider buying only organic
varieties. Many commercially-grown grapes in the US are sprayed
with a fluoride pesticide called Cryolite. The residues
of this pesticide can result in high levels of fluoride in wine
or grape juice. In the case of wine, if you don't want to spend
the extra money buying organic, consider purchasing a European
brand instead of a Californian brand, as Europe uses much less
cryolite on its vineyards.
5) Be careful of drinking too much green
or black tea.
Tea almost always has elevated levels of fluoride and can contribute
a substantial amount to one's total fluoride intake.
6) Minimize consumption of mechanically-deboned
chicken. Mechanically deboned chicken (e.g. "Chicken
McNuggets") has been found to contain elevated levels of
fluoride due to the incorporation of ground bone particles (which
are high in fluoride) into the meat.
7) If you live in a country which allows fluoridated
salt to be sold, make sure that the salt you buy
is unfluoridated. Consumption of fluoridated salt can greatly
increase a person's fluoride exposure.
8) Check to see if any prescription medicines
you are taking contain fluorine. If so, ask your doctor if there are
any appropriate alternatives - as some fluorine-containing
pharmaceuticals (e.g. Cipro) can metabolize into fluoride ion within the body, thereby increasing the body's exposure to fluoride.
9) If you are going to have surgery, ask your doctors if they
can use a non-fluorinated anesthetic. Fluorinated
anesthetics such as Enflurane, Isoflurane and
Sevoflurane will produce high peak levels of fluoride in blood
for up to 24 hours.
10) Avoid the use of teflon-coated
pans. Teflon-coated pans may increase the fluoride
content of food.
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You say that fluoride works topically.
Does this mean that you promote the use of fluoridated toothpaste?
While the use of fluoridated toothpaste has certain benefits
over water and salt fluoridation (e.g. the individual is given a
choice; the fluoride does not contaminate
the food supply; and the fluoride is applied to the teeth in
a more targeted manner); it also presents a number of risks
as well. For example:
- Children usually swallow
a lot of toothpaste when brushing their teeth, and therefore,
if they are using a fluoridated toothpaste they may ingest a lot
of fluoride. (For some children, fluoride toothpaste represents
the largest daily source
of ingested fluoride.) As noted in a recent review:
"Virtually all authors have noted that some children could
ingest more fluoride from
dentrifice alone than is recommended as a total daily fluoride
ingestion" (Levy 1999).
Swallowing toothpaste at a young age is one of the major risk
factors for the development of dental
fluorosis - a disfiguring condition that can have damaging
effects on a child's appearance and self-esteem.
- Even if one doesn't actually swallow the fluoride, the fluoride
may make it through the gum membrane and enter the bloodstream
- thus contributing to a person's systemic exposure to fluoride.
- Among hypersensitive individuals, fluoride toothpaste may
cause or aggravate dermatitis (skin rash, usually near the mouth) or stomatitis (mouth ulcers, "canker sores"). If you have dermatitis
near the mouth, consider trying a non-fluoride toothpaste
for 2-3 weeks and see if your condition improves. (If it does,
please let us know.)
- Recent research from the pharmaceutical company Sepracor indicates that fluoridated toothpaste may cause or contribute
to periodontal bone loss. This finding is serious because
periodontal bone loss is the #1 cause of tooth loss among
US adults. According to the scientists at Sepracor who conducted
the study:
"We have found that fluoride, in the concentration range
in which it is employed for the prevention of dental caries,
stimulates the production of prostaglandins and thereby exacerbates
the inflammatory response in gingivitis and periodontitis.... Thus, the inclusion of fluoride in toothpastes and mouthwashes
for the purpose of inhibiting the development of caries [cavities]
may, at the same time, accelerate the process of chronic, destructive
periodontitis."
- The concentrations of fluoride used in toothpaste are very
high (1,00o-1,500 ppm). Considering the fact that fluoride is
a suspected mutagen,
and that many mutagens are also carcinogens (i.e. they cause cancer),
there is some concern that fluoridated toothpaste may cause or
contribute to oral
cancer.
- There are safer
alternatives for protecting teeth than using a highly
toxic compound like fluoride. In addition to non-fluoridated
toothpastes, one alternative is xylitol,
a natural sugar that is now being widely used in oral health programs
throughout Scandinavia. Xylitol - which can be applied to the
teeth via mints, gum, and toothpaste - has been found to be very
effective in preventing tooth decay, and may even help remineralize
teeth as well. A healthy diet, however, will
always be the most important tool in the fight against tooth decay.
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QUESTIONS about FLUORIDE/PERSONAL HEALTH:
My child has dental fluorosis. What can
we do to fix it?
While
the damage that dental fluorosis causes to the internal matrix of the
teeth is permanent, the visible staining that fluorosis produces can be
cosmetically treated by a dentist.
Treatment
options for fluorosis vary and will depend in part on the severity of
the fluorosis and what you can afford (some of the treatments are very
expensive). For mild forms of fluorosis, the most common form of
treatment is "abrasion." For more advanced forms of fluorosis, it may
be necessary to use "composite bonding" or "porcelain veneers."
- Abrasion: Abrasion involves finely sanding off the outer layer of the enamel. It
is a common approach when the fluorosis is mild. However, if
the fluorosis is of a more advanced severity, abrasion is probably
not a good idea as it can bring to the surface of the teeth
a highly-porous enamel that will be prone to attrition.
- Composite bonding:
Composite bonding first involves lightly roughening the area
of the damaged enamel. After etching the enamel, a composite
resin (with a color matching your teeth) is "glued"
on to the exterior of the tooth.
- Porcelain veneers/laminates:
Made out of porcelain, veneers form a ceramic shell over the
surface of the tooth. Veneers may need to be replaced after
several years, however, which can become very expensive.
Ask your dentist to better determine which method of treating fluorosis will be best
for you. If your dentist
doesn't specialize in cosmetic dentistry, they should be able
to refer you to someone who does.
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If our water does not contain fluoride, should
we give our child fluoride supplements?
No. As pointed out by a growing number of dental researchers, fluoride supplements are unnecessary, ineffective, and much more likely to give your child dental fluorosis than to spare them a cavity.
- Fluoride Supplements are Unnecessary: A vast body of dental
research now indicates that there is no need to swallow fluoride at all - whether at a young or old age. This is because fluoride's
purported 'benefit' to teeth comes primarily from topical application, and not from ingestion. Thus, fluoride supplements
- which were developed in the 1950s under the incorrect assumption that fluoride needed to be swallowed - unnecessarily expose a child to systemic fluoride.
- Fluoride Supplements are Ineffective: According to a recent review in the dental journal Community Dentistry & Oral Epidemiology:
"The
basis for the widespread acceptance of fluoride supplements in caries
prevention is a large number of mostly small clinical trials in the
late 1950's and 1960's. The early studies have been reviewed again
recently in a series of publications and they have again been
criticised. The criticisms are serious and virtually none of the early
fluoride supplement studies would be published today, because of
methodological and other shortcomings. They present conclusions that
are not supported by their data or consistent with their designs....
the evidence in support of the effectiveness of fluoride supplements is
poor. The benefits claimed for fluoride supplements are, in any case,
available through regular toothbrushing with fluoride toothpaste and
fairly minor and sensible lifestyle changes."
- Fluoride Supplements Place a Child at High Risk for Fluorosis: About 30-45% of children receiving fluoride supplements develop dental fluorosis.
As noted by Dr. Paul Riordan: "Supplement use by children younger than
5 years entails a risk of fluorosis which, at the community level,
becomes a certainty."
- Fluoride Supplements Have Never Been Approved by FDA: Despite nearly 50 years of use, the US Food & Drug Administration
has never approved fluoride supplements as a safe and effective method for preventing
tooth decay. The FDA has only approved topical fluorides - e.g.
toothpaste.
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If I take a
shower with fluoridated water, will the fluoride enter through my
skin?
There
is anecdotal evidence indicating that some people may experience
adverse skin reactions from showering in fluoridated water. However,
there is very little information in the published scientific literature
to document this concern. There is also very little published research
documenting if, and to what extent, fluoridated water may pass through
the skin and enter the bloodstream. The tests that would be needed to
determine this would be simple to do. However, as with other important
issues related to fluoride and health, these tests have yet to be done.
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I think I have been impacted by excess
fluoride exposure. What should I do? How can I
'detoxify'?
The first and most obvious thing to do is reduce your fluoride
exposure. See the discussion above for ways to do this.
A sustained reduction in fluoride intake can bring about substantial
improvement in symptoms.
Other than reducing your fluoride intake, it will be important
to maintain a healthy
diet. The importance of a healthy diet has been suggested
by the repeated
observation that humans/animals with poor nutrition are more
severely impacted by fluoride toxicity than those with adequate
nutrition.
Other than reducing fluoride intake and maintaining good nutrition
(a diet rich in anti-oxidant),
there are few well-established ways of de-toxifying from chronic
fluoride poisoning. More research is definitely warranted.
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