To determine what scientific research has concluded about fluoride and it’s effectiveness in preventing cavities, being taken orally and/or topically, we first must understand the research process and why studies are so varied. Is ingested fluoride as beneficial as applied fluoride? Who regulates the dosage? Finally, who do I contact with my own concerns about fluoride in my state?
The Australian National Health and Medical Research Council (NHMRC) published an extensive review of scientific studies pertaining to the efficacy of fluoride use, taken topically and orally, and found that fluoride use does, in fact, reduce the rate of dental caries. I have used this review purposefully and I’ll tell you why. I cannot find a scientific study that isn’t backed by fluoride advocates or is, in some way, flawed. Even the studies referenced by the CDC, on their website, contain outdated information and research processes, or overtly convey that their testing methods/groups are not ideal. Similarly, articles published on the Fluoride Action Network are bound to represent their bias against fluoride use. Wading through both sides can be confusing, frustrating, and sometimes unsuccessful. Reviews such as this one by the NHMRC take the necessary task of throwing out the fishy information and reviewing the reliable ones as a whole.
So yes, manipulating fluoride levels in our water and taken topically “typically” reduce the rate of dental caries. However, science is a tricky advocate. For example, if I wanted to determine whether or not hydrochloric acid would clean my dishes, the factor of long term effects on the dishware, as well as adverse health effects from exposure, would not have to be included. This may be a bad example, as I am no chemist, but when it comes to fluoride, we cannot dismiss the potential side effects of fluoride just because research has shown that fluoride can reduce dental caries. This has been a major oversight on our part, purposefully encouraged or not, as there was no long term research on systemic health effects of administered fluoride before being administered. My next and final post on fluoride will encompass these health effects. For now, we still need to know who administers and regulates fluoride use.
When I wanted to discover whether or not fluoride was a regulated ingredient, I of course turned to the Food and Drug Administration (FDA). To my surprise, the FDA does not regulate fluoride, unless it is included in bottled water. The responsibility was given to the Environmental Protection Agency (EPA). The EPA is responsible for creating a maximum contaminant level (MCL), or the maximum amount of a substance that can be found in tap water, after taking all scientific research into account. That doesn’t bode well for us when we consider the quality and quantity of research out there that targets fluoride’s comprehensive health effects. However, the EPA re-evaluates the MCLs in drinking water every six years, and there has been a growing amount of disconcerting research on these adverse health effects. The last re-evaluation was in 2011 and focused more on the side-effect of dental fluorosis than any other health concern, making the next re-evaluation to take place no sooner than 2017.
Until then, we must continue to study all aspects of fluoride use. The EPA will continue to uphold it’s maximum contaminant level but they do not enforce it. Whether or not your tap water is fluoridated is strictly a state issue. The government does not require your water to be fluoridated. If you do have questions or opinions about water fluoridation, I suggest you personally contact your state water certification officer and express your concerns. Here is the link for contact information per state, http://water.epa.gov/scitech/drinkingwater/labcert/
Stay tuned for the last part of this fluoride series, as it will address not only the health effects of fluoride, but the main issue of why it is implimented in the first place.
“A Systematic Review of the Efficacy and Safety of Fluoridation.” nhmrc.gov.au. PART A: REVIEW METHODOLOGY AND RESULTS. Australian Government, 2007. Web. 2 April, 2015. <https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/eh41_1.pdf>
“Basic Information about Fluoride in Drinking Water.” Water.epa.gov. EPA, 23 July, 2013. Web. 2 April 2015. <http://water.epa.gov/drink/contaminants/basicinformation/fluoride.cfm>