Fluoride Realities, Fluoride Myths, Fluoride Politics

Most of the recent research on fluoride has focused on its potential impact on kids’ cognitive development. But that’s hardly the only reason for concern, as a new study in Environmental Health reminds.

Fluoride Exposure & Chronic Inflammation

Analyzing data from two cycles of the National Health and Nutrition Examination Survey (NHANES), researchers found that higher levels of fluoride in the blood of youth between the ages of 6 and 19 meant higher counts of white blood cells. White cells are infection-fighters. And a sign of inflammation.

Our findings of an association between plasma fluoride concentrations and increased WBC counts in U.S. children and adolescents suggest that ingested fluoride may be an environmental risk factor for inflammation for this population.

That’s a problem, of course. When fluoride ingestion is ongoing, thanks to fluoridated water, so is the inflammation. Normally, inflammation is an important defense mechanism against injury or infection. It’s a sign of your body’s innate healing abilities at work. When it never stops, however – when it’s chronic – it’s a driver of disease. Healthy tissues come under attack.

Chronic inflammation is one of several factors that link gum disease with systemic conditions such as heart disease, rheumatoid arthritis, cognitive decline, and certain cancers.

The Fluoride Myth

Risks such as these and the many others that have been scientifically documented are one of the big reasons why our office has been proudly fluoride-free for years. Additionally, studies like this one have shown that while topical fluoride – that is, fluoride applied directly to the teeth – may slow the rate of decay, it doesn’t actually prevent it.

What does prevent it is limiting the sugars and refined carbohydrates you eat. (Refined carbs are digested as sugar.) As the authors of a 2015 paper in the Journal of Dental Research put it,

Without sugars, the chain of causation is broken, so the disease does not occur (Sheiham 1967). So, it is clear that sugars start the process and set off a causal chain; the only crucial factor that determines the caries process in practice is sugars.

“Although fluoride reduces [decay],” they add, “unacceptably high levels of caries [tooth decay] in adults persist in all countries, even where there is wide-scale water fluoridation and the use of fluoridated toothpastes (Dye et al. 2007).”

So, aside from the fact that it’s what dentists and hygienists are taught in school, why on Earth would the dental profession continue to promote fluoride?

Dental Research Under the Influence

Part of the answer came several years ago, when PLOS Medicine published a paper exposing how the sugar industry influenced dental research in the 1960s and ‘70s. An examination of industry documents showed how

The sugar industry could not deny the role of sucrose in dental caries given the scientific evidence. They therefore adopted a strategy to deflect attention to public health interventions that would reduce the harms of sugar consumption rather than restricting intake.

Consequently, the Washington Post reported,

government-funded research focused on interventions that wouldn’t advise Americans to lower their sweets consumption. For instance, the research encouraged the wider use of fluoride and sealants in dental hygiene. The approach essentially conceded that imploring people to reduce sugar intake was impractical, even if it would help prevent tooth decay.

Now, new research out of the University of Washington School of Dentistry, adds to the story, documenting how similar conflicts of interest within organizations such as the American Dental Association (ADA) likewise promoted ineffective interventions instead of sensible dietary advice.

Where the ADA once recommended that people eat fewer carbs to prevent tooth decay, the organization did a complete reversal by the mid-20th century. Rather suddenly, they began promoting a high carb diet, coupled with fluoride and food fortification to offset the damage.

Internal records reveal that this pivot was driven by leaders with ties to the sugar and cereal industries.

A dental organization may have been among the first to open the doors to the fluoridated carbohydrate age simply because sugar and cereal executives regarded dental caries as one of their most pressing concerns. Some of these same industries (examples of private interests) may have led medical professional organizations to similarly reverse—in an absence of trustworthy evidence—towards high-carbohydrate nutritional guidelines. Medical professional organizations -in part due to interprofessional conflicts (another private interest)— furthermore began ignoring the evidence that dental symptoms were sensitive markers for micronutrient deficiencies. Fluoride-supplemented, possibly micronutrient-deficient, high-carbohydrate nutritional guidelines emerged. The main conclusion of this report is that private interests can provide explanations on the origins and persistence of key reversals in nutritional guidelines, feats which, at least for some reversals, appear challenging to explain from an evidence-based-medicine perspective.

And the public has been paying the price ever since.

But we can choose healthier ways of eating. We can embrace proper nutrition. We can opt for fluoride-free water. We can favor real food over ultra-processed products, most of which are likely made using fluoridated water.

And we can be hopeful that as the truth continues to come out about how the dental profession came under the influence, ever more dentists and hygienists will continue to heed the call and do better for their patients going forward.