A Sobering Look at Water Fluoridation
As a dentist whose top priority is the oral and overall health of my patients, I did my own deep dive years ago into all of the research and the history of water fluoridation, along with the effects of systemic ingestion of fluoridated water. Alarmed by what I discovered, I have been filtering fluoride out of my family’s water for over a decade now. The light that has recently come on this issue is a bright one and for that I am thankful.
Let me start by saying I believe that the promotion of water fluoridation by the dental profession is not out of ill will or maleficence. It is because health care training instills this belief. In dental school training, we all memorized and regurgitated the CDC’s 1999 MMWR report policy statement that “Water fluoridation is one of the top 10 public health achievements of the 20th century”. We were told that “all of the science supports this”, while never really being taught to take an honest and critical look at this outdated and poorly controlled science from the 40’s to the 70’s. It is also notable that much of this outdated pro-fluoridation research was conducted and/or promoted by public health bodies with vested interests in fluoridation policy. As you will see, “follow the money” plays a central role in water fluoridation, as it has in many other regulations throughout our recent history.
It is important that I admit that I was once one of the dentists obediently falling in line with what I had been told in school, and continued to be reminded in practice by well-meaning organized dentistry. In 2012, when the city of West Des Moines was being approached by a group wanting to end water fluoridation, I received the call to action in the chain email from the Iowa Dental Association, providing me with the draft letter to add my contact information and thoughts, to send to the WDM Water Works. I answered the call and promptly prepared and sent the letter stating the need to continue water fluoridation because <insert memorized and repeated talking point>. Shortly after that, I began to question the claims that I regurgitated as trained, and I looked into the science and this history myself. What I learned was jaw dropping and it gave me the spark that I needed to insert critical thinking and look for myself into all aspects of health.
There is such a need for an honest discussion of the facts on water fluoridation. Let’s lay out the facts.
Fact 1: Fluoride is not a natural component of any part of the human body, nor is it an essential nutrient for any function of our bodies.
It is not a “nutrient” for our teeth. Rather, it is able to incorporate into the natural hydroxyapatite (HAP) mineral structure of our teeth. There is not one biological function in the body that requires fluoride.
Fact 2: Fluoride is a very reactive and thus biologically potent compound.
Fluoride is the ionized form of Fluorine, the most highly reactive element on the Periodic Table. Both the elemental and ionized forms are extremely reactive and have a very strong affinity to bind calcium and other elements, leading to interference with bones, teeth, and enzymes.
Certainly you’ve heard the term “forever” chemicals. PFAS. Per- and polyfluoroalkyl substances. These man-made chemicals are so resistant to breakdown because of the extreme affinity of fluorine for the carbon in these products.
This extremely high bond strength of fluorine and fluoride is the reason for its adverse consequences throughout the body. In the thyroid, it outcompetes iodine and thus can suppress thyroid function. In the skeletal system, it displaces hydroxyl groups from the hydroxyapatite bone matrix, thus making bones more brittle and susceptible to fracture with varying degrees of skeletal fluorosis. Neurologically, fluoride’s affinity for essential elements in the body (such as calcium) causes inhibition of enzymes necessary proper function and development, it disrupts hormone production, its affinity for aluminum (especially in the acidic stomach environment) can form complexes that cross the blood-brain barrier and interfere with neurotransmission, creates oxidative stress and associated mitochondrial damage in neurons, and causes neuroinflammation. This is all well documented in recent and ongoing research. Even the suspicion of any such adverse effects warrants immediate discontinuation of this medical intervention until it can be proven safe.
Fact 3: Fluoride can have topical benefits for teeth, making the tooth structure less susceptible to breakdown of the mineral complex in acidic environments- this is well documented and absolutely a credible argument. Fluoride has shown no reasonable or measurable systemic benefits that cannot be obtained topically, instead having only the risk to cause harm when ingested.
This fact is supported by the CDC: “Fluoride’s caries-preventive action occurs primarily through topical mechanisms” ~MMWR 1999.
…by the NIH: “Fluoride works primarily by promoting remineralization and inhibiting demineralization of the tooth surface when it is present in the saliva” ~ NIH/National Institute of Dental and Craniofacial Research.
…by the Journal of Dental Research: “It is now well established that fluoride’s caries preventive action is mainly topical and not systemic” ~Featherstone, JDB (2000).
Fluoride’s strong affinity for calcium gives it the power to displace a hydroxyl group from the crystalline HAP natural matrix of our teeth and to bind to the calcium in the matrix, forming fluoro-hydroxyapatite. In small amounts and topically, this can be beneficial for prevention of tooth decay and reduction of sensitivity in those susceptible to these conditions. In larger amounts, particularly when ingested systemically during tooth development, too much fluoride incorporation into the HAP matrix will create a more brittle form of mineral structure of the teeth, fluoroapatite. Teeth with too much incorporated fluoride from high systemic ingestion are more susceptible to fracture with this brittleness. They can be esthetically compromised with chalky white spotting in a milder form of fluorosis, graduating to brown spotting and even pitting and gnarling of the enamel surface in more severe fluorosis.
Fact 4: The chemicals used for water fluoridation are not pharmaceutical grade. Instead, they are industrial waste products. You read that correctly. Our drinking water is being altered with the addition of industrial waste products, namely Fluorosilicic Acid and Sodium Fluorosilicate from fertilizer production and Sodium Fluoride from aluminum refining. These additives are not the form of fluoride that naturally occurs in groundwater, such as calcium fluoride. They are man-made chemical byproducts. This is a hard pill to swallow, but this is the absolute, undisputable, and often unrecognized truth.
All of these compounds are toxic to humans, corrosive to infrastructure, and environmentally damaging in the concentrated forms created from these industrial processes. If not rebranded as water additive, they would otherwise be classified as hazardous waste. If companies couldn’t sell their fluoride byproducts to municipalities, they would legally be required to follow strict EPA hazardous waste protocols for transport and neutralization, which would result in an estimated disposal cost of $2,000 to $5,000 per ton, possibly even more for fluorosilicic acid.
By reclassifying these industrial waste products as “water additives”, these companies avoid hazardous waste disposal costs. Rather, fertilizer and aluminum manufacturers are now able to sell these waste products for profit to municipalities, often earning $500 to $1,200 per ton. These are our tax dollars. Do the math and you’ll understand what is happening behind the scenes to drive continuation of this practice. I would again like to remind everyone that your dentist likely does not know this- very few people do. Dentists are merely supporting what they have been taught helps to achieve their number one goal: prevention of tooth decay. I imagine that most other dentists would be as astonished as I was to learn this.
Some communities are taking the initiative to follow the true science and remove the industrial waste additives from their community water supply. There is a great deal of push back on the federal level from regulatory agencies influenced by industry. The truth is that, if water fluoridation is ended, these fertilizer and aluminum companies will go from a position of selling their industrial waste for profit to having to pay much larger amounts to properly dispose of this hazardous waste. Let’s be sure to understand all of the things at play here.
Fact 5: The dose is critical. Fluoride is toxic. That is an indisputable fact. As with anything, it is true that “the dose makes the poison”. The argument in support of fluoride is that the dose deemed as low that is added to the water supply is safe. I would argue that blanket dumping of industrial waste fluoride chemicals into the water system simply cannot control the appropriate dose for all members of the population.
The dose of fluoride chemicals added to water is not rigorously tested. It has been a guessing game, and does not consider things such as the variation of water consumption throughout the population and the higher susceptibility to harm of some groups in the population.
In 1945, the recommended level in drinking water was 1.0 ppm. In 1962, US Public Health adjusted that to 0.7 to 1.2 ppm, citing variable water intake in different climates. In 2006, the National Research Council (NRC) called for reassessment. In 2015, US Public Health reduced to 0.7 ppm only, due to growing evidence of overexposure. In 2024, the US National Toxicology Program (NTP) division of the NIH concluded that sufficient evidence does not exist to rule out biological harms even at levels below the current 0.7 ppm.
Fact 6: The risk for vulnerable populations is large and I urge the dental profession to take an honest look and ask, “do the well documented risks outweigh the potential benefits?” in the case of water fluoridation. This is especially important when you consider that all governmental organizations have recognized that fluoride’s benefit potential for teeth is topical, not systemic.
High risk populations include infants and children who are in a stage of rapid neurological growth and development (including in utero exposure with pregnant women), those with impaired kidney function who cannot properly eliminate ingested fluoride, anyone with questionable skeletal health or arthritis, those with thyroid issues, etc.
Consider the dose received by an infant being exclusively fed formula made with fluoridated water. Take a birds’ eye view of the health trends in this country over the last four decades. Let me start by stating point blank that I am not saying that water fluoridation is THE cause of these things, I am pointing out that of the many societal health and dietary changes during this time that also correlate with these trends, water fluoridation should be considered as another possible contributing factor. Drastic increases in neurological issues of our children: ADHD, autism, motor tics and various degrees of Tourette’s, etc. Increase in adult neurological issues, such as Parkinson’s and Alzheimer’s. Increase in thyroid dysfunction. Increase in bone and joint disease, such as osteoporosis and arthritis. Increase in bone fractures. If this water fluoridation cannot be definitively ruled out from this, and a great deal of scientific evidence suggests some correlation, why are we accepting this risk? Why is the profession fighting so hard for systemic administration of a compound with known systemic toxicity when all of the prevailing evidence supports that the only benefits are topical? We are in a time where anyone anywhere throughout the country can get as much topical exposure to fluoride as they desire. It’s on the shelves of every grocery store, corner drugstore, and even gas station in toothpaste and mouthrinse. It can be professionally and topically applied at the dentist. There are many options for topical fluoride for those who want it and/or those at higher risk of dental decay.
I’ve heard some of the arguments that communities removing fluoride have had great increases in decay rates. What these arguments have failed to show me is any credible evidence to back them up. Manipulation of numbers and data can make for talking points, but they cannot provide credible support for an argument.
It is notable that modern counties without fluoridation have comparable or better dental health than our fluoridated country. The World Health Organization reports no clear difference in dental health trends between fluoridated and non-fluoridated countries. Claims of economic benefit are based on pro-fluoride models, not independent cost analyses. The claimed $6.5 billion in savings that you will often see in pro-fluoride talking points comes from CDC modeling rather than real-world cost-benefit analyses. Additionally, these models ignore the cost of treating dental fluorosis, which the CDC recently reported affects up to 41% of US teens, and they fail to factor in any potential long-term health burdens of systemic exposure.
To be frank, a lack of fluoride is not the cause of increased dental decay. Teeth decay more easily with increased consumption of simple starches and sugars, nutrient void ultraprocessed foods, and micro-nutrient depleted whole foods from our current agricultural systems. Consumption of these foods provide the acidic oral environment for the mineral structure of enamel to be stripped away, which is at the heart of the decay process, while not providing sufficient nutrient content for the teeth to replenish and remineralize themselves. Teeth decay more when the oral microbiome is imbalanced. Teeth decay more when oral hygiene is poor. Teeth decay more when side effects of medications cause a decrease in saliva. Any one of these things or any combination of these things increase one’s risk of dental decay.
In closing, I would like to share some information on the history of water fluoridation. I am the type of person who asks “why” very frequently. “Because I said so” never worked very well for my mom when I was growing up, and it still does not work with me in adult life with anything in the realm of health. I would highly recommend that everyone read Christopher Bryson’s book The Fluoride Deception, regardless of which side of the fluoridation argument you land. It is a very well-researched investigative book that utilized our own government’s declassified documents, scientific research, court cases, and first-hand interviews of those involved. If nothing else, it should bring questions that demand more transparent answers. Much of the history of industrial fluoride byproducts is from the World War 2 era, when aluminum manufacturing was ramped up and essential, and the toxic effects of fluoride were realized from death and severe health compromise of those working in or living around these manufacturing plants prior to proper control of the toxic fluoride waste products. Surrounding area livestock was desecrated with skeletal fluorosis and organ damage. Surrounding crops and plant life all died. Workers in nuclear weapons production plants were affected by documented serious fluoride-related neurological and skeletal damage, but these studies and reports were quickly classified to keep out of the public eye with fear of compromised weapons capacity during wartime. It was thought to be “for the greater good”. Hydrofluoric acid in airborne dust exposure in aluminum plants led to multiple worker handicaps with stiff and painful joints, skeletal deformities, and lung damage, but complaints and concerns were hidden, ignored, and quietly settled in lawsuits “for the greater good”. Once the toxicity of fluoride was realized, industrial measures were made to capture these fluoride byproducts to prevent exposure of workers and the surrounding environments of these plants. Then came the predicament of how to dispose of the hazardous waste. I can’t claim to know the whole story, but I find it interesting that in a similar timeframe of government need for no disruption in wartime production and in industrial need to dispose of a newly plentiful and captured toxic byproduct, fast and poorly studied measures were regulated to turn a chemical villain into a hero. For the greater good. It cannot be argued that this was a time of increasing tooth decay with the sudden shift from nutrient dense homegrown foods to more ultraprocessed shelf stable foods with depleted nutrient content, as well as increased simple sugar consumption and poor oral hygiene measures. The dental profession’s recent discovery in the 30’s and 40’s of the correlation between fluoride exposure and reduced decay susceptibility during this time of dentists trying to find answers to the rapidly growing dental decay epidemic paired well for a presumed “for the greater good” campaign to add this pesky industrial waste product in very small amounts to the community water supply. All sides went at this with the “for the greater good” mentality, without any consideration of potential harms. Nothing has really changed with the “general consensus” in the time since then.
It’s time for discussion, it’s time for a sober look at all of the information and evidence, it’s time for critical thinking to take the place of tradition.
✌️ Dr. Mindy
