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A few weeks ago I wrote an article on bioweapons and particularly my fears about smallpox. For me, a terrorist release of smallpox is the most terrifying prospect that should keep every legislator, scientist and attentive citizen awake at night.

But, interestingly, in the comments after the article, the back and forth devolved into a discussion of fluoride in our water. Fluoride? Really?

When I’m talking about an egg-full of virus with the potential of killing 60 percent of the world’s population … well, the answer is yes, fluoride. As it turns out, the readers were paying attention more than I or any member of organized (read: regimented) medicine about the dangers of fluoridation.

Fluorides are naturally occurring compounds that can seep into the water supply from certain rock formations, notably granite deposits. Before man-made inorganic fluorides were introduced into our water supply, researchers measured water around the world for various compounds and decided that just the right level of fluoride was helpful in preventing dental cavities. Too little fluoride: cavities. Too much fluoride: fluorosis, or mottling and discoloration of teeth, and abnormalities in overall bone formation. It seemed that the optimum amount was about 1 ppm (part per-million). Dentists, especially the American Dental Association, hailed this discovery as a great boon to childrens’ teeth everywhere and recommended cities adopt policies of fluoridating water to the correct level.

My father, Martin Deakins, M.D., Ph.D., D.D.S., was an early pioneer in dental research on the chemistry of teeth enamel and wrote numerous papers on the benefits of fluoride. He and his partner developed the first fluoride toothpaste – called ChildDent – but unfortunately lost the race to the patent, so I am continuing to work for a living. Ah, well. He was instrumental in getting my little Iowa town to begin fluoridation of the water. So it is with great irony that I, an orthopaedic surgeon, am in the position 60 years later of trying to get that decision reversed.

For years, there have been concerns raised whether or not fluoride supplementation increases cancer. No one can sort out the conflicting literature on the subject – certainly not I. But multiple agencies including the International Agency for Research on Cancer (of the World Health Organization), the U.S. Public Health Service and the British National Health Service basically conclude that the risk is unknown, asserting that some studies raise concern.

Interestingly, in a systemic review in 2000, the NHS commented, “Given the level of interest surrounding the issue of public water fluoridation, it is surprising to find that little high quality research has been undertaken.”

It is, of course, impossible to prove a negative with ultimate certainty. But the above statement suggests that the lack of safety data is troubling to some.

In 2006, a partial report released from a Harvard study showed that osteosarcoma was slightly more prevalent in boys exposed to fluoridated water, but not girls. The numbers barely reached statistical significance but take on more verisimilitude given that the same, sex-linked disparity was noted in animal studies – i.e. more male rats than female rats got osteosarcoma with fluoride exposure.

Confounding many of these epidemiological studies is the fact that artificially added inorganic fluoride is much more damaging to living tissue (not to mention corrosive to pipes) than organic, naturally occurring fluorides. And when measuring only the absolute levels of the fluoride anion, studies wind up comparing apples to oranges.

It is my experience and belief that, in the history of science and medicine, one very good study, one smart guy who looks at things in a logical way, is more apt to be right than a ton of studies that have to be mathematically analyzed for significance. Perhaps the most outspoken of the qualified opponents to fluoridation is Dr. Dean Burke, Ph.D, a co-founder of the National Cancer Institute and its head of the cytochemistry division for many years. Instead of measuring fluoride levels around the country, and instead of looking at one particular type of cancer, he and some colleagues examined overall cancer rates in cities after fluoridation.

It is worth quoting him at length: “We took the ten largest cities that had been fluoridated and compared with the ten largest cities that had not been fluoridated. The fluoridation didn’t start until 1952 to 1956 and has been continued ever since in the fluoridated group. Between 1940 and 1952 these two groups were identical, could not be distinguished on this curve. but from 1952 on, the curves have been continually widening to the point that there’s now a difference of approximately 35,000 a year. There’s no question about the data or our particular arrangement of it. The data is from government sources, which any high school student can look up and confirm. Nearly all of the fluoridation-linked cancer deaths are found to begin at the age of about 45 and then steadily increase with age. This situation is sharply different from the increased cancer deaths resulting from cigarette smoking, asbestos or hormones given to expectant mothers where a lag of 15 to 30 years is common. Increased death rates due to fluoridated water commence within a few years after initiation of fluoridation with marked continued increase thereafter.”

It is also true that when fluoridation began, there were few other sources of fluoride, but today we have fluoride dental rinses (at home at school and professionally), we use fluoride toothpaste, eat processed foods and drink exotic teas and wines with naturally occurring fluorides.

Dr. Albert Burgstahler, of the University of Kansas estimates the average adult daily intake today at 2-3 mg a day, at or above the “safe dose” of 1.5 to 2mg a day. An oral dose of 3 mg a day, as reported in the Canadian Medical Association Journal 50 years ago by Dr. William Costain, created ill effects in every test subject – effects ranging from bladder irritation to mental disturbance.

Too often in medicine we accept treatments that clearly benefit one body system at the expense of another. Due to specialization, we are ignorant of the problems that a targeted treatment may have caused somewhere else in the body.

Given the dramatic effects of fluoride in reducing cavities, the American Dental Association still pushes fluoridation unqualifiedly. But as far back as the 1940s the AMA had its doubts.

In October 1944, a JAMA editorial discussing known and unknown risks of fluoridation concluded, “We cannot afford the risk of producing such serious systemic disturbances in applying what is at present a doubtful procedure intended to prevent development of dental disfigurements.”

Ultimately, this is not a question of science, but of freedom. Most municipalities control the water supply totally for its population – you can’t sink your own well. So if the city politicos decide to add something, be it fluoride or anything else, most people cannot choose to avoid exposure. The poor are more apt to be harmed by this because they often cannot afford bottled water or a reverse osmosis system (which does eliminate fluorides in the water).

Again, Dr. Burke was eloquent when he stated on Canadian radio, “There have been almost as many excess deaths associated with fluoridation as the sum total of all American military deaths since the founding of the USA in 1776. Now that’s an awful burden for the pro-fluoridationists to bear if they can come to see that they have been responsible for this.”

Although I think he is probably right, whether Dr. Burke’s number is totally accurate is beside the point. The moral responsibility is the same. Given the sometimes murky and fleeting nature of “truth” in science, the decision to take fluoride for dentition, or not to take fluoride should be left to the individual. Oral fluoride tablets are available, so putting it in the water is not the only option. We should work to remove it from our public water supply and to avoid going down this road again when the next bright idea comes along.

Sorry, Dad.

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