Rethinking Fluoridation
by Darlene Sherrel

In the early 1930s, US dentists were becoming aware of the damage fluoride can cause during the development of our children's teeth. Communities in 16 states had observed disfiguring stains and pits in their children's teeth from naturally occurring fluoride in the water. Even H. Trendley Dean, who later became known as the "father of fluoridation," once described dental fluoride exposure as "a low-grade chronic poisoning."

During the last 20 years, a great deal of critical information has emerged about the health risks of fluoride, including links to tooth mottling, osteoporosis, arthritis, lower back pain, heartburn, stomach cramps and diarrhea. The problem is that these studies lie buried beneath executive summaries and official interpretations.

Today, millions of people show signs of dental disease and skeletal fluorosis. These afflictions are not caused solely by fluoridated water, but from the total daily fluoride intake: food processing using fluoridated water, the use of fluoride-based pesticides, fluoride dental products, and the result of increased industrial release of fluoride into the environment over the past 50 years.

In the 1940s, the US Public Health Service reported that the average total daily dietary intake of fluoride ranged from 0.2 to 0.3 milligrams. By the 1970s, total intake from dietary sources had increased to 3.44 mg/day. In 1991, the U.S. Public Health Service reported that total daily dietary fluoride exposure in "optimally" fluoridated areas could exceed 6.5 milligrams per day. In areas having 2 to 4 ppm fluoride in the water supply, exposures were even greater.

The recommended US "upper limit" for fluoride exposure in children was 0.04 to 0.07 milligrams per kilogram of bodyweight per day (mkd). During the 1940s, when the "optimum" US exposure level was set at 1 ppm fluoride in water, children received a total daily intake of 0.04 mkd.

In 1993, the National Academy of Sciences' National Research Council (NAS/NRC) estimated that the fluoride intake from food and drink by North American children up to 2 years of age had risen to as much as 0.13 mkd in areas with fluoridation. In areas without water fluoridation, however, the range in intake was even higher -- up to 0.16 mkd -- largely because of the widespread use of fluoride supplements in non-fluoridated areas.

This means that with or without water fluoridation, US infants and children may now be exposed to fluoride levels four times greater than the government's "optimum" safety limits.

In 1951, the NAS/NRC proposed that fluoride exposures would be considered safe as long as "not more than 10 to 15 percent of children age 12-14 years ... show the mildest detectable type of mottled enamel."

In 1993, NAS/NRC reported that in optimally fluoridated Augusta, Georgia, 80.9 percent of the children aged 12-14 suffered from dental fluorosis due to excess fluoride. Moderate to severely mottled enamel was found in 14 percent of the children.

Dr. Hodge's Error

The American Dental Association (ADA) pamphlet, "Fluoridation Facts," claims that "the daily intake required to produce symptoms of chronic toxicity after years of consumption is 20 to 80 milligrams or more depending upon body weight. Such heavy doses are associated with water supplies that contain at least ten parts per million (ppm) of natural fluoride."

However, the original World Health Organization reference cited by the ADA reported that skeletal fluorosis develops when the daily fluoride intake is just 2-8 mg per day. The WHO also reported that skeletal fluorosis was endemic in areas of India where the water supply contained less than 1 ppm. What accounts for this incredible disparity?

In 1989, I contacted the National Academy of Sciences asking for the basis of their 20 to 80 mg/day threshold dosage. After a wait of more than two years, the NAS finally replied that the figures came from Harold C. Hodge, Ph.D., the former chair of the NAS/NRC Committee on Toxicology.

In 1953, Hodge prepared a chart on fluoride effects for NAS/NRC and offered this reassuring information in congressional testimony in 1954, as Congress considered a bill to outlaw water fluoridation.

Hodge based his information on a European study by Kaj Roholm, who had studied the effects of fluoride on cryolite workers exposed to 0.2 to 0.35 milligrams of fluoride per kilogram of bodyweight per day for several years. Some developed crippling skeletal fluorosis (CSF). In general, the first stage of the disease appeared after 2.5 years. After 11 years, many of the workers had been totally disa bled by CSF.

In order to apply Roholm's data to the US, Hodge apparently chose an adult weight range of 100 to 229 pounds. He then multiplied 100 by 0.2 to get 20 mg/day and 229 by 0.35 to get 80 mg/day -- the "crippling" exposure level shown in his chart and in the subsequent ADA pamphlet. Unfortunately, Hodge neglected to convert pounds to kilograms. By failing to do so, he created a false margin of safety for water fluoridation -- one that remained uncorrected for 40 years. The erroneous figures subsequently found their way into hundreds of pamphlets, magazine articles, journals and textbooks.

Because Hodge's error involved arithmetic rather than scientific opinion, and had been corrected in 1979 by Hodge himself (and because I had the support of Dr. Robert J. Carton, then a senior official at EPA, and Senator Bob Graham of Florida), I eventually was able to persuade the National Research Council's Board on Environmental Studies and Toxicology (BEST) to correct their own 40-year-old e rror.

Hodge's erroneous figures were officially corrected in 1993 with the publication of BEST's EPA review, "Health Effects of Ingested Fluoride." The government's new estimate of the crippling fluoride dosage is 10 to 20 mg of fluoride daily for periods of 10 to 20 years, which is the same total quantity as 2.5 to 5 mg/day for 40 to 80 years -- a figure which now now agrees with the WHO.

And who was Dr. Hodge? Harold Hodge was the Atomic Energy Commission scientist who became a key figure in a secret plan to promote fluoride as a dental preservative in an attempt to derail lawsuits by US citizens exposed to the release of fluoride into the environment at the AEC's WWII uranium production plants [See "Fluoride, Teeth and the A-Bomb," Winter 97-98 EIJ].

Dental Health vs Industry Health

The journal Oral Surgery has reported mottled enamel occurring with exposure to just 0.5 ppm of fluoride in water. In 1993 NAS/NRC reported that dental fluorosis occurs with as little as 0.03 mkd fluoride in water. After 17 years of fluoridation in Grand Rapids, Michigan, 19.3 percent of the resident white children and 40.2 percent of black children had dental fluorosis.

Today, even while the vast majority of children are showing clear signs of fluoride overdose, dentists continue to argue for mandatory water fluoridation. Studies revealing no significant difference in tooth decay rates between fluoridated and non-fluoridated areas worldwide go conveniently unaddressed.

Studies published in peer-reviewed scientific journals worldwide describe increasing numbers of children whose teeth require complex dental treatment because of excess fluoride, and adults with headaches, back pain, gastrointestinal problems, arthritis symptoms, and hyperparathyroidism, all attributed to fluorosis. These documents also report that with increased fluoride dosage, cavities also tend to increase.

Once confined almost exclusively to drinking water, fluorides now reach us from a variety of sources including dental products, drugs, and virtually every food and beverage item. In the light of these studies, why is it that the EPA's maximum contaminant level for fluoride in drinking water fails to take into account the additional fluoride ingested from foods, dental products or beverages?

Mottled Teeth and Brittle Bones

Arthritis caused by fluoride exposure has been a threat to human health since the earliest times. Now, after 50 years of ever-increasing exposure, the world may be on the verge of a new health scourge -- crippling skeletal fluorosis.

When drinking water containing about one ppm of fluoride is the only source of ingested fluoride, 10 to 15 percent of the exposed children will show a faint change in the appearance of their teeth called dental fluorosis. With 2 or 3 ppm, nearly all children will be affected by this first (and only visible) sign of fluoride poisoning.

"Whereas dental fluorosis is easily recognized," the WHO reported in 1970, "the skeletal involvement is not clinically obvious until the advanced stage of crippling fluorosis ... [Early cases may be misdiagnosed as rheumatoid- or osteo-arthritis."

NAS/NRC noted that "a retention of 2 mg/day would mean that an average individual would experience skeletal fluorosis after 40 years, based on an accumulation of 10,000 ppm fluoride in bone ash." Because the severity of symptoms correlates directly with the level and duration of exposure, the advanced crippling stage can occur at any age. CSF has even been reported in children.

The initial symptoms of CSF include sporadic pain and stiffness of joints, with minor osteosclerosis of the pelvis and vertebral column. Phase two is marked by chronic joint pain, arthritic symptoms, slight calcification of ligaments and increased osteosclerosis of cancellous bones. In phase three, sufferers experience limitation of joint movement, calcification of ligaments in the neck and verteb ral column, crippling deformities of the spine and major joints, muscle wasting and neurological defects with compression of the spinal cord.

Despite the growing evidence of the spread of CSF, the affliction has never been recognized as a "reportable disease" in the US. While occupational health journals report an increase in fluoride in workers' urine measured during pre-employment physicals, the eligibility rules for Workman's Compensation were set to eliminate any workers whose fluoride exposure fell below Dr. Hodge's erroneous 20 to

80 milligram-per-day mark.

The Cover-up Continues

If there is so much evidence suggesting a health risk from over-fluoridation, why haven't dental and health professionals spoken out?

In 1979, Edward Groth III, Senior Staff Officer of the NRC's Environmental Studies Board, offered the following explanation: "The politically minded zealots have used tactics of intimidation, professional and financial reprisals, derogatory personal attacks, and relentless public relations propaganda to silence scientific critics, to prevent the publication of adverse evidence and to make politica lly untenable any interpretation except the official view -- that fluoridation is absolutely safe. Can scientific evidence really be suppressed in the free world? Easily."