Community water fluoridation efforts get boost from EPA ruling

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

The ongoing controversy over community water fluoridation is unlikely to go away despite a recent U.S. Environmental Protection Agency (EPA) ruling that won praise from the American Dental Association (ADA) and similar groups.

The EPA denied a petition filed by groups seeking to ban the addition of fluoride to community water systems, a longtime practice aimed at reducing tooth decay. Critics of the practice, led by the Fluoride Action Network, contend that that fluoride supplementation poses neurotoxic risks to the U.S. population.

The EPA in a February letter denying the petition said the anti-fluoridationists’ petition had “not set forth a scientifically defensible basis to conclude that any persons have suffered neurotoxic harm as a result of exposure to fluoride in the U.S. through the purposeful addition of fluoridation chemicals to drinking water or otherwise from fluoride exposure in the U.S.”

Fluoride opponents said they would continue their fight but have not yet filed an appeal. In a statement, Michael Connett, an attorney with the Fluoride Action Network and the author of the petition, said the EPA holds “outdated assumptions” about fluoride.

“We presented the agency with a large body of human and animal evidence demonstrating that fluoride is a neurotoxin at levels now ingested by many U.S. children and vulnerable populations,” Connett said. “We also presented the agency with evidence showing that fluoride has little benefit when swallowed, and, accordingly, any risks from exposing people to fluoride chemicals in water are unnecessary. We believe that an impartial judge reviewing this evidence will agree that fluoridation poses an unreasonable risk.”

However, the ADA and the American Fluoridation Society, an advocacy group founded in 2014, praised the federal agency’s action. “It is always heartening when our government comes down on the side of sound science,” ADA President Gary Roberts said in a statement. “Public health policy recommending community water fluoridation results from years of scientifically rigorous analysis of the amount of fluoride people receive from all sources.”

Over the past seven decades, jurisdictions across the country have been supplementing naturally-occurring fluoride in community water supplies to promote oral health. Numerous studies credit water fluoridation efforts with major reductions in tooth decay during the second half of the 20th century. Many too, attest to the safety of fluoridation at optimum levels.

The EPA in its letter restated the effectiveness of water fluoridation programs. “Water fluoridation provides both systemic and topical exposure which together provide for maximum reduction in dental decay,” the agency said.

4 thoughts on “Community water fluoridation efforts get boost from EPA ruling

  1. Kenneth Stoller

    The petition turned down by the EPA cites 196 peer-reviewed studies published over the last ten years, including over 2,500 pages of supporting documents. Out of 61 human studies, 57 found that fluoride caused harm, including behavioral problems and lowered IQ in children. Out of 115 animal studies, 112 found harm. Out of 17 cellular studies and three reviews, all found harm.

    But the EPA could find nothing that was scientifically defensible to support the evidence of harm?

    Fluoride is more toxic than lead but just try and sell your own toothpaste sweetened with that natural good taste of lead. You will be arrested for poisoning people.

    The National Research Council (NRC) of the National Academy of Sciences published Fluoride in Drinking Water, a review of over 1,000 studies. The NRC’s objectives were to assess if the maximum level of fluoride allowed in water, 4 parts per million (ppm), was safe (it determined it wasn’t) and assess fluoride’s toxicity in general, including its risk in relation to total exposure. It linked fluoride with known or possible health risks, including endocrine disruption, fluorosis, kidney and thyroid disease, diabetes and bone fractures, among others.

    It was unequivocal on neurotoxicity: “it is apparent that fluorides have the ability to interfere with the functions of the brain . . .“ In addition to numerous animal studies, it cited five Chinese studies linking higher levels of fluoride in water with lowered IQ in children. The studies varied in quality and detail, but the NRC concluded “the consistency of the collective results warrants additional research . . .”

    This Harvard-funded meta-analysis led by Anna Choi, PhD and published in Environmental Health Perspectives found that children in China exposed to higher levels of fluoride tested lower for IQ in 26 out of 27 studies. The average difference was significant – 7 IQ points lower. Potential confounding causes such as lead and arsenic were noted in some studies, but controlled for in others, and the authors determined that “it seems unlikely that fluoride-attributed neurotoxicity could be due to other water contaminants.”

    The Harvard meta-analysis was further reinforced by a study published in The Lancet by Philippe Grandjean, MD and Philip Landrigan, MD. In 2006, their first review identified six chemicals as known developmental neurotoxins (harming the brains of children), including lead, arsenic and PCB’s. Their 2014 study named six more. Fluoride was one of them. These chemicals are especially dangerous because they can cause brain damage that is often untreatable and permanent, including behavioral problems and lower IQ.

    No toxin is safe for everyone and most fluoride used by water districts in the USA come in bags from China contaminated with arsenic and lead. Somehow this is okay? Where is the precautionary principle? Where is Informed Consent?

    Why be upset about the people of Flint being poisoned by lead in their drinking water when their own water district was already adding in a neurotoxin far more potent than lead. By adding in fluoride they were also adding in extra lead and arsenic… no wonder everyone sat on their hands for two years about the lead that was in the water – look at what they were already doing.

    Clearly the EPA has been captured, is broken and needs to be shuttered.

  2. Steve Slott

    In response to the comment by Kenneth Stoller:

    1. Presenting a litany of studies does not mean that the studies are applicable, or relevant, to the issue of water fluoridation. In its 40+ page denial of the petition filed by the New York antifluoride faction, “fluoride action network” and others, the EPA provided detailed reasons why the human, animal, and cell studies provided by the petitioners failed to meet the minimum threshold of credibility for support of the claims of the petitioners. These reasons included the irrelevance of the studies to fluoride at the optimal level, their lack of proper methodology, lack of proper control for variables, and various other flaws which rendered them of little value in assessing fluoridated water in the US.

    For those who so desire, the EPA rejection document may be viewed on the Federal Register. It is self-explanatory:

    https://www.federalregister.gov/documents/2017/02/27/2017-03829/fluoride-chemicals-in-drinking-water-tsca-section-21-petition-reasons-for-agency-response

    2. Lead is of no relevance to optimally fluoridated water. The antifluoride tactic of comparing relative toxicities of substances is of no merit. These toxicity levels are in regard to quantity required to be toxic. Understanding that concentration level is the difference between safety and toxicity of any substance known to man, including plain water, is a basic tenet of toxicology. It is precisely why we closely monitor the intake of all substances we ingest, and why fluoride in optimally fluoridated water is strictly maintained at a consistent level far below the threshold of toxicity.

    If one wants to assess safety using relative toxicities as the parameter, then caffeine is more toxic than arsenic. Does this mean we should cease drinking our morning coffee?

    3. It is a mystery why Mr. Stoller believes anyone should add lead to toothpaste.

    4. The 2006 NRC Committee on Fluoride in Drinking Water was charged to evaluate the adequacy of the EPA primary and secondary MCLs for fluoride, 4.0 ppm and 2.0 ppm respectively, to protect against adverse effects. The final recommendation of this Committee was for the primary MCL to be lowered from 4.0 ppm. The sole reasons cited by the Committee for this recommendation were the risk of severe dental fluorosis, bone fracture, and skeletal fluorosis, with chronic ingestion of water with a fluoride content of 4.0 ppm or greater. Nothing else. Had this Committee deemed there to be any other concerns with fluoride at this level, it would have been responsible for stating so and recommending accordingly. It did not.

    Additionally, the NRC Committee made no recommendation to lower the secondary MCL of 2.0 ppm. Water is fluoridated at 0.7 ppm. one third the level which the 2006 NRC Committee on Fluoride in Drinking Water made no recommendation to lower.

    In March of 2013, Dr. John Doull, Chair of the 2006 NRC Committee on Fluoride in Drinking Water made the following statement:

    “I do not believe there is any valid, scientific reason for fearing adverse health conditions from the consumption of water fluoridated at the optimal level.”

    —John Doull, MD, PhD, Chair of the National Academy of Sciences, National Research Council 2006 Committee Report on Fluoride in Drinking Water

    5. The “Harvard-funded meta-analysis” ” is a reference to a 2011 review of 27 Chinese studies dug out of obscure Chinese journals by researchers Phillippe Grandjean and Anna Choi. These studies were of the effects of high levels of fluoride (as high as 11.5 ppm) in the well-water of various Chinese, Mongolian, and Iranian villages. These studies were also included in the EPA petition, and addressed in detail in the EPA rejection document.

    By the admission of Grandjean and Choi, themselves, these studies had key information missing, inadequate control for confounders, and questionable methodologies. These 27 studies were so seriously flawed that Grandjean and Choi were led to issue a public statement in March, 2012 that the studies should not be used to judge water fluoridation in the US. This obviously has not stopped antifluoridationists from doing so anyway.

    “These results do not allow us to make any judgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the U.S. On the other hand, neither can it be concluded that no risk is present. We therefore recommend further research to clarify what role fluoride exposure levels may play in possible adverse effects on brain development, so that future risk assessments can properly take into regard this possible hazard.”

    –Anna Choi, research scientist in the Department of Environmental Health at HSPH, lead author, and Philippe Grandjean, adjunct professor of environmental health at HSPH, senior author.

    https://cdn1.sph.harvard.edu/wp-content/uploads/sites/21/2012/07/Media-Statement_Fluoride-9-12-12-Revised2.pdf

    6. The 2014 article in the “Lancet” was not a study. It was simply the opinions of Phillippe Grandjean, and Phillip Landrigan regarding substances they believe to be environmental neurotoxins. They opined that fluoride is neurotoxic, based on nothing other than the discredited 27 Chinese studies of the the Choi/Grandjean meta-analysis. The EPA petition also addressed this “Lancet” article as part of the supporting evidence from the petitioners. The EPA stated the following:

    Grandjean and Landrigan refer only to the study of Choi et al. (2012), of which Grandjean is a co-author, in discussing fluoride. EPA’s observations about the limitations of Choi et al. (2012) thus apply with equal force to the cited statement from Grandjean and Landrigan.

    7. Fluoride does not “come in bags from China”. Fluoride is the anion of the element fluoride. An anion is a negatively charged atom. It does not “come in bags” from anywhere.

    The substance most widely utilized to fluoridate water systems is hydrofluorosilic acid (HFA). HFA is a co-product of the process which extracts the other co-product, phosphoric acid, from naturally occurring phosphorite rock. Phosphoric acid is used in soft drinks we consume and in fertilizers which become incorporated into foods that we eat. The HFA co-product is diluted to a 23% aqueous solution which is utilized to fluoridate water systems. To irrationally fear one co-product of this process is to irrationally fear the other.

    Once introduced into drinking water, due to the pH of that water (~7), the HFA is immediately and completely hydrolyzed (dissociated). The products of this hydrolysis are fluoride ions identical to those which have always existed in water, and trace contaminants in barely detectable amounts that are so far below US EPA mandated maximum allowable levels of safety that it is not even a certainty that those detected aren’t that already exist in water naturally. After this point, HFA no longer exists in that water. It does not reach the tap. It is not ingested.

    The amount of heavy metals, which includes arsenic and lead, are in barely detectable minuscule amounts far below US EPA mandated maximum allowable levels of safety.

    A complete list of the contents of fluoridated water at the tap including precise amounts of any detected contaminants and the EPA maximum allowable level for each may be found in the “Fact Sheet on Fluoridation Chemicals” on the website of NSF International.

    The source of HFA in the United States is the Mosaic Company.

    8. The precautionary applies when there is not scientific consensus of the safety of an initiative. The public health benefits of water fluoridation are recognized by those such as the past 6 US Surgeons General, the Deans of the Harvard Schools of Medicine, Dentistry, and Public Health, the US CDC, the US Institute of Medicine, the American Dental Association, the American Medical Association, the World Health Organization, the American Academy of Pediatrics, and over 100 more of the most highly respected healthcare and healthcare-related organizations in the world. Clearly there is scientific consensus of the safety of fluoridation. The precautionary principle does not apply.

    9. Informed consent applies to treatment rendered. It does not apply to a decision by local officials to adjust the concentration level of existing minerals in public water supplies under their jurisdiction.

    Anyone who wishes to have informed consent before drinking a glass of water is certainly free to inform himself, then give or not give informed consent to himself prior to “administering” that glass of water to himself.

    10. The attempt by fluoridation opponents to exploit the water problems of the citizens of Flint, in order to further their decades-old ideology against fluoridation, is reprehensible, to say the least. The problems with lead in the Flint water are not only irrelevant to water fluoridation, but began after Flint switched its water source from the fluoridated supply of Detroit to the non-fluoridated water of the Flint River.

    11. That which “needs to be shuttered” are fluoridation opponents who have no understanding of fluoridation, who are completely reliant on misinformation gleaned from antifluoridation websites, and who have no respect for truth and accuracy.

    Steven D. Slott, DDS
    Communications Officer
    American Fluoridation Society

  3. Kenneth Stoller

    Here is a one website link on the countries that have banned or rejected fluoride in water. Note that, places like Sweden have rejected “because no safety data exists.” Even polluted China banned fluoride?

    Yes, the irony that the country that has banned fluoride because of its dangers to human health will send us their fluoride effluvia to drink – bags of fluoride contaminated with lead and arsenic.. Water fluoridation was banned in China because ingested fluoride causes skeletal and dental fluorosis. China fluoridated some urban areas back in 1965, but banned it in 1983 due to the dangers discovered by international scientists. The Chinese government now considers any water supply containing over 1 ppm fluoride a risk for skeletal fluorosis. Skeletal fluorosis has even been found at the lower level of 0.7ppm.

    http://www.fluoridation.com/c-country.htm

    Despite pressure from those with unclean hands, 99% of western continental Europe has rejected, banned, or stopped fluoridation due to environmental, health, legal, or ethical concerns

    Only about 5% of the world population is fluoridated and more than 50% of these people live in North America. The Danish Minister of Environment recommended against fluoridation in 1977 because “no adequate studies had been carried out on its long-term effects on human organ systems other than teeth and because not enough studies had been done on the effects of fluoride discharges on freshwater ecosystems.”

    “In 1978, the West German Association of Gas & Water Experts rejected fluoridation for legal reasons and because ‘the so-called optimal fluoride concentration of 1 mg per L is close to the dose at which long-term damage [to the human body] is to be expected.’ ”

    The above quotes from: Hilleman B, “FLUORIDATION: Contention won’t go away,” Chemical and Engineering News, 1988 Aug, 66:31 (The [ ] brackets were in the original article)

    For those who want more truth accuracy here are just a couple of articles printed in the last few months:
    1) The Influence of Fluorine on the Disturbances of Homeostasis in the Central Nervous System https://www.ncbi.nlm.nih.gov/pubmed/27787813
    2) Groundwater fluoride contamination and its possible health implications in Indi taluk of Vijayapura District (Karnataka State), India https://link.springer.com/article/10.1007/s10653-016-9869-2

    To Mary Otto… I believe that it in the context of health care journalism, the lack of evidence based investigative journalism in this arena has been lacking to say the least.

    Fluoridation is one of those areas where journalists have just dropped the ball almost as muchI as the journalistic blackout about Fukushima and how it is destroying sea life in the Pacific- but maybe I have been reading too many anti-nuclear reactor websites.

    Back in the1950s, dentists believed that fluoride was a “nutrient.” A nutrient is a vitamin or mineral that is essential for a healthy human body. Many dentists may still be ordered to believe it by their dental societies and dental boards. Dentists don’t have a great record on reporting on the best evidence or science when it comes to human health. To this day main stream Dentists will tell you the mercury in dental amalgams is safe mercury and does not leech out of the fillings nor it is absorbed by the human body.

    People can have perfect teeth without consuming fluoridated water or any other fluoride product. As with teeth, no other tissue or cellular process requires fluoride. Accordingly, it is now accepted that fluoride is not an essential nutrient.

    “The prevalence of dental caries in a population is not inversely related to the concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not necessarily more efficacious in preventing dental caries.”
    SOURCE: CDC. 2001. Recommendations for using fluoride to prevent and control dental caries in the United States. Mortality and Morbidity Weekly Review 50(RR14):1-42.

    “Fluoride is not essential for human growth and development.”
    SOURCE: European Commission. 2011. Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water. Scientific Committee on Health and Environmental Risks (SCHER), page 4.

    “Fluoride is not in any natural human metabolic pathway.”
    SOURCE: Cheng KK, et al. 2007. Adding fluoride to water supplies. British Medical Journal 335:699-702.

    “[F]luoride is no longer considered an essential factor for human growth and development…”
    SOURCE: National Research Council. 1993. Health Effects of Ingested Fluoride. National Academy Press, Washington DC. p. 30.

    When you give something that is not essential to human health and that has risks when consumed, it is a medical intervention. It requires informed consent, and it requires dose control.

    Water fluoridation was not conceived of in our finest hour.

  4. Steven Slott

    In regard to Mr. Stoller’s second round of misinformation:

    1. The provision of “interpretations” on why countries may not fluoridate, based on copies of personal correspondence with various water treatment/utility personnel whom the New York antifluoridationist faction “FAN” chose to contact, does not constitute valid evidence of anything.

    The reasons why different countries may not fluoridate their water supplies are myriad, few, if any, associated with concerns with safety or effectiveness of this public health initiative. This includes such things as logistics of water systems rendering fluoridation cost-prohibitive, use of fluoridated salt and/or milk programs in lieu of water fluoridation, existing fluoride levels in water already at or above the optimal level, and equal access to comprehensive dental care by all members of the population.

    2. China is one of the countries with the largest problem of environmental fluoride pollution in the world. Skeletal fluorosis resultant of chronic exposure to abnormally high levels of fluoride from coal burning, in well-water, and from other sources, is commonplace.

    Given the enormous problem of this country with fluoride pollution, it is quite obvious why fluoridation of water is not allowed. It is simply not needed.

    If skeletal fluorosis was attributable to optimally fluoridated water, in the nearly 75% fluoridated US, this disorder would be rampant by now.

    Skeletal fluorosis is so rare in the US as to be nearly non-existent.

    3. Fluoride is the anion of the element fluorine. As anion is a negatively charged atom. Such atoms of fluorine are not sent to the US in bags.

    The substance most widely used to fluoridate water systems is the compound hydrofluorosilic acid (HFA). The major supplier of this substance in the US is the Mosaic Company, which obtains its HFA from phosphorite rock located mainly in Florida. That said, it makes no difference whether fluoridation substances are sourced from the US, China, the Moon, Mars, or the lost city of Atlantis. All water at the tap in the US must meet each of the stringent US EPA mandated quality certification requirements under Standard 60 of NSF International, regardless the source of any additives.

    Standard 60 requires that no contaminant be present in water at the tap in excess of 10% of the EPA maximum allowable concentration (MCL) for that substance. Under rigorous NSF testing of fluoridated water at the tap, in order to even detect any contaminants whatsoever, requires use of 10 times the manufacturer’s recommended single use amount of HFA. In that water, arsenic is only detected in less than half of the random samples. In those samples, the maximum amount of arsenic detected is only 60% of the Standard 60 maximum allowable, which is only 10% of the EPA MCL for arsenic. Obviously, arsenic is of no concern in optimally fluoridated water. Any other contaminants are in even less detectable amounts than arsenic, so far below Standard 60 maximum allowable levels, that it is not a certainty that those detected aren’t those that already exist in water naturally.

    A complete list of the contents of fluoridated water at the tap, including precise amounts of any detected contaminants, and the EPA mandated maximum allowable level for each, nay be found on the “Fact Sheet on Fluoridation Substances” located on the website of NSF International.

    4. Whatever conspiracy nonsense is meant by “pressure from those with unclean hands” is meaningless and irrelevant.

    5. For an explanation as to the reasons different countries may elect to not fluoridate their water systems, see my item #1 above.

    6. With due respect to the out-of-context, uncited quote attributed to the Danish Minister of Environment”, we have had 72 years of fluoridation, hundreds of millions having chronically ingested optimally fluoridated water, with no proven adverse effects. There can be no clearer demonstration of the safety of this initiative.

    In regard to effects on the environment, including “freshwater ecosystems”:

    “Fluoridated water losses during use, dilution of sewage by rain and groundwater infiltrate, fluoride removal during secondary sewage treatment, and diffusion dynamics at effluent outfall combine to eliminate fluoridation related environmental effects. In a literature review, Osterman found no instance of municipal water fluoridation causing recommended environmental concentrations to be exceeded, although excesses occurred in several cases of severe industrial water pollution not related to water fluoridation. Osterman found that overall river fluoride concentrations theoretically would be raised by 0.001-0.002 mg/l, a value not measurable by current analytic techniques. All resulting concentrations would be well below those recommended for environmental safety.”

    —Water Fluoridation and the Environment: Current Perspective in the United States Howard F. Pollick, BDS, MPH Int J Occup Environ Health 2004;10:343–350

    7. In regard to the uncited 1978 quote attributed to utility personnel of West Germany…..yes, unfortunately, as is also the case in the US, utility personnel in Germany and other countries, have fallen prey to the false claims and misinformation constantly disseminated by antifluoridationists, and have failed to exercise due diligence in verifying the validity of these claims. Had they done so, the West German utility personnel in 1978 would have quickly ascertained there is no valid, peer-reviewed scientific evidence of any “long term damage [to the human body]” from optimal level fluoride, nor is there any such evidence today.

    8. Regarding the articles for those who “want more truth and accuracy:

    A. The element fluorine is not added to water supplies. It’s anion, fluoride, is that which is added in order to adjust the existing fluoride level in that water to the point where maximum benefit will be attained, with no adverse effects. The paper on effects of fluorine has no relevance to optimally fluoridated water.

    B. The India study was one of incidence of skeletal fluorosis in Indian villages, whose groundwater had been contaminated with fluoride. India, like China, is one of the countries with the greatest amount of environmental fluoride pollution in the world. Effects on Indian populations which have been chronically exposed to abnormally high levels of fluoride pollution, in addition to that which they obtain from their well-water, is of no relevance to optimally fluoridated water in the US.

    Clear demonstration of this fact is the while skeletal fluorosis is rampant in India, this disorder is so rare in the nearly 75% fluoridated US, as to be nearly non-existent.

    9. Regarding that which is “To Mary Otto….” as I have clearly demonstrated, the information provided by Mr. Stoller is false, unsubstantiated, and gives no indication that he has exerted even a bare minimal amount of effort to properly educate himself on the issue from anything other than misinformation posted on antifluoridation websites.

    Given this, that he attempts to admonish healthcare journalists for what he claims to be a “lack of evidence based investigative journalism” is truly ironic.

    It is clearly obvious to intelligent readers that Ms. Otto has done far more research on fluoridation from legitimate sources of accurate information than has Mr. Stoller even attempted to do.

    10. From the 2001 CDC Mortality and Morbidity Weekly Review cited by
    Stoller:

    “Regardless of SES, water fluoridation is the most effective and efficient strategy to reduce dental caries”

    “Children and adults who are at low risk for dental caries can maintain that status through frequent exposure to small amounts of fluoride (e.g., drinking fluoridated water and using fluoride toothpaste). Children and adults at high risk for dental caries might benefit from additional exposure to fluoride (e.g., mouthrinse, dietary supplements, and professionally applied products).”

    —CDC. 2001. Recommendations for using fluoride to prevent and control dental caries in the United States. Mortality and Morbidity Weekly Review 50(RR14):1-42.

    11. “Fluoride is not essential for human growth and development.” “Fluoride is not in any natural human metabolic pathway.” “Fluoride is no longer considered an essential factor for human growth and development.”

    So what? Fluoride has been ingested in water by humans since the beginning of time. Fluoridation simply insures that we get maximum benefit when so doing, while strictly maintaining the concentration of that fluoride well below the threshold of adverse effects.

    If Stoller was truly “concerned” with purported “risks” from fluoride in water, then he would be advocating for fluoridation, not against it. The fluoride content of non-fluoridated systems is not monitored nearly as often or as closely as it is in fluoridated systems, and, while fluoridated systems are capped at the level of 0.7 mg/liter, non-fluoridated systems are capped only at the EPA mandated maximum allowable level of 4.0 mg/liter.

    Stoller’s “logic” makes absolutely no sense.

    12. “When you give something that is not essential to human health and that has risks when consumed, it is a medical intervention. It requires informed consent, and it requires dose control.”

    No one is given anything in regard to water fluoridation, and there are no risks of adverse effects involved in this initiative. Those in fluoridated areas have water piped into their homes sourced from supplies which strictly maintain the level of fluoride at the level of 0.7 mg/liter.

    There is no “medical intervention” involved in a decision by local officials to adjust the level of existing fluoride to that level at which maximum benefit is received by those served by that water supply, with no adverse effects. Any who desire not to drink that water are entirely free not to do so.

    The dose of fluoride in fluoridated systems is very strictly controlled. For every one liter of water consumed, 0.7 mg fluoride is ingested. The amount of fluoride ingested from one liter of non-fluoridated water could be as much as 4 mg. So, which system does Stoller believe requires greater “dose control”?

    There is no “informed consent” required for local official to approve the adjustment of the concentration level of existing fluoride ions in water systems under their jurisdiction. Consent for these officials to perform their responsibilities is conveyed upon their election/appointment to office.

    13. “Water fluoridation was not conceived of in our finest hour.”

    Antifluoridationists who seek to remove the benefit we receive from an existing mineral in our water supplies, while also removing the strict monitoring and maintenance of the concentration level of that mineral, are the ones who are not acting in their “finest hour”. Why? Because they fail to act responsibly in seeking to understand the initiative about which they disseminate patently false claims and misinformation. In so doing, they are a true menace to the health of the public.

    Steven D. Slott, DDS
    Communications Officer
    American Fluoridation Society

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