Mike Stobbe, AP Medical Writer
Fri Jan 7, 2011
ATLANTA – In a remarkable turnabout, federal health officials say many Americans are getting too much fluoride, and it's causing spots on children's teeth and perhaps other, more serious problems.
The U.S. Department of Health and Human Services announced plans Friday to lower the recommended level of fluoride in drinking water for the first time in nearly 50 years, based on a fresh review of the science.
The announcement is likely to renew the battle over fluoridation, even though the addition of fluoride to drinking water is considered one of the greatest public health successes of the 20th century. The U.S. prevalence of decay in at least one tooth among teens has declined from about 90 percent to 60 percent.
The government first began urging municipal water systems to add fluoride in the early 1950s. Since then, it has been put in toothpaste and mouthwash. It is also in a lot of bottled water and in soda. Some kids even take fluoride supplements. Now, young children may be getting too much.
"Like anything else, you can have too much of a good thing," said Dr. Howard Pollick, a professor at the University of California, San Francisco's dental school and spokesman for the American Dental Association.
One reason behind the change: About 2 out of 5 adolescents have tooth streaking or spottiness because of too much fluoride, a government study found recently. In extreme cases, teeth can be pitted by the mineral — though many cases are so mild only dentists notice it. The problem is generally considered cosmetic and not a reason for serious concern.
The splotchy tooth condition, fluorosis, is unexpectedly common in youngsters ages 12 through 15 and appears to have grown more common since the 1980s, according to the Centers for Disease Control and Prevention.
But there are also growing worries about more serious dangers from fluoride.
The Environmental Protection Agency released two new reviews of research on fluoride Friday. One of the studies found that prolonged, high intake of fluoride can increase the risk of brittle bones, fractures and crippling bone abnormalities.
Critics of fluoridated water seized on the proposed change Friday to renew their attacks on it — a battle that dates back to at least the Cold War 1950s, when it was denounced by some as a step toward Communism. Many activists nowadays don't think fluoride is essential, and they praised the government's new steps.
"Anybody who was anti-fluoride was considered crazy," said Deborah Catrow, who successfully fought a ballot proposal in 2005 that would have added fluoride to drinking water in Springfield, Ohio. "It's amazing that people have been so convinced that this is an OK thing to do."
Dental and medical groups applauded the announcement.
"This change is necessary because Americans have access to more sources of fluoride than they did when
water fluoridation was first introduced," Dr. O. Marion Burton, president of the American Academy of Pediatrics, said in a statement.
The fluoridated water standard since 1962 has been a range of 0.7 parts per million for warmer climates where people used to drink more water to 1.2 parts per million in cooler regions. The new proposal from HHS would set the recommended level at just 0.7. Meanwhile, the EPA said it is reviewing whether to lower the maximum allowable level of fluoride in drinking water from the current 4 parts per million.
"EPA's new analysis will help us make sure that people benefit from tooth decay prevention while at the same time avoiding the unwanted health effects from too much fluoride," said Peter Silva, an EPA assistant administrator.
Fluoride is a mineral that exists in water and soil. About 70 years ago, scientists discovered that people whose supplies naturally had more fluoride also had fewer cavities.
In 1945, Grand Rapids, Mich., became the world's first city to add fluoride to its drinking water. Six years later a study found a dramatic decline in tooth decay among children there, and the surgeon general endorsed water fluoridation.
And in 1955, Procter & Gamble Co. marketed the first fluoride toothpaste, Crest, with the slogan "Look, Mom, no cavities!"
But that same year, The New York Times called fluoridation of public water one of the country's "fiercest controversies." The story said some opponents called the campaign for fluoridation "the work of Communists who want to soften the brains of the American people."
The battles continue for a variety of reasons today.
In New York, the village of Cobleskill outside Albany stopped adding fluoride to its drinking water in 2007 after the longtime water superintendent became convinced the additive was contributing to his knee problems. Two years later, the village reversed the move after dentists and doctors complained.
According to a recent CDC report, nearly 23 percent of children ages 12 to 15 had fluorosis in a study done in 1986-87. That rose to 41 percent in a study that covered 1999 through 2004.
"I think most of the problem is not from the fluoride in water, it's from other sources, children swallowing fluoride toothpaste or eating it," said Susan Jeansonne, oral health program manager for Louisiana Department of Health and Hospitals.
Toothpaste labels have long recommended that parents supervise children under 6 when they are brushing their teeth; give them only a pea-size amount; and make sure they spit it out — not swallow it. Toddlers under 2 shouldn't use toothpaste with fluoride.
In 2006, the National Academy of Sciences released a report recommending that the EPA lower its maximum allowable level of fluoride in drinking water. The report warned severe fluorosis could occur at 2 parts per million. Also, a majority of the report's authors said a lifetime of drinking water with fluoride at 4 parts per million or higher could raise the risk of broken bones.
In addition, in 2005, the heads of 11 EPA unions, including ones representing the agency's scientists, pleaded with the EPA to reduce the permissible level of fluoride in water to zero, citing research suggesting it can cause cancer.
In Europe, fluoride is rarely added to water supplies. In Britain, only about 10 percent of the population has fluoridated water. It has been a controversial issue there, with critics arguing people shouldn't be forced to have "medical treatment" forced on them.
No More Fluoride in the Water - Waterloo, Ontario
08 November 2010
City pol wants remove fluoride from New York's drinking water, citing safety concerns
Erin Einhorn, email@example.com
Daily News City Hall Bureau
Tuesday, December 28th 2010
Four decades after New York started adding fluoride to its water, a city councilman armed with new research is launching a campaign to stop the practice.
"This amounts to forced medication by the government," said Councilman Peter Vallone (D-Queens), who plans to introduce fluoride-removal legislation at the next Council meeting. "What's next? They decide we're depressed and add Prozac to our drinking water?"
The federal Centers for Disease Control and Prevention hails the addition of fluoride to drinking water as one of the 10 greatest public health achievements of the 20th century - helping to drastically reduce tooth decay, especially in people with limited access to a dentist.
The CDC touts research showing fluoride is safe at the low levels added to city water systems.
A full 72% of Americans drink water fortified with the natural mineral.
"The bottom line is that we don't have any concern [about fluoride's safety]," said Linda Orgain, a CDC specialist.
But critics are troubled by new studies that suggest consuming too much fluoride can weaken teeth and bones. A recent study in China even suggested that exposure to high levels of fluoride can diminish children's intelligence.
"There is broad scientific consensus that the addition of fluoride to drinking water at optimal levels has significant oral health benefits and has no adverse health impacts," a Health Department spokeswoman said.
The city spends roughly $7 million a year adding fluoride to its water, but the Health Department believes taxpayers save millions more with improved dental health.
Safety isn't the only factor the city should consider, said John Doull, the University of Kansas emeritus professor of toxicology who was chairman of the National Academy of Sciences panel.
More people have access to fluoride from toothpaste and other sources today than they did in 1965, when the city started adding the mineral to our water, he said.
"It's been a long time since we've looked with scientific accuracy at whether this is still a public health benefit," Doull said. "There's no great evidence that it's producing harm [at low levels], but the question is: Does it really improve public health?"*******
Fluoride & the Brain
Key Findings - Fluoride & the Brain:
*******1) Fluoride's ability to damage the brain represents one of the most active areas of research on fluoride toxicity today.
2) The research on fluoride and the brain has been fueled by 18 human studies from China, India, Iran, and Mexico finding elevated levels of fluoride exposure to be associated with IQ deficits in children. Fluoride's impact on IQ is exacerbated among children with low-iodine exposure.
3) The impact of fluoride on children's IQ has been documented even after controlling for children's lead exposure, iodine exposure, parental education and income status, and other known factors that might impact the results (Rocha-Amador 2007; Xiang 2003 a,b).
4) In addition to IQ studies, 3 studies (Yu 1996; Du 1992; Han 1989) have found that fluoride accumulates in the brain of the fetus, causing damage to cells and neurotransmitters and 1 study (Li 2004) has found a correlation between exposure to fluoride during fetal development and behavioral deficits among neonates.
5) Several recent studies have found that even adult exposures to fluoride may result in central nervous system disturbances, particularly among industrial workers.
5) The findings of neurological effects in fluoride-exposed humans is consistent with, and strengthened by, recent findings from over 40 animal studies published since 1992. As with the studies on humans, the studies on animals have reported an impairment in learning and memory prorcesses among the fluoride-treated groups.
6) The animal studies have also documented considerable evidence of direct toxic effects of fluoride on brain tissue, even at levels as low as 1 ppm fluoride in water (Varner 1998). These effects include:
-- reduction in nicotinic acetylcholine receptors;
-- reduction in lipid content;
-- impaired anti-oxidant defense systems;
-- damage to the hippocampus;
-- damage to the purkinje cells;
-- increased uptake of aluminum;
-- formation of beta-amyloid plaques (the classic brain abnormality in Alzheimer's disease);
-- exacerbation of lesions induced by iodine deficiency; and
-- accumulation of fluoride in the pineal gland.
Fluoride's Impact on IQ:
“We found that exposure to fluoride (F) in urine was associated with reduced Performance, Verbal, and Full IQ scores before and after adjusting for confounders. The same pattern was observed for models with F in water as the exposure variable.... The individual effect of F in urine indicated that for each mg increase of F in urine a decrease of 1.7 points in Full IQ might be expected.”
SOURCE: Rocha-Amador D, et al. (2007). Decreased intelligence in children and exposure to fluoride and arsenic in drinking water. Cadernos de Saude Publica 23(Suppl 4):S579-87.
"These negative correlations between IQ and urinary As and between IQ and urinary fluoride indicate that exposure to high levels of As or fluoride, or both, could affect children’s intelligence... This study indicates that exposure to fluoride in drinking water is associated with neurotoxic effects in children."
SOURCE: Wang SX, et al. (2007). Arsenic and fluoride exposure in drinking water: children's IQ and growth in Shanyin county, Shanxi province, China. Environmental Health Perspectives 115(4):643-7.
"In agreement with other studies elsewhere, these findings indicate that children drinking high F water are at risk for impaired development of intelligence."
SOURCE: Trivedi MH, et al. (2007). Effect of high fluoride water on intelligence of school children in India. Fluoride 40(3):178-183.
"Based on the findings of this study, exposure of children to high levels of fluoride may carry the risk of impaired development of intelligence."
SOURCE: Seraj B, et al. (2006). [Effect of high fluoride concentration in drinking water on children’s intelligence]. Journal of Dental Medicine 19(2):80-86.
"A few epidemiologic studies of Chinese populations have reported IQ deficits in children exposed to fluoride at 2.5 to 4 mg/L in drinking water. Although the studies lacked sufficient detail for the committee to fully assess their quality and relevance to U.S. populations, the consistency of the results appears significant enough to warrant additional research on the effects of fluoride on intelligence."
SOURCE: National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. p. 6.
"Conclusion: High fluoride burden has a definite effect on the intellectual and physical development of children."
SOURCE: Wang S, et al. (2005). Effects of coal burning related endemic fluorosis on body development and intelligence levels of children. Journal of Applied Clinical Pediatrics 20(9): 897-898.
"In our study, it was shown that the average IQ of children in a fluoride endemic area was somewhat lower than the control, but the result was not significant (P>0.05). The rate of children with “low” IQs, however, was elevated as compared to the control, and this was very statistically significant... Our study showed that, within the fluoride endemic area, the average IQ of children suffering from dental fluorosis is clearly lower than those that show no signs of the disease, and this result is very significant (P <0.01). This IQ difference of 8.12 suggests that children suffering from dental fluorosis might be particularly sensitive to excess fluoride, and that the manifestation of this is not limited to the typical symptoms of fluorosis, but, more seriously, also disrupts intellectual development."
SOURCE: Li Y, et al. (2003). The effects of endemic fluoride poisoning on the intellectual development of children in Baotou. Chinese Journal of Public Health Management 19(4):337-338.
“Higher drinking water fluoride levels were significantly associated with higher rates of mental retardation (IQ <70) and borderline intelligence (IQ 70-79)... In endemic fluorosis areas, drinking water fluoride levels greater than 1.0 mg/L may adversely affect the development of children's intelligence.”
SOURCE: Xiang Q, et al. (2003a). Effect of fluoride in drinking water on children's intelligence. Fluoride 36: 84-94.
"As an additional part of our investigation of an association between fluoride in drinking water and children’s intelligence in two villages of Sihong County, Jiangsu Province, China, we have now determined blood lead levels of children in that study... The results show there is essentially no difference between the two villages in blood lead concentrations of the children... These results thus make it very unlikely that the differences in IQ of the children living in Wamiao and Xinhuai are the result of differences in exposure to lead rather than to fluoride."
SOURCE: Xiang Q, et al. (2003b). Blood lead of children in Wamiao-Xinhuai intelligence study. Fluoride 36: 198-199.
"After controlling by significant confounders, urinary fluoride correlated positively with reaction time and inversely with the scores in visuospatial organization. IQ scores were not influenced by fluoride exposure. An increase in reaction time could affect the attention process, also the low scores in visuospatial organization could be affecting the reading and writing abilities in these children.”
SOURCE: Calderon J, et al. (2000). Influence of fluoride exposure on reaction time and visuospatial organization in children. Epidemiology 11(4): S153.
"In terms of IQ ranking, the high fluoride groups showed significant deficits as compared to control (P<0.01)... Conclusion: When fluoride and iodine levels in excess of national standards for drinking water are present in the same area and ingested together, the harmful effects of fluoride are more pronounced, and the resulting damage compounded."
SOURCE: Hong F, et al. (2001). A study of fluorine effects on children's intelligence development under different environments. Chinese Primary Health Care 15: 56-57.
“The IQ of the 60 children in the high-fluoride area was significantly lower than that of the 58 children in the low-fluoride area... More children in the high-fluoride area were in the retardation or borderline categories of IQ than children in the low fluoride area. An inverse relationship was also present between IQ and the urinary fluoride level. Exposure of children to high levels of fluoride may therefore carry the risk of impaired development of intelligence.”
SOURCE: Lu Y, et al (2000). Effect of high-fluoride water on intelligence of children. Fluoride 33:74-78.
"A study of intelligence quotient (IQ) in China was conducted using Wickler's Intelligence Quotient Table for preschool children, in 4-7 year-old children, 147 from a district with high level of fluoride and 83 from a control area. High F intake had a significant influence on IQ of preschool children. Operation IQ was mainly affected."
SOURCE: Wang G, et al. (1996). Research on intelligence quotient of 4-7 year-old children in a district with a high level of fluoride. Endemic Diseases Bulletin 11:60-62.
"In Shanxi Province, China, children living in the endemic fluoride village of Sima located near Xiaoyi City had average IQ significantly lower than children living to the north in the nonendemic village of Xinghua.”
SOURCE: Zhao LB, et al (1996). Effect of high-fluoride water supply on children's intelligence. Fluoride 29: 190-192.
“The intelligence was measured of 907 children aged 8-13 years living in areas which differed in the amount of fluoride present in the environment. The Intelligence Quotient (IQ) of children living in areas with a medium or severe prevalence of fluorosis was lower than that of children living in areas with only slight fluorosis or no fluorosis. The development of intelligence appeared to be adversely affected by fluoride in the areas with a medium or severe prevalence of fluorosis. A high fluoride intake was associated with a lower intelligence.”
SOURCE: Li XS. (1995). Effect of Fluoride Exposure on Intelligence in Children. Fluoride 28:189-192.
“We made an investigation in 157 children, aged 12-13, born and grew up in a coal burning pattern endemic fluorosis area and an experiment on excessive fluoride intake in rat. The results showed: (1) Excessive fluoride intake since early childhood would reduce mental work capacity (MWC) and hair zinc content: (2) The effect on zinc metabolism was a mechanism of influence on MWC by excessive fluoride intake...”
SOURCE: Li Y, et al. (1994). [Effect of excessive fluoride intake on mental work capacity of children and a preliminary study of its mechanism] Hua Hsi I Ko Ta Hsueh Hsueh Pao. 25:188-91.
"An excess of fluoride and a lack of iodine in the same environment has been shown to have a marked effect on child intellectual development, causing a more significant intellectual deficit than lack of iodine alone. The subject group of children from the high fluoride, high iodine zone have an average IQ of 76.67±7.75, which was somewhat less than the control (IQ = 81.67 ±11.9), though the different is not significant (P>0.05). However, the percentage of subject children in the low range (16.67%) is higher than the control, suggesting that a high iodine, high fluoride environment also has a definite negative influence on child intellectual ability."
SOURCE: Yang Y, et al. (1994). Effects of high iodine and high fluorine on children's intelligence and the metabolism of iodine and fluorine. Chinese Journal of Pathology 15(5):296-8.
"The results of this study show that the children living in high fluoride areas have lower IQs than the children from the non-endemic area. Also, there were many more children from the endemic area with an IQ score ranking of below the borderline low level as compared to the control; in the endemic area, there were 18 such subject, or 30% of the total, while in the non-endemic area there were only 7, or a rate of 11.5%. The difference between the two groups is significant. The overall distribution shows marked difference, with the scores in control group on average one rank higher than the control... In summary, although diminished intellectual ability can result from a multitude of factors (both innate and acquired) that influence neural development and cell division in the cerebrum, the comparison conducted in this study of two areas where the other environment factors are basically the same shows clear differences in IQ, and it's probable that this difference is due to a high fluoride environment. It is not clear whether the underlying mechanism is fetal exposure to fluoride resulting from the poisoning of the mother or intake of fluoride after birth (in either case causing a disruption nerve cell development leading to mental deficits); this matter awaits further study."
SOURCE: Guo XC, et al. (1991). A preliminary exploration of IQ of 7-13 year old pupils in a fluorosis area with contamination from burning coal. Chinese Journal of Endemiology 10:98-100.
"This results of this study indicate that there is significant difference between the intellectual ability of the 7 – 14 year old children from the endemic area and those of the control, and moreover that the average IQ of the children from the endemic area is clearly lower. In the endemic region, the children in the 80-89 range and below make up more than 25% of the total, while in the control range only 18% of the children fall into that range, demonstrating that high fluoride has a direct connection with the intellectual development of children."
SOURCE: Chen YX, et al. (1991). Research on the intellectual development of children in high fluoride areas. Chinese Journal of Control of Endemic Diseases. 6(supplement):99-100.
“The significant differences in IQ among these regions suggests that fluoride can exacerbate central nervous lesions and somatic developmental disturbance caused by iodine deficiency. This may be in keeping with fluoride's known ability to cause degenerative changes in central nervous system cells and to inhibit the activities of many enzymes, including choline enzymes, causing disturbance of the nerve impulse.”
SOURCE: Lin Fa-Fu; 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.
"By testing of the intellectual ability of 447 elementary school students ranging in age from 9 to 10 1/2, it was discovered that both high and low fluoride had an effect on child intelligence. Fluoride levels greater than 2.0 mg/L or less than 0.2 mg/L can disrupt intellectual development."
SOURCE: Qin LS, Cui SY. (1990). The influence of drinking water fluoride on pupils IQ, as measured by Rui Wen's standards. Chinese Journal of the Control of Endemic Diseases 5:203-204.
"The effect of a harmful environment containing both high fluoride and low iodine on the development of child mental ability has yet to be reported on. To investigate this question, the authors used the Wechsler Intelligence Test to determine the IQs of a total of 329 eight- to fourteen-year-old children living in nine high fluoride, low iodine villages and seven villages that had only low levels of iodine. We discovered that the IQs of children from high fluoride, low iodine villages were clearly lower than those from the villages with low iodine alone."
SOURCE: Ren Da-Li. (1989). An investigation of intelligence development of children aged 8-14 years in high-fluoride and low-iodine areas. Chinese Journal of Control of Endemic Diseases 4:251.
No More Fluoride in the Water - Waterloo, Ontario
08 November 2010