Drinking Water Fluoridation: Is It Safe?

by Natasha Hobley | Apr 9, 2024

Experts have called the practice of adding the chemical compound fluoride to drinking water as “safe and effective” for decades. The U.S. Centers for Disease Control and Prevention (CDC) has named it one of the top 10 greatest health achievements of the 20^th century. For years, those who have opposed it have been called “anti-science” or conspiracy theorists. Yet in a San Francisco courtroom, experts and litigators battled the question, “Is water fluoridation safe?” in front of a U.S. Supreme Court judge.

Judge Edward Chen is expected to soon rule on the controversy to answer the question, “Is water fluoridation safe?”.

After a nearly four-year delay in court, the lawsuit wrapped up on Feb. 20, 2024. The lead plaintiff was the non-profit organization Fluoride Action Network (FAN) and the case was brought against the U.S. Environmental Protection Agency (EPA) as the first ever to reach trial under the Toxic Substance Control Act of 1976. FAN was joined by consumer advocacy groups Food and Water Watch and Moms Against Fluoridation, the American Academy of Environmental Medicine (AAEM), the Internal Academy of Oral Medicine and Toxicology (IAOMT), as well as public health associations.¹

Ingesting Fluoride Correlated to Decreased IQ

The practice of fluoridation dates back almost 80 years, but research has consistently shown potential adverse effects to human health. Most notably in the courtroom, attorneys and experts discussed studies that indicated that fluoride in drinking water is harming the human brain, particularly the “undeniable” correlations between decreased IQ and fluoride exposure in utero.¹

The findings of one study entitled “Association Between Maternal Fluoride Exposure During Pregnancy and IQ Scores in Offspring in Canada” were so convincing that the Journal of the American Medical Association Pediatrics (JAMA Pediatrics)² decided to publish it with an editorial comment about the decision. After publication, JAMA editor Dimitri Christakis, MD stated that “the decision to publish this article was not easy,”³ and stated in the JAMA podcast that the findings indicated the IQ effects were on par with lead exposure.

Dr. Christakis also discussed on the JAMA podcast how before there were “anti-vaxxers,” there were “anti-fluoriders,” and that from his learning in residency, those who wanted it out of the water system were “nuts.” But upon further investigation into the research, he felt there was information that deserved to be further considered. Christakis stated:

Given the nature of the findings and their potential implications, we subjected it to additional scrutiny for its methods and the presentation of its findings. The mission of the journal is to ensure that child health is optimized by bringing the best available evidence to the fore. Publishing it serves as testament to the fact that JAMA Pediatrics is committed to disseminating the best science based entirely on the rigor of the methods and the soundness of the hypotheses tested, regardless of how contentious the results may be.³

CDC and FDA Interfere with Release of National Toxicology Program Findings

The court case dragged on for almost four years largely due to the judge suspending the case until a report from the National Toxicology Program (NTP) was released. The report was an assessment based on work conducted by the NTP from 2016 to 2019 which classified fluoride as a cognitive developmental hazard, but the NTP removed that conclusion after reviewers said evidence was lacking since the data did not focus on how people respond to various doses of fluoride.⁴

What seemed a simple request from the court for the NTP’s report and analysis, turned into a bureaucratic limbo, with dental experts, the U.S. Food and Drug Administration (FDA), and the CDC registering concerns and trying to put a stop to the report being brought to the eye of the public and the courtroom. The report and accompanying analysis of fluoride research was sent to yet another round of review, this time by a board of scientists that advise the NTP.

Ultimately, the court had to settle on using a 393-page draft document. Some within the federal government found this process to be an unusual one that involved too much entanglement with agencies or professions that have a vested interest in the policy of fluoride.⁵

Federal Employees Cite “Infringement on Scientific Integrity”

Upset by the handling of the report, Brian Berridge left the NTP. He wrote in an e-mail to colleagues:

After 17 years in the industry, I’ve seen efforts to modify messages to fit commercial interests. I wasn’t party to that there, and I’m not game to do that here.

Berridge also stated, “That’s not the way I want to do science, so I decided to do something different.”⁵

Berridge was not alone in his criticism. Toxicologist Linda Birnbaum, who served as director of the NTP and National Institute of Environmental Health Sciences (NIEHS) from 2009 to 2019, stated:

I see this as an infringement of scientific integrity, that the scientists have been prevented from getting their information out. I think the data is overwhelmingly clear that fluoride is associated with the potential for neurodeficits.⁵

Fluoride Research Demonstrates Harm to Human Health

Research evaluating the toll of fluoride on human health extend far beyond neurological effects, including effects on the thyroid, bone health, and endocrine disruption.⁶ In 1944, the American Dental Association (ADA) was aware of some of the harm that fluoride does to human health and denounced the practice just one year prior to the introduction of water fluoridation stating:

We do know the use of drinking water containing as little as 1.2 to 3.0 parts per million of fluoride will cause such developmental disturbances in bones as osteosclerosis, spondylosis, and osteoporosis, as well as goiter, and we cannot afford to run the risk of producing such serious systemic disturbances in applying what is, at present, a doubtful procedure intended to prevent development of dental disfigurements in young children.⁷

Fluoride Banned Throughout the World

The controversy surrounding fluoride safety has been enough for most other countries to ban the chemical in drinking water. But beyond the fluoride safety conversation lies the violation of informed consent that comes with adding a bioactive chemical compound to drinking water, as well as the violations of principles of pharmacology.

Fluoridated Water Violates Informed Consent

Swedish pharmacologist and winner of the Nobel Prize in Medicine and Physiology Dr. Arvid Carlsson stated:

In modern pharmacology, it’s so clear that even if you have a fixed dose of a drug, the individuals respond very differently to one and the same dose. Now, in this, case you have it in the water and people are drinking different amounts of water. So you have huge variations in the consumption of this drug… it’s against all modern principles of pharmacology.⁸

In an article written for the online publication Science, epidemiologist Lynn Goldman who is also a former EPA official said that she doubts Judge Chen will order the EPA to ban fluoride in drinking water but that, likely, the court might order that fluoride is a toxic substance, making it a high priority for a new evaluation to establish safe exposure limits.⁴

National Research Council Member Says Science is Not Settled Regarding Fluoride Safety

If Goldman is correct, it seems unlikely that fluoride “science” and further evaluation will change much. Various government agencies have been aware of the fluoride harm issues for decades with no changes to currently accepted practices, but rather a complete opposite approach of digging their heels in and maintaining that fluoride is completely safe.

After reviewing fluoride research for two years, John Doull, MD, PhD of the National Research Council (NRC) stated:

What the committee found is that we’ve gone with the status quo regarding fluoride for many years—for too long really—and now we need to take a fresh look. In the scientific community, people tend to think this is settled… but when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should considering how long [fluoridation] has been going on. I think that’s why fluoridation is still being challenged so many years after it began. In the face of ignorance, controversy is rampant.⁹

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¹ EIN Presswire. Fluoride on trial: federal trial on the neurotoxicity of water fluoridation resumes next week. KRON4 Jan. 25, 2024.
² Green R et al. Association between maternal fluoride exposure during pregnancy and IQ scores in offspring in Canada. JAMA Pediatrics Aug. 19, 2019.
³ Christakis D. Decision to publish study on maternal fluoride exposure during pregnancy. JAMA Pediatrics Editor’s Note Aug. 19, 2019.
⁴ Stokstad E. Does fluoride in drinking water lower IQ? Questions looms large in court battle. Science Feb. 2, 2024
⁵ Schulson M. Baring teeth: the long battle over fluoride comes to a head. Undark Mar. 6, 2024.
⁶ Fluoride Action Network. Health effects.  Mar. 23, 2024.
⁷ Anthony L. The effects of fluorine on dental caries. The Journal of the American Dental Association Oct. 1, 1944.
⁸ Staff. Letters to the editor. Observer-Dispatch Mar. 22, 2008.
⁹ Fagin D. Second thoughts on fluoride. Scientific American Jan. 1, 2008.