Photo: Joe Shlabotnik / Flickr

It is perhaps ironic that the same day the WWII Battle of the Bulge ended on January 25th, 1945 (Hitler’s last offensive to dominate Europe) is also the exact day when fluoride was introduced into the American public water system, signaling a new kind of skirmish. The Monroe Avenue Water Filtration Plant in Grand Rapids, Michigan was built in 1913 and is the exact point fluoride came into our water and our consciousness. Today, the old water plant is a mixed-use project with luxury apartments.

Fluoride is a divisive issue; some people claim it’s nearly magical while others believe it’s poisoning us. So which is it?

Fluoride is both naturally occurring and chemically enhanced. Natural fluoride is an element occurring organically in soil and is widely distributed in the earth’s crust and parts of the upper mantle (underneath the crust) mainly as fluorine, fluorspar and cryolite, and it is one of the top 20 most common elements in our dirt. It is also found in seawater, groundwater, surface waters and in foods — particularly fish and tea.

While almost all foods contain minute traces of fluoride, water and non-dairy beverages are the main sources of ingested fluoride, accounting for 65 percent to 80 percent of fluoride in US adults. Other significant sources of ingested fluoride are toothpaste in young children who tend to eat toothpaste (I know I did), tea in tea-drinking communities and inhaled fluoride in some communities (like China) where coal containing high levels of fluoride is burned.

In short, fluoride is ubiquitous. There is also chemically enhanced sodium fluoride we put in our public drinking water and the vast majority of toothpastes.

Fluoride’s Rocky Debut

Fluoride’s role in preventing tooth decay started in 1901 when Frederick McKay opened a dentistry practice in Colorado Springs, Colorado. McKay noticed that many of his neighbors had brown stains on their mottled teeth, what we call fluorosis, yet those teeth, though visually unappealing, were surprisingly resistant to decay. McKay decided to find out why and decades later he discovered that the town’s drinking water had high levels of naturally occurring fluoride.

Picking up that mantle, the dental effects of fluoride in public drinking water were established during the 1930s and 1940s by Trendley Dean at the US Public Health Service (precursor to the Department of Health and Human Services). In a series of epidemiological studies, Dean demonstrated that as the concentration of fluoride naturally present in drinking water increased, the prevalence and severity of dental fluorosis also increased, however, the prevalence and severity of tooth decay decreased.

Dean’s data suggested that, given natural fluoride concentration of around 1 milligram per liter (the equivalent of 1 part per million or PPM), the impact of dental fluorosis was not of public health significance, but that the increased resistance to tooth decay was. This led to artificially raising the fluoride level of municipal water. Grand Rapids was the first test city, though there were others including Newburg, New York in May 1945, and Evanston, Illinois in 1947. In 1955, Crest became the officially sanctioned toothpaste of the American Dental Association (ADA) and any commercial toothpaste on the market today endorsed by the ADA of necessity contains added fluoride.

Is It Safe?

Since there is both naturally occurring and manufactured fluoride, can too much be a bad thing? Yes — and it’s known as skeletal fluorosis, a legitimate global problem whereby bone strength and integrity, as well as joints, can be severely compromised leading to structurally deficient bones over time.

The World Health Organization reported in 2004: “There is clear evidence from India and China that skeletal fluorosis and an increased risk of bone fractures occur as a result of long-term excessive exposure to fluoride at total intakes of 14 mg/L per day – and evidence suggestive of an increased risk of bone effects at total intakes above about 6 mg/L of fluoride per day.” Skeletal fluorosis is not a theory, it is a fact for millions of people around the globe, but it is rare in the US.

Manufactured fluoride has many uses, not merely what is added to municipal water. Sulfuryl fluoride is a fumigant, insecticide and rodenticide that was initially registered in the US in 1959 for control of termites. In 2004, EPA registered sulfuryl fluoride for control of insect pests in harvested and processed foods. Sulfuryl fluoride breaks down to form fluoride. According to the National Pesticide Information Center (a joint venture between EPA and Oregon State University) “symptoms of sulfuryl fluoride poisoning include nose and throat irritations, shortness of breath, numbness, weakness, nausea, abdominal pain and slowed speech or movements. It is a central nervous system depressant.” Cryolite AKA sodium aluminum fluoride is another ingredient in pesticides.

Conspiracy theories are always interesting because there is usually a kernel of truth in them. One of the most pervasive theories behind fluoride is about the Nazis and mind control during WWII. Many people have propagated this myth, among them Charles E. Perkins, a chemist from Milwaukee who wrote a pamphlet in 1954 titled “The Truth about Water Fluoridation.”

Among his writings: “In the 1930’s, Hitler and the German Nazis envisioned a world to be dominated and controlled by a Nazi philosophy of pan-Germanism. This plan was to control the population in any given area through mass medication of drinking water supplies. By this method, they could control the population in whole areas, reduce population by water medication that would produce sterility in women, and so on. Repeated doses of infinitesimal amounts of fluoride will in time reduce an individual’s power to resist domination, by slowly poisoning and narcotizing a certain area of the brain, thus making him submissive to the will of those who wish to govern him.”

There is no verifiable evidence to suggest that excessive fluoride impacts human behavior, as noted it mainly causes bone issues and some studies have suggested an increased risk of cancer. However, it is worth noting that in Germany in the late 1930s they were actively creating a nerve gas, which was made, in part, from elements of fluoride.

Can We Trust the Medical Establishment?

My goal here is not to engage every theory about the destructive uses of fluoride. There are far too many unsubstantiated blogs, websites and “studies,” which claim wildly ridiculous things about fluoride. What I want to show you is verifiable, documented information from the US federal government and other legitimate worldwide organizations. I do this for two reasons. First, there is much more documented, peer-reviewed information. And second, these organizations tend to be very conservative in their approach to scientific research. Therefore if a historically cautious institution raises concerns about fluoride, you might want to reconsider your own position.

In 1986, EPA set the maximum contaminant level for fluoride in public water systems at 4 parts per million (PPM). Understand that fluoride is not a national government program; it is governed and administered by municipalities in their states. Therefore EPA’s 4 PPM was the maximum amount allowed; states could do whatever they wanted as long as it didn’t go over 4 PPM. Yet EPA’s own website says: “Exposure to excessive consumption of fluoride over a lifetime may lead to increased likelihood of bone fractures in adults, and may result in effects on bone leading to pain and tenderness.”

  • The Centers for Disease Control and Prevention named the fluoridation of drinking water “one of the ten great public health achievements of the 20th century.”
  • The American Dental Association has supported fluoride since 1950. The American Academy of Pediatric Dentistry, and the American Dental Hygienists Association also support it.
  • A 1990 animal study by the National Toxicology Program (part of the Health and Human Services) found “equivocal evidence” of a link between fluoridated water and cancer in male rats.
  • UNICEF says: “Fluorosis is a serious bone disease caused by high concentrations of fluoride occurring naturally in groundwater. Fluorosis is endemic in at least 25 countries across the globe. The total number of people affected is not known, but a conservative estimate would number in the tens of millions.”
  • The American Association for the Advancement of Science, an international non-profit group reported that: “Ironically, children who consume too much fluoride in their first eight years of life may develop lasting problems with their teeth, including pitting of enamel and tooth decay. Excess fluoride also weakens bones over decades. In addition, some studies have shown that fluoride causes cancer in laboratory animals.”

Fluoride and the NAS

The ideas and concepts of fluoride have changed over time. The National Academy of Sciences (NAS), established in 1863, is today a private non-profit working closely with the US government to present peer reviewed/sanctioned information.

This is a timeline of their official views on fluoride.

  • 1951: NAS first reports on fluoride in drinking water, finding that fluoridation was safe and effective to optimum levels for oral health. Well,of course that was their conclusion, there were no long-term trials done at this point. Remember, it was only six years earlier that they even began to add fluoride to public water systems and its use was not yet widespread.
  • 1977: In their first official report, NAS concluded: “There is no generally accepted evidence that anyone has been harmed by drinking water with fluoride concentrations considered optimal.” Only two adverse health effects were identified in their report: dental fluorosis, and skeletal fluorosis.
  • 1993: A new NAS report concluded that the EPA level of 4 PPM in drinking water was an appropriate standard and was safe for ingestion at levels considered optimal for oral health.
  • 2006: NAS now reports three adverse health effects warranted consideration: severe dental fluorosis from exposure to high levels of fluoride for children between birth and eight years of age; risk of bone fractures; and severe forms of skeletal fluorosis after lifetime exposure.
  • 2007: NAS quickly updates the 2006 report stating that fluoride as a mineral can positively influence human health. They concluded that fluoride was considered to be an element essential for human life based on its role in cellular functions involving metabolic or biochemical processes. The report further stated that fluoride in drinking water has two beneficial effects: preventing tooth decay and contributing to “bone mineralization” and “bone matrix integrity.” There has been no study released since 2007.

Going Global

How do other countries view fluoride?

Australia began fluoridating their water in the 1960s and now over 70 percent of its population has fluoridated water.

Brazil has had fluoridated water since the 1950s and two-thirds of Brazilian cities are now fluoridated.

Canada’s rates of fluoridation vary wildly between its provinces — about 74 percent of the population in Ontario, compared with just 4 percent in British Columbia. About 30 Canadian cities, notably Calgary in 2011, have banned fluoride, yet the government is now trying to ban municipalities from removing fluoride from municipal water systems.

China pursued water fluoridation for about 20 years before backing away entirely from it in the 1980s. Parts of the country already have high levels of naturally occurring fluoride

EU countries back fluoride, including Spain, Poland, Ireland and the UK. Just 10 percent of the UK’s population, however (about six million people) get either naturally fluoridated or artificially fluoridated water.

Germany stopped fluoridating its water in the 1970s; the Netherlands and Sweden have discontinued water fluoridation. France never started.

New Zealand: About half of the population has access to fluoridated water.

In Israel, fluoridated water has been mandatory since 1998, but in 2013, due to legislative language, not health concerns, Israel ceased adding fluoride to their water.

According to a 2012 report by the Centers for Disease Control (CDC) based on community water systems (not private wells), the most fluoridated state in the US was Kentucky with 99.9 percent of that population having fluoride in their water. The least most fluoridated state? Hawaii, with 10.8 percent of the population affected by fluoridated water.

But the most telling thing about fluoride occurred in 2011. With little fanfare and barely reported on by the media (I wrote about it at the time), Health and Human Services (HHS) in conjunction with EPA proposed that the recommended level of fluoride in drinking water in the US be set at its lowest level ever.

The press release is the typical dull information you’d expect, but HHS Assistant Secretary for Health, Howard K. Koh, MD, MPH said: “HHS and EPA reached an understanding of the latest science on fluoride and its effect on tooth decay prevention and the development of dental fluorosis that may occur with excess fluoride consumption during the tooth forming years, age 8 and younger. HHS proposed recommendation of 0.7 milligrams of fluoride per liter of water replaces the current recommended range of 0.7 to 1.2 milligrams. This updated recommendation is based on recent EPA and HHS scientific assessments to balance the benefits of preventing tooth decay while limiting any unwanted health effects.”

Those last three words say it all: unwanted health effects. So is fluoride dangerous? Well, the facts are simple. Yes, trace amounts help prevent tooth decay, however, the long-term effects of too much fluoride in the body have consequences, and if two government agencies reverse their entrenched positions about how much you should be consuming, you need to be aware of that. We already live in a toxic world. We do not need more toxins in our air and food, and certainly not in our water.

To find out if there is fluoride in your water supply, contact your local water municipality. They are required by law to provide you with a water analysis.

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