We thank www.fluoridation.com for these pictures and definitions.
Dental fluorosis is characterized by skeletal changes and by mottled enamel of the teeth when exposure to fluoride occurs during enamel formation. [Dorland's Medical Dictionary]
Studies from the MedLine
Prominent researcher apologizes for pushing fluoride
Why EPA's Headquarters Union of
Scientists Opposes Fluoridation.
Fluoride Pollution - National Research Council, Washington, D.C.
Perception of Dental Fluorosis- Scientific abstracts about its psychological impact
Fluoride and Thyroid Problems- Thyroid Power by Richard Shames MD & Karilee Shames RN, PhD
Dartmouth News - Study Finds Correlation Between Fluorides in Water and Lead Levels
Poisoning the Well:
Neurotoxic Metals, Water Treatment, and Human Behavior1999 Speech by Roger D. Masters, head of Dartmouth College Foundation for Neuroscience and Society.
Dental Fluorosis: Smile Please, But Don't Say Cheese
Links to informational websites about fluoride
Buying water or water filters
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Laboratory of Dental Research, Faculty of Dentistry, University of Bergen, Norway. asgeir.bardsen@odont.uib.no"In order to study the age-related susceptibility to dental fluorosis, 40 children who had been lifelong consumers of moderate- to high-fluoride water ... were examined, as well as a group of older siblings (n = 40) who were born 6 months to 6 years before the fluoride-containing drinking water was introduced to the household. ... As compared to their older siblings, the prevalence of dental fluorosis was significantly higher in the children who had consumed moderate-to high-fluoride water throughout their lives. ... Fluoride exposure starting during the 1st year of life showed the highest odds ratio as compared to exposure only after 2 years of age. The findings indicate that early mineralizing teeth (central incisors and first molars) are highly susceptible to dental fluorosis if exposed to fluoride from the first and--to a lesser extent--also from the 2nd year of life."
Department of Dental Research, Faculty of Dentistry, University of Bergen, Norway. asgeir.bardsen@odont.uib.no"... In order to prevent dental fluorosis, groundwater wells should routinely be analysed for fluoride."
"High exposures to fluoride (F-) may occur in environments rich in F- from natural or industrial sources and from misuse of F--containing dental care products, particularly by children. Both acute and chronic exposures to elevated levels of F- have negative effects on several calcium-dependent processes, including kidney glomerular and tubular function. ..."
Community Dental Services, Wellington-Dufferin-Guelph Health Unit, Guelph, Ontario, Canada. dbrothwell@globalserve.net"... CONCLUSIONS: These findings indicate that fluorosis is an important concern in non-fluoridated areas. Fluoride supplements should not be recommended unless an independent home water test is performed. Breast-feeding for 6 months or more may protect children from developing dental fluorosis in the permanent incisors."
Department of Surgery, University of Peradeniya, Sri Lanka."A case of skeletal fluorosis with spinal cord compression from Kekirawa following consumption of water with high fluoride content for about 20 years is described. ... The need to search for a cost effective method of defluoridation of water is stressed."
Dental Health Unit, Turner Dental School."This article reviews current thinking on the rational use of fluoride for the safe and effective prevention of dental caries, so that benefits may be maximized and risks minimized. "
Department of Internal Medicine, Faculty of Medicine, Addis Ababa University, Ethiopia."The results of surveys carried out between 1976 and 1985 in the fluorosis-endemic area of the Ethiopian Rift Valley is summarised... The neurological manifestations ... occurred after exposure to high fluoride (greater than 4 ppm) for longer than 10 years. These deficits were clearly found to be a consequence of fluoride deposition in bones, resulting in generalised sclerosis and osteophytosis, with reduction in the diameter of the intervertebral foramina and of the spinal conal. Advanced osteosclerosis commonly causes severe spastic quadriparesis in flexion, accompanied by distressing spasms and urinary incontinence."
School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. kheller@umich.edu"The purpose of this study was to investigate the relationships between caries experience and dental fluorosis at different fluoride concentrations in drinking water. The impact of other fluoride products also was assessed. ... In addition to fluoridated water, the use of fluoride supplements was associated with both lower caries and increased fluorosis. CONCLUSIONS: A suitable trade-off between caries and fluorosis appears to occur around 0.7 ppm F. Data from this study suggest that a reconsideration of the policies concerning the most appropriate concentrations for water fluoridation might be appropriate for the United States."
Department of Neurology, Affiliated Hospital of Shihezi Medical College, Xinjian, Republic of China.The CSF fluoride level of individuals drinking water with normal fluoride content and of patients with endemic fluorosis were studied. ... Fluoride was revealed in every CSF sample of the control group and its mean value was lower than that of the blood. ... The results suggests that fluoride is a normal component of CSF. In severe cases of fluorosis or breakdown of the blood-brain in some diseases of the central nervous system, the CSF fluoride value might be increased.
Note: Where is the control group drinking water without fluoride?
Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA. ismailai@umich.edu "This paper presents a systematic review of the dental literature that was carried out to investigate whether the regular use of fluoride supplements in non-fluoridated communities during the period of tooth development increases the risk of dental fluorosis. ... This review confirmed that in non-fluoridated communities the use of fluoride supplements during the first 6 years of life is associated with a significant increase in the risk of developing dental fluorosis."
Oral Health Research Institute, Indiana University School of Dentistry, USA."...In February 1992 and December 1994, children who were residents of one of three communities with varying levels of fluoride in their communal water supply were examined for dental fluorosis. ... RESULTS: ... In the negligibly and optimally fluoridated communities, the incidence of dental fluorosis increased by 12% and 7%, respectively. In the 4X optimally fluoridated community, all the children examined had evidence of fluorosis at both examinations. CONCLUSION: Fluoride continues to be the primary therapeutic agent for the prevention of dental caries in adults and children. ... continued monitoring of the prevalence of dental fluorosis in young children is needed to determine if any additional steps are even necessary to restrict fluoride intake during the years that enamel formation is occurring."
When reading numerical data, remember that if the level of problem is high to start with, even a large increase will be a low percentage of increase - so in the 4X (high level) community they had 100% fluorosis each time which means no increase.... if the level is low to start with, then a small increase in numbers is a high percentage of increase
"It has long been accepted that fluoride accumulates in the leaves of the tea plant. Camellia sinensis. In addition it is known that some of this fluoride is released into the infusion which is drunk as tea. The exact concentration of fluoride in a cup of tea and the effects of this fluoride have been the subject of many international studies. ... By identifying potential sources of high fluoride ingestion, recommendations can be made to reduce consumption from these sources in patients who may be at risk of dental fluorosis. ..."
Bureau of Dental Health, New York State Department of Health, Albany 12237."A study was undertaken in New York State to determine the changes in dental fluorosis prevalence from 1955 to 1986 in fluoridated Newburgh and non-fluoridated Kingston children. ... The increased risk for dental fluorosis for Kingston residents appears to be from the use of fluoride tablets. An analysis of dental caries data revealed that caries prevalence declined substantially in both fluoridated and non-fluoridated areas."
New York State Department of Health, Albany 12237-0619, USA."This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. ... RESULTS: Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. CONCLUSIONS: The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline."
Bureau of Dental Health, New York State Department of Health, Albany 12237-0619, USA. jvk01@health.state.ny.us"This analysis was conducted to determine the changes in the effect of exposure to fluoridation and other sources of fluoride on dental fluorosis in children attending Newburgh and Kingston school districts in New York State. ... RESULTS: Children examined in 1996 were at higher risk for both questionable and very mild to severe dental fluorosis if they received fluoride from water or daily tablet use, or started brushing before the age of 2 years. The increase in risk from 1986 to 1995 was greater for African-American children. CONCLUSION: This analysis showed that the risk of developing dental fluorosis did not decline over time in these communities... "
"... the authors studied a cohort of persons born in 1900-1930 (n = 144,627), ... among younger women, those aged 50-64 years, higher fluoride levels increased the risk of hip fractures. Among older men and women and younger men, no consistent association was seen. ... The results suggest that fluoride increases the risk of hip fractures only among women. "
Section of Health Services Research, College of Dentistry, Ohio State University, Columbus, USA. mascarenhas.1@osu.edu"OBJECTIVES: To quantify the risk of fluorosis from fluoride toothpaste in a population whose only potential source of fluoride was fluoride toothpaste. ... Among children with fluorosis, beginning brushing before the age of 2 years increased the severity of fluorosis significantly ... CONCLUSIONS: Fluoride toothpaste use before the age of 6 years is a risk indicator for fluorosis in this study population."
Stobhill Hospital NHS Trust, Glasgow, UK."The presence of excessive quantities of fluorine in drinking water is accompanied by a characteristic sequence of changes in teeth, bone and periarticular tissues. These changes lead to a variable degree of locomotor disability, ranging from simple mechanical back pain to severe, crippling, combined locomotor and neurological impairment. In endemic areas, a substantial proportion of the population may be affected, posing a severe public health problem. In some areas, the hazards to human health are not fully appreciated and are under-reported. The maximum impact is felt in those communities engaged in physically strenuous activities, either agricultural or industrial. The need of these often isolated communities in economically hard-pressed countries, for the provision of low-fluoride drinking water remains a hope rather than an expectation at the present time."
Harvard School of Dental Medicine, Boston, Massachusetts, USA."This study investigated the potential association between fluoride exposure and behavior problems in children, as well as the prevalence of and risk factors for fluorosis. ... CONCLUSION: Although there was no association between the fluoride exposures in aggregate and fluorosis, there was a significant association between supplemental fluoride exposure from ages 0-3 years and fluorosis. There was no association between behavior problems and dental fluorosis in this population."
"Fluoride (F) is known to affect mineralizing tissues, but effects upon the developing brain have not been previously considered. ... Fluoride exposures caused sex- and dose-specific behavioral deficits with a common pattern. ... the severity of the effect on behavior increased directly with plasma F levels and F concentrations in specific brain regions. Such association is important considering that plasma levels in this rat model ... are similar to those reported in humans exposed to high levels of fluoride."
"Dental plaque fluid is normally supersaturated with respect to enamel mineral but this may change to a state of undersaturation when plaque pH falls following sugar exposure, placing the adjacent enamel at risk of caries. [ i.e., When the saturation falls, the enamel minerals will dissolve in the fluid] ...... some evidence was obtained that the test mouthrinses can counteract the fall in saturation level found when plaque is exposed briefly to sucrose. Potential long-term benefits of the test mouthrinses deserve further study."
Health Department of Western Australia, University of Western Australia, Perth."... The aim of this study was to record age of weaning and fluoride exposure from water, toothpaste and supplements, and to relate these to the presence of caries [tooth decay] and fluorosis in children born in 1983. ... Major risk factors for more severe fluorosis ... were early weaning and swallowing toothpaste ... Residence in a fluoridated area (OR 2.2) was not a statistically significant risk" factor.
"Fluoride may be ingested from a variety of sources, including many foods and beverages. ... the prevalence of dental fluorosis has increased in North America, suggesting that the levels of fluoride ingestion need to be closely monitored. ... Dietary fluoride supplements should be considered a targeted, preventive procedure only for those at elevated caries risk, and before prescribing them, careful consideration should be given to other fluoride sources, including home and child-care water supplies, foods, and beverages. "
Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, USA."... While the caries decline can be largely attributed to widespread fluoride dentifrice use, as well as many other sources of fluoride, several recent studies have attributed much of the increase in fluorosis prevalence to early use of fluoride dentifrice..."
Several bottled waters have been accepted for use within the Feingold Program. The Product Information questionnaire asks for disclosure about flouride and, if present, it is noted in the Foodlist & Shopping Guide for certain regions of the country.The decision on whether or not to use water filtration equipment to treat drinking water is personal and not addressed by the Feingold Program. Consumer Reports, however, recommends having water tested periodically if there is concern about its taste, odor or possible contamination. If a problem is discovered, it will be possible to shop for the most effective unit to serve the specific situation.
Besides cost, other issues that might be disucssed with a prospective supplier are:
- Location and size of the unit
- What specific contaminents will the unit remove and to what level
- Speed of the unit's operation and its total daily output
- How often will the filter element need changing and by whom
- Will the filter itself add any residual chemicals to the water as it is treated
- What special steps should be taken if the water system will not be used for a period of time
- Will any part of the system need cleaning, how often, with what substances and by whom
- Any other issues of particular concern
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