There is a reason why the Latin word for Health, Sanitas, is the etymological origin of the word Sanitary: En Vivo Veritas, En Aqua Sanitas; In Wine, there is Truth, In Water, Health. “The Truth,” Rachel Carson wrote in the introduction of Silent Spring, “seldom mentioned, but there for anyone to see,”1 is that one particular chemical is not only found as Pesticide Residues2-4 in the wine5-6 we drink… It is also regulated as an Air Pollutant,7-11 a Water Contaminant,12-3 banned by international treaty as a Greenhouse Gas;15 this chemical is classified as “toxic”15-6 and “corrosive”17 Hazardous Industrial Waste by the United Nations International Programme on Chemical Safety.15-7 What if I told you this chemical is intentionally added to the public drinking water of over 200 million Americans?18-23 What if I told you the Center for Disease Control (CDC) has found 41% of Children24 in this country have what the World Health Organization (WHO) has defined as a Disease25 caused by ingesting too much of this chemical in drinking water?
This chemical is neither related to disinfection of water nor is it classified as an essential nutrient;26-8 this chemical is regulated as a Drug for topical use,29-31 but it is not approved for systemic ingestion.32-5 When we ingest this chemical via food, water or wine, it is known to permanently bind with the calcium in our bodies, ultimately bio-accumulating in our teeth, bone,36-7 and other calcifying tissues like the pineal gland,38 located in the center of the brain. What are the public health implications of adding this chemical to the public drinking water of 200 million American Citizens?
“If we are to live so intimately with these chemicals – eating and drinking them, taking them into the very marrow our bones – we had better know something of their power and nature.”39 “The obligation to endure gives us the right to know.”40
Today, we know there are Health Risks related to bone fracture and a disease41 affecting the teeth and bones, called Fluorosis – both are associated with drinking water with less than 4 parts per million of fluoride.42 This is the official conclusion of the 2006 National Research Council (NRC) of the National Academies of Sciences’ systematic review entitled, “Fluoride in Drinking Water.”42 As such, the NRC recommended the Environmental Protection Agency (EPA) reduce the Maximum Contaminant Level of fluoride in drinking water. 42 Data published in this report also revealed the vast majority of infants43 exceed minimum dosages of fluoride associated with a risk of adverse health effects44when drinking water at concentrations “recommended”45 as “optimal”46 by federal public health agencies since the 1950s.47 The NRC findings catalyzed the Department of Health and Human Services (DHHS) to reduce the “optimal” concentration of water fluoridation by 40%.48 For decades, up to 1.2ppm of fluoride was promoted as “safe and effective,”49 but now “safe and effective” is said to be 0.7ppm.50
Public Water, Public Right to Know
Since “it is the public that is being asked to assume the risks, the obligation to endure gives us the right to know.”51 The public has a right to know the “power and nature” of the chemical itself. We have a right to know the health effects documented by the most recent science, and the public certainly ought to know what the 2006 National Research Council of the National Academies of Sciences has concluded regarding such health effects.52 This is why this research thesis was written.
Science Speaks For Itself: “Questions Unsettled”
The purpose of this essay is to allow the science to speak for itself; thus it is written de facto so as to allow the reader to determine whether recent science supports health risks because you have this authority as a rational being. As such, this paper lacks a formal thesis structure per se, as there are no grounds for a conclusion on this matter and if there is one, the purpose is to instill a paradigm based in the humility of the precautionary principle. Therefore, this paper is not concerned with whether water fluoridation is “safe and effective.” No one cares for the fallacy of asking questions no one knows the answer to; as will be demonstrated through the science itself, there is much epistemic uncertainty with the safety of fluoridation as this “whole situation is beset with questions for which there are at present no satisfactory answers.”53
What we do know is: “many of these questions are unsettled,” and “now we need to take a fresh look,” according to the chairman of the 2006 NRC, Dr. John Doull:
“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. When the U.S. Surgeon General comes out and says this is ‘one of the top ten 10 greatest achievements of the 20th century,’ that’s a hard hurdle to get over. 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 this has been going on.”54 Interview in Scientific American, 2008
“We Need To Take A Fresh Look”
The whole methodology of this essay is to disseminate information; it is thus written de facto in the sections devoted to The Chemical Itself, and The Science Itself. The only exception will be the explication of Dosage versus Concentration & Margin of Safety – here, it will be self evident why the writer uses the words “suggests” or “implies.” Likewise, “should” or “ought” will certainly appear in the Ethics of Water Fluoridation section, primarily in the form of questions rather than assertions. Otherwise, this essay is intentionally devoid of such words. This is noteworthy as keeping the facts separate from commentary is the first principle of journalistic integrity. As Rachel Carson wrote: “Humbleness is in order; there is no excuse for scientific conceit here,”55 just an honest concern for public health. As such, this research thesis is an inquiry towards a matter-of-fact compendium of recent science and chemistry to inform individual knowledge, so as to engender ethical discourse related to the Common Good.
Beginning with the Chemical Itself: Fluoride, Fluorine & Fluoridation, this paper will be ordered as follows. To introduce The Chemical Itself, we shall begin by distinguishing fluoride in toothpaste from water fluoridation by Food & Drug Administration approval as it relates to topical fluoride use versus systemic ingestion as well as the purity of the fluoride product itself, as toothpaste is pharmaceutical grade, while water fluoridation is an unpurified industrial by-product.56 Given these by-products contain contaminants like lead and arsenic,57-60 fluoride is more appropriately termed fluoridation chemicals. Further discerned is that fluoridation chemicals are otherwise fluorine air pollution61-6 known to cause human illness.67-72 Hence, regulation as hazardous by the UN International Programme on Chemical Safety.73
This is followed secondly, by the conceptual foundation of a scientific paradigm based in calculated risk assessment, and so the distinction between Dosage versus Concentration as it relates to Margin of Safety is then discussed. This is intended to highlight the nuance between safe for all or adverse for some. Thirdly, the Health Effects Documented by Recent Science are presented. Specifically, the most significant findings and conclusions of the 2006 National Research Council’s systematic review, “Fluoride in Drinking Water”74 is used as the arbiter of The Science Itself.
First, the concept of Bioaccumulation is presented through Dental Fluorosis, Bone Fracture & Skeletal Fluorosis. Then, since the 2006 NRC concluded “fluoride appears to initiate or promote cancers, particularly of the bone,”75 Osteosarcoma research follows. Given, in addition, that the 2006 NRC also concluded “it is apparent that fluoride has the ability to interfere with the functions of the brain,”76 the section ends on the most recent research published on fluoride’s affects on Intelligence Quotient in children.
With the Science left to Speak for Itself, we postulate over the Ethics of Water Fluoridation in relation to reverence of life with the question: What if recent science may support the possibility of health risks? Given 41% of youth77 have fluorosis, a disease78 caused by ingesting too much fluoride, it is speculated that public health implications should be framed in terms of overexposure to a drug we would otherwise have a choice to use with toothpaste or consume with a prescription. This will lead to the principle of individual medical consent.79 Then, considering the World Health Organization states on its website that “the toxicity of fluorides is due to the toxicity of the fluoride ion, a direct cellular poison,”80 we explore the notion of whether dose makes the poison? Or, is toxicity an inherent property of the chemical itself?
Naturally, this transitions to the Lack of Scientific Consensus: Three out of 12 members on the 2006 NRC have signed Fluoride Action Network’s “Professional Statement to End Water Fluoridation.”81 Is it epistemic uncertainty about the possibility of health risks? Do they feel obligated out of a sense of Care Duty? Perhaps they believe its probably safer and healthier to simply drink clean water? This is all explored through the Precautionary Principle, which posits that we need not be 100% certain of risk, to warrant turning the knob off at the water treatment plant; for 100% certainty means we must wait to find proof of risk through finding harm. Then it is too late.
We then ponder why the Chair of another systematic review called the “York Review,” Dr. Trevor Sheldon – why has he also signed the “Professional Statement to End Water Fluoridation?”81 Why does he publicly claim a “legitimate scientific controversy” persists to this day, after 69 years of water fluoridation?82
The Ethics of Water Fluoridation is then consummated with a question:
Is it logically consistent to balance Risk with Reverence of Life? Or does this beg the question, presuming such a balance can be achieved?
Recent Science, Chemistry & Ethics of Water Fluoridation 