Paul Connett is at it again. His latest project is aimed at manipulating the natural concern parents have for their children. He is using crude fear-mongering in the hope of getting parents to come out against community water fluoridation (CWF) – a social health policy known to be both effective and safe (see Calling All Parents).
Image credit: Golisano Children’s Hospital
Sensible parents need to keep well away from this nonsense. If you have read his “statement” I offer instead the advice below as a counter to Connett’s rubbish. It is important for parents to learn the truth about this safe and effective social health policy so they can work together to counter attacks on it from ideologically motivated political activists like Connett.
1) Natural is not necessarily safe and “Nature” did not have “intentions for us.” Yes, mothers’ milk is low in fluoride, but it can also be deficient in other beneficial or essential trace elements. A brief scan of the scientific literature shows breast-fed children are prone to several microelement deficiencies. For example, Kodama (2004) and Domellöf, et al (2004) report deficient levels of zinc, selenium and iron in breast milk. Supplementation of breast-fed infants with micronutrients, including fluoride, is sometimes recommended.
2) Mild or very mild dental fluorosis is the only know negative effect of community water fluoridation. It is usually just cosmetic and often only noticed by a dental professional. Severe dental fluorosis is very uncommon in NZ, USA and most of Europe, but is usually caused by high fluoride intake from natural sources (eg in China or India), industrial pollution, consumption of fluoridated toothpaste, etc. Opponents of CWF often quote data for the common occurrence of mild dental fluorosis – but then describe it (or illustrate with photos) as if it were severe. See Dental fluorosis: badly misrepresented by FANNZ for an example of this misrepresentation.
3) CWF will not harm your child’s brain. Connett’s scare-mongering claims of CWF reducing the IQ of children are based on a selection of brief reports from areas of high natural fluoride in drinking water (Chio et al 2012). These are not relevant to CWF (Choi and Grandjean 2012). The reports are of poor scientific quality – mostly ignoring confounding factors like lead intake, breast-feeding and education which are known to influence IQ (National Fluoride Information Service 2013; Broadbent et al 2014). These reports also use data from naturally high fluoride areas in China and Iran where skeletal fluorosis and severe dental fluorosis are a problem. More detailed studies at the lower concentrations used in CWF have not found any connections between CWF and IQ levels (Whitford et al 2009; Broadbent et al 2014).
4) There is ample evidence fluoridation is beneficial to your child’s teeth. This is not surprising because fluoride is a natural and normal constituent of the bioapatites your teeth and bones are formed from. At optimum concentrations it strengthens them and helps prevent their corrosion by acidic foods, etc. Be wary of anti-fluoridation propagandists claims of studies showing no beneficial effects of CWF. These usually refer to situations where children receive other forms of fluoride such as fluoride oral rinses, fluoridated salt or milk, or topical fluoride varnish dental applications. Some propagandist also attempt to claim that the general improvement of oral health in developed countries in recent years without CWF “proves” it is ineffective. This improvement arises from improved diet and personal dental hygiene as well as improved care by dentists. These positive effects are usually in addition to the benefits of CWF and this becomes obvious when communities with and without CWF are compared in the same country.
5) Fluoride in water and food, as well as that in toothpaste, is beneficial . Development of permanent and baby teeth occurs in the first 4 years of life. Incorporation of optimum amounts of fluoride into the tooth enamel at this stage, even before teeth erupt, helps reduce tooth decay throughout life. Even after tooth eruption the existing teeth benefit from the fluoride which transfers to saliva from food and water. This helps to maintain a concentration of fluoride in saliva which reduces the demineralisation of the tooth surface by acid derived from acid food and drink and from bacterial action on carbohydrates. It also helps the remineralisation of the tooth enamel as the acid concentration in saliva reduces with time. The beneficial role of fluoride with existing teeth is mainly due to this surface, or topical, effect. However, fluoride concentrations in saliva decrease rapidly with time so CWF is important because regular consumption helps to maintain concentrations. Consequently CWF supplements brushing teeth with fluoridated toothpaste which, by itself, cannot maintain concentrations through the day.
The beneficial effects of CWF results from both ingestion (particularly during tooth development in young children) and maintenance of an effective concentration of fluoride in saliva protecting existing teeth against decay throughout life.
CWF is a proven safe and effective social health policy. It works for everyone because it doesn’t need individuals to remember to use mouth-rinses, take supplements or make applications to their teeth. Once in place we can forget about it and it still works.
For these reasons parents should support community water fluoridation. They should also be very wary of ideologically driven activists who use scare-mongering and misinformation to raise fears. Parents naturally have their child’s best interests at heart. Unscrupulous activists can take advantage of that. But informed parents can protect themselves from emotive propaganda.
Informed parents will reject Paul Connett’s latest fear-mongering campaign.
Broadbent, J. M., Thomson, W. M., Ramrakha, S., Moffitt, T. E., Zeng, J., Foster Page, L. A., & Poulton, R. (2014). Community Water Fluoridation and Intelligence: Prospective Study in New Zealand. American Journal of Public Health.
Choi AL, Grandjean LC (2012). Harvard Press Release: Statement on fluoride paper.
Choi, A. L., Sun, G., Zhang, Y., & Grandjean, P. (2012). Developmental fluoride neurotoxicity: A systematic review and meta-analysis. Environmental Health Perspectives, 120(10), 1362–1368. Retrieved from
Domellöf, M., Lönnerdal, B., Dewey, K. G., Cohen, R. J., & Hernell, O. (2004). Iron, zinc, and copper concentrations in breast milk are independent of maternal mineral status. The American Journal of Clinical Nutrition, 79(1), 111–5. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14684406
Kodama, H. (2004). Trace Element Deficiency in Infants and Children — Clinical practice —. Journal of the Japan Medical Association, 47(8), 376–381.
National Fluoride Information Service. (2013). NFIS Advisory A review of recent literature on potential effects of CWF programmes on neurological development and IQ attainment.
Whitford, G. M., Whitford, J. L., & Hobbs, S. H. (2009). Appetitive-based learning in rats: lack of effect of chronic exposure to fluoride. Neurotoxicology and Teratology, 31(4), 210–5.