National
Pure Water Association Campaign for Safe Drinking Water Founded in England,
1960
Dental fluorosis
" . . . the health and welfare of
the public is not served by the addition of this substance (fluoride)
to the public water supply . . . for which there is virtually no evidence
of significant benefits . . . and substantial evidence of adverse effects."
- Statement by William J Hirzy, PhD, on behalf of the Union of
government scientists at the United States Environmental Protection
Agency, 2 July, 1997.
Dental fluorosis was first reported by two dentists in 1916 (1).
By 1931 there was extreme concern about what was called 'Colorado Brown
Stain' and 'Texas Teeth'. It is now called 'dental fluorosis'. In that
year three independent groups of scientists showed conclusively that the
areas with this condition had high levels of fluoride in their water(2-4).
Although fluoride was known to be the cause, water fluoridation
was instituted as a public health measure to help limit dental caries
in 1945.
Reports from China(5), Argentina(6), Britain(7), Italy(8)
and Japan(9) have shown significant levels of mottling of teeth (fluorosis)
in children drinking fluoride-contaminated water. The usually recommended
level of 1 part per million produced fluorosis in 28 percent of children
aged between 11 and 13 in a study carried out by the University of Rochester,
USA(10).
However, with the advent of fluoridated dentifrices,
fluoridated infant formulas, and commercially prepared beverages with
fluoridated water, the incidence of dental fluorosis is increasing.
Scientists at the Dental Research Unit, Health Research
Council, Wellington School of Medicine, New Zealand investigated fluoride
exposures from juices and juice-flavored drinks manufactured with water.
In the study, the authors analyzed 532 juices and juice drinks for fluoride.
Fluoride ion concentrations ranged from 0.02 to 2.80 parts per million,
in part because of variations in fluoride concentrations of water used
in production. They say that children's ingestion of fluoride from juices
and juice-flavored drinks can be substantial and a factor in the development
of fluorosis (11).
Fluorosis is a permanent disfigurement. But it is more
than just a cosmetic problem that the fluoridistas would have us believe,
fluorosis is a visible sign of damage to bones throughout the body (12).
Poor children are more at
risk The fluoride intake, diet, and health status of children in two dental
fluorosis-afflicted areas in the Province of Jiangxi, China were studied
in an attempt to correlate nutritional status with dental fluorosis(13).
The relationship between mild consumption and the incidence of dental
fluorosis among children was stressed in this study. Average body weight
of the children approximated that of the national standard. Protein intake
was above the national standard of 0.75 g/kg body weight/day, But the
protein was derived mainly from plant sources. Calcium intake was found
to be insufficient. Based on the diet and fluoride intake of the studied
groups, the areas with a better nutritional status were found to have
a lower incidence of dental fluorosis. The incidence among milk-consuming
children was lower than that of non-milk consuming children.
What this study demonstrates is that the very children whom dentistry
claims will benefit from ingesting fluoride -- poor children -- are the
ones who are most affected by fluoride's toxic effects because of inadequate
nutrition.
This is true wherever dental fluorosis
is seen.
Dr L C Simko of the Duquesne University School of Nursing, Pittsburgh,
PA, USA, pointing out the worrying increase in fluorosis, says that "health
care professionals need to understand the history of water fluoridation,
examine the benefits and complications of fluoride, and, if need be, take
an informed political stance on an issue that is affecting large numbers
among our pediatric population."(14)
That dental fluorosis occurs is undisputed -- and
its occurence, therefore, is foreseeable. To see the legal implications
for recommending any fluoride product under these circumstances, see Dental
Fluorosis: Smile please - But Don't Say Cheese!
References
1. Black GV, McKay F. Mottled teeth: an Endemic developmental imperfection
of the enamel heretofore unknown in the literature of dentistry. Dental
Cosmos 1916; 58 (2): 129-156.
2. Churchill HV. The occurrence of fluorides in some waters of the United
States. J Am Water Works Assn. 1931; 23: 1399-1403.
3. Smith MC, et al. The cause of mottled enamel, a defect of human
teeth. Technical Bulletin No. 32, University of Arizona College of
Agriculture, 10 June 1931.
4. Velu H. Dental dystrophy in mammals of the phosphate zone and chronic
fluorosis. C R Seances Soc Biol Ses Fil. 1931; 108: 750-2.
5. Anderson BG. An endemic center of mottled enamel in China. J Dent
Res. 1932; 12: 591-3.
6. Chaneles J. A dental problem of interest in Argentina:
The etiology of 'mottled teeth'. Rev Odontol (Buenos Aires).
1932; 20: 64-73.
7. Ainsworth NJ. Mottled teeth. Br Dent J . 1933; 55: 233-250.
8. Ricci E. The phenomenon of mottled teeth in Italy. Ann Clin Odontol.
1933; 12: 1029-43.
9. Nakano R. A statistical observation of endemic effects on teeth.
Rinsho Shika. 1933 2: 102.
10. Leverett D. Fluorides in the changing prevalence of decay rates.
Science. 1982; 217: 26-30.
11. Kiritsy MC, Levy SM, Warren JJ, Guha-Chowdhury N, Heilman JR, Marshall
T. Assessing fluoride concentrations of juices and juice-flavored drinks.
J Am Dent Assoc 1996; 127: 895-902
12. Singh A, Jolly SS. Chronic toxic effects on the skeletal system.
In: Fluorides and Human Health. WHO, Geneva, 1970: 238-49.
13. Chen YC, Lin MQ, Xia YD, Gan WM, Min D, Chen C, Nutrition survey in
dental fluorosis-afflicted areas. Fluoride 1997; 30:2, 77-80
14. Simko LC. Water fluoridation: time to reexamine the issue. Pediatr
Nurs 1997; 23: 155-9.
