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Fluoride: Should It Be In Our Water System?

I read a recent article about an ongoing debate in Great Britain: whether or not to include fluoride in the water supply. In the United States, we began adding tiny amounts of this naturally occurring substance to the water supplies over 60 years ago. In fact, as much as 75% of the drinking water in the US is artificially fluoridated, and the purpose is to improve the health of our teeth. I was wondering what the research shows about the need for additional fluoride in our diet, and if there are any risks posed by fluoridation of our water supplies. I asked Revolution Health dental expert, Dr. Andres Garcia, what he thought about this issue. Here are his thoughts:

Dr. Val:  Is there compelling evidence that adding fluoride to our water system is beneficial for teeth?

Dr. Garcia: Numerous studies by the ADA have shown that a decrease in cavity exposures of 20-40% can be expected when water is fluoridated in communities. In 1999, the CDC listed fluoride as one of the ten great public health achievements of the 20th century.  The current goal by the USPHS (U.S. Department of Health and Human Services) is to have 75% of the drinking water in the U.S. fluoridated to optimum levels by 2010.

Dr. Val: how do people get the benefits from fluoridated water exactly?

Dr. Garcia:You get the benefits from drinking fluoridated water in two ways, systemically and topically.  Systemically, small children ingest fluoride as the teeth are forming.  The fluoride is incorporated into the enamel and causes the enamel to be stronger and more resistant to decay.  After the teeth have erupted, fluoride has a topical action.  Fluoride from toothpaste, water, or other sources bathe the teeth, and the fluoride ions reverse tooth damage from decay and harden the enamel to resist further decay.  The optimum fluoride intake is a combination of ingestion of fluoride before the teeth erupt and subsequent topical application after eruption.

Dr. Val: Is there any risk associated with too much fluoride?

Dr. Garcia: Fluoride toxicity can occur if people are exposed to high concentrations of the substance over long periods of time, though the water supply is closely monitored to ensure that the concentrations are well within acceptable limits.  Fluoride toxicity is called “fluorosis.”  If toxic amounts of fluoride are ingested when a child is young, the teeth will be weakened when they form.  (This is counter intuitive because small amounts of fluoride strengthen the teeth, but large amounts weaken the teeth.) When the teeth erupt into the mouth, the enamel is very thin and breaks easily.  The teeth are also prone to cavities.  They will have a brown “mottled” appearance.  Bones are also susceptible to fluorosis.  Excess fluoride is stored in the bone, and the bones can be brittle and more prone to fractures.

Dr. Val: So if small amounts of fluoride are good for us, why are the British so hesitant to add it to their water supplies?

Dr. Garcia: Many European countries, such as Britain, have been slow to adopt fluoride supplementation due to high levels of other natural sources providing an adequate amount of fluoride in the diet.  Tea has been shown to contain from 1ppm to 6.5ppm fluoride concentration.  In the U.S., the recommended concentration of fluoride is 1.0-1.2ppm/day as recommended by the USPHS.  So regular tea drinkers get enough fluoride naturally. There is also strong anti-fluoride opposition in the public with fears of “forced immunization” and possible adverse health side effects.

Dr. Val: Should people living in areas where the water supply is not fluoridated take additional steps to get more fluoride?

Dr. Garcia: Areas that lack fluoridated drinking water should seek other sources for optimal fluoride intake.  The best way is to contact your dentist or pediatrician.  Supplements in the form of pills or topical gels can be prescribed to supplement a lack of fluoride.  Care must be taken to avoid over supplementation.  If the community receives its drinking water from an underground source, they may already be ingesting a higher level of fluoride than is necessary. Toothpaste is also a good source of fluoride.  Care must be used in infants as they swallow the toothpaste unknowingly.

Dr. Val: What about those additional fluoride treatments that I had as a child? Are those really necessary?

Dr. Garica: Fluoride should only be used in individuals at high risk for cavities.  Kids with braces, a high caries rate, adults with xerostomia, these are ideal candidates for fluoride use.  I have all patients learn about fluoride and they make a choice for themselves.  I personally will not use anything stronger than an OTC toothpaste for myself and family.  Fluoride is a known toxic substance that irreversibly binds to the hard tissues of the body.  I am wary of the long term effects of any non essential diet supplement.  It is equal to taking antibiotics constantly to stave off a possible infection.   Good oral hygiene will keep an individual cavity free.  Only in rare cases is someone genetically predisposed to cavities.  It is usually a consequence of diet (refined foods) and poor oral hygiene that causes the decay.

For more information, check out Revolution Health’s Dental Health Center

.This post originally appeared on Dr. Val’s blog at

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4 Responses to “Fluoride: Should It Be In Our Water System?”

  1. NYSCOF says:

    Fluoride Damages the Thyroid, Report Shows

    New York –  September 24, 2007 – There is clear evidence that small
    amounts of fluoride, at or near levels added to U.S. water supplies, present
    potential risks to the thyroid gland, according to the National Research
    Council’s (NRC) first-ever published review of the fluoride/thyroid

    Fluoride, in the form of silicofluorides, injected into 2/3 of U.S.
    public water supplies, ostensibly to reduce tooth decay, was never

    “Many Americans are exposed to fluoride in the ranges associated with
    thyroid effects, especially for people with iodine deficiency,” says Kathleen
    Thiessen, PhD, co-author of the government-sponsored NRC report. “The recent
    decline in iodine intake in the U.S could contribute to increased toxicity of
    fluoride for some individuals,” says Thiessen.

    “A low level of thyroid hormone can increase the risk of cardiac disease,
    high cholesterol, depression and, in pregnant woman, decreased intelligence of
    offspring,” said Thiessen.(C)

    Common thyroid symptoms include fatigue, weight gain, constipation, fuzzy
    thinking, low blood pressure, fluid retention, depression, body pain, slow
    reflexes, and more. It’s estimated that 59 million Americans have thyroid

    Robert Carton,
    PhD, an environmental scientist who worked for over 30 years for the
    U.S. government including managing
    risk assessments on high priority toxic chemicals, says “fluoride has
    detrimental effects on the thyroid gland of healthy males at 3.5 mg a day. With
    iodine deficiency, the effect level drops to 0.7 milligrams/day for an average
    male.”(E) (1.0 mg/L fluoride is in most water supplies)

    Among many others, the NRC Report cites human
    studies which show

    – fluoride concentrations in thyroids exceeding
    that found  in other soft tissues


    – an association between endemic goiter and
    fluoride exposure or enamel fluorosis in


    – fluoride adversely affects thyroid and
    parathyroid hormones, which affect bone


    “If you have a thyroid problem, avoiding fluoride may be a good
    preventive health measure for you,” writes Drs’ Richard and Karilee Shames in
    “Thyroid Power.”(F).

    Over, 900 Physicians, Dentists, Scientists, Academics and
    Environmentalists urge Congress to stop water fluoridation until Congressional
    hearings are conducted. They cite new scientific evidence that fluoridation is
    ineffective and has serious health risks. (

    Please sign the petition and Congressional letter to support these
    professionals http://www.FluorideAction.Net

    “Fluoride can harm bones, teeth, kidneys, the brain and more,” says
    lawyer Paul Beeber, President, New York State Coalition Opposed to

     NYS Coalition Opposed to


    “Fluoride in Drinking
    Water: A Scientific Review of EPA’s Standards,” Committee on Fluoride in
    Drinking Water, Board on Environmental Studies and Toxicology, Division on Earth
    and Life Studies, National Research Council of the National Academies of
    Science. March 2006 Chapter 8

    “Thyroid Function: Fluoride
    exposure in humans is associated with elevated TSH concentrations, increased
    goiter prevalence, and altered T4 and T3 concentrations.” (Page

    “(The thyroid effects are
    associated with average fluoride intakes that) will be reached by persons with
    average exposures at fluoride concentrations of 1-4 mg/L in drinking water,
    especially the children.” (Page 260)

    (B) Sodium Hexafluorosilicate and Fluorosilicic

    of Toxicological Literature, October 2001

    (C) Chemical & Engineering News,
    “Fluoride Risks Are Still A Challenge,” byBette Hileman,September 4, 2006,

    (D)   Mary Shomon, Thyroid editor, Patient
    Advocate — Author of “The Thyroid Diet” and “Living Well
    With Hypothyroidism”

    (E) Fluoride,
    “Review of the 2006 National Research Council Report: Fluoride in Drinking
    Water,” July-September 2006, by Robert J. Carton

    (F)  Thyroid  Power and Feeling Fat Fuzzy or
    Richard Shames MD & Karilee Shames RN, PhD

    Fluoride/Thyroid Health Effects

    Sources of Fluoride

    Sulfuryl Fluoride Pesticide Residues Allowed on Foods

    United States Department of Agriculture (USDA) National
    Fluoride Database of Selected  Beverages
    and Foods

  2. Dr. Scherger says:

    Thank you Val and Dr. Garcia for this very informative posting.  My two sons, ages 28 and 30, have grown up with essentially no tooth decay, and I wish I could say they took good care of their teeth.  The bottom line is that they grew up drinking fluoridated water.  I was not so lucky, and my fillings are multiple and have been replaced through the years.

    Those against fluoride are simply misinformed and a little paranoid about good public health.  Some of these same people are against immunizing children, and we are having a measles outbreak in San Diego as a result of that.  When the research is solid, and the experience is good, we should all embrace good public health recommendations, like small amounts of fluoride in the water.

    Finally, on a personal note, Dr. Garcia is my dentist and I’m delighted he contributed to this posting.  We are both Bruins, and go UCLA with the NCAA tournament coming up.

  3. RH Host Melissa says:

    Thank you Dr. Val for sharing this interview with us.  Very interesting reading.  

  4. toothfairy79 says:

    I have to completely agree with the doctors explaination on fluoride in the water supply. It’s really an “unknown” in the general publics knowledge on the benefits. If I were to ask any of our patients what they know about the affects of fluoride, alot of them wouldn’t know anymore than what they see on TV commercials. If they research it online they’ll get alot of information there, but many of them are not real knowledgable. We explain it during the treatment and that’s enough for them. I live and work in a community where there isn’t fluoride in the water supply.  We see alot of  early decay in children and young adults. We are very excited about new products out on the market that address the issues of slowing or stopping the decay process. It’s a prescription toothpaste but hopefully some day it will be over the counter. We are promoting the chewing gum with Xylotal.. it’s been proven to help in the breakdown of acids which cause decay. As long as the City leaders and the communitys are not willing to put fluoride in the water supply, then there are things people can do to help themselves.

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