Thursday, May 23, 2024
HomeFluorideWhy Is The Water Fluoridation Debate So One-Sided?

Why Is The Water Fluoridation Debate So One-Sided?

I read an opinion piece about water fluoridation this past Wednesday written by Katherine Kelly.  Katherine was one of the people who sponsored Measure A on Crescent City, California’s ballot, which would put a stop to water fluoridation in Crescent City.

Water Fluoridation ArgumentsIn her editorial she brings up two scientific sources, one from the American Dental Association and one from the Centers for Disease Control.  She acts like both of these sources have “admitted” that water fluoridation isn’t effective.  I took a look at both of these articles, and here’s what I found.

The ADA Article on Water Fluoridation

Katherine says that the American Dental Association article “clarified for every dentist that the swallowing of fluoride presents no significant benefit, that if there is a benefit it would be from applying it to the surface of the tooth.”

Let’s look at what John Featherstone, the author of the ADA’s cover story in July 2000, actually said:

“Fluoride, the key agent in battling caries, works primarily via topical mechanisms: inhibition of demineralization, enhancement of remineralization and inhibition of bacterial enzymes.”

Water Fluoridation: A Hotly Debated TopicDr. Featherstone also suggested that we “exploit [fluoride’s] known effects on bacteria, inhibition of demineralization and enhancement of remineralization by using ‘topical’ fluoride delivery by means of dental products, drinking water, beverages and foods.”

So, the author stated that fluoride works by being in direct contact with teeth.  Drinking fluoridated water puts it in contact with teeth, so he supports the fluoridation of drinking water based on his statement.

The CDC Article on Water Fluoridation

Katherine also mentioned that the CDC stated in 2001 that water fluoridation was one of the top 10 public health achievements of the 20th century.  She goes on to say the following:

On page 4 of the same report [the] CDC declares there is no correlation between fluoride incorporated in the enamel of teeth due to ingestion and the incidence of tooth decay.  Whoa! Shouldn’t this have halted fluoridation? Well not necessarily, because the support of fluoridation by seemingly prestigious groups was not about fact, it was about endorsements of the public policy goal.

By saying this, Katherine makes it seem like the CDC is contradicting itself and that it really doesn’t know what it’s talking about when it comes to water fluoridation.  The CDC was simply stating that fluoride’s role in preventing cavities isn’t by getting incorporated into the tooth as a result of swallowing it.  Water fluoridation protects the teeth by increasing the fluoride concentration in the mouth, allowing the fluoride to get incorporated into teeth by coming in direct contact with them.

If you have any doubts about the CDC’s position on water fluoridation, here’s one of their pages describing the benefits of fluoride.

Why does fluoride make teeth stronger?  Click here to read why!

It’s Not Just Opponents of Fluoride That Tell Half-Truths

I don’t mean to put down Katherine for what she wrote.  Even as a dental student, I’m not sure where I stand on the water fluoridation issue.  It is very complex!

Despite there being arguments both for and against water fluoridation, it doesn’t seem that either side recognizes the valid claims its opponent makes.  This refusal to either address the opposing view or to admit that the other side has any credibility at all weakens the argument of both sides.

One striking difference between these two groups are how they define fluoride.

How the American Dental Association Defines Fluoride

The American Dental Association defines fluoride as follows in their Fluoridation Facts booklet:

Fluoride is a naturally occurring compound that can help prevent dental decay.  Fluoride compounds are components of minerals in rocks and soil.  Water passes over rock formations and dissolves the fluoride compounds that are present, releasing fluoride ions.  The result is that small amounts of fluoride are present in all water sources.

How a Prominent Anti-Fluoride Researcher Defines Fluoride

John Yiamouyiannis, one of the anti-fluoridation movement’s greatest supporters defines fluoride as follows in his publication The Lifesaver’s Guide to Fluoride:

Fluoride is a poison and has been used as a pesticide. It is more poisonous than lead and just slightly less poisonous than arsenic. Procter & Gamble, the makers of Crest, acknowledges that a family-sized tube of fluoride toothpaste “theoretically, at least, contains enough fluoride to kill a small child.” While no one is going to die from drinking one glass of fluoridated water, just as no one will die from smoking one cigarette, it is the longer-term chronic effects of glass after glass of fluoridated water that takes its toll in human health — and life.

Both Sides Fail to State the Whole Truth

Reading the ADA’s definition, you would think that we should all be getting an optimal amount of fluoride to prevent tooth decay.  John Yiamouyiannis’ definition makes me want to get as far away from fluoride as I can.

The ADA doesn’t mention that fluoride is a poison when ingested in sufficient quantities.  John Yiamouyiannis failed to mention that fluoride is able to make teeth more resistant to cavities.

A Neutral Voice

I enjoy discussing the water fluoridation issue.  In fact, in one of my classes next week I will be participating with another student in a debate on the subject of water fluoridation.  I will be arguing against water fluoridation.  Preparing for this debate has helped me learn a LOT about this topic.

I’ll be posting a lot more articles on water fluoridation in the future.  If you have any issues you would like me to address, leave them below in the comments section.  Thanks for reading!



  1. Regardless of what it’s called, fluoride is neither a nutrient nor required for healthy teeth meaning that consuming a fluoride free diet does not cause tooth decay. As such fluoride is actually a drug because it alters a body system. Whether that’s good or bad depends on which side of the argument you are on.

    Ingesting fluoride does not reduce tooth decay and if you look deeper into the CDC’s report you’ll find they speak out of two sides of their mouth also:

    The CDC says:“Fluoride works primarily after teeth have erupted…”“The concentration of fluoride in ductal saliva, as it is secreted from salivary glands, is low — approximately 0.016 parts per million (ppm) in areas where drinking water is fluoridated and 0.006 ppm in nonfluoridated areas.

    “This concentration of fluoride is not likely to affect cariogenic activity”

    “The prevalence of dental caries in a population is not inversely related to the concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not necessarily more efficacious in preventing dental caries.”

    Fluoride does harden outer enamel topically; but it can actually hide rather than prevent tooth decay. Decay seeps below the surface and creates “fluoride bombs” – teeth that appear intact but pop or “explode” open when probed. They are too small to be seen on an X-ray. Those new electronic diagnodent devices picks up the decay that’s beneath the surface but that’s not visible tot he naked eye.

    While toothpaste is a topical application of fluoride, fluoride still gets absorbed into the bloodstream and involuntarily swallowed. Children under 2 swallow 50% and children under 5 swallow 25%, studies show

    One area where both proponents and opponents of fluoridation agree is that too much fluoride is a bad thing. Adding fluoride chemicals into public water supplies delivers doses based on thirst – not need, health, size and/or presence of teeth.

    Fluoride is present in virtually all foods and beverages, especially high in tea, ocean fish and mechanically de-boned meats.
    Several case studies show people fluoride damaged simply from brushing their teeth too many times a day and/or consuming large amounts of tea.

    Fluoride is regulated as a drug in toothpaste by the Food and Drug Administration. Children’s fluoride supplements are require a doctor’s prescription. The water supply should never be used as a drug deliver system.

    for more info

    • Thank you for your comment, nyscof. The CDC quotes were informative. I haven’t heard of fluoride bombs, do you have any sources talking about them?

      Sometimes case studies can be a little misleading. I usually look for studies that include a large number of participants. For example, you could have a case study that “proves” that brushing with too much fluoride causes problems (I’m not sure what fluoride damage is…). However, if you had a very large study, it may show that only one person who brushed many times with fluoride toothpaste developed fluoride damage, thus showing you that perhaps there was something else that was the true cause.

      I do agree that fluoride is present in MANY foods and drinks. Water fluoridation has a large halo effect and I think that this may be contributing to the increasing levels of enamel fluorosis that we are seeing lately. I also agree that fluoride is a drug.

      Just so everyone here knows, the website that nyscof mentions is a very strong anti-fluoridation site. In order to provide a more balanced view, here is a link to the American Dental Association’s Fluoridation Facts booklet.

  2. My source for “fluoride bombs” doesn’t come from the literature but from listening in on Dentists’ conversations. I suggest you contact Dr. Hardy Limeback who is a professor of preventive dentistry at the University of Toronto. He confirmed to me that this is an issue.

    There are case studies in the literature showing bone damage from people who drink huge amounts of tea (which has a natural fluoride content) and who brush their teeth too many times a day, thereby, ingesting way too much fluoride. Their symptoms are bone pain, stiffness, thickened bones. In some case their symptoms disappear after fluoride removal.

    While studies like these are carried out on large groups of people in other countries where high water fluoride is common along with skeletal fluorosis, you’ll never see such evidence in the US because grant money is not given to look for skeletal fluorosis. US physicians aren’t trained to diagnose skeletal fluorosis. And apparently dentists aren’t trained in that area either.

    The Fluoride Action Network is a science-based organization where you can find information you are not taught in dental schools showing the peer-reviewed science in respectable journals linking fluoride to adverse health effects at http://www.FluorideAction.Net/health

    Did you have any classes in school that were sponsored by corporations that benefit from fluoride and tooth decay such as Colgate, Procter & Gamble, Johnson & Johnson and others? If you did, do you believe that they sufficiently teach you about fluoride’s adverse effects when too much is ingested. Do they teach you what foods have fluoride and in what amounts so you can counsel your patients?

    • Hi nyscof – I did look into Dr. Hardy and found a presentation that said fluoride could cause these “fluoride bombs.” To be honest, I am skeptical since I haven’t found any articles in any journals on this subject. If it is such a huge problem, it would seem that there would at least be a few articles giving attention to this phenomenon.

      To be honest, I think our education is lacking when it comes to diagnosing dental fluorosis. Out of the 80 or so students in my class, there is only one other student that I know of who understands the side effects of too much fluoride. It would be nice if we talked a little bit more about this, especially since they spent so much time having us memorize the dosages for fluoride supplements in children. We never received any education informing us about the amount of fluoride in food and other drinks, such as mechanically de-boned chicken, and drinks bottled in fluoridated areas.

      Actually, we don’t have any classes sponsored by large corporations or businesses. My dental school is affiliated with a large university that has a large hospital system. The hospital system has banned visits from corporate sponsors, and that policy has trickled down to the dental school.

      Thanks for your comment!

  3. If you want flouride in your water, put it in your own water, leave the rest of us out of it.
    If fluoride were “proven,” there should be evidence of its glory in Kentucky, which has been 100% fluoridated for over 40 years. Kentucky, however, leads the nation in the number of dental cavities in children, and in the number of completely toothless adults, according to government records.

    Most of Europe (16 countries) has rejected fluoridation and is 98% fluoride free. and the WHO reports that they have a better tooth decay rate than any fluoridated country.
    There is no scientific evidence to support the idea that drinking fluoridated water has any effect on cavity reduction — NONE! The best source for information on the health hazards and ineffectiveness of fluoridation can be found here: (

    • HI jwillie6, I see that you’re pretty passionate about this issue! That is one of the credible arguments against fluoride. Some people with great oral hygiene wouldn’t benefit from fluoride intake – they would only be put at an increased risk for dental fluorosis. Is it fair that they should have to put themselves at risk to help others not get as many cavities?

      Perhaps people in Kentucky have worse diet habits and/or oral hygiene. In a majority of the scientific literature, water fluoridation has been shown to be effective at reducing tooth decay.

      I am interested in where you found the World Health Organization stating that all of Europe has a lower tooth decay rate than any fluoridated country.

      If drinking fluoridated didn’t reduce cavities, there would be no reason to drink it.

      There are many sources to get information about fluoride, some are against it, some are for it. It’s good to read the opinions of both sides.

      • In California where they mandate water be fluoridated they classify under law that 39 different types of fluorides ARE LISTED AS HAZARDOUS WASTE!

        Here is a label for hydrofluorosilicic acid DANGER POISON: DO NOT TAKE INTERNALLY WARNING but then gives instructions for water fluoridation? WTF!?

        HazMat Data: For First Response, Transportation, Storage, and Security: HYDROFLUOROSILICIC ACID DESCRIPTION: Colorless to straw yellow, fuming liquid, none to slight acrid odor. REACTS WITH WATER PRODUCING TOXIC AND CORROSIVE FUMES.


        Hazard Classification (based on NFPA-National Fire Protection Association Rating System) HEALTH HAZARDS (BLUE): 4; Rating System goes 0-4 0 meaning NO harm to 4 MEANING SEVERE OR EXTREME HAZARD POTENTIAL!

        THIS IS THE DESCRIPTION FOR NFPA HEALTH RATING SYSTEM: A rating of 3 or 4 is for highly to extremely toxic (deadly) material (and any carcinogen, mutagen, or teratogen). These materials will require specialized equipment (e.g. respirator (or exhaust hood), full face shield, rubber apron, specialized glove, handling tongs, etc) beyond that required for moderately toxic material.

        WHO graph on fluoridated vs unfluoridated countries

        the York Report, a review of several hundred selected papers on fluoridation was published. Profluoridationists touted the report as “proving” fluoridation was safe. So misleading were their statements, that in an unusual step, the Chairman in charge of the York Report had to issue a statement a month later clarifying what was stated in the report, including “The review did not show water fluoridation to be safe.” The vast majority of the studies reviewed did not pass and had a grade of C “poor quality with a risk of bias.” None reached the highest quality (Level A)

        Why doesn’t your professor tell you about the astounding 24 peer-reviewed scientific studies done that have shown fluoride intake is linked with lower IQs?


  4. Have you looked at the study between Kingston and Newburg NY? The unfluoridated town (kingston) has consistently had better oral health than the fluoridated, and has remained unfluoridated ever since the original trial in 1955 giving a clear view of the lack of benefit

    • Hi Nancy – Thanks for your comment! There are many studies similar to this one that seem to discredit water fluoridation. However, when all of the studies are looked at together, they do appear to show two things:

      1 – That water fluoridation does reduce the number of cavities and
      2 – That water fluoridation does increase the amount of people who get dental fluorosis.

      Here is the link to a systematic review (a scientific paper that attempts to answer a question by finding all valid research studies on a particular topic) that studied the question of water fluoridation by looking at all available studies:

      Let me know if you have any questions/differing opinions 🙂 Thanks for your comment!

      • What the ‘York Review’ on the fluoridation of drinking water really found

        Originally released : 28 October 2003

        A statement from the Centre for Reviews and Dissemination (CRD).

        In 1999, the Department of Health commissioned CRD to conduct a systematic review into the efficacy and safety of the fluoridation of drinking water. The review specifically looked at the effects on dental caries/decay, social inequalities and any harmful effects. The review was published on the CRD Fluoridation Review website and in the BMJ in October 2000.

        We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. As such, we urge interested parties to read the review conclusions in full.

        We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.

        What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children’s teeth.

        This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.

        An association with water fluoride and other adverse effects such as cancer, bone fracture and Down’s syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.

        The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.

        Since the report was published in October 2000 there has been no other scientifically defensible review that would alter the findings of the York review. As emphasised in the report, only high-quality studies can fill in the gaps in knowledge about these and other aspects of fluoridation. Recourse to other evidence of a similar or lower level than that included in the York review, no matter how copious, cannot do this.

        • Hi nyscof – Here’s the conclusion I read taken straight from a PDF copy of the systematic review:

          “The evidence of a reduction in caries should be considered together with the increased prevalence of dental fluorosis. No clear evidence of other potential negative effects was found. This evidence on positive and negative effects needs to be considered along with the ethical, environmental, ecological, financial, and legal issues that surround any decisions about water fluoridation. Any future research into the safety and efficacy of water fluoridation should be carried out with appropriate methodology to improve the quality of the existing evidence base.”

          As you stated above, the evidence shows that water fluoridation was likely to have a beneficial effect. Unfortunately, we don’t have a lot of quality evidence on water fluoridation because it is something that is really hard to study.

          Thanks for your insightful comment. I think there are too many people in the dental community that simply jump on the water fluoridation bandwagon without really realizing that there isn’t a lot of reliable evidence out there.

          I’ve tried to show both sides on this blog – you can read my article about the Top 10 Reasons to Oppose Water Fluoridation to see that I see both sides of the issue.

          Thanks for your comment!


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