from an expert in the field:
from an expert in the field:
Howard Pollick is a clinical professor of preventive and restorative
dentistry and a member of the American Dental Association’s National
Fluoridation Advisory Committee ( www.ada.org).
Opinions expressed are those
of the individuals or organizations represented and are
presented to foster discussion. Costco and The Costco
Connection take no position
on any Debate topic.
FLUORIDE IS nature’s cavity fighter. It is naturally
present in all water. Community water fluoridation is
simply the adjustment of the
amount of naturally occurring fluoride to the recommended amount to help
prevent tooth decay. Fluoridated water is regulated by sophisticated controls under direct supervision by trained water engineers.
Because of its role in preventing cavities, fluoridation of community water supplies has been
proclaimed by the Centers for Disease Control
and Prevention as one of 10 great public health
achievements of the 20th century.
Studies show that community water fluoridation prevents at least 25 percent of tooth decay in
children and adults. On an individual basis, the
lifetime cost of fluoridation is less than the cost of
one dental filling. For communities, every $1
invested in water fluoridation saves $38 in dental
Critics often point to dental fluorosis as a
result of fluoridated drinking water. Dental fluo-
rosis is not a disease but rather a change in the way
teeth look. The vast majority of fluorosis appears
as barely noticeable faint white lines or streaks on
tooth enamel. This type of fluorosis has no effect
on tooth function and may make the tooth enamel
more resistant to decay.
Critics also allege that fluoridated water is
associated with lower IQ. However, the studies do
not stand up to scientific scrutiny. Both the 2006
National Research Council report and an inde-
pendent review from England noted many study
limitations that make it difficult, if not impossible,
to assess these studies’ validity.
For example: Many of the papers omitted
important procedural details; not all of the studies
identify the level of fluoride in the water where the
children lived; the studies did not take into
account other factors that can affect IQ, such as
poverty, exposure to heavy metal pollution (arse-
nic and lead) and dietary deficiencies; and the
majority of the studies are from China, India and
Mexico, where environmental conditions are sig-
nificantly different from those in the U.S.
The bottom line is that water fluoridation
remains the single most effective public health
measure to prevent tooth decay. That is why the
past five surgeons general and organizations such
as the American Dental Association, American
Academy of Pediatrics, American Medical
Association and more than 100 other interna-
tional organizations recognize the public health
benefits of fluoridation. C
votes received by
May 14, 2014.
Results may reflect
Debate being picked
up by blogs.
Paul Connett is co-author of The Case Against Fluoride (Chelsea Green,
2010) and director of the Fluoride Action Network ( www.fluoridealert.org).
MOST COUNTRIES in the
world (including 97 percent
of Europe) do not fluoridate
their water. Yet, tooth decay
has been coming down as
fast in non-fluoridated countries as in fluoridated ones,
according to a World Health Organization study.
It is a poor medical practice to use the water
supply to deliver medicine. You cannot control
the dose or who gets the medicine, and it violates
the individual’s right to informed consent to medical treatment.
U.S. government-funded studies cited in the
Journal of Dental Research and the Journal of Public
Health Dentistry indicate that the evidence supporting swallowing fluoride to reduce tooth decay
is very weak. Even the Centers for Disease Control
and Prevention (CDC) admits that the predominant
benefit of fluoride comes from topical, not systemic, application. Fluoride works on the surface of
the tooth, not from inside the body. Thus, there is
no need to swallow fluoride and no need to force it
on people who don’t want it.
Proponents argue that the level at which we
fluoridate— 1 part per million (ppm)—is so small
that it couldn’t possibly hurt anyone. However, 1
ppm is 250 times the level found in mothers’ milk.
It is reckless to give a bottle-fed baby 250 times
more fluoride than nature intended.
Today our children are being grossly overex-
posed to fluoride, as evidenced by a CDC study
indicating that 41 percent of U.S. children age 12
to 15 have dental fluorosis (irreversible damage to
the enamel). More worrying are the many animal
and human studies showing that fluoride is a neu-
rotoxin. For example, a Harvard team showed that
out of 27 studies, 26 found a lowering of IQ in
children exposed to fluoride, with an average loss
of 7 IQ points, which is substantial.
Fluoridation’s proponents have argued that
this meta-analysis can be ignored because the
fluoride concentrations were much higher than
the levels used in fluoridation. But this is simply
not true. In nine of the studies the concentrations
were less than 3 ppm. This leaves no adequate
margin of safety to protect all of our children from
damage to their developing brains.
Alternative solutions are available. The
Childsmile program in Scotland has shown that
large reductions in tooth decay can be achieved in
low-income families with cost-effective programs
involving teaching tooth-brushing in nursery
schools, educating parents on better diets and
providing topical fluoride varnishes to those most
vulnerable. Our reckless practice of fluoridating
public drinking water must be brought to an end
as soon as possible. C