Side Effects of Water Fluoridation: Dental Fluorosis

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According to the CDC, about a third of American children now have some form of cosmetic defects in their tooth enamel due to fluoride exposure, known as dental fluorosis.

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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.

Fluoride research over a half century has historically established water fluoridation to be safe, when used at typical fluoridation doses of one part per million. However, naturally fluoridated waters up around two parts per million can put children under the age of nine at increased risk for dental fluorosis, and a lifetime of drinking water at four ppm can cause skeletal fluorosis and increase the risk of bone fractures. You can see these kinds of levels in the Earth’s natural fluoride belts that extend from Turkey through Iraq, Iran, and Afghanistan to China and Japan.

The reason susceptibility to dental fluorosis ends at around eight years old is that’s when enamel maturation is completed, before our final permanent teeth finish erupting. After teeth are formed, dental fluorosis can no longer develop or worsen. At one ppm, one part per million of fluoride, public health authorities estimated that less than 10 percent of kids would develop the condition, and only in its mildest forms. We’ve since learned that the prevalence and severity of fluorosis is much higher than predicted. According to the CDC, about a third of American children now have some form of dental fluorosis, with about one in 30 experiencing a moderate to severe case. This may reflect exposure to multiple fluoride sources not factored in to the original calculations.

Now, most fluorosis is so mild as to be hardly noticeable, taking the form of white streaks or splotches visible only to dentists under the bright lights of their exam chair. But serious cases can involve severe pitting and discoloration, and present more than just a cosmetic defect. For example, one study found that children with severe cases are more likely to be viewed by their peers as less attractive, less careful, less clean, less happy, less healthy, less intelligent, less kind, less reliable, less social. Imagine what that could do to a kid’s self-esteem.

Given the higher-than-expected rates of fluorosis, in 2015, the U.S. Public Health Service reduced the recommended fluoride concentration of drinking water down to 0.7 ppm across the board. Previously, levels were set at up to 1.2 ppm in cooler areas where people tend to drink less water. This change would be estimated to keep the percentage of those developing fluorosis of “aesthetic concern” down to approximately 12 percent.

In terms of other health concerns, until recently, mainstream medicine’s view might have perhaps best been summed up by the final statement in an exhaustive report published by Consumer Reports in 1978: “The simple truth is that there is no scientific controversy over the safety of fluoridation. The practice is safe, economical, and beneficial. The survival of this fake controversy, in the Consumers Union’s opinion, is one of the major triumphs of quackery over science in our generation.” In the last few years, though, there have been growing concerns about the adverse effects of fluoride on brain development, which I’ll address next.

Please consider volunteering to help out on the site.

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.

Fluoride research over a half century has historically established water fluoridation to be safe, when used at typical fluoridation doses of one part per million. However, naturally fluoridated waters up around two parts per million can put children under the age of nine at increased risk for dental fluorosis, and a lifetime of drinking water at four ppm can cause skeletal fluorosis and increase the risk of bone fractures. You can see these kinds of levels in the Earth’s natural fluoride belts that extend from Turkey through Iraq, Iran, and Afghanistan to China and Japan.

The reason susceptibility to dental fluorosis ends at around eight years old is that’s when enamel maturation is completed, before our final permanent teeth finish erupting. After teeth are formed, dental fluorosis can no longer develop or worsen. At one ppm, one part per million of fluoride, public health authorities estimated that less than 10 percent of kids would develop the condition, and only in its mildest forms. We’ve since learned that the prevalence and severity of fluorosis is much higher than predicted. According to the CDC, about a third of American children now have some form of dental fluorosis, with about one in 30 experiencing a moderate to severe case. This may reflect exposure to multiple fluoride sources not factored in to the original calculations.

Now, most fluorosis is so mild as to be hardly noticeable, taking the form of white streaks or splotches visible only to dentists under the bright lights of their exam chair. But serious cases can involve severe pitting and discoloration, and present more than just a cosmetic defect. For example, one study found that children with severe cases are more likely to be viewed by their peers as less attractive, less careful, less clean, less happy, less healthy, less intelligent, less kind, less reliable, less social. Imagine what that could do to a kid’s self-esteem.

Given the higher-than-expected rates of fluorosis, in 2015, the U.S. Public Health Service reduced the recommended fluoride concentration of drinking water down to 0.7 ppm across the board. Previously, levels were set at up to 1.2 ppm in cooler areas where people tend to drink less water. This change would be estimated to keep the percentage of those developing fluorosis of “aesthetic concern” down to approximately 12 percent.

In terms of other health concerns, until recently, mainstream medicine’s view might have perhaps best been summed up by the final statement in an exhaustive report published by Consumer Reports in 1978: “The simple truth is that there is no scientific controversy over the safety of fluoridation. The practice is safe, economical, and beneficial. The survival of this fake controversy, in the Consumers Union’s opinion, is one of the major triumphs of quackery over science in our generation.” In the last few years, though, there have been growing concerns about the adverse effects of fluoride on brain development, which I’ll address next.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the second video in a five-part series on water fluoridation. If you missed the first one, see Why Is There Fluoride in Water? Is It Effective?. The rest of the series is coming soon: 

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