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.
Side Effects of Water Fluoridation: 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.
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- Palmer CA, Gilbert JA. Position of the Academy of Nutrition and Dietetics: the impact of fluoride on health. J Acad Nutr Diet. 2012;112(9):1443-1453.
- 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.
- Pollick H. The role of fluoride in the prevention of tooth decay. Pediatr Clin North Am. 2018;65(5):923-940.
- Grandjean P. Developmental fluoride neurotoxicity: an updated review. Environ Health. 2019;18(1):110.
- 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.
- Iheozor-Ejiofor Z, Worthington HV, Walsh T, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2015;2015(6):CD010856.
- Williams DM, Chestnutt IG, Bennett PD, Hood K, Lowe R, Heard P. Attitudes to fluorosis and dental caries by a response latency method. Community Dent Oral Epidemiol. 2006;34(2):153-159.
- U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. U. S. Public health service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Rep. 2015;130(4):318-331.
- Margolis FJ, Cohen SN. Successful and unsuccessful experiences in combating the antifluoridationists. Pediatrics. 1985;76(1):113-118.
- Bellinger DC. Is fluoride potentially neurotoxic? JAMA Pediatr. 2019;173(10):915-917.
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.
- Palmer CA, Gilbert JA. Position of the Academy of Nutrition and Dietetics: the impact of fluoride on health. J Acad Nutr Diet. 2012;112(9):1443-1453.
- 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.
- Pollick H. The role of fluoride in the prevention of tooth decay. Pediatr Clin North Am. 2018;65(5):923-940.
- Grandjean P. Developmental fluoride neurotoxicity: an updated review. Environ Health. 2019;18(1):110.
- 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.
- Iheozor-Ejiofor Z, Worthington HV, Walsh T, et al. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2015;2015(6):CD010856.
- Williams DM, Chestnutt IG, Bennett PD, Hood K, Lowe R, Heard P. Attitudes to fluorosis and dental caries by a response latency method. Community Dent Oral Epidemiol. 2006;34(2):153-159.
- U.S. Department of Health and Human Services Federal Panel on Community Water Fluoridation. U. S. Public health service recommendation for fluoride concentration in drinking water for the prevention of dental caries. Public Health Rep. 2015;130(4):318-331.
- Margolis FJ, Cohen SN. Successful and unsuccessful experiences in combating the antifluoridationists. Pediatrics. 1985;76(1):113-118.
- Bellinger DC. Is fluoride potentially neurotoxic? JAMA Pediatr. 2019;173(10):915-917.
Motion graphics by Avo Media
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Title
Side Effects of Water Fluoridation: Dental Fluorosis
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor'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:
- Is Water Fluoridation Safe?
- Why I Changed My Mind on Water Fluoridation
- Medicine’s Response to the Changing Science on Fluoride Safety
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