Fluoride in Drinking Water Position Statement - Board of Health

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READING, PA 19601-3690

(610) 655-6204


Subject: Water Fluoridation in the City of Reading


During a recent city council meeting, the subject of water fluoridation was discussed and as a result of that, the Board of Health was asked to review the subject and provide a position statement.


After a comprehensive review of the credible medical and scientific information available, we believe the following to be true:


  1. Supplementation of fluoride at .7 ppm has been shown to have a very significant positive effect on the reduction of dental caries (cavities) in children. This translates not only to improved health of our children, but also to a significant cost savings in the treatment of tooth decay.


  2. There are no known adverse health effects at levels of .7 ppm. Undesirable effects of fluorosis (staining of the teeth) can occur at excessive levels of 4 ppm or above. The board has reviewed the past year's data showing the actual levels of fluoride which were measured and recorded daily. The data showed that the levels were controlled very tightly with no significant variation from the desired level of .7 ppm. In short, there is no reason to suspect that the fluoride levels in Reading have exceeded the optimum therapeutic level of .7ppm.


  3. Virtually every credible Health organization has supported fluoridation of water. These include, but are not limited to, the following:


    • Center for Disease Control

    • Berks County Community Foundation

    • American Academy of Pediatrics

    • Pew Children's Dental Campaign

    • American Dental Association

    • American Medical Association

    • World Health Organization


  4. For anyone who might be interested, there is an excellent monograph by Dr. Johnny Johnson which addresses the concerns brought up by those opposed to fluoridation. This will be made available upon request.


Respectfully submitted,
John C. Dethoff MD
Chairman, Board of Health, City of Reading


FAX: (610) 655-6549 TTD: (610) 655-6442




Water Fluoridation Benefits




Claims Made by Those Opposed to Water Fluoridation



Prepared by:


Johnny Johnson, Jr., DMD, MS
Pediatric Dentist

Diplomate, American Board of Pediatric Dentistry
Palm Harbor (Pinellas County), FL



C. Eve J Kimball, MD, FAAP

Diplomate, American Board of Pediatrics

Senior Managing Partner, All About Children Pediatric Partners, PC
Reading , PA




Table of Contents   page
Benefits of Optimally Fluoridated Water & Legal Challenges   4
Current Antifluoridation Tactics   5
Statements from Ten Leading Health Authorities Regarding
Community Water Fluoridation
Fluoridation is "Recognized by more than 100 Organizations   9
ADA Fluoridation Facts   12
The Community Preventive Services Task Force: Recommends Fluoridation   12
10 Reasons to Fluoridate Public Water   13
Fluorosis Dental   15
Fluorosis Skeletal   16
Antifluoridaitonists' Claim that 60% of 12-15 year olds are afflicted with Fluorosis   17
Fluoridation Additives Used in Fluoridation of Water & Arsenic Claims   18
Claim: Hydrofluorosilicic acid isn't safe/approved for human consumption   21
Pharmaceutical Grade Fluoride-Antifluoridationist's Claim its Desirability   22
Harvard Study: IQ   23
Kidney Disease and Fluoridation   25
Diabetes and Fluoridation   26
Fluoride in Drinking Water: A Scientific Review of EPA's Standards, NRC   27
Cancer Claims   28
Thyroid Claims   29
Allergy Claims to Fluoride at 1.0ppm   30
Pineal Gland Claims   30
Cardiovascular Claims   31
Topical & Systemic Effects of Fluorides   32
Fluoridation is on the Decline Claim   33
Infant Formula and Use of Fluoridated Water   34
Toothpaste Claims   35
Legal/Mass Medication/Civil Rights Violation Claim   36
Fluoride is an Unapproved Drug Claim (also Aspirin)   37
Fluoridation Opposition is Scientific, Respectable, & Growing Claim   38
FDA Regulatory Authority regarding Water Fluoridation   39
Claim: Lead Levels are Elevated in Children   40
Reductions in Cavities in Adults   42
Information: Johnny Johnson, Jr., DMD, MS, Pediatric Dentist   43





BENEFITS of Optimally Fluoridated Water:


Optimally fluoridated water (fluoridated) is:

  1. Safe: It causes no adverse health effects in anyone at optimal levels.

  2. Effective: It provides 25% or greater cavity reductions over a person's lifetime simply by drinking the water. It requires no change in a person's behavior to impart its benefits

  3. Cost Saving: It's cheap and cost effective. For every $1 spent on water fluoridation, $38 in dental treatment costs are avoided.

  4. It is legal. No court of last resort in the U.S. has ever found fluoridation to be unlawful.

    Most recent court decision dismissed:
    Foli v. Metropolitan Water District of Southern California
    Charges were:

    • Mass medication using an Unapproved Drug, hydofluorosilicic acid, via the water system to deliver it
    • Violation of Constitutional Rights and Private Rights
    • Violation of Informed Consent
    • Violation of Safe Water Drinking Act


    Plaintiffs brought a claim challenging the addition of HFSA to the water supply under 42 U.S.C. § 1983 and the California Business & Professions Code for declaratory and injunctive relief. The court held that § 1983 and the California Business & Professions Code cannot be used as a means to enforce the Food, Drug and Cosmetic Act, noting that the FDCA does not provide for a private right of action. The Plaintiffs alleged the claims of unlawful business practice, unfair business competition, and fraudulent business practice under the California Business & Professions Code. Specifically, the court noted that the Plaintiff cannot pursue their FDCA claim by "recasting the action as one for unfair competition." The court dismissed the complaint without prejudice.


  5. Most important of all, fluoridated water reduces not only the number of cavities that a person will get, but also the severity of those cavities. Along with this reduction in number and severity of cavities comes less pain and suffering that those cavities cause.






"Current anti-fluoridation tactics have focused on additives used to fluoridate water supplies. There is no credible evidence to support the notion that the add itives are unsafe. In the past, tactics have focused on studies that purported to show that fluoridation was linked to cancer and myriad other health problems. 48 However, such assertions were based on improper science, and numerous subsequent studies found no association between fluoridation and cancer.58"


Water Fluoridation and the Environment: Current Perspective in the United States, Pollick, Howard F., Int J Occup Environ Health, 2004; 10:343-350




Additional References:


When public action undermines public health: A critical examination of antifluoridationist literature, Armfield, Jason M , Aust New Zealand Health Policy 2007; 4: 25


The Anti-Fluoridationist Threat to Pu bl ic Health, Dodes, J. E., Easley, M W., Institute for Science in Medicine, White Paper, April 2012

http://www.scienceinmedicine.org/policy/papers/ AntiFluoridationist.pdf




Statements From Ten Leading Health Authorities Regarding Community Water Fluoridation:


American Dental Association (ADA)

"The Association endorses community water fluoridation as a safe, beneficial and cost-effective public health measure for preventing dental caries. This support has been the Association's policy since 1950."

--ADA Operational Policies and Recommendations Regarding Community Water Fluorid ation (Trans.1997:673).


Centers for Disease Control and Prevention (CDC)

"During the 201h century, the health and life expectancy of persons residing in the United States improved dramatically. To highlight these advances, MMWR will profile 10 public health achievements in a series of reports published through December 1999 (Fluoridation of drinking water was chosen as one of these achievements and profiled in the October 22, 1999 MMWR). Fluoridation safely and inexpensively benefits both children and adults by effectively preventing tooth decay, regardless of socioeconomic status or access to care. Fluoridation has played an important role in the reductions in tooth decay (40%-70% in children) and of tooth loss in adults (40%-60%)."

--CDC, Morbid ity and Mortality Weekly Report. "Ten Great Public Health Achievements­ United States 1900-1999" April 1999.


American Medical Association (AMA)

"The AMA recognizes the important public health benefits of drinking properly fluoridated water and encourages its member physicians and medical societies to work with local and state health departments, dental societies, and concerned citizens to assure the optimal fluoridation of community drinking water supplies."

--AMA Letter to the American Dental Association, March 10, 1995.


American Academy of Pediatrics

"Water fluoridation is a community-based intervention that optimizes the level of fluoride in drinking water, resulting in preemptive and posteruptive protection of the teeth. Water fluoridation is a cost-effective means of preventing dental caries, with the lifetime cost per person equaling less than the cost of 1 dental restoration. In shott, fluoridated water is the cheapest and most effective way to deliver anticaries benefits to communities."

--AAP Policy Statement Preventive Oral Health Intervention for Pediatricians. Pediatrics 2008; 122:1387-1394


U.S. Surgeon General

"A significant advantage of water fluoridation is that all residents of a community can enjoy its protective benefit - at home, work, school or play - simply by drinking fluoridated water or beverages and foods prepared with it . ...Water fluoridation is a powerful strategy in our effotis to elimi nate differences in health among people and is consistent with my emphasis on the impotiance of prevention . ..Fluoridation is the single most effective public health measure to prevent tooth decay and improve oral health over a lifetime, for both children and adults.


While we can be pleased with what has already been accomplished, it is clear that there is much yet to be done. Policymakers, community leaders, private industry, health professionals, the med ia, and the public should affirm that oral health is essential to general health and well being and take action to make ourselves, our famil ies, and our commtinities healthier. I join previous Surgeons General in acknowledging the continuing public health role for community water fluoridation in enhancing the oral health of all Americans."

-- Surgeon General Richard H. Carmona, Statement on Community Water Fluoridation, July 28, 2004. Association of State and Territorial Dental Directors


"The Association of State and Territorial Dental Directors CASTDD) fully supports and endorses community water fluoridation (maintaini ng optimal fluoride levels between 0.7 and 1.2 parts per million) in all public water systems throughout the United States."

--Community Water Fluoridation Policy Statement. Association of State and Territorial Dental Directors (ASTDD) Adopted: April 18, 2009.


American Association of Public Health Dentistry


  1. Reaffirms its support for the continuation and expansion of community water fluoridation; and

  2. Encourages its members and constituents to be well informed about and to continue to support optimal fluoridation, and to help develop national and regional coalitions in support of fluoridation; and

  3. Commends communities and states that are provid ing access to optimal levels of fluoride in the drinking water and encourages them to continue to fluoridate and to monitor the process, and pmticipate in national monitoring activities; ..."

--Adopted by the Assembly of AAPHD members, October 16, 1992. J Pub Health Dent 1993;53(1):59-60.


American Public Health Association "
...Therefore be it resolved that APHA-

  • Reiterates its strong endorsement and recommendation for the fluoridation of all community water systems as a safe and effective pu blic health measure for the prevention of tooth decay;..."

--APHA Policy Statement: Community Water Fluoridation in the U nited States (Policy Number 20087) Adopted 10/28/08


National Institute of Dental & Craniofacial Research CNIDCR)

"The National Institute of Dental and Craniofacial Research continues to support water fluoridation as a safe and effective method of preventing tooth decay in people of all ages. Community water fluoridation is a public health effort that benefits millions of Americans. For more than half a century, water fluoridation has helped improve the quality oflife in the U.S. through reduced pain and suffering related to tooth decay, reduced tooth loss, reduced time lost from school and work, and less money spent on dental care."

--NIDCR: Statement on Water Fluoridation, June 2000.


World Health Organization (WHO)

"Most recently, efforts have been made to summarize the extensive database (on fluorides) through systematic reviews. Such reviews conclude that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries ....Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health ..."

--WHO Effective use of fluorides for the prevention of dental caries in the 21st century; the WHO approach." Community Dentistry and Oral Epidemiology 2004;32:319-21


International Association of Dental Research

"The International Association for Dental Research (IADR), considering that dental caries (tooth decay) ranks among the most prevalent chronic diseases worldwide; and recognizing that the consequences of tooth decay include pain, suffering, infection, tooth loss, and the subsequent need for costly restorative treatment; and taking into account that over 50 years ofresearch have clearly demonstrated its efficacy and safety; and noting that numerous national and international health-related organizations endorse fluoridation of water supplies; fully endorses and strongly recommends the practice of water fluoridation for improving the oral health of nations."

--IADR Policy Statement Fluoridation of Water Supplies (Adopted 1979, Updated 1999).





Fluoridation is "Recognized by more than 100 organizations."

The American Dental Association (ADA) as well as the U.S. Public Health Service, the American Med ical Association, the World Health Organization and more than 125 national and international organizations recognize the public health benefits of water fluoridation.


National and International Organizations That Recognize the Public Health Benefits of Community Water Fluoridation for Preventing Dental Decay


Academy of Dentistry International
Academy of General Dentistry
Academy for Sports Dentistry
Alzheimer's Association

America's Health Insurance Plans
American Academy of Family Physicians
American Academy of Nurse Practitioners

American Academy of Oral and Maxillofacial Pathology
American Academy of Orthopaedic Surgeons

American Academy of Pediatrics
American Academy of Pediatric Dentistry
American Academy of Periodontology

American Academy of Physician Assistants

American Association for Community Dental Programs
American Association for Dental Research

American Association for Health Education

American Association for the Advancement of Science
American Association of Endodontists

American Association of Oral and Maxillofacial Surgeons
American Association of Orthodontists

American Association of Public Health Dentistry
American Association of Women Dentists
American Cancer Society

American College of Dentists

American College of Physicians-American Society of Internal Medicine
American College of Preventive Medicine

American College of Prosthodontists
American Council on Science and Health
American Dental Assistants Association
American Dental Association

American Dental Education Association
American Dental Hygienists' Association
American Dietetic Association

American Federation of Labor and Congress of Industrial Organizations

American Hospital Association
American Legislative Exchange Council
American Medical Association

American Nurses Association
American Osteopathic Association
American Pharmacists Association
American Public Health Association
American School Health Association

American Society for Clinical Nutrition
American Society for Nutritional Sciences
American Student Dental Association
American Water Works Association
Association for Academic Health Centers
Association of American Medical Colleges
Association of Clinicians for the Underserved

Association of Maternal and Child Health Programs
Association of State and Territorial Dental Directors
Association of State and Territorial Health Officials
Association of State and Territorial Public Health Nutrition Directors

British Fluoridation Society
Canadian Dental Association

Canadian Dental Hygienists Association
Canadian Medical Association

Canadian Nurses Association
Canadian Paediatric Society

Canadian Public Health Association
Child Welfare League of America
Children's Dental Health Project
Chocolate Manufacturers Association
Consumer Federation of America

Council of State and Territorial Epidemiologists
Delta Dental Plans Association

FDI World Dental Federation
Federation of American Hospitals
Hispanic Dental Association

Indian Dental Association (U.S.A.)
Institute of Medicine

International Association for Dental Research
International Association for Orthodontics
International College of Dentists

March of Dimes Birth Defects Foundation

National Association of Community Health Centers
National Association of County and City Health Officials
National Association of Dental Assistants

National Association of Local Boards of Health
National Association of Social Workers
National Confectioners Association

National Council Against Health Fraud

National Dental Assistants Association
National Dental Association

National Dental Hygienists' Association
National Down Syndrome Congress
National Down Syndrome Society

National Foundation of Dentistry for the Handicapped
National Head Start Association

National Health Law Program

National Healthy Mothers, Healthy Babies Coalition
Oral Health America

Robert Wood Johnson Foundation
Society for Public Health Education
Society of American Indian Dentists
Special Care Dentistry

Academy of Dentistry for Persons with Disabilities
American Association of Hospital Dentists
American Society for Geriatric Dentistry

The Children's Health Fund

The Dental Health Foundation (of California)

U.S. Department of Defense

U.S. Department of Veterans Affairs

U.S. Public Health Service

Health Resources and Services Administration (HRSA)

Centers for Disease Control and Prevention (CDC)

National Institute of Dental and Craniofacial Research (NIDCR)

World Federation of Orthodontists

World Health Organization


ADA Fluoridation Facts Compendium.







One of the most widely respected sources for information regard ing fluoridation and fluoride is the American Dental Association. A copy of this valuable resource has been distributed to each of you. The 3 main additions to this resource that is being included in the soon to be released update will be:


  • Fluoride Will Not Be Added to the List of Known Carcinogens California Proposition 65 Ruling

  • Community Water Fluoridation and IQ, September 2011

  • New Recommendations for Optimally Fluoridated Water to be set at 0.7ppm







What is the Community Preventive Services Task Force's purpose?

The Community Preventive Services Task Force (Task Force) was established in 1996 by the

U.S. Department of Health and Human Services to identify population health interventions that are scientifically proven to save lives, increase lifespan, and improve quality of life. The Task Force produces recommendations (and identifies evidence gaps) to help inform the decision making of federal, state, and local health departments, other government agencies, communities, healthcare providers, employers, schools and research organizations.

Community Preventive Services Task Force Members

The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid panel of public health and prevention experts that provides evidence-based find ings and recommendations about community preventive services, programs, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community preventive services, public health, health promotion, and disease prevention.


The fifteen Task Force members are appointed by the Director of the Centers for Disease Control and Prevention (CDC). Task Force members serve five year terms, with possible extensions to maintain a full scope of expertise, complete specific work, and ensure consistency of Task Force recommendations.


Task Force Findings:

The Community Preventive Services Task Force recommends community water fluoridation based on strong evidence of effectiveness in reducing dental caries across populations. Evidence shows the prevalence of caries is substantially lower in communities with CWF. In addition, there is no evidence that CWF results in severe dental flurosis.





10 Reasons to Fluoridate Public Water


Single most effective public health measu re to prevent tooth decay. The Centers for Disease Control and Prevention (CDC) has proclaimed community water fluoridation one of 10 great public health achievements of the 20th century.

Centers for Disease Control and Prevention. "Ten Great Public Health Achievements - United States, 1990-1999." MMWR 1999;48(12):241-3.

Natural. Fluoride is already present in all water sources, even the oceans. Water fluoridation is simply the adjustment of fluoride that occurs naturally in water to a recommended level for preventing tooth decay.

Similar to fortit'yi ng other foods and beverages. Water that has been fluoridated is similar to fortifying salt with iodine, mil k with vitamin D, orange ju ice with calcium and bread with folic acid.

Prevents dental d isease. It is the most efficient way to prevent one of the most common childhood diseases - dental decay. An estimated 51 million school hours are lost each year due to dental-related illness.

Gift, H.C. "Oral Health Outcomes Research: Challenges and Opportunities." In Slade, G.D., ed., Measuring Oral Health and Quality of Life. Chapel Hill, NC: Department of Dental Ecology, University of North Carolina 1997;25-46.

Protects all ages against cavities. Studies show that community water fluoridation prevents at least 25 percent of tooth decay in children and ad ults, even in an era with widespread availabil ity of fluoride from other sources, such as fluoride toothpaste.

*Griffin S.O., et al. "Effectiveness of Fluoride in Preventing Caries in Adults." J Dent Res 2007;86(5):410-415.

** Task Force on Community Preventive Services. "Promoting Oral Health: Interventions for Preventing Dental Caries, Oral and Pharyngeal Cancers, and Sports-related Craniofacial Injuries: A Report on Recommendations of the Task Force on Community Preventive Services." MMWR 001 ;50(RR21 ):1-13. View information at and cdc.gov/mmwr/preview/mmwrhtml/rr5021a1.htm

Safe and effective. For more than 68 years, the best available scientific evidence consistently ind icates that community water fluoridation is safe and effective.

Saves money. The average lifetime cost per person to fluoridate a water supply is less than the cost of one dental filling. For most cities, every $1 invested in water fluoridation saves $38 in dental treatment costs.

Griffin S.O., Jones, K., Tomar, S.L. "An Economic Evaluation of Community Water Fluoridation." J Public Health Dent 2001;61(2):78-86.


Recognized by more than 100 organizations. The American Dental Association (ADA) as well as the U.S. Public Health Service, the American Medical Association, the World Health Organization and more than 125 national and international organizations recognize the public health benefits of water fluoridation.

ADA Fluoridation Facts Compend ium. Available at ADA.org/4378.aspx

Availability of fluoridation contin ues to grow. Inthe United States, 73.9 percent of the population on public water systems receive fluorid ated public water, or a total of 204 million people.* This is an increase of almost nine percent from 2000. The Healthy People 2020 goal is for 79.6 percent of the population on public water systems to have access to fluoridated water.**

*CDC Reference Statistics on Water Fluoridation Status, cdc.gov/fluoridation/statistics/reference_stats.htm

**Healthy People 2020,


Endorsed by the American Dental Association. One of the most widely respected sources for information regarding fluoridation and fluoride is the American Dental Association. Learn more on the ADA's website at ADA.org/fluoride.









It is important to understand that fluorosis that occurs in areas where concentration in water consumed is less than 4 ppm in water is a purely cosmetic "problem" and CAUSES NO PAIN OR OTHER DISEASE. HOWEVER, PEOPLE WHO HAVE FLUOROSIS HAVE NO DECAY OR DENTAL DISEASE THAT WORSENS DIABETES, ASTHMA, CORONARY ARTERY DISEASE, ETC!




Fluorosis is the visible change in tooth enamel that is evident when the level of fluoride from all sources, including food, beverages, and toothpaste, reach a certain threshold.


This is an extremely important point to understand. Even WITHOUT water fluoridation, fluorosis can be seen because of its presence in our d iets, but primarily because of toothpaste being swallowed by children under 8 years old.


Several points are important to understand about fluorosis in the US:


  1. Fluorosis that is visible in this country is almost entirely of the type "very mild" or "mild". This type of fluorosis is visible to dental professionals when the teeth have been thorou ghly air dried. It is essentially not visible to the casual observer. See the pictures of all types of fluorosis at the following CDC website:


    image image image




  2. Fluorosis does not degrade the health of a tooth. In fact, studies have shown that teeth with fluorosis are more resistant to cavities:


    "Conclusion: This study's findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis." Iida, Hiroko, Kumar, Jayanth V., The Journal of the American Dental Association, July 2009 vol. 140 no. 7, 855-862



  3. Severe fluorosis, as seen above and on the next page, is vi1tually 0% when fluoride in water, added or naturally occurring, is below 2.0ppm. See page 114 of the document "Fluoride in Drinking Water: A Scientific Review of the EPA Standards"


    "The prevalence of severe enamel fluorosis is close to zero in communities at all water fluoride concentrations below 2.0 mg/L."



    Severe Fluorosis is virtually non­ existent in the United States







    Skeletal Fluorosis in United States

    "Crippling skeletal fluorosis continues to be extremely rare in the United States (only 5 cases have been confirmed during the last 35 years), even though for many generations there have been communities with drinking water fluoride concentrations in excess of those that have resulted in the cond ition in other countries."




    Fluoride in Drinking Water: A Scientific Review of EPA's Standards, Committee on Fluoride in Drinking Water, National Research Council


    ISBN: 0-309-65796-2, 530 pages, 6 x 9, (2006)


    This PDF is available from the National Academies Press at:




    Antifluoridationists' Claim that 60% of 12-15 vear olds are afflicted with fluorosis:

    Antifluoridationists claim that the Centers for Disease Control reports that 60% of 12-15 year-olds are afflicted with fluoride overdose symptoms - dental fluorosis, white spotted, yellow, brown and/or pitted teeth. Yet, tooth decay crises are occurring in all fluoridated cities, states and countries.




    This is a complete misrepresentation of the data:


    The data that this information is actually "pulled" from is the CDC NCHS Data Brief. The link can be found below.


    To clarify the true facts of this data, the following accurate interpretation of the data is:

    1. 40.7%, NOT 60%, of adolescents aged 12-15 had dental fluorosis.

    2. More than 96% had were either unaffected, or had questionable, very mild, or mild fluorosis.

    3. In people having fluorosis of the very mild or mild types, the appearance of the white flecks or streaks are typically only noticeable by dental professionals after the teeth have been thoroughly dried.

    4. Less than 1% of all subjects of this study ranging in age from 6-49 years old had the severe form of fluorosis.



      image imageimage


      Along this same exaggerated set of claims, antifluoridationists' claim that dentists make money by repairing the damage done by severe fluorosis by performing cosmetic dental procedures. Given the fact that only Severe Dental Fluorosis would require the extensive dental care that they claim, and understanding the fact that Severe Fluorosis is virtually non-existent in the U.S. as it only occurs when the concentration of fluoride in the water exceeds 2.0ppm, the falseness of this claim is immediately obvious.





      Fluoridation Additives Used in Fluoridation of Water

      Hydrofluorosilicic Acid (FSA or HFS) use as the source for fluoridating water:


      There is absolutely NO question regarding the safety or purity of this prod uct according to the CDC. .Two excerpts followed by the link to the CDC website on this topic follow:


      "Since the early 1950s, FSA has been the chief additive used for water fluoridation in the United States. The favorable cost and high purity of FSA make it a popular source."


      "Consumers sometimes raise concerns about arsenic in drinking water and the fact that fluoride add itives may contain some arsenic. The EPA allowable criterion for arsenic consumption in drinking water is I 0 pmis per billion. NSF quality testing has found that most fluoride additive samples do not have detectable levels of arsenic. For those samples that do test positive, the arsenic level that an average consumer would experience over an entire year of drinking water at a maximum dosage of 1.2 mg/L fluoride would only be about 1.2% of the EPA allowable a1nount."






      Water Fluoridation Additives f act Sheet


      On this page:


      • Types of Fluoride Additives

      • Sources of Fluoride Additives

      • Regulatory Scope on Additives

      • EPA Regulatory Criteria for Fluoride Additives

      • AWWA Standards

      • NSF/ANSI Standards for Drinking Water Additives

      • Measured Levels of Impurities

      • FDA Regulatorv Criteria for Fluoride

      • United States Phamacopeia (USP) Grade Fluoride Products

      • Fluoride Additives Are Not Different From Natural Fluoride






      The following Information is from an Email to me from Kip Duchon, National Fluoridation Engineer, when I asked him to address specific claims made by the opposition to fluoridation:


      Kip Duchon, National Fluoridation Engineer, CDC, 11-26-12

      1. Antifluoridationists' Claim: Fluorosilicates are not natural.


        CDC Response to Antifluoridationists' Claim: This is a fascinating argument to me for fluoride is the 13th most abundant element in the earth's crust and is overwhelmingly in the form of either fluorosi licate or calcium fluoride. It is in the calcium fluoride form when it water deposited in geological formations, and it is in fluorosilicate form when it is in the crystalline structure of the rock. When you consider that geologists estimate that

        most rocks in the earth's crust are igneous (estimates as high as over 90%), fluorosilicates would likely dominate the natural occurrence. Remember that by definition granites are minimum 20% silica content, so there is some portion of silica in association with



      2. Antifluoridationists' Claim: Fluorosilicates have never been tested for safety in humans.


        CDC Response to Antifluoridationists' Claim: Experts in inorganic aquatic chemistry at the US Environmental Protection Agency have studied ionic speciation of fluorosilicates and have concluded that at the pH and fluoride concentration of potable water, fluorosilicates would completely dissolved to fluoride and silica. Researchers at the U niversity of Michigan attempted to verify those theoretical pred ictions of ionic speciation and were unable to detect any residual fluorosilicates at pH over 4.8, and considering that drinking water are adjusted to minimize potential corrosion of metal pipes to pH over 7, and typically over 8, persistence of fluorosilicates cannot occur.


      3. Antifluoridationists' Claim: Fluorosilicates have never been tested for safety in humans.


        CDC Response to Antifluoridationists' Claim: When you consider that fluorosilicates do not exist at the pH in drinking water, it impossible to measure the health effects since you cannot measure the health effects of somethi ng that cannot be consumed by people.


      4. Antifluoridationists' Claim: Fluoride products have contamination including Arsenic.


        CDC Response to Antitlnoridationists' Claim: In the CDC Fact Sheet there is a link the NSF website and a Fact Sheet published by NSF on the actual measured level of impurities. All water add itives have some level of impurities since reagent grade products are never necessary for water processing, but Standard 60 specifies allowable levels of impurities based on EPA criteria. What is remarkable is that NSF conducts regular verification testing of fluoride products for the Standard 60 certification and has never measured any fluoride prod ucts that exceed the allowable impurity levels with respect to EPA allowable levels. The majority of product testing does not even measu re detectable levels of Arsenic.



Additional References:


Water Fluoridation and the Environment: Current Perspective in the United States

Pollick, Howard F., In f J Occup Environ Health, 2004;10:343-350


"Fate of Fluorosilicate Drinking Water Additives", Urbansky, Edward T, Chem. Rev. 2002, 102, 2837-2854


"Can Fluoridation Affect Lead(II) in Potable Water? Hexafluorosilicate and Fluoride Equilibria in Aqueous Solution", Urbansky, Edward T, and Schock, Michael R., Intern. J Environ.Studies, 2000,

Vol. 57, pp. 597-637


"The Manufacture of the Fluoride Chemicals": Reeves, Thomas G., P.E., September 2000, National Fluoridation Engineer, Program Services Branch, Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention




Claim that Manufacturers won't state that Hydrofluorosilicic Acid (HFS) is safe for human consumption:


Follows is an email that I received from Chris Fleming of the Dumont Chemicals Company. The question I posed was whether their product is safe for human consumption.

This question stems from the frequent claim by those who oppose water fluoridation that hydrofluorosilicic acid is unsafe for human consumption. This question is a twist on reality as no one in their right minds would consume a concentrated product of any sort. The question is intended to frighten the public into thinking that HFS isn't approved for consumption, when in fact it is what it becomes in water: Hydrogen ions, Fluoride ions, water, and silica (sand)

Chris Fleming <chrisf@dumontchemicals.com> Fri, Feb 21, 2014 at 9:06 AM
To: "Dr. Johnny Johnson" <drjohnnyjohnson@gmail.com>

Dr. Johnson,


As for your question if our Fluoride is safe to drink. Dumont's HFS 23000 Fluoride is certified by Underwriting Laboratories (UL) to be NSF/ANSI 60 and AWWA approved for drinking water. That means it is·safe to put in drinking water and if it is safe to put in drinking water then it would be safe to drink.


Dumont also has other products that have this same certification from UL that are used all across the State of Florida. These other products are Sodium Hydroxide 25% (SH 2500) and (50% SH 5000), all of our ClearFlow Corrosion Inhibitor products and Ammonium Sulfate 40% (AS4000). I have attached our list to this email.


I hope that this information is helpful to you. If you have any questions please let me know.


Chris Fleming | Technical Support Administrator
381 South Central Avenue | Oviedo, FL 32765

Mobile: 407.923.3101 | Office: 800.330.1369 | Fax: 800.524.9315

From: Dr. Johnny Johnson [mailto:drjohnnyjohnson@gmail.com]
Sent: Friday, February 14, 2014 6:03 AM




Pharmaceutical Grade Fluoride: Antifluoridationists' Claim its Desirability

United States Pharmacopeia (USP) Grade Fluoride Products


Some have suggested that pharmaceutical grade fluoride additives should be used for water fluoridation. Pharmaceutical grading standards used in formulating prescription drugs are not appropriate for water fluoridation additives. If applied, those standards could actually increase the amount of impurities as allowed by AWWA and NSF/ANSI in drinking water.

The U.S. Pharmacopeia-National Formulary (USP-NF) presents monographs on tests and acceptance criteria for substances and ingred ients by manufacturers for pharmaceuticals. The USP 29 NF-24 monograph on sodium fluoride provides no independent monitoring or quality assurance testing. That leaves the manufacturer with the responsibility of quality assurance and reporting. Some potential impurities have no restrictions by the USP including arsenic, some heavy metals regulated by the U.S. EPA, and radionuclides.


The USP does not provide specific protection levels for ind ividual contaminants, but tries to establish a relative maximum exposure level of a group of related contaminants. The USP does not include acceptance criteria for fluorosilicic acid or sodium fluorosilicate.

Given the volumes of chemicals used in water fluoridation, a pharmaceutical grade of sodium fluoride for fluoridation could potentially contain much higher levels of arsenic, radionulcides and regulated heavy metals than a NSF/ANSI Standard 60 certified product.


AWWA-grade sodium fluoride is preferred over USP-grade sodium fluoride for use in water treatment facilities because the granular AW WA prod uct is less likely to result in dusting exposure of water plant operators than the more powder-like USP-grade sodium fluoride.







"Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis."


While the studies the Harvard team reviewed did indicate that very high levels of fluoride could be linked to lower IQs among schoolchildren, the data is not particularly applicable here because it came from foreign sources where fluoride levels are multiple times higher than they are in American tap water.

27 studies were reviewed, 25 of which were done in China. The HIGH fluoride group was exposed to water !Ox the concentration of that in the US. The CONTROL group were exposed to water up to 0.8ppm.

One of the studies that was translated from Chinese to English language. The Chinese researchers stated that:

"The IQs of adults in the area were also measured and the intellectual ability and even life expectancy of people in the (high-fluoride) endemic region appeared to be higher than the non-endemic region, indicating that the effect of fluoride poisoning on intellectual ability is negligible," the study said.

-research scientists Anna Choi and Associate Professor Philippe Grandjean, of the Dept of Environmental Health at the Harvard School of Public Health.



Monday, Nov.26, 2012

Posted on Tue, Sep. 11, 2012

Harvard scientists: Data on fluoride, IQ not applicable in U.S.

By Dion Lefler

The Wichita Eagle




Excerpt: "Harvard University scientists say that Wichita voters shouldn't depend on a research study they compiled to decide whether to put fluoride in the city's drinking water to fight tooth decay.

While the studies the Harvard team reviewed did indicate that vel)I high levels of fluoride could be linked to lower IQs among schoolchildren, the data is not particularly applicable here because it came from foreign sources where fluoride levels are multiple times higher than they are in American tap water.

Opponents of adding fluoride to Wichita's drinking water have frequently cited the Harvard research in their efforts to persuade Wichitans to reject a ballot initiative that would require the water department to introduce the cavity-fighting chemical into the water supply.

Fluoride supporters gathered more than 11,000 signatures in favor of fluoridated water, forcing the City Council to put it to a vote on the Nov. 6 ballot.

Two of the scientists who compiled the Harvard study on fluoride said it really doesn't address the safety of fluoridation levels typical of American drinking water.

"These results do not allow us to make anyjudgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the U.S.," the researchers said in an e-mail response to questions from The Eagle."





Fluoride Intake and Chronic Kidney Disease

New information on fluoride intake and chronic kidney disease is available from the National Kidney Foundation and Kidney Health Australia.


National Kidney Foundation


On its newly revised Fluoride Web page, NKF notes, "The benefits of water and dental products containing fluoride is the prevention of tooth decay and dental cavities in people of all ages." In discussing potential health risks NKF states, "The risk is likely greatest in areas with naturally high water fluoride levels." Due to the limited available research on the topic, NKF has not issued specific recommendations regard ing fluoride intake and kidney disease and currently has no official position on the optimal fluoridation of water. NKF recommends that "Dietary advice for patients with CKD should primarily focus on established recommendations for sodium, potassium, calcium, phosphorus, energy/calorie, protein, fat, and carbohydrate intake. Fluoride intake is a secondary concern."



Kidney Health Australia

In a position statement issued in March 2007, Kidney Health Australia concluded:


1) there is no evidence that consumption of optimally fluoridated drinking water increases the risk of developing CKD, although only limited studies addressing this issue are available; and


2) there is no evidence that the consumption of optimally fluoridated drinking water poses any risks for people with CKD, although only limited studies addressing this issue are available.








Any dental or medical professional understands the importance of optimal health and prevention for our patients with diabetes. Their ability to fight infection is compromised, as is their exaggerated response to an infection. It is therefore paramount that these patients receive the optimal benefits of prevention that is available to them.

Antifluoridationists'claim that the "National Institute of Diabetes has stated that diabetics and other consumers of large quantities of water should drink bottled water."

This is incorrect per the latest information from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

In a booklet dated February 2012, entitled "Prevent Diabetes Problems: Keep your mouth healthy", the topic of fluorides, both topical and systemic, are discussed.

This booklet, specifically on page 12, specifically states:

"Drink water that contains added fluoride or ask your dentist about using a fluoride mouthrinse to prevent tooth decay."


Further, many people are unclear about the fluoride content of bottled water. The opposition to fluoridation claims that fluoride is removed from bottled water, or that it doesn't contain it. This is also incorrect.


The fluoride content of bottled water can vary from none to almost twice the level of optimally fluoridated water. This depends solely on where it's prod uced. The FDA does not require that this information be put on the label of this food product. As such, the opposition's claim that diabetics should drink bottled water is further founded in incorrect informati on.


Information on Bottled Water Quality Reports can be found here:




Fluoride in Drinking Water: A Scientific Review of EPA's Standards, Committee on Fluoride in Drinking Water, National Research Council, 2006


The opposition to fluoridated water will often cite the periodic review of the EPA's Standards on fluoride contaminant level in drinking water to portend that they apply to optimally fluoridated water.

This is completely incorrect.

This Scientific Review was done to review the standards that the EPA sets for maximum contaminant levels in drinking water. This review is completed on a regular interval.


The scope of this study WAS NOT to be a study on Optimally fluoridated water. This is stated clearly on pp 20-21, starting with the last paragraph on page 20:


"The committee is aware that some readers expect this report to make a determination about whether public drinking-water supplies should be fluoridated. That expectation goes beyond the committee's charge. As noted above, the MCLG and SMCL are guidelines for areas where fluoride concentrations are naturally high."



The 2006 NRC Report, "Fluoride in Drinking Water: A Scientific Review of EPA's Standards", was conducted to review the EPA's standards for fluoride concentrations found NATURALLY occurring in water supplies. Specifically, naturally occurring in water ABOVE 4ppm fluoride content, not the concentrati on of optimally fluoridated water.


This group's charge was to look at the EPA's recommendations and evaluate the levels of fluoride that the EPA considered to be the maximum concentration allowed for teeth to remai n healthy.


The NRC report's conclusions did not raise serious health concerns for community water fluoridation levels that are considered optimal for dental health. In other words, community water fluoridation at the previous recommendations of 0.7-l.2ppm, and new recommendation of 0.7ppm, did not reveal any health concerns in their conclusions. At levels which exceeded 4ppm, health concerns were discussed and direction of future areas of studies encou raged.









The opposition to fluoridation likes to claim that optimally fluoridated water causes osteosarcoma, based on the research by Bassin and others. Her results were based on a subset of patients from a 15 year ongoing research project at Harvard University. Her results were published in 2006 for her doctoral dissertation work. The full study results were completed and published in 2011. The conclusions of the full study did not support her partial study findings.

In addition, other studies which have looked at fluoride in the water, whether natu rally occurring or through community water fluoridation, have not shown any association between fluoride and osteosarcoma.

1. "Age-specific fluoride exposure in drinking water and osteosarcoma" (United States), Bassin, Elise B., et al, Cancer Causes Control (2006) 17:421-428



Bassin reported some age specific relationships between fluoride and osteosarcoma. However, the authors themselves raised a flag of caution in their final paragraph with the note that they are aware of additional findings from other incident cases that appear not to replicate the findings from the cases presented in their paper.


Bassin's study research article was based on a subset of patients in a 15 year ongoing study of fluoride and osteosarcoma being conducted at Harvard. When the study was completed, her results were not confirmed by the final results of the complete set of data.

Conclusions of completed study:

"No significant association between bone fluoride levels and osteosarcoma risk was detected in our case-control study, based on controls with other tumor diagnoses."

Kim, F.M , et al, JDent Res. 2011 October; 90(10): 1171-1176



2. "Recently, researchers examined the possible relationship betweenfluoride exposure and osteosarcoma in a new way: they measured fluoride concentration in samples of normal bone that were adjacent to a person's tumor. Because fluoride naturally accumulates in bone, this method provides a more accurate measure of cumulativefluoride exposure than relying on the memory of study participants or municipal water treatment records. The analysis showed no difference in bonefluoride levels between people with osteosarcoma and people in a control group who had other malignant bone tumors (7). "


National Cancer Institute, at the National Institutes of Health, Fluoridated Water, Fact Sheet, Feb 02, 2012



3. This latest study findings from Great Britain (2014) are the results from a 25 year study which evaluated fluoride in drinking water. It once again reaffirmed that fluoride in water, either naturally high levels or at levels added through fluoridation, does not lead to greater risk of osteosarcoma or Ewing sarcoma:


"CONCLUSIONS: The.findings.from this study provide no evidence that higher levels offluoride (whether natural or artificial) in drinking water in GB lead to greater risk of either osteosarcoma or Ewing sarcoma."


"Is fluoride a risk factor for bone cancer? Small area analysis of osteosarcoma and Ewing sarcoma diagnosed among 0-49-year-olds in Great Britain, 1980-2005" Blakey, K, et al., Int J Epidemiol. 2014 Jan 14






The opposition to water fluoridation states that fluoride causes Thyroid Issues. This claim has not been borne out by cred ible scientific research or reviews.

In a review by the British Fluoridation Society (2006), they concluded that:


The available med ical and scientific evidence suggests an absence of an association between water fluoridation and thyroid disorders.

Many major reviews of the relevant scientific literatu re around the world support this conclusion. Of particular importance are:


  • an exhaustive review conducted in 1976 by an expe1t scientific committee of the Royal College of Physicians of England;

  • a systematic review in 2000 by the NHS Centre for Reviews and Dissemination at the University of York; and,

  • a 2002 review by an international group of experts for the International Programme on Chemical Safety (IPCS), under the joint sponsorship of the World Health Organisation (WHO), the United Nations Environment Programme (UNEP), and the International Labour Organisation (ILO).


None has found any cred ible evidence of an association between water fluoridation and any disorder of the thyroid.






Allergy Claims made against fluoride in water at l.Oppm

"There is no evidence of any deleterious effect on specific immunity following fluoridation nor any confirmed reports of allergic reactions."

Challombe, SJ, Community Dent Health. 1996 Sep; 13 Suppl 2:69-71




"As a result of this review, the members of the Executive Committee of the American Academy of Allergy have adopted unanimously the following statement:


"There is no evidence of allergy or intolerance to fluorides as used in the fluoridation of community water supplies."

American Academy of Allergy, Asthma, and Immunology: pdf available upon request



"My own opinion is reflected in the first paragraph with the "short answer" of the American Dental Association's thoughts in this regard. That is basically that there is a lack of credible evidence to incriminate fluoride in the water as causing adverse events." (2012)






Part of the aging process is that the pineal gland accumulates calcium as we age. Just as we don't bounce as well as we did when we were teenagers, we lose our flexibility as we age, and playing a game of touch football might be a near-death experience for some, this is part of aging.


Fluoride, being a reactive halide, is attracted to calcium and goes along for the ride. The fact that fluoride is present with the calcium in the pineal gland has nothing to do with a loss of dreaming capacity or spiritual awareness.





Antifluoridationists' claim that fluoride has been shown to cause cardiovascular disease. They reference the study listed below to "prove" that fluoride is causing "hardening of the arteries".


This is a complete FABRICATION. This study was done to determine if active plaques could be identified by means of a sugar uptake with attached Fluoride (18F) in these active plaques. The 18F(fluoride) was along for the ride to be able to let the researchers find out which plaques were actively taking up more sugar than the others. The PET/CT scans would allow them to do this by tracking the 18F.

The conclusion section is where one word, fluoride, was used instead of 18F fluoride, as was used in the rest of the study. The antifluoridationists seized upon this opportunity to lay claim thatatherosclerosis was due to fluoride.


"Conclusion: sodium [18F]fluoride PET/CT might be useful in the evaluation of the atherosclerotic process in major atieries, includ ing coronary arteries. An increased fluoride uptake in coronary arteries may be associated with an increased cardiovascular risk."


"Association of vascular fluoride uptake with vascular calcification and coronary artery disease",

Li, Yuxin, et al Nuclear Medicine Communications:

January 2012 - Volume 33 - Issue 1 - p 14-20





Topical and Systemic Effects of Fluorides:

Opposition to community water fluoridation state that the benefits are only from topical exposure to the fluoride, and that NO benefit is realized by swallowing (systemic) it.

This is incorrect.


The following citations provide current evidence that systemic benefits of fluoridation remain important in decay prevention:

Abstract: Clinical trials, animal studies, and in vitro tests demonstrate effectiveness of exposure to topical (posteruptive) fluoride in caries prevention and reduction of enamel dissolution. However, careful analyses of human epidemiologic data on caries increments, following communal waterfluoridation, show unquestionably thatfluoride has an importantpreemptive effect on caries inpermanent teeth, particularly onpit andfissure surfaces. These preemptive or systemic benefits also apply to the use offluoride supplements orfluoridated salt when used continuously during the period of toothformation. The role of systemic fluoride in caries prevention is neither "minimal" nor "f borderline significance. " On the contrary, it is a major factor inpreventing pit andfissure caries, the most common site of tooth decay. Maximal caries­ preventive effects of water fluoridation are achieved by exposure to optima/ fluoride levels both pre- and posteruptively.

Systemic Benefits of Fluoride and Fluoridation, Newbrun, Journal of Public Health Dentistry, Volume 64, Issue Supplement sl, pages 35-39, September 2004


Additional References:

Evidence-Based Clinical Recommendations on the Prescription of Dietary Fluoride Supplements for Caries Prevention, Rozier, Gary R., et al, JADA December 2010 vol. 141 no. 12 1480-1489
Centers for Disease Control and Prevention. Recommendations for using fluorid e to prevent and control dental caries in the United States. MMWR Recomm Rep 200l;50(RR-14):1-42.






Antifluoridationists' Claim: the CDC reports that 225 less communities adjusted for fluoride between 2006 and 2008. About 100 US and Canadian communities rejected fluoridation since 2008.




This is a skewing of the data to confuse the reader. There are many factors that have gone into communities discontinuing fluoridation, among which are costs to small communities in a down economy, the comm1mity has appropriate levels of fluoridation naturally under the new HHS proposed recommendations of 0.7ppm, and antifluoridationists on the governing bodies.


However, these claims give the appearance that fluoridation is decreasing in the United States. Nothing could be further from the truth.


Facts: Total Population US population
served by fluoridated water
% on fluoridated water
2006 299,398,484 184,028,038 69.2%
2008 304,059,724 195,545,109 72.4%
2010 308,745,538 204,283,554 73.9%


As can be seen by the above illustration, even with some communities dropping out of the ranks of communities fluoridating their water, again for a variety of reasons, the net result is that the total number of the population as well as the percent of the population on fluoridated water systems continues to increase.





Anitjluoridationists' Claim: Infant Formulas are not to be mixed with fluoridated water per the CDC and ADA.

This is completely FALSE!


Can I use optimally fluoridated tap water to mix infant formula? Yes, you can use fluoridated water for preparing infant formu la. However, if your child is exclusively consuming infant formula reconstituted with fluoridated water, there may be an increased chance for mild dental fluorosis. To lessen this chance, parents can use low-fluoride bottled water some of the time to mix infant formula; these bottled waters are labeled as de-ionized, purified, demineralized, or distilled.



The recommendations have never been to avoid, or not use, fluoridated water to reconstitute infant formulas. They have always been, and continue to be, to discuss the use fluoridated water to reconstitute infant formula with your dentist or physician. The fact remains that even in the absence of the availability to discuss this with dentists or physicians for some folks, very mild and mild fluorosis are the predominant forms of fluorosis in the U.S.


Additional Resources:

"The fluoride content of infant formulas available in 1985"

Pediatric Dentistry, March 1987, Vol. 9, No. 1, Johnson, J, Bawden, J. W.,



"Evidence-Based Clinical Recommendations Regarding Fluoride Intake From Reconstituted Infant Formula and Enamel Fluorosis: A Report of the American Dental Association Council on Scientific Affairs", Berg, Joel, et al, JADA 2011; 142(1): 79-87

(see box 2)







Antifluoridationists' Claim: The warning on the back of the tube of toothpaste states "Keep out of reach of children. If more than used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away" This statement is an indictment of fluoride as being a toxic hazardous chemical poison.

The facts accurately quoted by the antifluoridationists stopped within the quotation marks. Everything else is conjecture and science fiction.




No one has ever died in the United States from accidental swallowing of toothpaste. No one.


Theoretically, if a child of 40 pounds were to get their hands on 2 adult sized tubes of fluoridated toothpaste and eat both of them, then they could ingest a lethal dose of fluoride. HOWEVER, the soapy foamy product in toothpaste would cause them to throw up before they could ever get enough down to cause more than a gastric upset.

The back of the tube further states that Supervision is needed. What parent would allow a young child to have 2 full tubes of adult sized toothpaste available to them without paying any attention to what they were doing? Probably the same parents whose kids are ending up at the ED's now having swallowed these new packets of dishwasher detergent that are gushy and look so pretty. I'm certain one look at that container would have a similar warning on it: Watch your kids.




PolitiFact examined the claims that anti-fluoride activists often make about fluoride toothpaste/warning label and found their assertions were mostly false:


Calculating lethal dose of fluoride in toothpaste: Origin of Toothpaste Warning Label: Email from Clifford W. Whall, Jr, PhD, Director, Acceptance Program

Council on Scientific Affairs, whallc@ada.org




Legal/Mass Medication/Civil Rights Violation:


Antifluoridationists often use the threat of lawsuits to intimidate the public and politicians into believing that the policy that they're setting is unlawful.

FACT: No court of last resort has ever found fluoridation to be unlawful. The most recent case was in California in April, 2012. The court dismissed the charges against the plaintiff, the Metropolitan Water District of Southern California:





Antifluoridationists' Claim that Fluoride is a Unapproved Drug by FDA


"While the FDA technically hasn't had companies submit clinical trials info on fluoride supplements, it's because they have been around a long time, have been in general use for a long time, and have been accepted as efficacious for a long time--before FDA set up their clinical trials requirements for Rx drugs. Aspirin has never been approved by FDA, but it's widely used by hundreds of millions of people for several indications.


Since the FDA regulates all prescription drugs, even though they might not have gone through the modern-day clinical trials, they will require the drug companies to immediately pull them from the market if they are shown to be unsafe or if they weren't efficacious relative to the claims made by the companies."




Anti-jluoridationist's Claim:

Fluoridation Opposition is Scientific, Respectable & Growing


The antifluoridationists' state that more than 4,038 professionals (including 331 dentists and 518 MD's) urge that fluoridation be stopped citing scientific evidence that ingesting fluoride is ineffective at reducing tooth decay and has serious health risks.


This statement is misleading to the reader. The number of people stated sounds large, but in fact are only a fraction of the healthcare professionals in the United States:


The total number of licensed dentists in the US as of 2009 statistics was 186,084.
The total number of licensed physicians in the US as of 2010 statistics was 954,000
The sum total of this is that out of 1,140,084 licensed physicians and dentists in the US, 849 are quoted as some of the professionals opposed to fluoridation.


The number opposed is 0.074% of the total physicians and dentists in the US. It's difficult to ever get l 00% of any group to agree on anything.




FDA Regulatory Authority and Water Fluoridation:

The safety of the water supply falls under the regulation of the EPA, not the FDA.

Per CDC:

"FDA Regulatory Criteriafor Fluoride"


"The U.S. Food and Drug Administration (FDA) does not regulate additives to community drinking water, because its regulatory reach concerns the safety and efficacy of food, drugs, or cosmetic-related products."






These claims are not substantiated in credibly conducted scientific research.





Edward T. Urbansky and Michael R. Schock, Intern. J Environ. Studies, 2000, Vol. 57. pp. 597-637



Recent reports on the possible effects of water fluoridating agents, such as hexafluorosilicic acid, sodium hexafluorosilicate, and sodium fluoride are inconsistent with accepted scientific knowledge, and the authors fail to identify or account for these inconsistencies. Many of the chemical assumptions are scientifically unjustified, and alternate explanations (such as multiple routes of Pb11 exposure) have not been satisfactorily addressed. At present, there is no evidence to suggest that the common practice of fluoridating drinking water has any untoward health impacts via effects on lead (II) when done properly under established guidelines so as to maintain total water quality. Our conclusion supports both EPA and PHS/CDC policies on water fluoridation.


2. "Blood Lead Concentrations in Children and Method of Water Fluoridation, United States, 1988-1994", Macek M, Matte T, Sinks T, Malvitz D. Environmental Health Perspectives 2006; 114:130-134.



Summarized Abstract:

"Some have hypothesized that community water containing sodium silicofluoride and hydrofluosilicic acid may increase blood lead concentrations (BLCs) in children by leaching of lead from water conduits and increasing absorption of lead from water. This analysis aimed to evaluate the relationship between method of water fluoridation and BLCs in children. BLC data was used (n = 9,477) from the Third National Health and Nutrition Examination Survey (1988- 1994) for children aged 1-16 years and merged with water fluoridation data from the 1992 Fluoridation Census. The main outcome measure was geometric mean BLC. Covariates included age, sex, race/ethnicity, poverty status, urban dwelling status, and length of time living in residence.


Geometric mean BLCs for each water fluoridation method were 2.40 µg/dL L (sodium silicofluoride), 2.34 µg/dL (hydrofluosilicic acid), 1.78 µg/dL (sodium fluoride), 2.24 µg/ dL (natural fluoride and no fluoride), and 2.14 µg/dL (unknown/mixed status). In multiple linear and logistic regression, there was a statistical interaction between water fluoridation method and year in which dwelling of residence was built. Controlling for covariates, water fluoridation method was significant only in the models that included dwellings built before 1946 and dwellings of unknown age. Across stratum-specific models for dwellings of known age, neither hydrofluosilicic acid nor sodium silicofluoride were associated with higher geometric mean BLCs or prevalence values.


Given these findings, our analyses, while not definitive, do not support concerns that silicofluorides in community water systems cause higher BLCs in children. Current evidence does not provide a basis for changing water fluoridation practices, which have a clear public health benefit."


Reductions in cavities in adults:


  1. "Cavity reductions continue to occur into adulthoodfrom access tofluoridated water. The reduction in caries previously demonstrated in children has extended to adults. The impact is a decline in the needfor restorative dentistry. "


    "Trends in caries among adults 18 to 45 years old", Brown LJ, Wall TP, Lazar V., J Am Dent Assoc. 2002 Jul;133(7):827-34.



  2. "It was once thought that fluoridated drinking water only benefited children who consumed it from birth," explained Slade, who is John W. Stamm Distinguished Professor and director of the oral epidemiology Ph.D. program at UNC. "Now we show that fluoridated water reduces tooth decay in adults, even if they start drinking it after childhood In public health terms, it means that more people benefit from water fluoridation than previously thought."


    "Effects of Fluoridated Drinking Water on Dental Caries in Australian Adults"

    G.D. Slade, A.E. Sanders, L. Do, K. Roberts-Thomson and A.J: Spencer, J DENT RES published oline 1 March 2013



  3. "To date, no systematic reviews have found fluoride to be effective in preventing dental caries in adults. The objective of this meta-analysis was to examine the effectiveness of self- and professionally applied fluoride and water fluoridation among adults.

    The prevented fraction (reduction in cavities) for water fluoridation was 27% (95%CI; 19%-34%). These findings suggest that fluoride prevents caries among adults of all ages."


    "Effectiveness of Fluoride in Preventing Caries in Adults"

    S.O. Griffin, E. Regnier,P.M Griffin, and V. Huntley, J Dent Res 86(5):410-415, 2007







I advocate for the health and protection of children's rights everywhere, especially in the area of fluoridation challenges.

I have been involved in fluoridation challenges in numerous communities throughout Florida and the United States. When the authorities that oversee fluoridation decisions are presented with the credible, scientific, peer reviewed and published data which supports the safety, effectiveness, and cost savings of optimally fluoridated water, they make the prudent decision to start, continue, or resume fluoridation for their communities. They understand that the science which overwhelmingly supports fluoridation is crystal clear. Failure to provide community water fluoridation results in irreparable harm to their families, both children and adults. Moreover, spending a communities time and efforts to review a Public Health Policy that continues to be supported by ongoing research is not only a waste of time for local communities, it is a waste of valuable resources which could best be spent on solving local issues.

When community leaders are faced with challenges to any medical, dental, or public health measure, they turn to the experts which have studied these issues and render their recommendations based on the best available research. They no more depend those without credible expertise who email them, or voice opposition to, the construction design of a nuclear power plant, bridge, hospital, road when faced with these decisions to make. They do not put out to referendum any of these issues to ask the public to decide if our credible experts are to be trusted. And why would they? To do so only passes the buck back to residents to be the fall guy if an issue has the potential to be unpopular. This is not how our government in the United States was set up. Failure of our officials to lead and make the tough decisions is the difference between an organized society and one in chaos. We chose to live in an organized society where all can be heard, but decisions are reached by our elected officials for the benefit of the greater good. Public Health Policy is made for the protection of an entire community. It cannot be tailored to the desires or opinions of the few who may oppose it.

You are the elected officials that were elected to make these informed decisions for your constituents. Make the prudent, scientifically valid, and credibly researched decision by voting to proceed with fluoridation of Hernando County's water. I urge you to continue to rely on the experts that we all trust, and to put this issue to rest here and now. Your residents all depend on your leadership for their health, well-being, and safety. Your children and adults, especially those most in need and living in poverty, deserve to receive the health benefits of fluoridation.

Finally, make no mistake. The folks speaking against fluoridation are here to make a national statement. They desperately want to have a community, no matter how large or small, fall prey to their tactics. They will use their "win" to build perceived credibility in their science-fiction claims and momentum in other communities. They did it in my home county of Pinellas and were successful in having it cut off to 700,000 residents. We fought for a year to have it returned and were successful, only after 2 incumbent county commissioners were replaced by the voters. Please do not allow these folks to create a similar "win" in Hernando County by having you vote to block your startup of community water fluoridation. After all, who really wins when the health of your community is jeopardized by a few who oppose fluoridation? No one. Including those that oppose it.


Johnny Johnson, Jr., D.M.D., M.S.

Pediatric Dentist

Diplomate, American Board of Pediatric Dentist

Palm Harbor, Pinellas County, Florida

Board of Health Meeting Agendas

Board of Health Meeting Minutes