Fluoride: Poisonous prevention

WHAT DOCTORS DON'T TELL YOU Volume 3, No. 9

How we are being bombarded with fluoride in our water and dental supplies and what it does to you.

What would you say if you heard that the government planned to contaminate the public water supply with an agent that has been associated with cancer, genetic disorders, brittle bones and mottled teeth? For around 10 per cent of the population in the UK and 50 per cent in the US, this is already happening.

In these areas, fluoride is routinely added to the water supply on the basis that it strengthens teeth and protects against cavities. Fluoride has long been regarded as a dental cavity preventative, but increasingly this premise is being challenged all over the globe.

The prevailing wisdom used to be that fluoridation led to a dramatic reduction-of up to 60 per cent-in decayed, missing and filled teeth among children. More recent studies have revised this figure downwards to between 20-40 per cent. And new evidence from New Zealand and Canada suggests there may be a higher level of tooth decay in fluoridated areas. Writing in 1984 John Colquhoun, New Zealand's former chief dental health officer, said: "When any unfluoridated area is compared with a fluoridated area of similar income level, the percentage of children who are free of dental decay is consistently higher in the unfluoridated area."

Filling levels are more likely to be related to income levels than to fluoride levels, Colquhoun concluded following a government study of more than three-quarters of the NZ population. Colquhoun was originally responsible for implementing fluoridation in NZ but later became a staunch antifluoridationist.

No one disputes that too much fluoride is harmful to teeth. The debate is simply about how much is too much and what other harm it causes. Even fluoride proponents concede that - whether from fluoridated water, toothpaste, tablets or any other source-excessive fluoride leads to fluorosis, a condition where teeth become pitted, mottled and eventually destroyed. Yet, even as early as the 1930s, H T Dean of the US Public Health Service observed that susceptible individuals, particularly those with a poor nutritional profile, would suffer mottling at lower doses than the supposed optimal daily level of 1 mg.

One in four people is in danger of overconsuming fluoride, even when the water isn't fluoridated.'

Fluoridating the water supply makes a fundamental simplistic assumption: that all the people drinking it, no matter what their size, age or state of health, require the same fluoride level. This supposed "optimal" daily amount - of 1 mg - has somehow translated into a belief that the water supply should be fluoridated at one part per million (1ppm) (Department of Health, Report on Health and Social Subjects, October 1991). Such a blanket approach ignores the fact that there is no control over how much water people consume, that fluoride is widely available from other sources, and that thirsty children weighing 2 or 3 stones (28-42 pounds) receive the same amount of fluoride as adults four times their size.

Fluoride also accumulates in the body from a great number of natural sources. Tea is a major source of fluoride, even if made with non-fluoridated water. In the abovementioned report, the Department of Health itself recognizes that: "Those consuming large volumes of tea would have an intake of 4.4-12.0 mg depending on whether tea was prepared from fluoridated water." These were considered levels far above those generally recognized as safe.

In a magazine entitled Health for All (January 1970), researcher H A Cook records instances of individuals suffering fluorosis from tea drinking alone. He conducted a study which found that tea-drinking children take in levels of fluoride more than twice as high as the recommended daily dose.

Fluoride is also absorbed through the lungs from industrial air emissions, and any foodstuffs grown, manufactured or cooked in fluoridated areas will contain large amounts of it. Even teflon cooking utensils can be a source. (See box p 3.)

Large amounts of fluoride are ingested from toothpaste and mouthwashes. A 1988 study (B P Rajan et al, Fluoride, 21: 1988) found that toothpaste can double the level of fluoride in the blood within five minutes of being used. Even when the toothpaste is not swallowed, it is absorbed into the blood directly through the skin of the tongue and cheeks. Despite this, toothpaste manufacturers continue to increase the present high levels of fluoride-up to 1450 ppm - with no warnings over how their products should be used or how much fluoride they contain. And of course children who tend to swallow toothpaste can end up ingesting excessive - even lethal - levels.

Dentists routinely recommend fluoride tablets for children, never testing to see whether fluoride levels are actually low and without being trained to recognize existing fluoride damage. Fluoride tablets are a major source of fluorosis, according to a Danish study of 56 children regularly taking them. "Almost half showed dental fluorosis to some degree," conclude the authors (M J Larsen et al, Community Dent Oral Epidemiol 1989). They can also kill. National Fluoridation (Vol XXIX, No 1) reports the case of a 3-year-old boy who collapsed and died after consuming the equivalent of 16 mg/kg body weight of fluoride tablets.

In 1991 Lincolnshire-based Dr Peter Mansfield set up the UK's first laboratory to test individual fluoride levels. According to results from the first 100 people he has tested - most of whom come from areas where the water is not fluoridated - one in four people in the UK is in danger of overconsuming fluoride.

"Far from being deficient in fluoride, the British public is in danger of consuming too much," he says.

The great problem with overconsumption of fluoride is that only around half of that ingested is excreted by the body in healthy adults.

Children, diabetics or those with kidney problems may retain up to two-thirds of the fluoride they take in.

This build-up in the body of what Mansfield calls "a poison - full stop" is associated with a host of other problems, including cancer. An American study, sponsored by the government's National Toxicology Program (Lancet, 3 February, 1992) found evidence of numerous cancers in rats and mice after they were exposed to low levels of fluoride.

The researchers reported bone or bone-related cancer; liver/bile cancer; oral lesions; abnormal cell changes; and metaplasias (replacement of one tissue type with another).

Despite the findings, the US Public Health Service reaffirmed its faith in the safety of fluoridated drinking water by concluding that the NTP findings were equivocal.

Others disagreed, notably William Marcus, chief toxicologist for the Environmental Protection Agency's drinking water programme and Dr Robert Carton, an environmental scientist in the EPA's Office of Toxic Substances. Both Marcus and Carton publicly accused the PHS of underplaying the dangers of fluoride. Some 35 dentists have mounted a law suit against the American Dental Association, claiming that it has consistently released misinformation on fluoridation.

Dr David Kennedy, one of these dentists, says: "I think it is criminal to expose large groups of the population to toxic substances without any evidence of safety. The proponents of toxic dentistry claim that you can't prove the agent caused a specific problem .... It is not our responsibility to prove that a poison is not a poison. It is the responsibility of the person who applies the poison to prove that it is harmless..."

While evidence of a link with cancer is relatively new, the link between fluoride and brittle bones is well established. Fluoride which is not excreted accumulates in the bones (Fluorine and Fluorides, 1984; Hodge et al, 1970). This accumulated fluoride serves to increase the bone mass, but although the bones are more dense, they are also more brittle. There have been four studies over the last two years which show increased incidence of hip fractures in the elderly in areas with fluoridated water (C Danielson et al, JAMA 1992; 268; S J Jacobsen et al, JAMA 1990; 264; C Cooper et al, JAMA 1991; 266; M R Sowers et al, AM J Epidemiol 1991;133).

Despite solid evidence to the contrary, fluoride is still prescribed as a treatment for osteoporosis. The medical rationale is that because fluoride increases bone density, it ought to be able to reverse osteoporosis, a condition where bones become porous and lose density. The US authors of the Danielson study mentioned above conclude: "Exposure to fluoride apparently causes new bone formation of an inferior quality, especially in the femoral head where there is more cortical bone . . . .its compressive strength increases, but its tensile strength decreases." In other words, fluoride may make your bones thicker, but they'll break more easily.

Fluoride build-up can also affect your immune system. Dr Sheila Gibson, a research physician at Glasgow Homoeopathic Hospital, tested the effect of low levels of fluoride on the action of leucocvtes-infection-fighting white blood cells. She found that fluoride concentrations of well below that recommended as "optimal" for adding to the water supply (1 ppm) inhibited the ability of leucocytes to migrate.

Gibson's work refutes the claims that fluoride does not have adverse physiological effects below a concentration of 10 micrograms per millilitre. "It is, however, more likely that fluoride affects cellular metabolism at all concentrations, but that in some systems this effect is not detectable until doses in excess of 10 micrograms per millilitre are reached," she says. "The present series of experiments clearly demonstrate effects of fluoride as low as 0.5 micrograms per millilitre."

Gibson says that this action affects the ability of the immune system to function efficiently, which in turn reduces the resistance to infection as well as increasing the susceptibility to cancer and immune-depressed states, such as post-viral fatigue syndrome and AIDS. "The effect on individuals already suffering from such immunedepressed conditions is likely to be serious."

Fiona Bawdon

Fiona Bawdon is a WDDTY contributing editor. Additional reporting and research material supplied by Anne-Lise Gotzche.

Avoiding fluorosis

As well as being a well documented cause of mottled teeth, fluoride overload is also associated with a range of other symptoms. In his book, Fluoridation: the Great Dilemma, the late Dr George Waldbott lists the following symptoms. Their severity and duration will depend on an individual's age, nutritional status, environment, kidney function and susceptibility to allergies.

• Chronic fatigue not relieved by extra sleep or rest

• Headaches

• Dryness of throat and excessive water consumption

• Frequent need to urinate

• Aches and stiffness in muscles/bones

• Muscular weakness and spasms

• Gastrointestinal disturbances, including diarrhoea and constipation

• Pinkish-red or bluish-red spots on the skin, which fade after around a week

• Skin rash or itching after bathing

• Dizziness

• Visual disturbances

1) If you are displaying what you believe are symptoms, have your fluoride levels tested. Currently, this test is only available from Good Healthkeeping in Lincolnshire at £9 and f5 for a follow-up test (0507 327655).

2) If you live in a fluoridated area, your only option is to use solely bottled water; or fit a reverse-osmosis water purifier in your home (again available from Good Healthkeeping at around £300, plus the cost of renewing the filter membrane every six months). Both options are expensive. You may also purchase a service which will deliver bottled mineral water and supply a dispenser for f20-f30 a month.

3) Reduce your intake of tea and soft drinks. Drink herbal tea made with non-fluoridated water instead.

4) Switch to a non-fluoridated toothpaste. Never let children use "adult" fluoride toothpaste.

5) Check your nutritional status. A poor diet will only increase your susceptibility to symptoms of fluoride poisoning. Adequate levels of magnesium, zinc and iron will help your body counter the effects of fluoride.

6) Watch your consumption of prepared foods, particularly frozen vegetables.

7) Never use fluoridated water for baby formula (another good argument for breastfeeding).

Why fluoride cannot be controlled

The issue of artificial fluoridation of water is complicated by the high fluoride levels in the diet and in beverages. Since World War II the use of both organic and inorganic fluoride compounds in industry has burgeoned, as has industrial fluoride pollution. You cannot burn a piece of coal without liberating fluoride. Even fluoride dust taken in through the lungs can lead to dental fluorosis. Natural fluoride, cryolite, a sodium aluminium fluoride, is used in aluminium production, and apatite, a calcium and fluoride-containing phosphate complex, is used as the raw material for phosphate fertilizers. Fluorides have also been used for many years as insecticides and rodenticides, the latter being the reason many opponents still like to describe fluoride as a "rat poison".

Fluorine has been introduced into pharmaceutical drugs including steroids, the synthetic oestrogens used in the Pill and, most recently, antibiotics.

Fluorinated anaesthetics - often called "halogenated" anaesthetics - can give off high concentrations of inorganic fluorides when metabolized in the liver, according to Professor Philippe Grandjean, a top international fluoride expert and WHO scientist, from the Institute of Community Health, Odense University, Denmark.

An apple contains between 0.22 and 1.30 ppm fluoride, according to the World Health Organization, but the fluorine containing insecticide sprayed on the tree producing the apple may add another I mg of fluoride to it-and to your bodily load.

In Fluoridation: The Great Dilemma (Coronado Press, Kansas, 1978) Dr George Waldbott, among others, warned that baby foods can contain up to 18 ppm fluoride, enough to produce mottled teeth, and that fish-protein concentrate distributed to people in the Third World may contain up to 370 ppm. Others, such as the British dentist Dr Geoffrey E Smith, now living in Australia, point out that infant milk formulae made up with fluoridated water can contain up to 100 times the amount of fluoride obtained from mother's milk. Even fluoride preservatives in cheap wines have been shown to cause wine fluorosis in heavy drinkers, according to an oft quoted paper by M. Soriano from the University of Barcelona in 1966.

Modern estimates of dietary fluoride intakes by fluoride promoters tend to hark back to a 1943 study done by F J McClure of the American National Institute of Dental Research. He found that the typical American adult obtained between 0.3 and 0.5 mg of fluoride a day from food. Independent scientists such as the late John Mader of the Division of Biological Sciences at the National Research Council of Canada claim that diet alone may contribute up to 5.5 mg fluoride a day.

• The average consumer would be hard put to judge his or her fluoride intake today. Official guidelines on "optimal" doses for dental purposes, on "safe and adequate" doses, and even on toxic and lethal levels, are also confusing and can vary from country to country, and from one scientific or academic institution to another.

"Fluoride," wrote Canada's John Marier in a major fluoride report in 1977, "is a persistent bioaccumulator, and is entering into human food and beverage chains in increasing amounts."

Some of the fluoride ingested may be stored in bone for a long time before being slowly released. The half life, or average turnover rate, can be as much as nine years, which means that both dental and medical effects can be caused by much earlier exposure, and need not be related to the toothpaste, tablets or drinking water being used when the symptoms appear.

There is also the problem of biotransformation in the body, whereby organic fluorine compounds belonging to the fluorocarbon group can release inorganic fluorides through bacterial metabolism and degradation.

For many years these fluorinated hydrocarbons were regarded as stable and inert Today, however, many scientists in fields such as organic chemistry insist that few organo-fluorine compounds are biologically stable.

Magnesium is at the very centre of the body's reactions to fluoride from all sources. Fluoride "chelates" (chemically "grabs") magnesium in the body, making the magnesium unavailable for its many functions. Magnesium in turn, protects against fluoride toxicity.

As John Marier put it in a paper presented to dentists at the University of Kuopio in Finland in 1979, "... the toxic effects-of fluoride [are] a direct function of the severity of the magnesium deficiency. Thus, very low levels of dietary fluoride are toxic at ultra-low levels of dietary magnesium, whereas much higher levels of fluoride are innocuous when dietary magnesium is increased."

It is plain that many people consume quite high amounts of fluoride from both natural and industrial sources without developing mottled teeth or fluoride-related medical afflictions.

The reason is that fluoride can be chelated not only by magnesium but by other naturally occurring metals, which means that its bioavailability is low.

Anne-Lise Gotzche

Medical journalist Anne-Lose Gotzche has written widely on the hazards of fluoride, particularly from industrial sources.