Tap water fluoridation and our precious bodily fluids

[Puppycow]

(This topic has been discussed in this forum before but the most recent thread I could find on it was from 2019.)

I saw this article from Reuters and it set off some alarm bells for me (there goes RFK Jr.), but reading past the headline I saw some things that at least appear to raise legitimate scientific and public health policy questions.

US Health Department will make new fluoride recommendation (Reuters)

WASHINGTON, April 7 (Reuters) - The U.S. Department of Health and Human Services will be reconvening an independent panel of health experts to make a new recommendation on putting fluoride in drinking water, a spokesperson said on Monday.

So here's the stuff that made me wonder whether there is more to this than the age-old conspiracy theories about it:

Utah became the first U.S. state to ban the use of fluoride in public water systems after Governor Spencer Cox signed legislation to that effect last month.
The American Dental Association opposed the Utah law and has maintained support for community water fluoridation to help prevent tooth decay.
The U.S. Public Health Service recommends that drinking water levels for fluoride remain below 0.7 milligram per liter.
Levels above 1.5 mg/L, twice the recommended limit, are known to increase health risks such as bone fractures, thyroid disease and nervous system damage.
The enforceable limit as currently set by the EPA is 4.0 mg/L. In September 2024, a federal judge in California ordered the EPA to strengthen its regulations, saying the compound poses an unreasonable potential risk to children at levels that are currently typical nationwide.

Here's that article from the last link:
EPA must address fluoridated water's risk to children's IQs, US judge rules (Reuters)

Sept 25 (Reuters) - A federal judge in California has ordered the U.S. Environmental Protection Agency to strengthen regulations for fluoride in drinking water, saying the compound poses an unreasonable potential risk to children at levels that are currently typical nationwide.
U.S. District Judge Edward Chen in San Francisco on Tuesday sided, opens new tab with several advocacy groups, finding the current practice of adding fluoride to drinking water supplies to fight cavities presented unreasonable risks for children’s developing brains.

"The scientific literature in the record provides a high level of certainty that a hazard is present; fluoride is associated with reduced IQ," wrote Chen, an appointee of Democratic former President Barack Obama.

I suppose this means that what the health department is doing is simply following a judge's order; a judge appointed by Obama, no less.
But scientifically, an "association" between fluoride and reduced IQ doesn't necessarily mean that there is a casual relationship.

I went to see what I could find from Science Based Medicine, and the most recent article I could find appears to be almost 10 years old. Even that one seems to indicate that most of the science backing it up dates from 1975 or earlier, before the use of fluoride in toothpaste was widespread. (I should add, however, that toothpastes which do not contain fluoride have become more popular in recent years.)

Cochrane Review on Community Water Fluoridation

One of the overriding themes of the Science Based Medicine blog is to use rigorous science when evaluating any health claim – be it medical, dental, dietary, fitness, or any other assertion put

sciencebasedmedicine.org

 

[Puppycow]

I did find a couple more recent (2019 rather than 2015) articles on the topic at Science Based Medicine using a different way of searching:

Maternal Fluoride and IQ

New study purporting to show correlation between fluoride and IQ comes under heavy criticism.

sciencebasedmedicine.org

Maternal Fluoride and IQ – The Scientific Community Pushes Back

A follow-up on a questionable study of the impact on water fluoridation and IQ. Science marches on, and we're helping it out!

sciencebasedmedicine.org

 

[Norman Alexander]

oxicity depends on dose. If you empty a bucket of flouride solution into the Hoover Dam, it will be barely discernible in tests and will be harmless. If you empty the same bucket of fluoride solution into RFK Jr., it will be fatal...for him.

 

[Orphia Nay]

"The U.S. Public Health Service recommends that drinking water levels for fluoride remain below 0.7 milligram per liter.
Levels above 1.5 mg/L, twice the recommended limit, are known to increase health risks such as bone fractures, thyroid disease and nervous system damage.
The enforceable limit as currently set by the EPA is 4.0 mg/L. In September 2024, a federal judge in California ordered the EPA to strengthen its regulations, saying the compound poses an unreasonable potential risk to children at levels that are currently typical nationwide."

Sounds like the US Public Health Service needs to have a word with the EPA, if they haven't already.

 

[Andy_Ross]

UJ is about to extend fluoridation of tap water to more areas this year.

 

[EHocking]

Not sure this action by the University of Johannesburg will affect too many people?

 

[Andy_Ross]

UK

 

[Puppycow]

UK

Apparently, the maximum allowed in the UK is 1.5mg/l, so maybe they are on to something. I wonder why the EPA allows up to 4.0 mg/L.

Fluoridation of Drinking Water - Drinking Water Inspectorate

Overview Fluoridation is the term used to describe the dosing of water supplies to bring the fluoride level up to 1 milligram per litre as a public health measure intended to prevent tooth decay. The maximum permitted value of fluoride in drinking water is 1.5mg/l (milligrams per litre). In...

www.dwi.gov.uk

Fluoridation is the term used to describe the dosing of water supplies to bring the fluoride level up to 1 milligram per litre as a public health measure intended to prevent tooth decay. The maximum permitted value of fluoride in drinking water is 1.5mg/l (milligrams per litre).

There's a map too (appears to be current as of 2022):

https://dwi-production-files.s3.eu-west-2.amazonaws.com/wp-content/uploads/2021/10/11170837/Fluoride-Map22.pdf

Most of England, including London, appears to be below 0.5 mg/L.

 

[Andy_Ross]

Water supplied around Hartlepool has high natural fluoride content and it was noticed the teeth of those drinking it were better than the national average.
That's where the idea of adding it to the water supply came from.

 

[Planigale]

I think the problem arises from using the term fluoridation or adding fluoride. We should just say that fluoride levels will be normalised or even equalised. Then we should start refering to fluoride as vitamin F, essential for the growth of healthy teeth. The fact that some vitamins can be toxic in excess doesn't stop people accepting a low dose in the diet is necessary. Fluoride in water is natural, the amount varies. Some natural water supplies have too high a fluoride level and it needs reducing, some too little and it needs increasing.

Affluent people claim that fluoridation removes choice, but affluent people are those with choice they can buy water filters, bottled water and pay for dentists to fluoridate their teeth. Poor people are denied the benefits of fluoride if water supplied is deficient in fluoride as they cannot afford dental treatment.

One solution in the UK has been to offer free dental fluoride treatment to poor children (those receiving free school meals) in fluoride deficient areas where there is strong resistance to normalising fluoride levels in the public water supply.

Poor dental hygeine is associated with increased risk of heart disease.

Although causality cannot be asserted, the geographical pattern of CHD in Finland is consistent with the concentration of fluoride in drinking water. One mechanism could be that fluoride prevents dental infections, which in turn reduces mortality from CHD. The more widespread use of fluoridated toothpastes, soft drinks and certain food items since the 1960s may have reduced the significance of drinking water as a source of fluoride.

Fluoride in the drinking water and the geographical variation of coronary heart disease in Finland - PubMed

Although causality cannot be asserted, the geographical pattern of CHD in Finland is consistent with the concentration of fluoride in drinking water. One mechanism could be that fluoride prevents dental infections, which in turn reduces mortality from CHD. The more widespread use of fluoridated...

pubmed.ncbi.nlm.nih.gov

The NTP monograph concluded, with moderate confidence, that higher levels of fluoride exposure, such as drinking water containing more than 1.5 milligrams of fluoride per liter, are associated with lower IQ in children. The NTP review was designed to evaluate total fluoride exposure from all sources and was not designed to evaluate the health effects of fluoridated drinking water alone. It is important to note that there were insufficient data to determine if the low fluoride level of 0.7 mg/L currently recommended for U.S. community water supplies has a negative effect on children’s IQ. The NTP found no evidence that fluoride exposure had adverse effects on adult cognition.

https://ntp.niehs.nih.gov/sites/default/files/2024-08/fluoride_final_508.pdf

This systematic review and meta-analysis found inverse associations and a dose-response association between fluoride measurements in urine and drinking water and children’s IQ across the large multicountry epidemiological literature. There were limited data and uncertainty in the dose-response association between fluoride exposure and children’s IQ when fluoride exposure was estimated by drinking water alone at concentrations less than 1.5 mg/L. These findings may inform future comprehensive public health risk-benefit assessments of fluoride exposures.

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2828425

So water should probably contain <1.5mg/L and parents should be caustious about total fluoride intake including from mouthwashes, toothpaste, etc.