Fluoride is a
powerful toxin at high concentrations. It is considered safe at low
concentrations. It has a clear protective effect on dental health. At issue
currently is the safety margin between recommended levels for optimal dental health
and levels that can harm children as well as assessment of all avenues of
exposure to measure total exposure.
A new ruling by a
federal district court judge in California questions the safety of currently
recommended levels of fluoride in drinking water, citing studies that suggest
fluoride from other sources such as toothpaste and food added makes the levels
potentially unsafe. He also noted that studies suggest that high fluoride
levels lower IQ in children. He argued that current allowable levels in
drinking water are too close to levels that are toxic. The judge noted that there
is a preponderance of evidence that suggests that there is an “unreasonable
risk” of current levels of fluoride added to drinking water. It seems the
decision basically requires the EPA to look more into the issue and come up
with some kind of response.
According to the CDC’s Public Health Service (PHS):
“The PHS panel that provided the recommendation
considered all sources of fluoride intake and recommended 0.7 mg/L as the
concentration that maximizes fluoride's oral health benefits while minimizing
potential harms, such as dental fluorosis.”
Dental fluorosis refers to damage to developing teeth
caused by excessive levels of fluoride. The recommended level is 0.7 mg/L and
the level considered to be safe is less than 1.5 mg/L. Apparently, that 0.8mg/L
margin between fluoride levels deemed safe and levels considered to be harmful
to human health, especially of children, are not as high of a safety margin as
some, including the judge, deem necessary.
One of the
studies cited was just completed by the National Institutes of Health (NIH)National
Toxicology Program (NTP). Their findings include the following:
“The NTP monograph concluded that higher levels of
fluoride exposure, such as drinking water containing more than 1.5 milligrams
of fluoride per liter, are associated with lower IQ in children. The NTP review
was designed to evaluate total fluoride exposure from all sources and was not
designed to evaluate the health effects of fluoridated drinking water alone. It
is important to note, however, that there were insufficient data to determine
if the low fluoride level of 0.7 mg/L currently recommended for U.S. community
water supplies has a negative effect on children’s IQ.”
The monograph also suggests that more research is needed
regarding the safety of low fluoride concentrations. Fluoride is clearly
beneficial for dental health at lower levels so my guess is that the EPA will
review the issue as required and either not change the recommendation or lower
it a small amount.
The American Academy
of Pediatrics questioned the NIH report:
“While additional research to better understand the
association and potential biologic mechanisms would be important, there’s
nothing about the research that makes me concerned (about) … low levels of
fluoride through use of toothpaste and drinking fluoridated water,” said
Charlotte W. Lewis, M.D., M.P.H., FAAP, a member of the AAP Section on Oral
Health.
They also questioned the reliability of the methodologies
and conclusions of the report, which was essentially a meta-analysis of previous
data. The AAP points out that other studies and meta-analyses utilizing the same
data came to different conclusions, that fluoride was not associated with lower
IQ. Apparently, the NIH research suggested that child IQ could be lowered by 4
points. That is not a large amount and could be within a margin of error or not
statistically significant. They also opine that the problem of dental caries is
far more damaging than any risks to IQ associated with safe fluoride levels. Water
fluoridation is not required. They point out that in places where it has been
discontinued, there were subsequent increases in dental caries.
Critics have noted
that other countries have reduced cavity levels without water fluoridation. The
CDC still says it is the best way to protect dental health:
The CDC has argued that continued water fluoridation
is still the “most cost-effective method of delivering fluoride to all members
of the community regardless of age, educational attainment, or income level.”
The judge referred the EPA to a number of options in response
to the ruling. These include adding a warning label about fluoride's risks at
current levels to possibly lowering the levels added to public drinking water
systems.
The plaintiffs
in the case, which include activist groups such as Food and Water Watch, have a
clearly stated goal of banning the addition of fluoride to any drinking water,
suggesting unscientifically that no levels are safe.
According to the CDC water fluoridation is a cost-effective
way to improve dental health:
“Drinking fluoridated water keeps teeth strong and
reduces cavities by about 25% in children and adults. This results in less
mouth pain, fewer fillings or teeth pulled, and fewer missed days of work and
school.”
“Communities of 1,000 or more people see an average
estimated return on investment (ROI) of $20 for every $1 spent on water
fluoridation. The ROI for community water fluoridation increases as the
community size increases, but even small communities save money. Communities
served by fluoridated water save an average of $32 per person a year by
avoiding treatment for cavities.”
The CDC notes
that 74 million Americans lack access to fluoridated drinking water.
Fluoride
concentrations in naturally occurring water sources vary and must be considered
to get concentrations to the desired levels. Most groundwater sources in the U.S.
have naturally occurring fluoride concentrations between 0.1 and 0.7 mg/L. Some
groundwaters have clearly unsafe levels of fluoride as the U.S. map below shows.
Fluoride can be removed from drinking water via microfiltering.
In 1945, Grand Rapids, Michigan became the first city to
fluoridate its community water, when they adjusted existing levels to 1 mg/L or
1 ppm. Since then, it has been adjusted to the current recommended level of 0.7
mg/L (ppm). As mentioned, fluoridation is not a requirement. Anti-fluoride activist
groups which have been active for a long time, campaign to stop water
fluoridation. The map below shows U.S. communities without drinking water
fluoridation. Below the map, the graph shows how many people live where fluoridation
is banned. Portland, Oregon, with a population of 900,000 is the largest city under
a fluoridation ban.
References:
Federal court rules against EPA in lawsuit over fluoride in water. Alexander Tin. CBS News. September 25, 2024. Federal court rules against EPA in lawsuit over fluoride in water (msn.com)
Judge
orders EPA to address potential IQ impacts of fluoride in drinking water. Rachel
Frazin. The Hill. September 25, 2024. Judge
orders EPA to address potential IQ impacts of fluoride in drinking water
(msn.com)
Community
Water Fluoridation Recommendations. Center for Disease Control. Community
Water Fluoridation Recommendations | Fluoridation | CDC
About
Community Water Fluoridation. Center for Disease Control. About Community Water
Fluoridation | Fluoridation | CDC
Fluoride
Exposure: Neurodevelopment and Cognition. National Institutes of Health.
National Toxicology Program. Fluoride
Exposure: Neurodevelopment and Cognition (nih.gov)
AAP
stands by recommendations for low fluoride levels to prevent caries. Melissa
Jenco. American Academy of Pediatrics. August 23, 2024. AAP
stands by recommendations for low fluoride levels to prevent caries | AAP News
| American Academy of Pediatrics
Dental
fluorosis. Wikipedia. Dental
fluorosis - Wikipedia
The
fluoride fight: Data shows more US cities, towns remove fluoride from drinking
water. Mary Walrath-Holdridge. USA Today. April 17, 2024. Fluoride
being removed from water systems in more U.S. communities (usatoday.com)
No comments:
Post a Comment