Sunday, April 20, 2014
YOLO COUNTY NEWS
99 CENTS

Fluoridation is not social justice

By Barbara King

Several proponents of adding fluoridation chemicals to Davis water have argued for it on the basis of social justice for minority and poor residents.

But such civil rights activists as the League of United Latin American Citizens and Andrew Young — former Atlanta mayor, former U.S. ambassador to the United Nations and friend and supporter of Dr. Martin Luther King Jr. — oppose fluoridation partly as a civil rights issue because some minorities and others are disproportionately at risk of harm from fluorides.

Early in his letter against mandatory fluoridation, Young writes: “My father was a dentist. I formerly was a strong believer in the benefits of water fluoridation for preventing cavities. But many things that we began to do 50 or more years ago we now no longer do, because we have learned further information that changes our practices and policies. So it is with fluoridation.”

He also says, “So now we know that fluoride’s impacts are primarily topical and are very limited where needed most in the teeth (pits and fissures). And on top of this we are learning that fluorides do not simply affect teeth, but can also harm other tissues and systems in the body. So we must weigh the risks to kidney patients, to diabetics and to babies against the small amount of cavities prevented by swallowed fluorides.

“The National Research Council (NRC) has acknowledged that kidney patients, diabetics, seniors and infants are susceptible groups that are especially vulnerable to harm from fluorides. There are millions of these persons who have these health conditions or who meet the criteria for concern.”

The 2006 NRC report, “Fluoride in Drinking Water,” examines diabetics’ and physically active people’s fluid intakes in Section 2, “High Intake Population Subgroups.” It reports that physically active people’s daily fluid intake “can range from 6-11 L (liters),” and that diabetics’ daily urine output can range from 3 to 30 liters, with most central diabetes insipidus patients having daily urine volumes of 6-12 liters.

Diabetics’ (and others’) high fluid intake is significant because the concentration of fluoride in water is not the only thing that determines the fluoride dose a person ingests. Dose equals concentration (mg/L) times intake (liters of water consumed). So a person drinking 8 liters of water containing 1 ppm of fluoride gets the same dose as a person drinking 1 liter of water containing 8 ppm. Fluoridation proponents assume an intake of 1 to 2 liters of water a day (containing 0.7 ppm fluoride), so diabetics can ingest up to 30 times the intended dose.

The NRC’s 2006 report says an estimated 18.2 million people in the United States have diabetes, up to 50 percent of them undiagnosed. This is a lot of people to risk overexposing to ingested fluoride. And, according to the Office of Minority Health, non-Hispanic black adults and Hispanic/Latino adults have diabetes at 1.7 times the rate of non-Hispanic white adults.

And the increased risk does not stop there. Diabetes further magnifies the effects of ingested fluoride when the diabetes damages the kidneys, resulting in less efficient clearance of fluoride from the body. Kidney disease, like diabetes, occurs at higher rates in some minorities, leaving them — again — more vulnerable than the population at large to the ill effects of ingested fluoride.

Some minorities also experience more enamel fluorosis — caused by ingesting too much fluoride — than white non-Hispanics, especially moderate and severe fluorosis.

The U.S. National Health and Nutrition Examination Survey, 1999-2002, Table 23 — “Enamel fluorosis among persons aged 6-39 years, by selected characteristics” — clearly shows higher rates of moderate and severe enamel fluorosis in black non-Hispanics and Mexican-Americans than in white non-Hispanics.

And the NRC’s 2006 “Fluoride in Drinking Water” reports that only two of the 12 committee members did not agree that severe enamel fluorosis is an adverse medical effect. This is very significant because, for decades, fluoridation proponents dismissed all enamel fluorosis as merely cosmetic, including moderate fluorosis (in which “all enamel surfaces of the teeth are affected, and surfaces subject to attrition show marked wear. Brown stain is frequently a disfiguring feature.”) and severe fluorosis (in which “all enamel surfaces are affected and hypoplasia is so marked that the general form of the tooth may be altered. The major diagnostic sign of this classification is the discrete or confluent pitting. Brown stains are widespread and teeth often present a corroded appearance.”).

At the end of his letter, Young writes, “I am most deeply concerned for poor families who have babies: If they cannot afford unfluoridated water for their babies’ milk formula (as the ADA and CDC recommend to prevent fluorosis), do their babies not count? Of course they do. This is an issue of fairness, civil rights and compassion. We must find better ways to prevent cavities, such as helping those most at risk for cavities obtain access to the services of a dentist.”

The same government that advocates water fluoridation acknowledges that fluoride’s predominant effect on teeth is topical, not systemic. So it makes no sense to expose everyone — including the most vulnerable — to the risks of ingesting fluoride (dental fluorosis and skeletal problems, among others). Instead, the money for fluoridation should be used to provide topical fluorides (toothpaste, rinses and lacquers), toothbrushes, floss, dental sealants and dental care to those in need.

We should not — in a well-intended effort to do something good for minority and poor Davis residents — inadvertently do something risky and ineffective to all Davis residents.

— Barbara King is a Davis resident and a member of Davis Citizens Against Fluoridation. Reach her at dcaf95616@gmail.com

Special to The Enterprise

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Discussion | 5 comments

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  • John MurphySeptember 13, 2013 - 11:36 am

    Men of science have spoken passionately against fluoride and fluoridation. Phillipe Grandjean has remarked on the lack of good studies on fluoride’s affect on the brain. (though we’ve been putting it in the water for 60 years) Dean Burk called it public murder on a grand scale after heading a department at the American Cancer society and studying and working there for 34 years on groundbreaking lifesaving research. Aarvid Caarlson winner of the 2000 Nobel Prize in medicine advised the government of Sweden and recommends pharmacologically active substances not be added to the environment. nor medication given to the public instead of the individual. He called it obsolete. "I am opposed to fluoridation because of the overwhelming evidence that fluoridation is not only potentially harmful but has already caused considerable, well-documented harm." Albert Schatz, Ph.D., biochemistry, world-renowned discoverer of streptomycin (Oct., 1999)Toxic waste should not be diluted then dumped into the ground and the waterways (through mopping sprinklers, toilets, baths, and washing) and it certainly shouldn’t be used to grow food, prepare food, be in most beverages and in one of life’s necessities. Most of the world has stopped doing this. More people receive artificially fluoridated water in the United States than the rest of the world combined. It may be good for teeth at 1-3mg per day, but the dosage you get is probably higher. It affects the thyroid, the pineal, the brain, the kidneys, and the bones. There are no studies of fluoride in regards to dermal absorption though when looking at similar issues intake when showering or bathing is often even higher than when drinking. If we drink, eat, brush with, and bathe in fluoride what is our total intake? There are few or no studies on many of these issues, and that is why you are told so frequently that fluoridation is safe. Why are there no studies of this nature after 68 years of fluoridation? This is about more than just teeth. Men of science speak against this, but to find anything for it one must turn to agencies, organizations, and bureaucracies. There is fluoride in most food: from the USDA http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/Fluoride/F02.pdf While daily intake of 1–3 mg of fluoride prevents dental caries, long-term exposure to higher amounts may have deleterious effects on tooth enamel and bone. from the world health organization. http://www.euro.who.int/__data/assets/pdf_file/0018/123075/AQG2ndEd_6_5Fluorides.PDF “according to clinical research, the fluoride dose capable of reducing thyroid function was notably low-just 2-5 mg per day over several months” (Galetti & Joyce 1958) “this dose is well within the range (1.6 to 6.6 mg/day) of what individuals living in fluoridated communities are now estimated to receive on a daily basis.” Fluoride is a neurotoxin http://www.epa.gov/ncct/toxcast/files/summit/48P%20Mundy%20TDAS.pdf But don’t take my word for it. Read it yourself. It’s out there. If you are only skeptical about that which you are uncertain you are not using skepticism properly. Take out your beliefs and give them an airing out on occasion.

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  • Robert CanningSeptember 13, 2013 - 6:38 pm

    Ms. King speaks passionately about the NRC study without informing readers that the report quoted at length did not address the effects (beneficial or otherwise) of the usual concentration of fluoride in drinking water in the United States. The NRC report states: "The committee’s conclusions regarding the potential for adverse effects from fluoride at 2 to 4 mg/L in drinking water do not address the lower exposures commonly experienced by most U.S. citizens. Fluoridation is widely practiced in the United States to protect against the development of dental caries; fluoride is added to public water supplies at 0.7 to 1.2 mg/L. The charge to the committee did not include an examination of the benefits and risks that might occur at these lower concentrations of fluoride in drinking water." The proposed concentration of fluoride in Davis municipal water supplies is 0.7 mg/L. Let's be clear and transparent in our discussion rather than only providing the public with partial and biased opinions.

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  • September 13, 2013 - 10:49 pm

    Here is a longer description, from the 2006 NRC report “Fluoride in Drinking Water” : “COMMITTEE’S TASK: In response to EPA’s request, the NRC convened the Committee on Fluoride in Drinking Water, which prepared this report. The committee was charged to review toxicologic, epidemiologic, and clinical data on fluoride— particularly data published since the NRC’s previous (1993) report—and exposure data on orally ingested fluoride from drinking water and other sources. On the basis of its review, the committee was asked to evaluate independently the scientific basis of EPA’s MCLG of 4 mg/L and SMCL of 2 mg/L in drinking water and the adequacy of those guidelines to protect children and others from adverse health effects. The committee was asked to consider the relative contribution of various fluoride sources (e.g., drinking water, food, dental-hygiene products) to total exposure. The committee was also asked to identify data gaps and to make recommendations for future research relevant to setting the MCLG and SMCL for fluoride. Addressing questions of artificial fluoridation, economics, risk-benefit assessment, and water-treatment technology was not part of the committee’s charge.” That does not mean that the data—gathered from many sources--that they used to accomplish their task is not applicable to a discussion of the .7 ppm proposed for Davis water. For example, given that the target level of fluoride in water was based in part on the assumption that people drink 1-2 liters of water a day, diabetics with a urine output of 3-30 liters a day (which would be somewhat less than their fluid intake) would still be ingesting up to 30 times the intended dose, regardless of the charge of the NRC committee that wrote the report “Fluoride in Drinking Water.”

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  • Barbara KingSeptember 13, 2013 - 10:54 pm

    I hit "return" when I should have hit "tab." Here is my comment with my name attached this time: Here is a longer description, from the 2006 NRC report “Fluoride in Drinking Water” : “COMMITTEE’S TASK: In response to EPA’s request, the NRC convened the Committee on Fluoride in Drinking Water, which prepared this report. The committee was charged to review toxicologic, epidemiologic, and clinical data on fluoride— particularly data published since the NRC’s previous (1993) report—and exposure data on orally ingested fluoride from drinking water and other sources. On the basis of its review, the committee was asked to evaluate independently the scientific basis of EPA’s MCLG of 4 mg/L and SMCL of 2 mg/L in drinking water and the adequacy of those guidelines to protect children and others from adverse health effects. The committee was asked to consider the relative contribution of various fluoride sources (e.g., drinking water, food, dental-hygiene products) to total exposure. The committee was also asked to identify data gaps and to make recommendations for future research relevant to setting the MCLG and SMCL for fluoride. Addressing questions of artificial fluoridation, economics, risk-benefit assessment, and water-treatment technology was not part of the committee’s charge.” That does not mean that the data—gathered from many sources--that they used to accomplish their task is not applicable to a discussion of the .7 ppm proposed for Davis water. For example, given that the target level of fluoride in water was based in part on the assumption that people drink 1-2 liters of water a day, diabetics with a urine output of 3-30 liters a day (which would be somewhat less than their fluid intake) would still be ingesting up to 30 times the intended dose, regardless of the charge of the NRC committee that wrote the report “Fluoride in Drinking Water.”

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  • Terri LeonardSeptember 14, 2013 - 1:02 am

    I continue to be surprised at fluoride proponents disregard for the concept of margin of safety. In conventional risk assessment, the U.S. EPA uses a default margin of safety of ten. This means the EPA seeks to limit exposure to chemicals to levels that are ten times less than the levels that cause adverse effects. Margin of safety is a deeply rooted cornerstone in all modern risk assessments, yet fluoride proponents will state that they are not concerned about studies that show adverse health effects at fluoride levels of, say, 2 ppm or 4 ppm, because Davis water will be fluoridated at a level of .7 ppm. The 2006 National Research Council report was the first U.S. report to look at low-level fluoride toxicity in a balanced way. The report concluded that the maximum contaminant level goal (MCLG) of 4 ppm in drinking water was too high and should be reduced. Since 4 ppm is too high (by an unspecified amount) to be acceptable as a contaminant, it is not sensible to deliberately add fluoride to our drinking water to bring the level of fluoride in our water up to .7 ppm. That implies a margin of safety of less than 5.7 times, and possibly much less, which is absurdly low by toxicological standards. Acceptance of such a small margin of safety indicates a disregard for public health. It is irresponsible to continue promoting fluoridation when studies indicate thyroid function may be lowered at 2.3 ppm, IQ in children may be lowered at levels as low as 1.9 ppm (or at 0.9 ppm if there is borderline iodine deficiency), and hip fractures in the elderly may be increased at levels as low as 1.5 ppm. Unless all of the relevant studies have been shown to be fatally flawed, there is clearly no adequate margin of safety to protect the whole population from these effects. Fifty percent of the daily intake of fluoride is absorbed by and accumulates in bone. An important study from China (Li et al.,2001) indicates practically no margin of safety sufficient to protect a whole population with a lifelong consumption of water at 1 ppm from hip fracture. It is important to remember that we are talking about mass medication, not a drug that is prescribed after due consultation with an individual patient. A risk of harm estimated at, say, 1 in 10,000 may be entirely acceptable in the case of an individual patient. In fact, we accept far higher risks of undesirable side effects if we are seriously ill. But if we are giving a drug to nearly 400 million people worldwide, that risk translates into 40,000 cases of harm from one cause. The risks for some harms due to fluoridation are probably much higher. Proponents and opponents of fluoridation carry different burdens of proof. Proponents need to have conclusive proof of substantial benefit and very strong evidence for an extraordinarily low risk of harm. They have neither. For opponents, it should suffice to show that there is an identifiable risk of serious harm. Even small risks are indefensible when deliberately imposed on a large population. This is common sense, but it eludes the proponents of fluoridation, who continue to talk about small risks as if they are acceptable. The onus is on proponents to demonstrate that there is an adequate margin of safety between the doses that cause harm and the huge range of doses that may be experienced by those drinking uncontrolled amounts of fluoridated water and at the same time receiving unknown amounts of fluoride from other sources. And, such a margin of safety should be large enough to protect everyone in society, not just the average person. The very young, the very old, those with poor nutrition, and those with impaired kidney function are more susceptible to fluoride's harmful effects.

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