Fluoridation: Don't Let the Poisonmongers Scare You
Bob Sprague
Mary Bernhardt
Stephen Barrett, M.D.
Fluoride is a mineral that occurs naturally in most
water supplies. Fluoridation is the adjustment of the natural fluoride
concentration to about one part of fluoride to one million parts of water.
Although fluoridation is safe and effective in preventing tooth decay, the scare
tactics of misguided poisonmongers have deprived many communities of its
benefits.
The history of fluoridation in the United States underlines its unique
standing as a public health measure copied from a natural phenomenon. In the
early 1900s, Dr. Frederick S. McKay began an almost 30-year search for the cause
of the staining of teeth that was prevalent in Colorado, where he practiced
dentistry. In his investigation, McKay found the condition common in other
states, including Texas, where it was known as "Texas teeth." In 1928, he
concluded that such teeth, although stained, showed "a singular absence of
decay," and that both the staining and the decay resistance were caused by
something in the water. In 1931, the "something" was identified as fluoride.
The Public Health Service then took over to determine precisely what amount
of fluoride in the water would prevent decay without causing staining. Years of
"shoeleather epidemiology" by Dr. H. Trendley Dean traced the dental status of
7,000 children who drank naturally fluoridated water in 21 cities in four
states. In 1943, he reported that the ideal amount of fluoride was one part per
million parts of water. This concentration was demonstrated to result in
healthy, attractive teeth that had one-third as many cavities as might otherwise
be expected—and no staining.
The next step was to determine whether water engineering could copy nature's
amazing dental health benefit. At several test sites, the fluoride concentration
of the public water supply was adjusted to one part per million.
One such test was conducted in the neighboring cities of Newburgh and
Kingston, New York. First, the children in both cities were examined by dentists
and physicians; then fluoride was added to Newburgh's water supply. After ten
years, the children of Newburgh had 58% fewer decayed teeth than those of
nonfluoridated Kingston. The greatest benefits were obtained by children who had
drunk the fluoridated water since birth. Other studies showed that teeth made
stronger by fluoride during childhood would remain permanently resistant to
decay. As the evidence supporting fluoridation accrued, thousands of communities
acted to obtain its benefits.
Too much fluoride can cause dental fluorosis, which, in its mildest form,
causes small, white, virtually invisible opaque areas on teeth. In severe form,
fluorosis results in brownish mottling. However, dental fluorosis is not caused
by artificial fluoridation, because the levels are kept low enough to avoid this
effect.
In recent years, fluoridation has been reducing the incidence of cavities 20%
to 40% in children and 15% to 35% in adults. The reduction is less than it used
to be, probably due to improved dental hygiene and widespread use of fluoride
toothpaste. Currently, more than 140 million Americans live in fluoridated
communities. But 80 million others receive public water supplies that are not
fluoridated—thanks largely to the efforts of poisonmongers.
How Poisonmongers Work
The antifluoridationists' ("antis") basic technique is the big lie. Made
infamous by Hitler, it is simple to use, yet surprisingly effective. It consists
of claiming that fluoridation causes cancer, heart and kidney disease, and other
serious ailments that people fear. The fact that there is no supporting evidence
for such claims does not matter. The trick is to keep repeating them—because if
something is said often enough, people tend to think there must be some truth to
it.
A variation of the big lie is the laundry list. List enough "evils," and even
if proponents can reply to some of them, they will never be able to cover the
entire list. This technique is most effective in debates, letters to the editor,
and television news reports. Another variation is the simple statement that
fluoridation doesn't work. Although recent studies show less difference than
there used to be in decay rates between fluoridated and nonfluoridated
communities, the benefit is still substantial. In fact, the Public Health
Service estimates that every dollar spent for community fluoridation saves about
fifty dollars in dental bills.
A key factor in any anti campaign is the use of printed matter. Because of
this, antis are very eager to have their views printed. Scientific journals will
rarely publish them, but most local newspapers are willing to express minority
viewpoints regardless of whether facts support them. A few editors even welcome
the controversy the antis generate—expecting that it will increase
readership.
The aim of anti "documents" is to create the illusion of scientific
controversy. Often they quote statements that are out of date or out of context.
Quotes from obscure or hard-to-locate journals are often used. Another favored
tactic is to misquote a profluoridation scientist, knowing that even if
the scientist protests, the reply will not reach all those who read the original
misquote.
Half-truths are commonly used. For example, saying that fluoride is a rat
poison ignores the fact that poison is a matter of dose. Large amounts of many
substances—even pure water—can poison people. But the trace amount of fluoride
contained in fluoridated water will not harm anyone.
"Experts" are commonly quoted. It is possible to find
someone with scientific credentials who is against just about anything. Most
"experts" who speak out against fluoridation, however, are not experts on the
subject. There are, of course, a few dentists and physicians who oppose
fluoridation. Some of them object to fluoridation as a form of government
intrusion, even though they know it is safe and effective.
Innuendo is a technique that has broad appeal because it
can be used in a seemingly unemotional pitch. Some antis admit that fluoridation
has been found safe "so far," but claim that its long-range effects have "not
yet" been fully explored. The waiting game is a related gambit in which antis
suggest that waiting a bit longer will help to resolve "doubt" about
fluoridation's safety. No doubt, some antis will continue to use this argument
for a few hundred more years.
A few antis have offered a "reward" for proving that
fluoridation is safe. During the 1970s, a $100,000 offer required the pros to
post a bond "to cover any costs which the offerers of the reward might incur if
the proof is deemed invalid." The offer did not state who would judge the
evidence, but it was safe to assume that the antis themselves would have
appointed the judges. If a suit had been filed to collect the reward, the court
might have ruled that the offer was a gambling bet that should not be enforced
by a court. Such a suit would have required at least $25,000 for the bond and
legal fees. Even if it had been won, however, there was no assurance that the
money would have been recovered from the individuals who sponsored the reward.
Most of them were elderly and scattered widely throughout the United States and
Canada.
Since the scientific community is so solidly in favor of
fluoridation, antis try to discredit it entirely by use of the conspiracy
gambit. The beauty of the conspiracy charge is that it can be leveled at anyone
and there is absolutely no way to disprove it. After all, how does one prove
that something is not taking place secretly? Favorite "conspirators" are the
U.S. Public Health Service, the American Dental Association, the American
Medical Association, and the aluminum industry. Apparently, in the minds of the
antis, these groups could all be working together to "poison" the American
people! Years ago, conspiracy claims would work primarily with the very
paranoid. But modern-day government scandals may make them seem realistic to a
wider audience.The "slippery slope" claim is a related gambit. "This is only the
beginning!" the antis wail. "First they will add fluoride, then vitamin
pills, and the next thing you know it will be birth control pills!" Who
"they" are need not be specified.
Scare words will add zip to any anti campaign. Not only
the more obvious ones like "cancer" and "heart disease," but also more
specialized terms like "mongoloid births" and "sickle-cell anemia." Ecology
words are also useful. Calling fluoride a "chemical" (rather than a nutrient)
can strike fear in the minds of many Americans who fear we are already too
"chemicalized." The fact that water itself is a chemical and the fact that
responsible use of chemicals is extremely helpful to our society will not
reassure everyone. Fluoride is also called "artificial" and "a pollutant," which
is "against nature."
Faced with the fact that fluoridation merely copies a
natural phenomenon, the antis reply that "natural" fluoride differs from
"artificial" fluoride—a "fact" as yet undiscovered by scientists.
Suggesting alternatives is another common tactic. Here
the antis propose that the community distribute free fluoride tablets to parents
who wish to give them to their children. The suggested program sounds
"democratic," but it will not be effective from a public health standpoint. Most
parents are not motivated to administer the 4,000+ doses needed from birth
through age twelve. The plea for alternatives is often made by a "neutral"
individual who sounds like he will support an alternative program if water
fluoridation is defeated. Don't bet on it. Such advocacy is almost always a
propaganda ploy.
Once fluoridation has begun in a community, antis can
resort to the "cause-of-all-evil" gambit—blaming fluoridation for everything
that occurred after it started. An example of this tactic, one that backfired on
opponents, took place in Cleveland on June 1, 1956—when fluorides were to be
added to the city's water supply. That day, the phone calls began: "My goldfish
have died." "My African violets are wilting." "I can't make a decent cup of
coffee." "My dog is constipated." Although the basis of such complaints is
emotional rather than physical, this time fluoridation's innocence was beyond
question. Last-minute problems had delayed its start until July!
"Let the People Decide"
The antis' most persuasive argument, both to legislators
and to the general public, is to call for a public vote. On the surface, this
appears to be the democratic way to settle the issue. But the antis are dealing
from a stacked deck. First, the people who need fluoridation the most—the
children—do not vote. Second, it is not difficult to confuse voters by flooding
the community with scare propaganda. Average citizens do not have the
educational background to sort out claim and counterclaim or to judge which
"authorities" to believe. To turn against fluoridation, they don't need to
accept all the anti arguments—only one. The sheer bulk of the
controversy is itself likely to arouse doubt in the minds of most voters.Antis
who say, "Let the people decide," may sound as if they wish to use a democratic
process to make the decision, but experience in many cities has shown otherwise.
If fluoridation wins a referendum, the usual anti response is to work for
another one. In some communities that allow repeated referendums on the same
subject, fluoridation has been in and out, and in and out again. When this
happens, not only do children suffer, but taxpayers are saddled with the cost of
the referendums.Curiously, studies have shown that referendums can lose even in
communities where public opinion favors fluoridation. People will usually go to
the polls to vote against what they don't like. So the crucial factor in
many referendums is the ability of proponents to mobilize the supporters. A 1998
Gallup Poll commissioned by the American Dental Association found that when
asked "Do you believe community water should be fluoridated?" 70% of respondents
believed that community water should be fluoridated, 18% did not, and 12% were
undecided. Yet small numbers of vocal critics still manage to impede its
implementation in many communities.
Cancer Scares
In the mid-1970s, John Yiamouyiannis, Ph.D. and another
anti began issuing a series of reports claiming that fluoridation causes cancer.
Experts concluded that these reports were based on a misinterpretation of
government statistics. They had compared cancer death rates in fluoridated and
nonfluoridated cities but failed to consider various factors in each city (such
as industrial pollution) that are known to raise the cancer death rate. By 1977,
independent investigations by eight of the leading medical and scientific
organizations in the English-speaking world had refuted the claims, but they
still surface today in many communities that consider fluoridation.In 1990, the
cancer charge was raised again following an unauthorized release of data from an
experiment in which rats and mice were exposed to high dosages of fluoride. The
experiment was conducted by the National Toxicology Program, a branch of the
National Institute of Environmental Health Sciences. The agency's final report
stated that there was no evidence of cancer-causing activity in female rats or
in male and female mice and only "equivocal evidence" in male rats. Subsequent
review by a U.S. Public Health Service expert panel concluded that the data
were insignificant and that fluoridation posed no risk of cancer or any other
disease.
Don't Be Misled
As a public health measure, fluoridation is unusual in
several ways. It is a copy of a naturally occurring phenomenon. It is supported
by libraries full of articles that document its safety and effectiveness—more so
than any other public health measure. It is supported by a variety of health,
scientific, and civic groups that could hardly be expected to agree on any other
single measure. But most significant, it is the only health measure that is
often put to public vote.If you live in a community with fluoridated water,
consider yourself lucky. If you do not, don't let the poisonmongers scare you.
Fluoridation is still a modern health miracle.
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