Pros and Cons: Adding Fluoride in Drinking Water

Note from the writer: SPOKANE, Wash.  The City of Spokane would pay nearly $11 million in capital costs and millions more to maintain a system that would add fluoride to the city's drinking water. A fluoridation implementation study commissioned by the city was just released and will now be used for elected officials to consider when deciding whether to add fluoride.

According to a recent statewide report, 46% of people in Washington have access to fluoride-treated drinking water.

Spokane has considered it several times over the years, but has never made the decision to add fluoride to the water system.

Spokane Mayor Nadine Woodward has said in the past she wants the issue to go to a public vote.

PAST COVERAGE: 'It should be on the ballot'

: Woodward says decision to fluoridate water should be up to voters. The Spokane City Council voted last year to study the issue and now the report is complete.

Many of the arguments against fluoride are rooted in a fear of how it was first discovered and later introduced into the United States’ water supply. Coupled with the fact that fluoride is most beneficial during a child’s early and adolescent developmental stages, the question of whether fluoride is good for you and your kids comes up quite often.

Recent Legislative Changes for Public Water Systems

During this past Legislative Session, House Bill 1251 was passed and signed by Governor Inslee on April 20, 2023. The purpose of this bill is to set notification requirements for public water systems that want to start adding fluoride to their drinking water, or systems that would like to discontinue adding fluoride to their drinking water. Starting July 23, 2023, public water systems considering starting or discontinuing fluoridation of their water on a continuing basis must notify their customers and ODW, at least 90 days prior to a vote or decision on the matter.

 

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In the movie Dr. Strangelove, General Ripper claimed that water fluoridation was destroying “our precious bodily fluids”, a reference to the claim that water fluoridation was a conspiracy designed to weaken US willpower and make the country susceptible to a Communist takeover. Although there were occasional references to a Communist conspiracy in the anti-fluoridation movement in the United States and Canada, this was not a common feature of the debate. More commonly, opponents believed that they should not have to take medicine against their will. Much of the opposition focused on the possible health risks.

1-    Controversy about adding fluoride or not in drinking water

·       Combining several methods of self-administered topical fluoride products with water fluoridation will lead to caries reduction benefits greater than when using only one method. Having a dose-response relationship, the exposure to multiple sources of fluoride, especially in lower concentrations administered daily, increases the caries reduction benefits. Combining topical fluoride products with the consumption of fluoridated water will benefit high-risk patients.. Bennett BL. Mosby’s 2014 

·       As with fluoridated water, there has been some concern about the simultaneous combination of fluoride ingested from both salt and toothpaste. Available data suggest that this combination has not resulted in objectionable enamel fluorosis levels. However, observations of increased mild dental fluorosis were seen in children who consumed fluoride tablets and fluoridated salt. Pollick HF. 2013  

 

2-    Fluoride: Safety or Danger?

In 1909, dentist Frederic Mc Kay, while observing the condition of children's teeth in Pikes Peak, Colorado, noticed that their teeth had turned an unusually dark brown color compared with children living in other parts of the country. USA. His conclusion at that time was that the domestic water here was contaminated with fluorine in the form of salt. 

Currently, the national recommended allowance for fluoride in drinking water is    1 mg/L and toothpaste is 2 mg/L. WHO guidelines for fluoride? Fluoridated toothpastes containing between 1000 and 1500 ppm fluoride is the standard recommended by WHO as a public oral health measure for the prevention of caries.  This has been approved by the US Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention (CDC).

·       Why is fluoride banned in Europe? All other treatment chemicals are added to treat the water (i.e. to improve the water's quality and safety - which fluoride does not do). This is one of the reasons why much of Europe has rejected fluoridation.

·       Is there fluoride in drinking water worldwide? Water fluoridation by country. Worldwide, the Irish Republic and Singapore are the only countries which implement mandatory water fluoridation. Most of the drinking water in the Republic, (but not Northern Ireland), is fluoridated. Singapore's tap water contains small amounts of chlorine, pesticides, lead and other heavy metals, nitrates, nitrites, fluoride and possibly other people's medical drugs. Why? The chlorine and fluoride are added to kill bacteria and allegedly strengthen our teeth.

·       Why does Ireland have fluoride in water? The level of fluoride in drinking water in Ireland has been set at between 0.6-0.8 parts per million (ppm). To achieve this, HFSA is diluted by a factor of more than one in a hundred thousand. This level of fluoride is deemed optimal for protecting the oral health of all age groups. The Irish Government is coming under mounting national cross-party political pressure to end public water fluoridation in the run-up to the impending General Election planned for 2016.

The reason there are different opinions about the application of fluoride is due to the concentration of this element present in the water source. Recently, the National Research Council (NRC) has established a Research Council of dentists, toxicologists, and public health experts. The research results were published in March 2006 in which the preliminary conclusion was that the allowable concentration of fluoride in domestic water was too high. With this permissible level), the Council concluded that children using water with the above concentration for a long time will damage teeth, and may reduce intelligence index (IQ). In addition, if using this water throughout life, old age can cause osteoporosis, and the risk of hip fracture is very high. And a group of Harvard professors added to the conclusion that teenagers can develop bone cancer when drinking fluoridated water. 

According to research, if using water with a concentration higher than 4 mg / L, the risk of tooth decay is highest, especially for children. Historically in Hong Kong, since the introduction of fluoride into drinking water, tooth decay among children and adolescents aged 6 to 19 has increased from 23% in the late 1980s to 32% annually. 2006. It is estimated that currently one in four HK children has absorbed twice the amount of fluoride needed by the body. 

That is why Professor Hardy Limeback of the University of Toronto added to the National Research Council that putting fluoride in toothpaste will be one of the ten mistakes of the 21st century.

3-    State Officials points

 

The question is, currently, through the above contradictory views, what and how the US competent authorities in this matter such as the National Research Council, the Poison Control Center (PCC) must react and have different opinions about the presence of fluoride.in water and toothpaste? 

·       For toothpastes that contain fluoride, it is required for the manufacturer to clearly state on the label on the outside of the tube: Fluoride toothpaste is packaged with the mandatory warning: “Keep out of reach of children under 6 years of age” by FDA. If more than used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away.”

·       Particularly, the Occupational Safety and Health Administration (OSHA), requires workers working on bringing fluoride into the water to wear protective clothing and gas masks. Workers in factories related to fluorine often suffer from skin allergies and gastrointestinal diseases due to the influence of fluorine gas released into the air. Sometimes workers also die in severe cases. Fluoride is also classified as a toxic chemical (poison) because fluoride in high concentrations is used to kill rats and kill some pests in agriculture.

 

4-    PFAS may cause cancer!

According to a report by the US Environmental Protection Agency (EPA), if people are exposed to or ingest too much PFAS, it will be deposited in the blood, liver and kidneys, increasing the risk of risks such as cancer, obesity. obesity, thyroid disease, high cholesterol, infertility, liver disease, hormonal imbalance...

Recently, 3M reaches $10.3 billion settlement over “forever chemicals” PFAS in public water systems.

 

5-    How Fluoride enters the human body. 

The next question is: So, through the above presentation, how does fluoride infect the body and affect humans?

Fluoride enters the body through the esophagus and is absorbed through skin cells by using fluorinated water or breathing in air contaminated with fluorine gas. It can be said that half of the 50% of fluoride absorbed in the body will be expelled from the body through urine, and the other half will accumulate in teeth and bones.

6-    In Vietnam, which communities suffer from fluoride in soil and water? 

In Vietnam, water wells in Ninh Hoa at Nha Trang province contains fluoride levels above 10 mg/L, so most people living here have fluorosis in their teeth. And in 2003, UNICEF gave a $3 million grant to install defluorination systems for the population living in this area.

7-    And how about the effect of Fluoride on intelligence?

As for IQ, children drinking waters containing fluorine concentrations of 2.5 mg/L or more have an IQ reduction of 8 points compared to children living in low-fluoridated waters.

For adults who have been exposed to fluoride for a long time, the American Medical Journal (AJM) published research results at the end of 2005 on a woman who had been exposed to fluoride and suffered from fluorosis. bone fluorosis, as well as joint pain with movement. This is because this woman has been drinking one to two gallons of tea continuously for over 20 years. She lives in an area with limestone and high fluoride content in the soil. According to the same study, the scientists estimated that the women had absorbed at least 10 mg of fluoride a day for more than 20 years, and the tea leaves had absorbed fluoride in the soil. Remember, Lipton Instant Tea we often see in the market has an average content of about 6.5 mg/L. 

Also through the same medical journal, elderly people living in areas with high soil fluoride levels from 2 to 4 mg/kg, such as in Texas, Virginia, Oklahoma, were 41 percent more likely to have a hip fracture than those living in areas of low concentration.

8-    Conclusion: 

The questions below are from the extract of an article from Catherine Carstairs - Am J Public Health. 2015 August on Debating Water Fluoridation: “Most scientists doing research in the field were very clearly identified as pro-fluoridation or anti-fluoridation, with confusing ramifications for the public debate. 

·       Who should members of the public believe in?

·       The reassuring pamphlets that told the public that fluoridation was safe, effective, thoroughly tested, and endorsed by experts?

·       Or the far more lengthy and detailed books, leaflets, and pamphlets distributed by the anti-forces that asserted that fluoride might lead to joint problems, heart and kidney disease, and cancer? The fact that the scientists and doctors appeared to be so divided may have contributed to the perception that the experts were hiding evidence of possible harm. 

In fact, we must recognize the phenomenon that fluoride accumulates in the body. Healthy adult kidneys excrete 50 to 60% of the fluoride ingested each day (Marier & Rose 1971). The remainder accumulates in the body, largely in calcifying tissues such as the bones and pineal gland (Luke 1997, 2001). Infants and children excrete less fluoride from their kidneys and take up to 80% of ingested fluoride into their bones (Ekstrand 1994). The fluoride concentration in bone steadily increases over a lifetime (NRC 2006). 

From these above statements, my point of view for giving some clarifications from these contradictory concepts are: 

• If we use chemicals to a certain extent, and with an appropriate dose, chemicals will be a factor that helps us to solve many problems in life or helps us to eliminate or prevent certain human diseases.

• If we use too much, the risk of adverse reactions will be unavoidable. 

In the case of fluorine is no exception. The American National Research Council concluded that, after 55 years, it is safe to introduce fluoride into domestic water sources less than 1mg/L (which already has naturally in US soil. So we don’t need to add). There are specific results showing that the presence of fluoride below these concentrations reduces the incidence of tooth decay in children. 

·       Finally, adding more fluoride into drinking water, to me, you may have more risk of damaged teeth and gum inflammation. Excess amounts of fluoride in drinking water can cause dental fluorosis, skeletal fluorosis, arthritis, bone damage, osteoporosis, muscular damage, fatigue, joint-related problems, and chronicle issues. And, according to Dr. Izabella Wentz, ingesting too much fluoride can cause damage to the thyroid gland and hypothyroid symptoms. 

·       Teeth will become dark brown, and gums often become infected and numb. The discoloration of teeth is explained as follows: When teeth are growing and exposed to fluoride for a long time, the fluoride element will penetrate deeper into the dentin and the teeth will turn brown and the gum became dark (gum inflammation) as the case of people living in Ninh Hoa, Vietnam. This disease is called dental fluorosis.

 Mai Thanh Truyết

Speech for 8/19/2023 at Spokane, WA