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As some of you who follow me on Steady Health know, I'm getting old. I can remember the era before fluoride was added to almost all municipal water supplies in the United States and Canada. However, I had heard about the issues of fluoride and drinking water before that.

That's because I grew up in the 1950's and 1960's not too far from a little town in Texas that has the highest natural fluoride content in drinking water in North America. This town has fluoride 100 to 10,000 times more concentrated than the fluoride in "fluoridated" water. The effects of the water are very obvious.

For one, despite what Dr. Howard Pollick is supposed to have said, heavily fluoridated water really does prevent cavities. Most people in that little town who drink tap water don't get cavities. (Most don't drink the tap water, but that's another issue.) Even in surrounding communities, like my own, where the natural fluoride content of well water is about the same as fluoridated water, people just don't get cavities.

However, that doesn't mean they don't have dental problems. Many, many people get ugly brown crystals all over their teeth. This is a reaction of calcium and fluoride to make what is essentially a coating of rock over the teeth. Sure, caries and cavities are almost unknown, but misshapen and malformed teeth are very common.

You aren't likely to have this problem with fluoridation at the levels commonly used in drinking water in the United States and Canada. There really is an anti-cavity benefit, or at least there was back in the 1950's and 1960's when fluoridation programs were started.

Here's the thing about fluoridation and cavity prevention. If you don't brush your teeth regularly, fluoride in your water helps prevent tooth decay. If you do brush your teeth regularly, fluoride in your water doesn't have much of an effect.

Most people born after 1980 can't imagine just how much poorer people were before 1950. There were many families that could not afford toothpaste. There were some families that could not afford toothbrushes. If the main protection from cavities was the fluoride in drinking water, it made a huge difference.

In the twenty-first century, however, people not only can afford toothpaste and toothbrushes but they can also afford all kinds of oral care appliances (or at least many people can) and mouthwashes. Most people can afford to see a dentist regularly. Sixty years ago, most people could not.

In the US, the places where more children are getting cavities than they used to are the same places where most children live in poverty. The problem is poverty, not the presence of absence of fluoride in drinking water. As I noted earlier, fluoride in drinking water makes a difference in whether or not children, teens, and adults get cavities, but not at the levels that it is added to drinking water. Naturally high-fluoride water has a strong anti-cavity effect. Fluoride at the level it is added to drinking water now makes a difference primarily for people who otherwise have poor dental hygiene.

What the pre-toothpaste era dental researchers didn't realize was that fluoride works on your teeth, not in your teeth. A fluoride toothpaste strengthens your enamel because it is in close contact with your enamel for at least a few seconds. You then spit out the toothpaste so it does not affect the rest of your body. Fluoridated water is in contact with your teeth for almost no time at all, and then goes into your body where it can have various side effects, real and imagined.

What is to be made of the many claims that adding fluoride to water has deleterious effects on mental development and mental health? I don't want to make perjorative statements about the people in the little town I mentioned, but my general impression is that mental health issues are especially rife there. However, that's a problem with getting 10,000 times too much fluoride.

However, like so many other questions in health, the reason that fluoride is linked to mental health issues is probably a lot more complicated than it first appears. The sequence of events probably goes something like this:

  • Exposure to high levels of fluoride forces the thyroid to "work harder" to get enough iodine to make thyroid hormone.
  • When someone stops drinking fluoridated water, the thyroid continues extracting iodine from the bloodstream, but makes more thyroid hormone.
  • Excess thyroid hormone sets up a greater likelihood of manic reactions and attention deficit, but not everyone is affected in the same way.

Inother words, yes, high levels of fluoride in drinking water contributes to mental health issues, but these problems only occur when you quit drinking it. What scientists know about this phenomenon comes mostly from observing mental health problems in people who moved from East Africa, a place like Texas in that many wells are naturally high producers of fluoride, to Sweden, where they encountered psychiatric issues. The problem turned out not to be cultural.

What can you do about this problem? Getting your drinking water in plastic bottles is probably at least as harmful to your health as drinking fluoridated water. Reverse osmosis really isn't effective.

Instead of trying to drink bottle water everywhere I go, I avoid baked goods made with bleached flour. which contains bromides, which adds to problems caused by fluorides. I avoid conventionally produced strawberries, which in the US are almost always sprayed with fluoride compounds. I make sure I get enough iodine in my diet.

I do not, however, get especially worked up about fluoridated water. It's an idea that is past its time, but it is neither the savior of children's teeth nor the destructive poison it is made out to be. Whether or not something is a toxin always depends on how much you get.

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