F.A.N. Newsletter

Summary

The Fluoride Action Network (FAN) is pleased that the updated NTP Review has re-confirmed that fluoride is “presumed to be a cognitive neurodevelopmental hazard to humans.” We would also underline that

the NTP rating of “presumed” is the highest confidence rating possible
without doing a controlled human experiment, which would be unethical. 
Human experiments are not allowed for testing toxicity of a chemical

However, FAN is concerned with NTP’s highly flawed “risk assessment” which claims that

the evidence that fluoride lowers IQ in children is less robust and less consistent
at levels below 1.5 ppm.

This claim is not supported by the science that their review used. The highest quality studies, including several funded by the National Institute for Environmental Health Sciences, have shown that IQ (or cognitive development) is lowered at exposure levels experienced in communities that have fluoridation programs which add 0.7 ppm fluoride to the water (Bashash ¹ 2017; Green ² 2019 and Till ³ 2020).

Background

The National Toxicology Program (NTP) performed a Systematic Review of Fluoride Exposure and Neurodevelopmental and Cognitive Health Effects (the “Review). This Review was initiated in response to a nomination from FAN. The NTP began the Review in 2016 and produced its first draft in 2019. The first draft Review was sent to the National Academies of Sciences, Engineering and Medicine (NASEM) for peer review. The NASEM Committee (see members below) that performed the peer-review recommended that NTP make several changes. The NTP incorporated the changes requested and released a second draft Review in September 2020 which was sent to NASEM for a second peer-review.

The NASEM Committee held a zoom meeting on October 19 that was open to the public and gave FAN’s Science Director, Chris Neurath, the opportunity to communicate our agreement with their overall finding but challenge their flawed risk assessment.

Making the best studies disappear

At this meeting FAN was shocked when Kyla Taylor, of the NTP, showed a slide of a table of results from a NTP meta-analysis of IQ studies that indicated that the Bashash 2017 study did not find a lowering of IQ!  See figure A5-6 on page 268 of the Review:

This figure above shows a Forrest plot for the range of IQ loss for a meta-analysis of all the high-quality studies. The bottom axis shows the IQ points lost. The NTP authors show the IQ values in the Bashash, 2017 study range from a loss of 0.18 to an increase of 0.42 IQ points with a mean IQ above the No effect level (0). Such a selected data set is miss-leading and a miss-representation of the full Bashash study. Even so the overall SMD for all the studies combined is -0.50 which is equivalent to a loss of 7-8 IQ points. So while this meta-analysis does not affect the overall – and vitally important - conclusion that fluoride is a presumed developmental neurotoxicant, this manipulation of the Bashash study helped the NTP to incorrectly question the robustness of the studies performed at less than 1.5 ppm and their relevance to the US fluoridation program.

How could this have happened?

For those who have followed the studies on fluoride’s neurotoxicity, Bashash 2017 had been the big breakthrough study showing a strong relationship between pregnant women’s exposure to fluoride and 1) a lowered cognitive function (CGI) in their offspring at 4 years of age and 2) a lowered IQ measured between 6 and 12 years of age. It was the breakthrough moment when they confirmed that the critical period of vulnerability to fluoride’s neurotoxicity was during fetal development.  So how could the NTP now suggest that the Bashash study does not show a lowering of IQ? 

Neurath has delved into how the NTP reached this “extraordinary” conclusion about the Bashash 2017 findings in particular and the studies at lower fluoride exposures generally?  The good news from a science perspective is that the NTP is wrong.  However, FAN is deeply concerned about why such disturbing manipulations occurred. It leaves us questioning whether the CDC or other pro-fluoridation forces have corrupted the NTP’s analysis.

While this downplaying of the Bashash 2017 study did not alter the overall conclusion that fluoride is a presumed developmental neurotoxin, it is a key factor in the NTP’s tacked-on claim that at exposure levels relevant to the US and artificial fluoridation, the evidence is “inconsistent” and “unclear."

This claim arises in a section the NTP added that they call "Generalizability to the US”. It is essentially a risk assessment.  This section was never within the planned scope nor was it in the protocol, so it violates a fundamental principle of systematic review. The NAS peer review panel itself said in 2019 it was not appropriate.  But worse than doing an unplanned risk assessment, the NTP used improper methods that underestimate the confidence that fluoride causes developmental neurotoxicity at levels relevant to the US and to artificial fluoridation – which is what the strongest studies have found.

FAN’s submission to the NTP/NAS

Chris Neurath, on behalf of FAN, submitted formal written comments to NASEM and NTP, as well as the short oral comments during the public meeting:

1. Transcript of Chris' 5-minute oral presentation at the Oct 19 meeting (see above).
    
2. Outline summary of findings.
    
3. Full written submission to the NTP and NAS.

Chris identified and explained how the NTP downgraded evidence in the 2020 review. The following are the downgrades (fully discussed in Chris’ submission – see 3. above)

NTP downgraded the following evidence in their 2020 Review. The NTP:

• Excluded the largest effect in the strongest study: Bashash 2017.
• Excluded strongest low-dose studies from dose-response meta-analysis.
• Unnecessary division of studies lowers power in dose-response meta-analyses.
• Simplistic exposure assessment underestimates hazard at doses relevant to US.
• NTP’s simplistic dose-response meta-analysis methods underestimated effects at low doses because they used the mean exposure while most studies had individual-level exposures that ranged well below the mean.
• Improperly downgraded the animal evidence to “inadequate” despite the NTP 2016 review of the animal evidence concluding it was “low to moderate”.
• The NTP monograph deviated from the OHAT guidelines in its section “Generalizability to the U.S. Population”.
• Meta-analyses have inadequate documentation.

Downgrading the Bashash study

On the specific case of the “downgrading” of the Bashash study discussed above, Neurath gives several examples, here are two:

1. The NTP discriminated against the findings in the Bashash study by ignoring neurocognitive development findings for 4-year-olds in favor of the IQ studies for 6-12-year-olds. They used the latter finding to conclude a threshold for lowering of IQ at 0.8 ppm in maternal urinary levels. Whereas, the excluded analysis for cognitive index (GCI) in 4-year-olds found a linear dose-response relationship with no threshold down to the lowest measured level of 0.2 ppm. This bizarre exclusion was based on the NTP’s characterization of GCI (General Cognitive Index) scores as an “other outcome” rather than a measure of neurocognitive development. These GCI measures are used for young children where IQ measures are less appropriate. GCI is generally considered as a valid measure of neurocognitive development and the NTP was wrong to exclude this key analysis.
    
2. Also for the Bashash study, the NTP focused on a secondary analysis which used childhood urine fluoride levels dichotomized into just two levels (below 0.8 ppm versus 0.8 ppm and above) as the measure of fluoride exposure, instead of the primary analyses, which used maternal urine fluoride levels. The former only found a small non-significant effect, the latter a large and significant effect (11 IQ points lost per 1 ppm maternal urine fluoride).

Bashash 2017 was a landmark study in part because

• it was the first to focus directly on fetal fluoride exposure
• it was a longitudinal cohort study (of the subtype prospective cohort)
• it had individual-level exposure data
• it controlled for a wide range of other factors
• it was very rigorously conducted 

Many of the previous ecological studies in China had been restricted to children who were mostly life-long residents of a single location with a constant water F concentration.  For those studies, their prenatal exposure would have been similar to their exposure measured when they were older children.  So, the prenatal period was captured in those studies and probably explains why the IQ loss was so great in many of them, with an average of -7 IQ points

Paul Connett’s submission

A separate submission by FAN executive director, Paul Connett, PhD, emphasizes that NTP’s conclusion of harm to the developing brain at levels at or above 1.5 ppm offers no adequate margin of safety to protect all children in the USA. It is standard practice in Risk Assessment to divide a dose that finds harm in a human study by 10 to determine a safe dose sufficient to protect the whole population. This is especially needed In the case of fluoride, not only to allow for the anticipated range of genetic susceptibility in a large population of children but also to allow for wide range of doses they are likely to experience. If we ignore the difference between dose and concentration, 1.5 ppm divided by 10 would indicate that in order to protect the whole population the level of fluoride allowed in water should not be higher than 0.15 ppm. 

A simple way of demonstrating why a safety factor is necessary is to look at the EPA’s exposure assessment handbook where it shows that the 5% of Americans who drink the most water drink twice as much as the average.  Therefore, the NTP’s conclusion that water concentrations of 1.5 ppm are presumed to cause neurotoxic harm to those who consume AVERAGE amounts of water, would also apply to anyone drinking twice as much water with a concentration of around 0.7 ppm.  Their internal dose would be roughly the same as those drinking water with 1.5 ppm.

From even such a simple but valid Risk Assessment, it is clear that adding fluoride to water at 0.7 ppm (the current recommended level) is likely to be harming some children. Paul Connett’s commentary on Margin of Safety can be viewed on video.

FAN was pleased to see that Dr. Linda Birnbaum, former head of both the NIEHS and the NTP, submitted her Oct 19 Op-ed to the NASEM panel for their consideration. In this Op-ed she advised that there was enough solid evidence in the available neurocognitive studies for regulatory bodies to recommend to pregnant women that they avoid fluoridated water and parents not use fluoridated tap water to make up baby formula.

We have provided links to all the documents pertaining to the NTP’s systematic review and our criticisms. See the Overview of the NTP study that contains the documents, news articles, and videos. 

York professor responds to public letter criticising research of prenatal exposure to fluoride

 Christine Till, professor in the Faculty of Health, was embroiled in controversy when a letter signed by an international group of fluoridation experts was sent to York on September 21. The group demanded that Till’s research on prenatal exposure to fluoride be evaluated and reviewed by an international committee, as they claim her studies are not scientific and spread harmful misinformation based on ideology. 

The incident launched Till into the media spotlight with several articles being published within days.

On September 29, President and Vice-Chancellor Rhonda Lenton replied to the letter citing York’s support for academic freedom and meritocracy, defending Till’s right to conduct and publish the research. The response also outlined that even though everyone’s freedom of speech is respected, it does not mean York agrees with the content of that speech. 

The letter further stated that “free expression, especially on controversial topics, is best regulated by vigorous counterspeech. It is not appropriate for the university to decide which side of a particular issue is correct.”

Till was happy with the university’s response, but believes her reputation and credibility has already been tarnished — what she believes was the goal of the letter. 

Till defends her research and addresses the criticism aimed at her findings. 

“Adding fluoride to drinking water is promoted as a safe and effective way to prevent cavities. However, ingesting too much fluoride can be detrimental to children’s brain development and that is what we found in a national study,” Till explains.

The study was conducted in six cities across Canada, following 512 mother-child pairs. The women provided urine samples every trimester to measure fluoride levels at each stage, giving a marker of fluoride exposure. 

“What we found was that women who had higher levels of fluoride in their urine during pregnancies had children with lower IQs. The effect was similar to what we would see with lead,” says Till. “We found an effect of about four and a half IQ points per one milligram per litre increase in fluoride. We concluded that fluoride ingestion during pregnancy at levels that are within the range of community water fluoridation, may not be safe for an unborn child.” 

    “I have not come out to say that fluoride is harmful for everyone, we are specifically talking about pregnant women and their young infants.”

Till goes on to explain that her findings are not the first to suggest potential harm from fluoride, and that she is simply adding to previous work that shows similar results. “This is not debated, there is no benefit of fluoride to the fetus or the young baby until the teeth grow.” 

Till believes her suggestion for pregnant women and children — to stop fluoride consumption in the first six months — is appropriate and supported by science. 

“Given there is no benefit whatsoever, but potential for harm, we concluded that the recommendation at this point is to reduce fluoride intake and that can include reducing intake of fluoridated water, but also other sources of fluoride — for example, black tea,” says Till. 

Till goes on to specify that she is not inherently anti-fluoride and is only a proponent of the claims her own research brought forth.

“I have not come out to say that fluoride is harmful for everyone, we are specifically talking about pregnant women and their young infants,” says Till.

Although the research topic that Till focuses on is controversial, it is not new. Vera Kornilovsky, a fifth-year French studies student, remembers avoiding tap water since she was a child, as her family feared the consumption of potentially harmful chemicals.

“I personally have been drinking filtered water since I was young. My parents told me that tap water is not safe to drink, and thus, I have been wary of drinking tap water,” says Kornilovsky. “The main concern is over various minerals contained in tap water, such as fluoride and lead. I have heard that fluoride can lead to skeletal problems.”

The skeletal problems Kornilovsky mentions is known as skeletal fluorosis, a disease which causes excess fluoride to calcify on bones causing joint and muscle pains. 

Kornilovsky continues: “My parents used to tell me that it was not safe to drink tap water often, but they never really gave me an explanation. I must admit that I have not researched this topic myself, and got used to not drinking tap water without questioning it.”

Although Kornilovsky and her family may not know why they avoid tap water, their fears are not unfounded. A study conducted in Iran found skeletal fluorosis of people who live in areas with high fluoride concentration is 18.1 per cent higher than that of individuals who live in areas with low fluoride concentration.

    “There are people who will protect fluoride no matter what the cost, no matter what the evidence says. They will disregard the evidence and continue to say that it is unequivocally safe and effective. We’ve seen this over and over by people who have strong interests in promoting fluoridation.”

The initial article that started this incident included comments from Till’s critics who claim that she is leading a debate by playing on people’s emotions instead of scientific facts.

“It’s bothersome that an academic goes around yelling ‘fire, fire,’ when there’s no fire,” stated Myron Allukian, former president of the American Public Health Association, a critic of the research. He went on to accuse Till of “misleading the public and others by distorting the data and not doing the proper analysis.” 

Till was asked why her critics seem to oppose her claims so fervently.

“There are people who will protect fluoride no matter what the cost, no matter what the evidence says. They will disregard the evidence and continue to say that it is unequivocally safe and effective. We’ve seen this over and over by people who have strong interests in promoting fluoridation,” says Till.

The professor claims she has no agenda for her research and it was only conducted to look into a mainstream scientific idea, one that she believes was being overlooked. 

“I went into this research thinking ‘either way, if we find an effect or not find an effect, both ways it’s important results.’ We can’t go around saying it’s safe when no one has done science to look at the prenatal exposure in Canadian women.”  

Worth seeing again

Community Water Fluoridation Programs: Clinical Effectiveness and Safety a 2020 Update

 Results 

Five non-randomized studies1-5 were identified regarding the clinical effectiveness of community water fluoridation in the prevention of dental caries and the negative effects of community water fluoridation on human health outcomes. 

No relevant health technology assessments, systematic reviews, or randomized controlled trials were identified regarding the clinical effectiveness of community water fluoridation in the prevention of dental caries, the effects of community water fluoridation cessation on dental carries, or the negative effects of community water fluoridation on human health outcomes. 

Additional references of potential interest that did not meet the inclusion criteria are provided in the appendix. Health Technology Assessments 

No relevant literature identified. Systematic Reviews and Meta-analyses No relevant literature identified. Randomized Controlled Trials No relevant literature identified.

Fluoridation: 'Adding Chemicals to the water supply' and 'forced medication'

 

Jamie Hankins

@Wight1984

Posted,Yesterday (edited)

There's a Liberal Democrat councillor (low-level unpaid local politician) in my region who is passionate about preventing fluoridation of water supplies, which he perceives as a form of medication without consent:.......................................

The Fluoride Deception

 

The Fluoride Deception: Why We Must Stop Water Fluoridation And Sodium Fluoride

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 In FOODIZZ

Fluoride does not prevent dental problems and is a dangerous toxin. In this video, you will learn about fluoride and how it destroys our health. You will also find out about the fraudulent water fluoridation program and fluoride's use in nuclear weapons.

Download The Natural Dental Care Plan

https://bit.ly/34mapihThe Fluoride DeceptionFluoride is a chemical that has become the lifeblood of our modern industry. In the 1920s, aluminum manufacturing boomed. The industry needed to use fluoride to make steel and aluminum from the earth's ore.Fluoride was the aluminum industry's most devastating pollutant.

The same substance is also a waste product of the fertilizer manufacturing process. The biggest dilemma for industries that use fluoride was the cost to dispose of this hazardous waste. Andrew Mellon found a market for his toxic waste in the municipal water supply.

Gerald J. Cox proposed that the USA should fluoridate its water reservoirs. Cox was not a doctor or a dentist, but a scientist who worked for the country's largest producer of fluoride. In the 1940s, scientists noted that high-level fluorine areas had better teeth. But scientists conducting the studies had ties to companies selling fluoride.

Fluoride Health Problems

Sodium fluoride is neurotoxic and causes birth defects and osteoporosis. It also damages the immune, digestive, and respiratory systems. Fluoride also affects the kidneys, liver, and brain.

It also affects the thyroid function and increases the risk of hip fractures in the elderly. Fluoride also increases the risk of osteosarcoma, a rare bone cancer often found in young men.

Fluoride DangersThe same rock used to mine for phosphate is also mined for uranium. How much of this radioactive material that ends up in fluoridation is unknown.

Making a toxic waste material into a saleable product is attractive for the phosphate industry. Once someone buys this toxic waste, it no longer has to meet EPA's rules for handling dangerous waste. In terms of acute toxicity, fluoride is more toxic than lead but slightly less toxic than arsenic.

You can observe the dangers of fluoride throughout history. Since World War II, fluoride spilling has had more damage claims than any other industry. It's more than all 20 other major air pollutants combined.

The Manhattan Project

The atomic bomb in the 1940s coincided with the birth of fluoridation. Authors Griffiths and Bryson obtained declassified WWII-era documents of the Manhattan Project. It was the ultra-secret U.S. military program that produced the atomic bomb.

Fluoride was the key chemical in atomic bomb production, according to the documents. Millions of tons of fluoride were essential to yielding uranium and plutonium for the bomb. Bomb program researchers made the most extensive U.S. study of water fluoridating.

It was part of a classified operation code-named "Program F." It took place in Newburgh, New York, from 1945 to 1955. Fluoride In Our WaterA vast majority of countries in the world do not fluoridate their water. Only about 30 countries in the world fluoridate their water.

European countries have no more tooth decay as a result of rejecting fluoridation. Fluoride in drinking water causes a condition called dental fluorosis. Dental fluorosis is a discoloration of the tooth enamel. White patches become more discolored, going from yellow to orange and then brown.

Even if fluoride showed some benefits, using the public water supply to deliver it is inefficient. Over 99.5% goes to washing the dishes, flushing the toilet, and watering the garden. Only a minuscule part goes anywhere near the teeth. Fluoridation of our water violates the patient's right to informed consent.

This assault is not something doctors are allowed to do to their patients. A problem with delivering medicine via the water supply is that there is no control over the dose. Fluoride is not a regulated prescription drug or supplement.

There is little or no evidence that fluoride is an essential nutrient. It has not undergone any clinical trials required by the FDA for other drugs. The FDA regulates fluoride in toothpaste but not in the water.

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Fluorinated Chemicals Affecting More Americans Than Previously Estimated

 By Environmental Working Group

A peer-reviewed study by scientists at the Environmental Working Group estimates that more than 200 million Americans could have toxic fluorinated chemicals known as PFAS in their drinking water at a concentration of 1 part per trillion (ppt) or higher. Independent scientific studies have recommended a safe level for PFAS in drinking water of 1 ppt, a standard that is endorsed by EWG.

The study, published in the journal Environmental Science & Technology Letters, analyzed publicly accessible drinking water testing results from the Environmental Protection Agency and U.S. Geological Survey, as well as state testing by Colorado, Kentucky, Michigan, New Hampshire, New Jersey, North Carolina and Rhode Island.

“We know drinking water is a major source of exposure of these toxic chemicals,” said Olga Naidenko, Ph.D., vice president for science investigations at EWG and a co-author of the new study. “This new paper shows that PFAS pollution is affecting even more Americans than we previously estimated. PFAS are likely detectable in all major water supplies in the U.S., almost certainly in all that use surface water.”

The analysis also included laboratory tests commissioned by EWG that found PFAS chemicals in the drinking water of dozens of U.S. cities. Some of the highest PFAS levels detected were in samples from major metropolitan areas, including Miami, Philadelphia, New Orleans and the northern New Jersey suburbs of New York City.

There is no national requirement for ongoing testing and no national drinking water standard for any PFAS in drinking water. The EPA has issued an inadequate lifetime health advisory level of 70 ppt for the two most notorious fluorinated chemicals, PFOA and PFOS, and efforts to set an enforceable standard could take many years.

In the absence of a federal standard, states have started to pass their own legal limits for some PFAS. New Jersey was the first to issue a maximum contaminant limit for the compound PFNA, at 13 ppt, and has set standards of 13 ppt for PFOS and 14 ppt for PFOA. Many states have either set or proposed limits for PFOA and PFOS, including California, Massachusetts, Michigan, New Hampshire, New Jersey, New York and Vermont.

“The first step in fighting any contamination crisis is to turn off the tap,” said Scott Faber, EWG senior vice president for government affairs. “The second step is to set a drinking water standard, and the third is to clean up legacy pollution. The PFAS Action Act passed by the House would address all three steps by setting deadlines for limiting industrial PFAS releases, setting a two-year deadline for a drinking water standard, and designating PFAS as ‘hazardous substances’ under the Superfund law. But Mitch McConnell’s Senate has refused to act to protect our communities from ‘forever chemicals.’”

PFAS are called forever chemicals because they are among the most persistent toxic compounds in existence, contaminating everything from drinking water to food, food packaging and personal care products. They are found in the blood of virtually everyone on Earth, including newborn babies. They never break down in the environment.

Very low doses of PFAS chemicals in drinking water have been linked to suppression of the immune system and are associated with an elevated risk of cancer and reproductive and developmental harms, among other serious health concerns.

“When we look for PFAS contamination, we almost always find it,” said David Andrews, Ph.D., a senior scientist at EWG and one of the co-authors. “Americans should trust that their water is safe, but far too many communities have water supplies polluted by toxic PFAS chemicals. These are some of the most insidious chemicals ever produced, and they continue to be used. Our analysis was largely limited to PFOA and PFOS, but many more PFAS are found to contaminate drinking water and the entire class of PFAS chemicals is a concern.”

The EPA has identified over 600 PFAS in active use in the U.S. According to the most recent analysis of state and federal data by EWG, 2,230 locations in 49 states are known to have PFAS contamination, including more than 300 military installations.

PFAS contamination has raised alarms among a bipartisan group of lawmakers in Congress. The PFAS Action Act also includes a provision that would set a two-year deadline for the EPA to establish a national drinking water standard for the two most notorious PFAS chemicals – PFOA, formerly used to make DuPont’s Teflon, and PFOS, formerly an ingredient in 3M’s Scotchgard.

The House versions of the National Defense Authorization Act and EPA spending bill also include important PFAS reforms.

“It’s not too late for this Congress to protect us from the growing PFAS contamination crisis,” Faber said.

Published with permission by Environmental Working Group. 

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Fluoride in Drinking Water May Harm Children

 

Fluoride in Drinking Water May Harm Children, Scientific Evidence Mounts

By Michele Merkel

Since 1945, local governments have added fluoride to public drinking water supplies to reduce the rates of tooth decay. Now, more than 207 million people in the U.S. receive fluoridated drinking water — nearly three-quarters of the population served by community water systems.

Hailed as a major public health accomplishment of the 21st century, community water fluoridation has contributed to significant declines in dental caries. Thanks to fluoridated products like toothpaste and mouthwash, we’ve also seen similar reductions in countries that don’t fluoridate drinking water. The benefits of fluoride in preventing tooth decay are well documented, but it’s time to revisit community water fluoridation in light of new research. Scientists are coming together to raise the alarm about fluoridated drinking water. The data show fluoride consumed from drinking water may have adverse neurological health impacts — especially among children.

This is why Food & Water Watch, alongside groups including Fluoride Action Network and American Academy of Environmental Medicine, filed a petition in 2016 asking the U.S. Environmental Protection Agency (EPA) to limit or ban fluoridation. We’ve since taken them to court. When science is constantly under attack, we need to hold our public health agencies accountable, ensure they review new research, and make science-based decisions to protect our communities.

Risks to children outweigh benefits of water fluoridation

Mounting scientific evidence suggests fluoride could have harmful neurotoxic effects, especially among formula-fed infants, the elderly, African Americans and the undernourished. These risks include a decrease in average IQ in children, ADHD, and cognitive impairment in older populations.

Studies in Canada and Mexico, for example, found associations between fluoride concentrations in pregnant women and adverse outcomes in their children — including lower IQ and greater risk of ADHD and inattention. Another Canadian study found formula-fed infants in regions with fluoridated drinking water had lower non-verbal intelligence scores, compared to those living in non-fluoridated regions. Because formula-fed infants consume more water than breastfed infants, and therefore more fluoride when living in fluoridated areas, they tend to be at greater risk of elevated fluoride exposure. Additionally, regions where more people receive fluoridated drinking water have seen higher rates of ADHD in children and teens, even after adjusting for socioeconomic differences.

The EPA hasn’t considered the neurotoxic effects of fluoridation

Despite the emerging science, existing limits and recommendations made by the EPA and the U.S. Department of Health and Human Services for fluoride in drinking water aren’t based on the potential neurotoxicity of fluoride — they’re based on impacts to teeth and the skeletal system. But several studies have found neurological effects from consumption of fluoride at concentrations considered acceptable by the EPA – less than 4 mg/L. Average IQ reductions have been observed where fluoride levels fall below EPA’s limits. Even at lower fluoride concentrations where drinking water is “optimally fluoridated” to prevent tooth decay (0.7 mg/L), formula-fed infants could experience adverse IQ outcomes. Considering the benefits but not the drawbacks, as EPA has done with fluoridation, isn’t sound science or good policymaking.

Community water fluoridation has been a hotly controversial issue since it started over a half a century ago. What shouldn’t be controversial is the commitment to making science-based decisions to protect public health. When the growing body of science indicates community water fluoridation may put the public at unreasonable risk, we need to assess the threat seriously. And when safer alternatives to preventing tooth decay exist, we can’t take a fluoridation ban off the table.