Health Dangers of Water Fluoridation

By the end of this article you’ll discover the health dangers of water fluoridation and the history they don’t want you to know.

People writing off fluoride as a conspiracy is proof that it’s working as intended.

—Anonymous

• Research continues to mount that it lowers IQ.
• 98% of Europe banned it.
• It’s a common ingredient in rat poison.

Yet, the US consumes more fluoridated water than the rest of the world combined, and the CDC calls it one of the top 10 public health achievements of the 20th century.

Let me take off my tin hat.

For years I’ve worked for Smile America Partners drilling, filling, and extracting kids’ teeth across Missouri. One week they assign me out in a rural community that has fluoridated water, the next week I’m in a different county without fluoridated water.

No matter the county, almost all the kids, like 9 out of 10, have cavities. Because of the high caries rate, it’s hard to tell if my workload is higher in communities without water fluoridation.

But this is what Dr. McKay noticed over 100 years ago…

The History of Water Fluoridation

In 1901, after finishing dental school, Dr. Frederick McKay opened his practice in Colorado Springs. Unlike the patients he saw in school, many residents of Colorado Springs had brown stained teeth.

McKay started doing some informal epidemiology. He found pockets of brown stain throughout the country and studied what these people were eating and drinking. He noticed that they not only had stained teeth, but also seemed to have lower rates of cavities.

McKay thought it was something in the water. But he couldn’t prove it until ALCOA helped solve the mystery.

In Arkansas ALCOA, an aluminum manufacturer, mined for bauxite, an ore of aluminum. The children in this town started to get the brown stain. People thought ALCOA’s aluminum cookware was poisoning them. This prompted ALCOA to run tests where they discovered unusually high levels of the element fluorine in the water.

Between McKay’s observations and ALCOA’s testing they solved the mystery.

Animal studies soon after confirmed the link between fluoride ingestion and stained teeth, which became known as dental fluorosis.

Fluoride: The Shift from Poison to Prevention

At this time people knew fluoride as a poison. It was a main ingredient in rat poison.

Run off from rock formations containing fluorine, “poisoned” the water in Colorado Springs where McKay practiced.

In Arkansas the fluoride-rich water was thanks to ALOCA’s aluminum processing.

Perhaps no one was more motivated by fluoride than Andrew Mellon, a founder of ALCOA and the US Treasury Secretary.

Mellon had two big problems.

For one, ALCOA had a toxic waste disposal problem with fluoride.

Secondly, cavities were (and still are) the #1 most widespread health problem and it was a major military issue. (r)

Records show that in 1916, 1/3 of potential military recruits failed their health exam due to caries-related problems. During WW2, when the 1st 2,000,000 draftees of the US army were examined, dental problems were again the #1 cause of rejection. (r)

If ALCOA’s waste product could be sold as a product to prevent cavities, Melon could solve two problems at once.

Mellon got government funding to see if the military’s cavity problem could be solved with ALCOA’s toxic waste problem.

Mellon enlisted Dr. Trendley Dean, an army dentist, with the task. Between Dean (the army dentist), McKay (the Colorado Springs dentist), and Public Health Service (PHS) researchers, they discovered the “magic number.”

The magic number was the amount of fluoride that could help prevent cavities while limiting dental fluorosis (brown stain).

That number was 1 part per million (1 ppm or 1 mg/L).

The Fluoridated Water Uprising

With the magic number in hand, Dean devised a 15-year fluoridation trial, slated to begin in 1945, Grand Rapids, Michigan.

For the 1^st time in history we added fluoride to the water supply. Muskegon, Michigan, a neighboring community, was selected as the control group and remained fluoride free.

There was an uprising.

But not due to the fluoridation. Rather, people weren’t willing to wait 15 years.

Dr. John Frisch campaigned in Madison, Wisconsin to add fluoride to the water, and after 2 years convinced city officials to start medicating the public water supply.

Muskegon, the control group in the Michigan study, also grew impatient. The officials thought their citizens’ dental health was being sacrificed for science that was already settled. And so, they cut the study 9 years short and began fluoridating their water in 1951.

With the help of some private interests, the dominos started to fall.

The Fluoridated-Carbohydrate Age: The history they don’t want you to know

One of the biggest dominos to fall was the American Dental Association (ADA) giving their stamp of approval.

Prior to 1942 the ADA didn’t recommend fluoride because the potential for harm was unknown.

Further, the prevailing research indicated that cavities were a sign that one’s diet was deficient in nutrients and too high in carbohydrate. In fact, in 1942 the ADA recommended restricting carbohydrates to control cavities. This was at a time when a medical journal published a paper saying dentistry should take precedence over medicine in determining the proper nutrition to prevent the chronic diseases of civilization.

“The mouth is frequently a sensitive indicator of nutritional maladjustment. The teeth may be the first to portray abnormalities in the whole skeletal structure and the gums may reveal deficiencies which exist in other parts of the body as well”

—Robert S. Harris, 1943, nutritional biochemist and professor at MIT

Cavities are the canary in the coal mine, the early warning system, that tell you when your diet is off. Dentists have a front row seat to see problems before they insidiously become more widespread throughout the body.

So, the ADA worried that if fluoride was effective it would mask this important indicator of nutrient deficiencies.

But by the end of the decade, the ADA changed their tune. They switched to recommending a vague “well-balanced” diet, which increasingly became known as a high-carb diet.

This switch coincided with the changing guard of two key positions in the ADA.

American Dental Association (ADA): Reversing Recommendations

First: The head of the Kellogg Foundation became the chair of the ADA Council on Dental Health who supervised over $2 billion dollars (inflation-adjusted) of donations from Kellogg during his tenure. He proceeded to appoint Dean, the pioneering water fluoridation dentist, to the ADA Research Committee.

Second: The editor of the Journal of the American Dental Association (JADA), who had concerns about fluoride safety was replaced in a “most diabolical and undercover campaign.” The new JADA editor was in cahoots with the Sugar Research Foundation and agreed to “carry announcements about future Sugar Research Foundation grants.” According to internal records, the 1^st scientific director of the Sugar Research Foundation reported that sugar caused cavities and during the coming “carbohydrate age” fluoride needed to be a part of the diet. (r)

An advertising rift between the ADA and AMA (American Medical Association) was the final straw. Both journals (JADA and JAMA) were vying for ad revenue from toothbrushes, but JAMA was allowing therapeutic claims unsupported by research and the ADA. This overreach enabled JAMA to secure most of the ad revenue. (r)

Soon after these events, toothbrushes and fluoridated water were endorsed by the ADA.

ADA Opens the Door to the Fluoridated-Carbohydrate Age

It’s worth noting that at this time the dental profession, and thus the ADA, appeared to be failing as 80% of the US population had unmet dental needs.

Along with the economic interests of people in power, the ADA justified their reversal on diet and fluoride safety in the absence of new evidence because they didn’t think people could change their eating habits.

For example, according to Dr. Belding,

“Yes, dental caries can be controlled by limiting the amounts of starches and sweets consumed, but the method has little practical value, for very few people would be willing to make the necessary dietary concessions.” 

The ADA was among the 1^st to open the doors to the fluoridated-carbohydrate age because sugar and cereal executes regarded cavities as one of their most pressing concerns.

History shows that private interests’ influence of dietary recommendations extended beyond the ADA and led other professional health organizations to similar reversals in the absence of evidence towards high-carbohydrate nutritional guidelines (r).

With the PHS caving to pressures and the ADA endorsement, fluoridated water flowed downhill. It got the stamp of approval from government bureaus and other professional organizations.

The Economics of Water Fluoridation

Fluoridating water with pharmaceutical grade sodium fluoride would be prohibitively expensive.

The solution came in the form of toxic waste products.

Florida has some of the largest phosphate deposits in the world that are used to make synthetic fertilizer for agriculture.

When phosphate rock is treated with sulfuric acid, it releases hydrogen fluoride and silicon tetrafluoride. These highly toxic gases can be converted into fluorosilicic acid (FSA), the most common form of fluoride added to water (sodium fluorosilicate is a sodium salt of FSA used in about a quarter of fluoridated water supplies).

FSA is not pharmaceutical grade fluoride. It’s a waste product. And has shown to be contaminated with arsenic and lead. (r, r)

For decades fluoride waste products have been transported from fertilizer factories to water reservoirs throughout the US where it is dripped into the drinking water.

Fluoridated Water: Top 10 Greatest Public Health Achievement of the 20th Century

The CDC proclaimed water fluoridation one of the top 10 greatest public health achievements of the 20^th century. (r)

But not everyone agrees.

Throughout fluoride’s history, there have been skeptics and dissenters.

Many people viewed water fluoridation as forced medication without oversight.

Fluoride is added to drinking water solely to prevent a disease (dental caries) and as such becomes a medicine by FDA definition. Fluoride is not an essential nutrient. Water fluoridation as a form of mass medication is a reason 98% of Europe has banned it. (r)

However, in the US anti-fluoridation movements were repeatedly quelled by false appeals to nature.

As Dean testified in court, “fluoridation of public water supplies simulates a purely natural phenomenon—a prophylaxis which Nature has clearly outlined in those communities that are fortunate enough to have about 1 part per million of fluoride naturally present in the public water supply.”

What Dean didn’t mention is that nature rarely supplies water with 1 ppm fluoride. In fact, 1 ppm was a magic number for a few reasons.

1. It rarely occurs in nature.
2. The therapeutic effect and toxic dose of fluoride are close together, meaning 1 ppm was a “magic number” that (apparently) threaded the needle between poison and medicine.  

However, research continues to mount that the magic number isn’t so magical.

The Health Dangers of Water Fluoridation

Between 2011 and 2015 US governing bodies started lowering the “magic number.”

In 2011 the US Department of Health and Human Services (HHS) and the EPA lowered the recommended level of fluoride to 0.7 mg/L.

In 2015, for the 1^st time in 53 years, the US Public Health Services lowered its recommended levels of fluoride in drinking water to 0.7 ppm, and the FDA followed suit, telling manufacturers of bottled water to limit fluoride to 0.7 mg/L. (r)

Coincidentally, also in 2015, the Cochrane Collaboration, a global independent network of researchers known for rigorous scientific reviews, published an analysis of water fluoridation to evaluate its effectiveness. Upon review, they concluded that almost all the key early studies were deeply flawed. Further, they expressed concerns over the potential for harm. (r)

This wasn’t the first or last of extensive reviews of fluoride’s history, safety, and effectiveness. In 2000 “The York Review” expressed the same concerns that the Cochrane Review had 15 years later – that there is little quality research on safety and limited effectiveness. (r)

Apparently, the new “magic number,” the lowered recommendations, were based on data showing that 40% of teens had dental fluorosis. (r) But while they blamed the cosmetics of stained teeth as the rationale for lowering fluoride levels, perhaps it was to save face with the mounting evidence that fluoridated water could be damaging health…

Health Dangers of Water Fluoridation: The Neurotoxic Effects of Fluoride

For decades, studies have continued to mount on the neurotoxic potential of fluoridated water.

Some of the 1st concerns on how fluoride could damage a developing brain came out of the “Mullenix Study,” which found that rats, both prenatal and postnatal, had deficits in cognition when exposed to fluoride. (r) This led to a resurgence in fluoride interest and follow-up research.

The “Bashash Study,” published in 2017 after 12 years of work, found that mother’s drinking 1 ppm fluoride had children with IQ points 5 to 6 points lower than fluoride-free mothers’ kids. (r)

To put this in perspective, a 5-point reduction in IQ is on par with lead.

Further, there was no “magic number.” There was no “safe limit.” No needle to thread between therapeutic dose and toxic effects. Instead, they found a dose-dependent relationship. The higher the mother’s urine level of fluoride, the lower the IQ in the child. Similar results were found in the “Ding Study” where the researchers found that for each 1 ppm increase of fluoride in urine there was a loss of 0.59 IQ points. (r)

Just 2 years after the Bashash Study, JAMA Pediatrics, the world’s premier pediatric journal, published a new study showing that low levels of fluoride during pregnancy can affect fetal brain development, dropping IQ 3-4 points. (r)

A year later a 2020 study found that a 0.5 mg increase in fluoride intake from infant formula corresponded to a 9-point reduction in IQ points compared to breastfed infants. (r)

In a 2019 review of fluoride and neurotoxicity, researchers concluded:

“Given the large number of studies showing cognitive deficits associated with elevated fluoride exposure under different settings, the general tendency of fluoride-associated neurotoxicity in children (p < 0.001) seems robust…[this] supports the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable.” (r)

Other Neurotoxic Implications of Fluoride

While the neurotoxic effects as seen by the lowered intelligence of developing children have grabbed most of the attention, there are other neurodevelopmental concerns with fluoridated water.

The neurotoxic effects have been linked with ADHD. Children in areas that receive fluoridated water from public water supplies have higher rates of ADHD diagnoses. (r, r, r)

Many neurodevelopmental disabilities, including autism, ADHD, dyslexia, and other cognitive impairments, seem to be increasing in frequency. Researchers have identified known industrial chemicals like lead, methylmercury, PCBs, arcenic, and toluene to contribute to rising rates of neurodevelopmental disabilities. In 2014 they added fluoride to the list. (r)

Further, adults aren’t free from potential adverse consequences. Fluoride can impair neuron signaling and can interfere with axonal neurofilaments. It may even increase the plaques that contribute to dementia as happened in studies with rats that were given fluoridated drinking water. (r, r, r, r)

The research on fluoride and its impact on the brain is alarming. But it doesn’t stop here. There are over 2000 other studies demonstrating how fluoride consumption can adversely impacts other aspects of health. (r)

Health Dangers of Water Fluoridation: Fluorosis

Dental fluorosis, “brown stain,” isn’t just a cosmetic problem. It isn’t just a stain on your teeth. Teeth with moderate fluorosis have weaker dentin with increased tubule size that can make teeth more prone to fracture. And if you have a visual effect on your teeth, it likely means you’ve over accumulated it in your body, like in your bones.

Skeletal fluorosis can result from excess fluoride uptake into bones. Heavily fluoridated bones become hardened and less elastic, increasing the risk of fractures and damage to the joints (osteoarthritis).

Before we knew this, high doses of fluoride were used in trials to treat patients with osteoporosis in an effort to harden their bones and reduce fracture rates; however, it led to the exact opposite – more fractures. (r, r, r)

A Canadian study evaluated the fluoride content of bones in Toronto where the drinking water is fluoridated, and Montreal, where it is not. In Toronto they had 1,033 ppm fluoride in their bones on average, with altered bone architecture that caused a decrease in resistance to compression, increasing brittleness. While in Montreal they had 643 ppm fluoride in bones and thus bones that were more resilient and tough. (r)

In some areas, notably parts of Asia, skeletal fluorosis is prevalent and known to cause joint pain, which is often misdiagnosed as rheumatoid arthritis or ankylosing spondylitis. (r)

Health Dangers of Water Fluoridation: Hypothyroid

According to the U.S. National Research Council’s 2006 report, fluoride can impair the thyroid. (r)

In fact, some European doctors even used it to reduce hyperthyroidism in patients.

Fluoridated water exposes people to amounts that associate with hypothyroidism, especially if iodine intake is inadequate as fluorine and iodine are both halogens (similar chemical properties) and can thus potentially compete for the same receptors.

Hypothyroidism happens more frequently in fluoridated communities. (r, r)

A 2018 analysis concluded:

“The link between fluoride exposure during pregnancy at the fluoride levels present with community water fluoridation, disturbed thyroid hormones, and developmental disorders due to disturbed thyroid hormone metabolism is now sufficiently clear to warrant the immediate cessation of community water fluoridation schemes.” (r)

Health Dangers of Water Fluoridation: Endocrine Disruption

Fluoride is classified as an endocrine disruptor by the US National Research Council. (r)

Along with the thyroid, fluoride can impair other glands like the pancreas and pineal gland.

For example, excess fluoride accumulates in calcifying tissues like the bones and also glands like the pineal gland. (r)

For her PhD thesis, Dr. Jennifer Luke studied fluoride’s effect on the pineal gland and showed how fluoride reduces melatonin production and can lead to early onset of puberty. (r)

A number of studies show how fluoride can damage sperm and increase infertility and how couples in high-fluoride areas have increases rates of infertility and the men have lower levels of testosterone. (r)

Health Dangers of Water Fluoridation: Kidney Disease

You use your kidney’s to eliminate fluoride in the urine. Evidence suggests fluoride can injure the kidneys during this process, and thereby making it more difficult to clear ongoing fluoride consumption, and thus more likely to accumulate in the body. (r, r)

In a review on fluoride’s role in kidney disease, the researchers conclude:

“These studies reveal that there are direct adverse effects on the kidneys by excess fluoride, leading to kidney damage and dysfunction. With the exception of the pineal gland, the kidney is exposed to higher concentrations of fluoride than all other soft tissues. Therefore, exposure to higher concentrations of fluoride could contribute to kidney damage, ultimately leading to chronic kidney disease (CKD).” (r)

Health Dangers of Water Fluoridation: Nutrient Deficiencies

While evidence is mounting that fluoride can directly cause harm in various ways as described, it could also be causing indirect harm by inducing mineral deficiencies.

In a study that compared people with dental fluorosis (higher fluoride exposure) to “healthy” controls, they found those with dental fluorosis had significantly lower levels of zinc, copper, and magnesium. (r)

In this way, fluoride acts like an antinutrient.

Risk : Benefit Analysis of Water Fluoridation

With all the potential risks that come with water fluoridation, you’d think it must at least be very effective at preventing cavities. Right?

Wrong.

The largest ever study of childhood dental health conducted in the US showed that fluoridated water associates with a reduction of cavities of less than 1 tooth surface (1 out 128) compared to non fluoridated water. (r)

Between 60-90% of kids have cavities, fluoridated or not, and so reducing one surface cavity isn’t moving the needle. There seems to be a tiny potential benefit that comes with massive potential lifelong irreversible risk.

I can fix a 1 surface cavity in a few minutes. I can’t fix a brain.

Further, most of the (small) benefit of fluoride on cavity prevention is topical, not systemic.

Throughout fluoride’s history its efficacy has continued to be revised downward from 60% to 35% to the point today where even the CDC acknowledges the benefit is mostly topical. (r)

Since the benefits are topical and risks are systemic, it doesn’t make sense to put fluoride in water maximizing the potential risk for the minimal possible benefit.

Topical Fluoride

While the risk : benefit ratio of fluoridated water is heavily skewed towards “risk,” what about topical fluoride?

Topical fluoride includes applications that touch the teeth but aren’t (supposed to be) ingested like toothpastes, mouthwashes, and fluoride varnishes.

Topical Fluoride Concentrations

Here’s a list of fluoride range estimates:

• Fluoridated drinking water: 0.7 ppm
• Mouthwashes: 200-1000 ppm
• Kids toothpaste: 500-1000 ppm
• Adult toothpaste: 1500 ppm
• Prescription fluoride toothpaste: 5000 ppm
• Fluoride varnish: 10,000 ppm

While water has much lower concentrations of fluoride, we drink water in far higher amounts. It’s still the #1 source of fluoride exposure.

That said, you absolutely don’t want to be swallowing these other products that have much higher concentrations of fluoride. I don’t recommend children use fluoridated products at all if there’s a chance they might swallow it.

Further, toothpastes contain humectants, foaming agents, preservatives, and flavorings that provide no benefit besides getting the right consistency and a product with shelf-life, and some ingredients beyond fluoride also have potential for harm.

While a deep dive into toothpastes is an article for another time, if you’re an adult, using a small amount of fluoride toothpaste, and spitting it out, poses some, but limited risks and likely some but limited benefit.

Regardless, I still don’t recommend fluoridated toothpastes as hydroxyapatite is a better option as a remineralization agent. (r, r, r)

Hydroxyapatite toothpastes have nano- or macro-sized bioidentical particles that can remineralize the surfaces of teeth. While I haven’t found a perfect toothpaste yet, RiseWell is a good brand.

My top recommendation is to eat a diet that removes the need for remineralization agents beyond your saliva, which is the best source of tooth protection.

If you are not eating a diet causing acid attacks (high carb), but rather eating a highly nutritious diet that fortifies teeth and creates healthy saliva, toothpastes become purely cosmetic.

Cavities aren’t caused by a fluoride deficiency.

Cavities are caused by a poor diet. Fix that and there is no need for fluoridated water, pastes, mouthwashes, and varnishes.

How to Filter Fluoride Out of Your Water

Most pitcher or faucet-mounted water filters do not filter out fluoride.

If a filter doesn’t specifically say it filters out fluoride, I’d assume it does not.

Options to remove fluoride from your water include:

Filters — Countertop filters like ZeroWater and Berkey. This is my top choice and most practical for most people. I use a Berkey (note: you have to purchase the additional fluoride filters).

Reverse Osmosis — This requires some work and expense, but it removes most fluoride as well as minerals. You’ll need to add minerals back to your water.

Distilled Water — Like reverse osmosis, with distilled water you’ll need to add minerals back to your water and I recommend limiting the amount of “dead water” consumed.

Mineral Water — If you need water on the go, mineral waters like Perrier, Gerolsteiner, San Pellegrino, Badoit, and Evian are fantastic ways to get water without the added fluoride and with the minerals. Mineral waters are bottled at the source and thus contain natural minerals and other trace elements.

Health Dangers of Water Fluoridation: Conclusions

Cavities are a disease of civilization.

They became prevalent during the Agricultural Revolution with the cultivation of cereal crops (~12,000 years ago) and rampant at the turn of the Industrial Revolution and the rise of refined grains and sugar (~300 years ago).

Cavities are also an early warning sign.

An ever-growing body of evidence suggests that a diet that leads to dental decay and periodontal disease also leads to other chronic diseases.

We used to know that nutritional deficiencies and high-carb diets led to cavities, and decaying teeth were an early warning sign for systemic diseases.

But when private interests started taking priority over public health, the ADA reversed their prior stances on carbohydrate reduction and concern about fluoride safety.

The foundation upon which fluoride endorsements were built had more to do with political science than health science.

It’s no surprise that those who recommend high carbohydrate diets (WHO, USDA) also advocate for fluoride.

Even with ever mounting evidence of the limited benefits and escalating risks of water fluoridation, those defending it for decades risk their credibility (and potential liability) if they admit fluoridation has decreased generations of IQ points, led to more hip fractures, and thyroid problems, while doing little to curb the caries burden.

Fluoride’s Changing Tide

While slow, the tide appears to be turning.

In 2022 the NIH provided a follow-on $2M of funding to a research team to assess the neurotoxicity of early-life exposure to fluoride as well as potential thyroid-disrupting effects. These researchers will be using baby tooth dentin to measure “fluoride rings” that correspond to specific life stages like rings on a tree. This will help us better understand when exposure occurred and how much crossed the placenta and reached the developing brain (earlier research used urinary fluoride levels in the pregnant women which doesn’t tell you how much fluoride reached the fetus).

Much of the research on water fluoridation, like nutrition research, is epidemiology. We can’t simply infer causation from population correlations. Like always, we need more and better research. But right now, with the evidence at hand, I’d recommend limiting fluoride exposure, especially for pregnant women and children.

To me, avoiding fluoridated water is a no-brainer.

P.S.

If you’d like to learn more about what our mouths says we should (n’t) be eating, I’m sharing 3 big clues in the Saturday 7 newsletter very soon 🙂