Water Fluoridation in Burlington

Greetings bioethics bloggers and thank you Linda for the invitation to post here. I have been a casual reader for some time now, but this will be my first contribution. For those who don't know me, my name is Kevin Hurley and you can read more about me here. I moved to Burlington about three years ago with the intention of getting involved in the production of educational/environmental media.

When I think of the word "Fluoride" I immediately think of healthy teeth. The word sounds harmless and friendly. Originally, I was very supportive of water fluoridation. I became interested in the issue about three years ago and have since spent a good deal of time traveling the country and world interviewing an array of professionals on the issue. I've interviewed toxicologists, fetal-toxicologists, neuro-toxicologists, dentists, doctors, politicians, lawyers, risk assessment scientists, etc. Among those interviews were three of the panelists from the National Academy of Science's National Research Council charged with reviewing the current EPA standards on fluoride. I must now humbly admit that I was wrong in my previous beliefs about water fluoridation. It appears that most of the new evidence about this practice shows that the risks of fluoride exposure to ourselves and our children are just not worth it.

Let's take a look at some recent developments:

1. In 2006 the National Research Council released a report entitled: Fluoride in Drinking Water. This report reviewed a huge body of old and new science relevant to water fluoridation and concluded that the allowable limits of fluoride are too high. It concluded that infants/children may be getting 3-4 times the dose of fluoride that adults do. It also identified "vulnerable subsets" of the population, including infants, diabetics, kidney patients, and seniors who more at risk of problems due to fluoride toxicity.
   
2. In response to this report, the American Dental Association changed their position on the use of fluoridated tap water ad infant formula in a warning stating that: "If using a product that needs to be reconstituted, parents and caregivers should consider using water that has no or low levels of fluoride.
3. In 2008 the National Kidney Foundation discontinued their support of water fluoridation stating that: "Individuals with CKD (Chronic Kidney Disease) should be notified of the potential risk of fluoride exposure..."
   
4. 23 new studies indicating that children from areas of higher fluoride exposure experience I.Q. deficits were acknowledged by the NRC. The panel found that the research seemed to be consistent enough to warrant further investigation.
   
5. In 2006, Elise Bassin's Harvard report was published. It showed a definite link between young boys who are exposed to fluoride during the ages of 6 and 8 and a 4-fold increase in their chances of developing osteosarcoma. The study found no link with girls. The study was described by the Washington Post as the most rigorous fluoride/cancer study ever done. It is known that fluoride is mutengenetic and therefore is a likely candidate for being carcinogenic as well.
   
6. Dr. Jennifer Luke's research found that fluoride was readily depositing in the human pineal gland ("The seat of the soul" or "The thousand petaled lotus") at the highest concentrations in the body (20,000ppm - more than 10X the concentration of fluoride in your toothpaste). This is especially alarming considering that this calcifying gland produces Melatonin and is so intimately connected with everything circadian. She thinks there maybe a connection between fluoride depositing in the pineal and the findings of the Newburgh-Kingston study showing that girls in fluoridated Newburgh were reaching puberty on average six months before girls in non-fluoridated Kingston.

There is little dispute that fluoride reduces tooth decay. Its primary effect, however, is topical. It works by brushing it onto the surface of the tooth using toothpaste or gels/varnishs given in the dentist's office. According to CDC and Department of Health and Human Services data, however, water fluoridation has NO correlation to healthy teeth. Sometimes health officials will argue: "Look at the rate of tooth decay in Burlington compared to Brattleboro. Obviously fluoridation makes a difference!" Obviously? Obviously we have not taken into account access to good dental care, or even the general socio-economics of the areas. When looking at two very specific cities, there are too many variables that could influence the average health of teeth. Again, this is why it is important to look at the whole population. I've yet to find any proof that water fluoridation is effective.

So what does all of this have to do with bioethics? Let me pose some questions.

• Let's pretend that water fluoridation does help to prevent tooth decay. Remember, fluoride has no other purpose in the water other than to prevent the disease, dental caries. It is not used to kill the bugs and make the water safe to drink, only to prevent a disease. U.S. law defines any substance intended to treat, mitigate, cure, diagnose, or prevent disease as a drug. Even if water fluoridation did reduce tooth decay, what are the ethics of using the public drinking water to deliver an uncontrolled dose of a medication? Does this set a precedent?
  
  
• If the distribution of fluoride chemicals to Burlington residents via the public drinking water is, in fact, the distribution of a drug, how do we account for the vulnerable people in our community who are more at risk for the adverse effects? Now that we know that infants are not supposed to receive fluoridated water, what are mothers in the low-income range supposed to do? What are kidney patients supposed to do now they we know they are more harmed by fluoride in the water? Can we ethically justify forcing this chemical into the drinking water of everyone, for the purpose of reducing tooth decay in a small population when 1) We know that it is ineffective at reducing tooth decay, and 2) we know that it poses increased risks to vulnerable people in our community?
  
  
• Let's not forget the actual chemical we, here in Burlington, add to the municipal water. Hydrofluorosilisic acid, is an industrial waste byproduct of the phosphate fertilizer manufacturing industry. Without communities willing to purchase this for water fluoridation it would be regulated by EPA as a hazardous waste. Claims by health authorities that it completely dissociates in water and thus behaves the same as the pure fluoride ion are unsubstantiated and untested so far as I can see. Science on these silicofluoride compounds is sparse, but what science does exist indicates that they do not behave the same way in water. Silicofluorides have been linked to increased lead up-take in children and increased violent behaviors in children (Masters Coplan).
  
  
• 32% of children in the United States have a condition called dental fluorosis according to the CDC. Dental fluorosis is white or brown flecks on the surface of the tooth that is caused by ingesting too much fluoride. Some consider this a disease, however the CDC considers it a "cosmetic defect". Regaurdless of what we call it, it is damage done to the tooth as a result of overexposure to fluoride. You might call your local dentist and as them how pricey it is to repair a single tooth that has fluorosis. At a minimum, do we have the right to add something to the water that we know causes damage others?
  

Being in opposition to water fluoridation is not a popular position in the US. But the fluoridation chemicals that we use in the water do not respect these politics. The words "safe and effective" and "sixty years of research" can not be repeated enough to convince the fluoride ion to stop depositing in the pineal, or to stop damaging the teeth and bones. Does the inertia of a policy justify its continuation now that we know its harmful effects? I understand that science and politics move slowly, but remember, at one point 9 out of 10 dentists recommended smoking Viceroys. Once upon a time things like lead, asbestos, and DDT were safe too. We do have the ability to be wrong, but we also have the ability to correct those errors when new information becomes available. If we really believe that fluoride is "safe and effective" based on the science than, by all means, let us keep adding it. But if you haven't researched it, I would highly urge you to do so.

Thank you.
Kevin Hurley