How did the medical and dental community react to U.S. regulators’ total 180 over water fluoridation, going from presumptively safe to presumptively dangerous?
Medicine’s Response to the Changing Science on Fluoride Safety
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The National Toxicology Program is part of the Public Health Service, in partnership with the CDC, FDA, and NIH, dedicated to the analysis of agents of concern to identify any toxic effects. How did the medical community respond to the draft conclusions in their recent systematic review that concluded that fluoride is to be presumed to be a cognitive neurodevelopmental hazard to humans, based on studies showing lower IQ scores among kids with higher fluoride exposure?
What do you do when current research contradicts public practices, when new evidence doesn’t conform with existing beliefs? Well, health authorities have continued to conclude that fluoride is unequivocally safe, despite the new studies in recent years linking fluoride exposure in pregnancy with adverse effects on fetal brain development. There are still papers on how to ‘sell’ fluoridation of the water supply, targeting social media and the person-to-person spread of fluoride “misinformation.” Search engines are to be encouraged, at the very least, to flag search engine results that point to water fluoridation health “misinformation” suggesting adverse effects. In promoting support for community water fluoridation, maybe we don’t even want to proclaim its safety for fear of raising questions about risks. I mean, if you’re saying it’s safe, then that begs the question, “Well, is it not safe?” Maybe we shouldn’t even talk about whether it’s safe.
The tendency to ignore new evidence that does not conform to widespread beliefs may be impeding our response to early warnings about fluoride as a potential developmental neurotoxin. But some are just so fixed in their views on fluoridation that they won’t reassess their stance, no matter what the latest research might show. Ironically, it was the anti-fluoridationists who were accused of their “anti-scientific attitudes,” but now it’s the pro-fluoridationists.
One of the most facile pro-fluoridation arguments I ran across is the suggestion that fluoride can’t be hurting IQs because over the last half century of fluoridation, IQ scores have been going up, rather than down. The jaw-dropping irony is that a substantial part of that rise may have been due to the removal of another neurotoxic element, lead. It’s worth remembering that the science surrounding the neurodevelopmental hazard of low-level lead exposure was also bitterly contested using the same kinds of arguments we see today in the fluoridation debate.
A few short years before leaded gas was effectively banned in the United States, a meta-analysis of lead exposure and child IQ only found 24 human studies, all cross-sectional, with a typical associated loss in intelligence of about four IQ points. The current data suggest a similar IQ loss from fluoride from an even stronger body of evidence.
A spokesperson for the American Dental Association responded to the new data by pointing out that some cities that have ended water fluoridation saw an increase in cavities. OK, but that’s kind of a strange response to data suggesting the potential for permanent brain damage in children. I mean, I know they are the dental association, but how could they so easily ignore the serious red flags of potential neurotoxicity for cavity reduction? This is not to say tooth decay isn’t a serious health issue, but there are ways to get the cavity-preventing benefits of fluoride without the risks. Since the primary benefits arise from topical contact with our enamel, but the primary risks arise from systemic absorption, we can follow Europe’s example and safely reap the rewards using fluoride toothpaste and mouthwashes. In Europe, 98 percent of the population drink unfluoridated water. Several countries, including France, Germany, the Netherlands, Denmark, and Sweden, banned fluoridation decades ago in favor of fluoride toothpaste, as more than ten years ago, the official scientific committee on health risks of the European Union concluded that topical application of fluoride is most effective in preventing tooth decay and that there appears to be no obvious advantage in favor of fluoridating the water supply.
Please consider volunteering to help out on the site.
- Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services. Draft NTP monograph on the systematic review of fluoride exposure and neurodevelopmental and cognitive health effects*. Sept 2020.
- Amiri A. Water fluoridation: When current research contradicts public practices. Public Health Nurs. 2020;37(4):475-477.
- Till C, Green R. Controversy: The evolving science of fluoride: when new evidence doesn’t conform with existing beliefs. Pediatr Res. 2021;90(5):1093-1095.
- How to “sell” fluoridation of the water supply. Br Dent J. 2022;232(1):37.
- Burgette JM, Dahl ZT, Yi JS, et al. Mothers’ sources of child fluoride information and misinformation from social connections. JAMA Netw Open. 2022;5(4):e226414.
- Vasantavada Priyanka V., Sanderson R, Ells L, Zohoori FV. Web search engines reveal conflicting information about water fluoridation. Br Dent J. Feb 2022.
- Kemp D, Mackert M, Bouchacourt L, et al. Promoting support for community water fluoridation: testing message effects and the role of normative beliefs. J Am Dent Assoc. 2021;152(12):1012-1019.
- Krisberg K. Public health messaging: How it is said can influence behaviors: beyond the facts. The Nation’s Health. 2014;44(6):1-20.
- Gravitz L. The fluoride wars rage on. Nature. Oct 2021.
- Griffith GW. Observations on the fluoridation controversy. Public Health. 1959;74:27-34.
- Beltrán-Aguilar ED, Barker L, Dye BA. Prevalence and severity of dental fluorosis in the United States, 1999-2004. NCHS Data Brief. 2010;(53):1-8.
- Kaufman AS, Zhou X, Reynolds MR, Kaufman NL, Green GP, Weiss LG. The possible societal impact of the decrease in U.S. blood lead levels on adult IQ. Environ Res. 2014;132:413-420.
- Bellinger DC. Is fluoride potentially neurotoxic? JAMA Pediatrics. 2019;173(10):915-917.
- Needleman HL, Gatsonis CA. Low-level lead exposure and the IQ of children. A meta-analysis of modern studies. JAMA. 1990;263(5):673-678.
- Berezow AB. Association between maternal fluoride exposure and child iq. JAMA Pediatr. 2020;174(2):212.
- Unde MP, Patil RU, Dastoor PP. The untold story of fluoridation: revisiting the changing perspectives. Indian J Occup Environ Med. 2018;22(3):121-127.
- European Commission, Directorate-General for Health and Consumers. Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water. European Commission. Aug 2013.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The National Toxicology Program is part of the Public Health Service, in partnership with the CDC, FDA, and NIH, dedicated to the analysis of agents of concern to identify any toxic effects. How did the medical community respond to the draft conclusions in their recent systematic review that concluded that fluoride is to be presumed to be a cognitive neurodevelopmental hazard to humans, based on studies showing lower IQ scores among kids with higher fluoride exposure?
What do you do when current research contradicts public practices, when new evidence doesn’t conform with existing beliefs? Well, health authorities have continued to conclude that fluoride is unequivocally safe, despite the new studies in recent years linking fluoride exposure in pregnancy with adverse effects on fetal brain development. There are still papers on how to ‘sell’ fluoridation of the water supply, targeting social media and the person-to-person spread of fluoride “misinformation.” Search engines are to be encouraged, at the very least, to flag search engine results that point to water fluoridation health “misinformation” suggesting adverse effects. In promoting support for community water fluoridation, maybe we don’t even want to proclaim its safety for fear of raising questions about risks. I mean, if you’re saying it’s safe, then that begs the question, “Well, is it not safe?” Maybe we shouldn’t even talk about whether it’s safe.
The tendency to ignore new evidence that does not conform to widespread beliefs may be impeding our response to early warnings about fluoride as a potential developmental neurotoxin. But some are just so fixed in their views on fluoridation that they won’t reassess their stance, no matter what the latest research might show. Ironically, it was the anti-fluoridationists who were accused of their “anti-scientific attitudes,” but now it’s the pro-fluoridationists.
One of the most facile pro-fluoridation arguments I ran across is the suggestion that fluoride can’t be hurting IQs because over the last half century of fluoridation, IQ scores have been going up, rather than down. The jaw-dropping irony is that a substantial part of that rise may have been due to the removal of another neurotoxic element, lead. It’s worth remembering that the science surrounding the neurodevelopmental hazard of low-level lead exposure was also bitterly contested using the same kinds of arguments we see today in the fluoridation debate.
A few short years before leaded gas was effectively banned in the United States, a meta-analysis of lead exposure and child IQ only found 24 human studies, all cross-sectional, with a typical associated loss in intelligence of about four IQ points. The current data suggest a similar IQ loss from fluoride from an even stronger body of evidence.
A spokesperson for the American Dental Association responded to the new data by pointing out that some cities that have ended water fluoridation saw an increase in cavities. OK, but that’s kind of a strange response to data suggesting the potential for permanent brain damage in children. I mean, I know they are the dental association, but how could they so easily ignore the serious red flags of potential neurotoxicity for cavity reduction? This is not to say tooth decay isn’t a serious health issue, but there are ways to get the cavity-preventing benefits of fluoride without the risks. Since the primary benefits arise from topical contact with our enamel, but the primary risks arise from systemic absorption, we can follow Europe’s example and safely reap the rewards using fluoride toothpaste and mouthwashes. In Europe, 98 percent of the population drink unfluoridated water. Several countries, including France, Germany, the Netherlands, Denmark, and Sweden, banned fluoridation decades ago in favor of fluoride toothpaste, as more than ten years ago, the official scientific committee on health risks of the European Union concluded that topical application of fluoride is most effective in preventing tooth decay and that there appears to be no obvious advantage in favor of fluoridating the water supply.
Please consider volunteering to help out on the site.
- Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services. Draft NTP monograph on the systematic review of fluoride exposure and neurodevelopmental and cognitive health effects*. Sept 2020.
- Amiri A. Water fluoridation: When current research contradicts public practices. Public Health Nurs. 2020;37(4):475-477.
- Till C, Green R. Controversy: The evolving science of fluoride: when new evidence doesn’t conform with existing beliefs. Pediatr Res. 2021;90(5):1093-1095.
- How to “sell” fluoridation of the water supply. Br Dent J. 2022;232(1):37.
- Burgette JM, Dahl ZT, Yi JS, et al. Mothers’ sources of child fluoride information and misinformation from social connections. JAMA Netw Open. 2022;5(4):e226414.
- Vasantavada Priyanka V., Sanderson R, Ells L, Zohoori FV. Web search engines reveal conflicting information about water fluoridation. Br Dent J. Feb 2022.
- Kemp D, Mackert M, Bouchacourt L, et al. Promoting support for community water fluoridation: testing message effects and the role of normative beliefs. J Am Dent Assoc. 2021;152(12):1012-1019.
- Krisberg K. Public health messaging: How it is said can influence behaviors: beyond the facts. The Nation’s Health. 2014;44(6):1-20.
- Gravitz L. The fluoride wars rage on. Nature. Oct 2021.
- Griffith GW. Observations on the fluoridation controversy. Public Health. 1959;74:27-34.
- Beltrán-Aguilar ED, Barker L, Dye BA. Prevalence and severity of dental fluorosis in the United States, 1999-2004. NCHS Data Brief. 2010;(53):1-8.
- Kaufman AS, Zhou X, Reynolds MR, Kaufman NL, Green GP, Weiss LG. The possible societal impact of the decrease in U.S. blood lead levels on adult IQ. Environ Res. 2014;132:413-420.
- Bellinger DC. Is fluoride potentially neurotoxic? JAMA Pediatrics. 2019;173(10):915-917.
- Needleman HL, Gatsonis CA. Low-level lead exposure and the IQ of children. A meta-analysis of modern studies. JAMA. 1990;263(5):673-678.
- Berezow AB. Association between maternal fluoride exposure and child iq. JAMA Pediatr. 2020;174(2):212.
- Unde MP, Patil RU, Dastoor PP. The untold story of fluoridation: revisiting the changing perspectives. Indian J Occup Environ Med. 2018;22(3):121-127.
- European Commission, Directorate-General for Health and Consumers. Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water. European Commission. Aug 2013.
Motion graphics by Avo Media
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Title
Medicine’s Response to the Changing Science on Fluoride Safety
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
We can get the best of both worlds with topical application of fluoride, so I continue to advocate for the use of fluoride toothpaste, but pregnant and breastfeeding women may want to consider non-fluoridated water sources to reduce the apparent risk to the developing brain.
This is the final video in my series on water fluoridation. If you missed any of the others, see:
- Why Is There Fluoride in Water? Is It Effective?
- Side Effects of Water Fluoridation: Dental Fluorosis
- Is Water Fluoridation Safe?
- Why I Changed My Mind on Water Fluoridation
You can also watch the recording of the webinar that I did on this topic, which includes a Q&A at the end.
I mentioned the example of lead exposure. If you want to know more, I have an entire series on that topic, starting with How the Lead Paint Industry Got Away with It.
I have a lot more videos on dental health, including a series on oil pulling and tongue scraping.
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