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Fluoride – the Danger that we must Avoid

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Fluoride – the Danger that we must Avoid 
H. BĂLAN 
“Carol Davila”University of Medicine and Pharmacy, Bucharest 
Medical Clinic Clinical Emergency Ilfov County Hospital, Bucharest, Romania 
One of the sad stories about what was considered to be a successful prevention of tooth decay 
is represented by fluoride supplementation of water and toothpastes. But even today, without knowing 
all the scientific reliable proofs, all the pieces of a very large puzzle, this action has many (especially 
in developing countries) promoters. That’s why we considered that a well-documented review in this 
domain would be of large interest, especially because the deleterious effects are many, accompanied 
by a large number of threats for the health, and the benefits are lacking. 
Key words: fluoride, toxic effects, oncologic impact, tooth decay. 
WATER FLUORIDATION & TOOTH DECAY 
We can say that’s another story about… 
better is the enemy of good. 
The addition of fluoride to water for the 
purpose of preventing tooth decay began in the 
1940s with the belief that fluoride’s primary benefit 
came from ingestion of fluoride during the tooth-
forming years; it is now acknowledged by the 
dental research community that fluoride’s primary 
benefit comes from topical contact, not from 
ingestion. 
Dr. Arvid Carlson – Pharmacologist, Nobel 
Laureate in Medicine/Physiology (2000): “In 
pharmacology, if the effect is local, it’s of course 
absolutely illogical to use it in any other way than 
as a local treatment.” 
“Since the current scientific thought is that 
the cariostatic activity of fluoride is mainly due to 
its topical effects, the need to provide systemic 
fluoride supplementation for caries prevention is 
questionable”. 
But the truth about fluoridation and how 
much of medical benefits were expected is pretty 
sad: 
“Some fifty years after the United States 
began adding fluoride to public water supplies to 
reduce cavities in children’s teeth, declassified 
government documents are shedding new light on 
the roots of that still controversial public health 
measure, revealing a surprising connection between 
fluoride and the dawning of the nuclear age” [1]. 
“Much of the original proofs that fluoride is 
“safe” for humans in low doses was generated by 
A-bomb program scientists, who had been secretly 
ordered to provide “evidence useful in litigation” 
against defense contractors for fluoride injury to 
citizens. The first lawsuits against the U.S. A-bomb 
program were not over radiation, but over fluoride 
damage, the documents reveal. Human studies were 
required. Bomb program researchers played a 
leading role in the design and implementation of the 
most extensive U.S. study of the health effects of 
fluoridating public drinking water – conducted in 
Newburgh, New York from 1945 to 1956. Then, in 
a classified operation code-named “Program F”, 
they secretely gathered and analysed blood and 
tissue samples from Newburgh citizens, with the 
cooperation of the State Health Department 
personnel. The original “secret” version – obtained 
by these reporters – of a 1948 study published by 
Program F scientists in the Journal of the American 
Dental Association shows that evidence of the 
adverse health effects from fluoride was censored 
by the U.S. Atomic Energy Commission (AEC) – 
considered the most powerful of Cold War agencies – 
for reasons of national security” [1]. 
Instead of a very costly process of decon-
tamination of industrial fluoride by-products, it was 
much easier and much cheaper to use these toxic 
products in what was considered a vast sanitary 
operation in the benefit of large populations: 
prevention of tooth decay. 
Fluoride compounds which are put: in water 
(fluoridation), in toothpastes, in supplemental tablets 
were never tested for safety before approval. 
Not only the lack of benefits must be a 
permanent preoccupation, but also the permanent 
statement: studies as early the 1930s showed 
extreme hazards to man and environment, due 
to fluoride dumping and exposure. 
ROM. J. INTERN. MED., 2012, 50, 1, 61–69 
 H. Bălan 2 62 
Independent researches made by scientists 
without any connection with dental trade organi-
zations made clear the following conclusions: 
– it is worth mentioning that the toxic effects 
were confirmed by previously-classified 
government research [2]; 
– in animals (rats) drinking only 1 part per 
million fluoride (NaF) in water were found 
histologic lesions similar to Alzheimer’s disease 
and dementia and also damage of the blood-brain 
barrier, after extended fluorid exposure [3][4]; 
– and, most important, it is also acknowledged 
that fluoride is ineffective at preventing tooth decay 
in the pits and fissures of teeth (where the majority 
of decays appears) [5–8]. 
In all western countries (whether it is a country 
using water fluoridation or not), in the latter half of 
the 20th century, tooth decay declined quite drama-
tically. 
But recent large-scale studies, using modern 
scientific methods showed “a strong positive 
correlation between the presence of fluorosis and 
the occurrence of dental caries” – The WHO/ 
FAO/UNICEF study (Bohdal, Gibbs, Simmons, 
1968) [9–27]. 
FLUORIDE TOXICITY 
Historically, most cases of fluoride toxicity 
have followed accidental ingestion of sodium fluoride 
based insecticides or rodenticides. In advanced 
countries, most cases are due to ingestion of fluoride 
products. Other sources are represented by: glass-
etching or chrome-cleaning agents (ammonium 
bifluoride or hydrofluoric acid), industrial exposure 
to fluxes to promote the flow of a molten metal on 
a solid surface, volcanic ejecta, metal cleaners, mal-
function of water fluoridation equipment [28–36]. 
Acute toxicity (poisoning being defined as 
the ingestion of a large amount of fluoride, in a 
very short period of time) is characterized by: 
abdominal pain, diarrhea, dysphagia, hypersalivation, 
mucosal injury, nausea, vomiting, accompanied by 
electrolytic abnormalities: hyperkalemia, hypocal-
cemia, hypoglycemia, hypomagnesemia. 
There are also impressive neurological 
symptoms, such as: headache, muscle weakness, 
hyperactive reflexes, muscular spasms, paresthesia, 
tetanic contractions, tremours. 
The most severe cases can be characterized 
by multiorgan failure. 
Death can result from: cardiac arrest, shock, 
large QRS and different kinds of arrhythmias [38–
40]. 
The Food and Nutrition Board recommends 
that public water supplies be fluoridated when natural 
fluoride levels are significantly below 0.7 mg per 
liter. 
FLUORIDATION – PROVEN INEFFECTIVE 
All the recent large-scale studies of water 
fluoridation have shown that there are no positive 
effects. A supplementary confirmation is given by 
the fact that countries without fluoridation have 
shown an equal improvement in dental health than 
those with fluoridation. And there are also proofs 
regarding the fact that excessive fluoride exposure 
leads to increased levels of caries [41–64]. 
N.B. Even pro-fluoridation scientists admit 
that there is not any properly-conducted research 
showing that fluoride supplements help prevent 
cavities. 
Independent Experts oppose dumping fluoride 
into water 
Over 1500 professionals at the USEPA voted 
unanimously to oppose the fluoridation initiative 
in California because of the health risks involved. 
We must warn our patients to avoid fluoridated 
water and fluoridated toothpaste (with a special 
consideration for children, which are more sus-
ceptible for the neurological toxicity of fluoride). 
We must also warn them that: carbon filters 
do not significantly remove fluoride compounds; 
many kinds of non-organic juices have large amounts 
of fluoride (from pesticide residues); they must 
avoid those toothpasteswith fluoride claimed 
“natural”; definitely do not give children any 
fluoride since they appear to be more susceptible to 
the neurological toxicity from fluoride (Level of 
fluoride in infant-formula made with fluoridated 
water is 100–200 times higher than fluoride level 
found in women’s breast milk); avoid toothpastes 
that have fluoride (it is impossible to avoid swallowing 
some fluoride from fluoridated toothpaste); avoid 
putting fluoridated water in humidifiers; many 
kinds of non-organic juice have large amounts of 
fluoride from pesticides residues. 
CDA Board of Directors: approved: March 
2003; reaffirmed: February 2008; revised: April 
2010 – reaffirmed the Canadian Dental Association 
(CDA) Position on use of fluorides in caries 
prevention: November 1997 [65]: “The availability 
of fluorides from a variety of sources must be taken 
into account before embarking on a specific course 
of fluoride delivery to either population or in-
dividual patient. 
3 Fluoride – the danger that we must avoid 63
The CDA abrogated its legal responsibility 
for fluoridation support to the Federal Provincial-
Territorial Committee on Drinking Water. This is 
particularly important for children under the age of 
six, where exposure to more fluoride than is 
required to simply prevent dental caries can cause 
dental fluorosis. 
Because young children tend to swallow 
toothpaste when they are brushing, the following 
guidelines must be followed: children from birth to 
3 years of age should have their teeth and gums 
brushed by an adult; parents should consult a health 
professional to determine whether a child up to 
3 years of age is at risk of developing tooth decay; 
if the risk exists, a minimal amount of fluoridated 
toothpaste should be used; children from 3 to 
6 years of age should be assisted by an adult in 
brushing their teeth; all children should be super-
vised or assisted until they develop appropriate 
manual dexterity; CDA recognize and support the 
professional topical applications of fluoride gels, 
foams and varnishes in the prevention of dental 
caries for individuals at risk; before prescribing 
fluoride supplements, a thorough clinical examination, 
dental caries risk assessment and informed consent 
with patients/caregivers are required; the use of 
fluoride supplements before the eruption of the first 
permanent tooth is generally not recommended: the 
total daily fluoride intake from all sources should 
not exceed 0.05–0.07 mgF/kg body weight (in 
order to minimize the risk of dental fluorosis). 
The Canadian Dental Association Consultant 
and Researcher urged people to avoid drinking 
fluoridated water. 
“Fluoridated water does not prevent tooth 
decay” – concluded Mark D. Gold (66) and he 
accused: “Dental Trade Organization have used 
flawed studies to convince dentists that fluoridation 
was useful”. 
“The original studies by H. Trendly on 
fluoridation (which led to the decision to allow 
fluoridation of municipal water supplies): were 
worthless (using his own criteria); did not considered 
other minerals in the water; didn’t considered the 
differences between “natural fluoride” (e.g. CaF) 
and fluoride waste products (e.g. NaF); only a 
subsection of the data were reported; had no/or 
little statistical analysis; only for dental fluorosis 
was included for observations regarding safety 
experiments [26]; showed that fluoridation of the 
U.S. water supply was worthless, at best (data 
from 39.207 U.S. schoolchildren in 84 different 
areas in USA, the data being confirmed by another 
study of Steelink et al. [67] on 26.000 elementary 
school children”. 
Another reliable data sustained that: “…a 
positive correlation was revealed. In other words, 
the more fluoride a child drank, the more cavities 
appeared in the teeth” [27]. 
Large reduction in tooth decay, in time, can 
be considered to an increased (wealthier) standard 
of life and cannot be attributed to fluoridation (it 
was noticed in both unfluoridated and fluoridated 
areas of at least eight developed countries) in the 
past forty years. 24 studies of unfluoridated areas 
proved this conclusion [41–64]. 
A 20-year study (1973–1993) of 400.000 
children in India, the largest ever made about tooth 
decay [24] showed that the higher was the fluoride 
concentration in water, the more caries occurred. 
And if a reduced intake of calcium is associated, 
the adolescents had extremely high rates of fluorosis 
and dental decay [68]. 
That’s why, many regions and countries 
rejected fluoridation. 
“Fluoridation will be banned in this country. 
It is in its death throes now. It just hasn’t stopped 
kicking! Like a snake, it keeps twitching for 
awhile!” (Virginia Rosenbaum). 
And the danger is even greater: “it is illogical 
to assume that tooth enamel is the only tissue 
affected by low daily doses of fluoride ingestion” – 
Hardy Limeback, 2000 (Head of Preventive 
Dentistry, University of Toronto). 
“Common sense should tell us that if a poison 
circulating in a child’s body can damage the tooth-
forming cells, then other harm is also likely” [5]. 
FLUORIDE CAUSES ACUTE ADVERSE REACTIONS 
A list of the acute adverse effects observed is 
composed by: gastro-intestinal symptoms, stomatitis, 
painful joints, headaches, visual disturbances, 
muscular weakness, extreme tiredness, but it is 
important to always remember that fluoride is a 
cumulative poison. 
And one must note, also, that health care 
practitioners are not trained to test or recognize the 
effects of chronic poisoning from fluoride. 
So that, after ingestion, they have initially a 
local action, generating hydroxyfluoric acid inside 
the stomach, that afterwards are binding calcium, 
interfering different enzymes, generating the following 
symptoms: abdominal pain, diarrhea, dysphagia, 
hypersalivation, nausea, vomiting, associated with: 
mucosal injury. 
In order of their frequency these are repre-
sented by: abdominal pain, diarrhea, dysphagia, 
hypersalivation, nausea, vomiting, headache, muscle 
 H. Bălan 4 64 
weakness, hyperactive reflexes, muscular spasms, 
paresthesia, seizures, tetanic contractures, tremors. 
As signs, it is mandatory to quote: mucosal 
injury, hyperkaliemia, hypocalcemia, hypoglycemia, 
hypomagnesemia. In severe cases: multiorgan failure 
and death that can result from: cardiac arrest, shock, 
large QT syndromes, different arrhythmias. 
In high concentrations, fluoride soluble salts 
are toxic, the contact of the skin or of the eyes 
being dangerous. For sodium fluoride, the median 
lethal dose varies between 1–10 grams, that means 
around 28 mg/kg body weight. 
That’s why in the USA is now required a 
poison warning on fluoride toothpastes. 
Regarding the chronic toxicity, the most significant 
event happened in India, where 60 million people 
have been poisoned by well water contaminated 
(the origin of fluoride being granite rocks) by 
excessive fluoridation. The different deleterious effects 
can be summarized as follows: 1) dental fluorosis; 
2) skeletal fluorosis, with changes in bone structure 
and strength; 3) osteoarthritis; 4) neurotoxic effects, 
even IQ lowering; 5) oncologic impact; 6) birth 
defects and perinatal deaths; 7) impairment of the 
immune system; 8) inhibition of key enzymes; 
9) suppression of the thyroid function; 10) the 
increase to lead and arsenic exposure; 11) contri-
bution to the development of repetitive stress injury. 
1. DENTAL FLUOROSIS 
Permanent disfigurement of the teeth in 
children is due to dental fluorosis (a permanent 
adverse structural change of teeth) 
A linear correlation between the Dean index 
of dental fluorosis and the frequency of bone 
fractures was observed among both children and 
adults [69]. 
“Dental fluorosis is defined as a permanenthypomineralization of enamel, characterized by a 
greater surface and subsurface porosity than in 
normal enamel, that results from excess fluoride 
reaching the developing tooth during developmental 
stages” [70]. 
 “Fluoride affects the forming enamel by 
causing porosity, e.g., widening gaps between the 
enamel rods and enlarging intercrystalline spaces in 
parts of the rod. With increasing severity, the 
subsurface enamel all along the tooth becomes 
increasingly porous… The more severe forms are 
subject to extensive mechanical breakdown of the 
surface [71]. 
“Dental fluorosis is characterized by an 
increased porosity (hypomineralization) of the 
subsurface enamel, causing the enamel to appear 
opaque… In advanced stages, the enamel may 
become so porous that the outer layers breakdown 
and the exposed porous subsurface becomes dis-
colored” [72]. 
Another problem that was confirmed (see 
skeletal fluorosis) is that a similar damage can be 
generated in the bones [73]. 
The structural damage of the hardest tooth 
layer compromises the health-protective function 
(the too mineralized zone is very fragile to 
mechanical stress) [74][75]. 
2. SKELETAL FLUOROSIS, WITH CHANGES IN BONE 
STRUCTURE AND STRENGTH 
Skeletal fibrosis is expressed by: pains in 
bones and joints, burning sensations, pricking and 
tingling in the limbs, muscle weakness, chronic 
fatigue, gastro-intestinal disorders, reduced appetite, 
backache, osteoarthritis. 
Skeletal fluorosis produces a wide variety of 
radiological manifestations, including osteosclerosis, 
osteomalacia, osteoporosis and secondary hyperpara-
thyroidism, thus a potential for misdiagnosis exists 
between skeletal fluorosis and these disorders. 
“In areas where fluorosis is endemic, skeletal 
fluorosis is a common mimic of seronegative 
arthritis and should be pursued with investigations 
for diagnosis of fluorosis with measurement of 
fluoride levels, wherever applicable [76]. 
Fluoride-induced bone fractures in clinical trials 
Due to its ability to increase bone mass, 
fluoride has been used as a treatment for osteo-
porosis, but the observed effect after 40 years of 
experimentation, a well-documented side-effect of 
fluoride therapy (in dosages of 20–34 mg/day) is 
increased bone fracture (arms, legs, hips): several 
clinical trials have reported a particularly high rate 
of spontaneous fracture in the femoral neck among 
fluoride-treated patients [77–84]. 
The high rate of spontaneous fracture among 
fluoride-treated patients may be related to the 
increase in incomplete fractures (“stress fractures”) 
among fluoride-treated patients. 
An increased number of microfractures was 
found frequently in fluorotic bone; because there 
are “pockets” of mineralization disorders (because 
fluoride can cause both hypomineralization and 
hypermineralization – the resulting inhomo- 
geneity of the bone structure can decrease its 
strength, increasing the probability that a fracture is 
produced. The osteocyte is a bone cell very active 
in the bone resorption process, that can be impacted 
by high levels of fluoride accumulation in the bone. 
5 Fluoride – the danger that we must avoid 65
So, fluoride-induced damage to osteocytes may be 
a particularly important factor in the pathogenesis 
of fluoride-induced microfractures. 
Fluoride’s impact on bone density tends to 
differ depending on the type of bone being studied: 
increases in density frequently noted in trabecular 
bone and decreases frequently noted in cortical 
bone [85–114.] 
“The weight of evidence indicates that, 
although fluoride might increase bone volume, 
there is less strength per unit volume” [115]. 
3. CAUSES OSTEOARTHRITIS 
It has been proven (Rheumatology International, 
2001 – quoted by [116]) that the level of exposure 
that water fluoridation in USA creates can generate 
osteoarthritis, that is clinically characterized as 
follows: clinical phase 1 fluorosis: sporadic pain; 
stiffness of joints; osteosclerosis of the pelvis and 
of the vertebral column; clinical phase 2 fluorosis: 
chronic joint pain; arthritic symptoms; slight 
calcification of ligaments…” [116] in more severe 
cases: vague and diffuse aches, stiffness of joints 
with decreased range of motion, followed by 
kyphosis with limited spinal mobility, flexion in 
contracture of the lower extremities, restricted 
chest wall expansion. 
4. NEUROTOXIC EFFECTS, EVEN IQ LOWERING 
The neurotoxicity of fluoride is one of the 
most active directions of research, a fact that made 
that even EPA considered necessary to change its 
standards [117]: “it is apparent that fluorides have 
the ability to interfere with the functions of the 
brain”. 
Many human studies (from China, India, Iran, 
Mexico) [118–138] demonstrated that high levels 
of fluoride exposure are associated with IQ deficits 
in chidren (even after controlling for different types 
of exposure: lead, iodine, parenteral education, 
income status). 
Other studies [139–140] demonstrated that 
fluoride accumulates in the fetal brain, damaging 
neural cells and neurotransmitters, generating 
behavioral deficits among neonates. 
But also, other recent studies showed that 
brain adult exposure to fluoride induced central 
nervous system disturbances, explained by the 
different neuro-toxical effects (demonstrated on 
animal studies): reduction in nicotinic acetylcholine 
receptors, in lipid content, impairment of the anti-
oxidant defense systems, damage of the hippo-
campus and of the Purkinje cells, appearance of the 
beta-amyloid plaques, enhancement of the iodine 
deficiency-induced lesions, accumulation of fluoride 
in the pineal gland. 
The blood-brain barrier is relatively imper-
meable to fluoride, but that means that, despite this 
fact, fluoride has the capability to penetrate the 
brain: difficulties with concentration and memory; 
general malaise; fatigue, explained by different effects: 
alteration of calcium currents, alteration of enzymatic 
configuration (by generating strong hydrogen 
bonds with amide groups), inhibition of the cortical 
adenylyl cyclase activity, the increase of the 
phophoinositide hydrolysis [134–138][140–144]. 
Many municipal water supplies are treated 
with both alum (aluminium sulphate) and fluoride 
(their combination in the blood, aluminum fluoride 
is very poorly excreted in the urine, being toxic for 
the kidneys). 
The National Research Council speculates 
that effects on the thyroid could lead to poor test 
results. The NRC stated that “many of the untoward 
effects of fluoride are due to the formation of AlFx 
(aluminium fluoride complexes) [145–148]. 
It has been demonstrated that aluminum salts 
in the brain are generating Alzheimer’s disease: 
“Fluoride also increases the production of free 
radicals in the brain through several different 
biological pathways. These changes have a bearing 
on the possibility that fluorides act to increase the 
risk of developing Alzheimer’s disease” [117]. 
Rats drinking only 1/1.000.000 fluoride (NaF) 
in water had histologic lesions in their brain similar 
to Alzheimer’s disease and dementia [149]. 
5. ONCOLOGIC IMPACT: FLUORIDE COMPOUNDS 
ARE CAUSING CANCER 
According to the National Toxicology 
Program – “the preponderance of evidence” from 
laboratory “in vitro” studies indicates that fluoride 
is a mutagen (= a compound that causes genetic 
damage)”. 
The Department of Health of New Jersey: 
bone cancer in male children was 2–7 times greater 
in areas with fluoridated water [150]. 
U.S. Environmental Protection Agency (EPA) 
confirmed the bone cancer – causing effects of 
fluoride at low levels in an animal model. 
Another study (see later) has shown the 
existence of a link to uterine cancer deaths. 
A series of studies indicate that fluoridecan 
cause osteosarcoma (bone cancer) in fluoride-
treated male rats and boys under the age of 20, 
living in fluoridated areas. 
Relative recent studies [151–153] confirmed 
these data. 
 H. Bălan 6 66 
A recent national case control study conducted 
by scientists at Harvard University found a sig-
nificant relationship between fluoride exposure and 
osteosarcoma among boys, particularly if exposed 
to fluoridated water between the age of 6 and 8 
years (the mid-childhood growth spurt)[154]; the 
data of this study are concordant with the U.S. 
National Toxicology Program’s Congressionally-
mandated fluoride/cancer study – National Research 
Council, 2006 [155]. 
Dr. Takeki Tsutsui et al. of the Nippon Dental 
College in Japan showed that fluoride not only 
caused genetic damage, but it was also capable of 
transforming normal cells into cancer cells [156]. 
“In cultured human and rodent cells, the 
weight of evidence leads to the conclusion that 
fluoride exposure results in increased chromosome 
aberrations (genetic damage) – National Institute of 
Environmental Health Sciences, 1993. 
It is easy to understand that bone is the 
principal site of fluoride accumulation, particularly 
during the growth spurts of children, and, due to 
the fact that fluoride is a mutagen when present in 
sufficient concentrations, its mechanism of muta-
genity being artificially stimulation of the proliferation 
of bone cells (osteoblasts). 
“When fluoride exposure increases, the 
following bone responses generally occur: 1) an 
increase in the number of fibroblasts, 2) an increase 
in the rate of bone formation, 3) an increase in the 
serum activity of alkaline phosphatase, and 4) an 
inhibition of osteoblastic acid phosphatase… The 
increase in osteoblast proliferation and activity may 
increase the probability that these cells undergo 
malignant transformation” [157]. 
“Osteosarcoma presents the greatest a priori 
plausibility as a potential cancer target site because 
of fluoride’s deposition in bone. It is biologically 
plausible that fluoride affects the incidence rate of 
osteosarcoma, and these effects would be the 
strongest during periods of growth, particularly in 
males” [158]. Approximately 99% of fluoride in 
the human body is contained in the skeleton, with 
about 59% of the daily ingested fluoride being 
deposited directly into calcified tissue (bone or 
dentition). 
“We observed that for males diagnosed before 
the age of 20 years, fluoride level in drinking water 
during growth was associated with an increased 
risk of osteosarcoma, demonstrating a peak in the 
odds ratios from 6 to 8 years of age. All of our 
models were remarkably robust in showing this 
effect, which coincides with the mid-childhood 
growth spurt. For females, no clear association 
between fluoride in drinking water during growth 
and osteosarcoma emerged” [159]. 
“Age-specific and age-standardized rates 
(ASR) of registered cancers for nine communities 
in the USA (21.8 million inhabitants, mainly white) 
were obtained from IARC data (1978–1982, 1983–
1987, 1988–1992)… The incidence rate of bone 
cancer as the mean of three five-years ASRs was 
significantly correlated with FD (fluoridated water) 
only in males, with CIR-100 of 1.22, whereas in 
1978-82 it showed a high CIR-100 of 2.53” [160]. 
By investigating 156 cancer deaths U.S. 
Government concluded that fluoride accumulates in 
body tissues and may eventually cause cancer 
and/or fatal diseases. 
Since 1990, the National Cancer Institute, the 
New Jersey Department of Health, and the Safe 
Water Foundation all found that the incidence of 
osteosarcoma was substantially higher in young 
men exposed to fluoridated water as compared to 
those who were not. 
All these reasons of concern were confirmed 
by relatively recent data (161–175). A study [176] 
has shown the existence of a link to uterine cancer 
deaths. 
6. GASTROINTESTINAL SIDE-EFFECTS 
[177] summarized with great concision the 
gastrointestinal effects of fluoride: “It is concluded: 
1) ingested fluoride damages gastroduodenal mucosa; 
2) gastrointestinal discomfort can be an early 
warning sign of fluorosis; 3) fluoride toxicity should 
be considered a possible reason for non-ulcer 
dyspepsia, especially in fluorosis endemic areas; 
4) gastrointestinal discomfort during sodium 
fluoride therapy calls for extreme caution and close 
monitoring; 5) gastrointestinal discomfort in the 
form of dyspeptic symptoms should be an important 
diagnostic feature when identifying fluorosis patients 
and should not be dismissed as non-specific”. 
Children may experience gastrointestinal distress 
upon ingesting sufficient amounts of fluoridated 
toothpaste: in 4 years (1990–1994) 628 subjects, 
mostly children, needed treatment after such toxi-
cologic effects [2]. 
7. CAUSES BIRTH DEFECTS AND PERINATAL DEATHS 
Regarding the possible correlation between 
birth defects and perinatal deaths, the following 
data have been gathered: in the United Kingdom 
the perinatal deaths in a fluoridated area was 15% 
higher than in proximal areas non-fluoridated. The 
fluoridated area had also a 30% higher rate of 
Down’s syndrome (178–184). In Chile fluoridation 
was banned after a link was demonstrated between 
infant deaths and fluoridation. 
7 Fluoride – the danger that we must avoid 67
8. IMPAIRS IMMUNE SYSTEM 
In the United States where toxic fluoride 
compounds are regularly added to water and given 
to children since the 1960s and 1970s, it is now 
becoming evident an overwhelming number of 
people of that generation who are developing 
chronic immune system disorders. 
Many studies confirmed the data concerning 
the complex disturbances of the immune system 
[185–195]. 
9. INHIBITS KEY ENZYMES 
The general toxic effect, as neurotoxicity, the effect 
on birth events and the before mentioned gastro-
intestinal effects and birth defects are explained by 
the capacity of fluoride to inhibit key enzymes, 
explained by the characteristic of fluoride: a 
cumulative toxic. 
10. SUPPRESSES THE THYROID FUNCTION 
At the beginning of the 20th century fluoride 
administration was used as an effective way of 
suppressing thyroid function, in treating hyper-
thyroidism [196–198], fluoride’s suppressive effect 
on the thyroid being more severe when iodine is 
deficient (thyroid effects in humans were associated 
with fluoride levels 0.05–0.13 mg/kg/day when 
iodine intake was adequate and 0.01–0.03 mg/ 
kg/day when iodine was inadequate). 
The neurotoxicity and the decrease of IQ are 
considered also other side-effects mediated by 
hypothyroidism [199–205]. 
11. INCREASES LEAD AND ARSENIC EXPOSURE 
There is often a simultaneous contamination 
with: lead, arsenic and radionuclides because fluoride 
compounds are toxic waste byproducts that largely 
come from polluting scrubbers of fertilizer plants. 
Water fluoridation was demonstrated to increase 
blood lead levels in children [206–208]. 
All the fluoride products used in the artificial 
fluoridation of water are contaminated with lead 
and arsenic (toxic waste products that otherwise 
would be prone to mandatory decontamination). 
The EPA estimates that 10–20% of the lead in 
children comes from water. But it was considered 
that the amount is too small to be of regulatory 
concern. But EPA has overlooked the fact that it 
concentrates in the body tissues, and over time, 
would add up to quite a lot. In addition, it becomes 
concentrated in products processed with water. The 
10–20% that came directly from water can easily 
become three or four times as much. 
At the end, some recent thoughts, informed 
opinions: “Over the past ten years a large body 
of peer-reviewed science has raised concerns 
that fluoride may present unreasonable health 
risks, particularlyamong children, at levels 
routinely added to tap water in American cities”. 
ENVIRONMENTAL WORKING GROUP, 
July 2005. 
“In summary, we hold that fluoridation is an 
unreasonable risk.” – US ENVIRONMENTAL 
PROTECTION AGENCY HEADQUARTERS’ 
UNION, 2001. 
“Carefully conducted studies of exposure to 
fluoride and emerging health parameters of interest 
(e.g., endocrine effects and brain function) should 
be performed in populations in the United States 
exposed to various concentrations of fluoride.” – 
US NATIONAL RESEARCH COUNCIL, 2006. 
“I am quite convinced that water fluoridation, 
in a not-too-distant future, will be consigned to 
medical history.” – Dr. ARVID CARLSSON, 
Pharmacologist, Nobel Laureate in Physiology and 
Medicine, 2000. 
 
 
Una dintre istoriile a ceea ce fusese considerată a fi o modalitate de succes 
de prevenţie a cariilor dentare este reprezentată de fluorizarea apei şi a pastelor 
de dinţi. Chiar în zilele noastre, fără a fi la curent cu toate dovezile ştiinţifice fiabile 
acumulate în timp (în special în ţările în curs de dezvoltare) acţiunea are în 
prezent susţinători care o promovează. Iată de ce am considerat că o documentată 
actualizare a acestei probleme poate prezenta interes, în special deoarece efectele 
nocive sunt numeroase, asociate cu un mare număr de ameninţări pentru sănătate, 
în timp ce beneficiile sale nu au fost dovedite. 
 
Corresponding author: H. Bălan, Assoc. Professor 
 Medical Clinic, Clinical Emergency Ilfov County Hospital, 
 Basarabia Blv. 49–51, Bucharest, Romania 
 Email: drhoriabalan@yahoo.com 
 H. Bălan 8 68 
REFERENCES 
1. GRIFFITHS J., BRYSON C., Fluoride, Teeth, and the Atomic Bomb. Copyright 1997. 
2. European Commission. The safety of Fluorine Compunds in Oral Hygiene Products for Chidren Under the Age of 6 Years. 
European Commission, Health & Consumer Protection Directorate-General, Scientific Committee on Consumer Products, 2005, 
September 20. 
3. Editorial, Neurotoxicity of fluoride, Fluoride, 1996, 29: 2, 57–58. 
4. STRUNECKÁ A., PATOÈKA J., Pharmacological Implications of Aluminofluoride Complexes. A Review of the Evidence for 
Pathophysiological Effects of Aluminium and Fluoride on Living Organism. Brain Res, 1998, 16, 784 (3–5). 
5. COLQUHOUN J., Why I Changed my Mind about Fluoridation. Perspectives in Biology and Medicine, 1997, 41: 29–44. 
6. HILEMAN B., Fluoridation of Water. Questions about Health Risks and Benefits Remain after More than 40 years. Chemical 
and Engineering News, 1988, Aug., 26–42. 
7. HIRZY J.W., Why EPA’s Headquarters Professionals’ Union Opposes Fluoridation. National Treasury Employees Union, 
1999, Chapter 280, May 1. 
8. Fluoride Action Network. Fluoride’s Impact on Smooth Tooth Surfaces vs Pits & Fissures. Compilation of Reports, 2005. 
9. DIESENDORF M., How Science Can Illuminate Ethical Debates a Case Study on Water Fluoridation, Fluoride, 1995, 28: 2. 
10. COLQUHOUN J., Child Dental Health Differences in New Zealand, Com Health Studies, 1987, XI: 2. 
11. 11.De LIEFDE B., The Decline of Caries in New Zealand over the past 40 years, NZ Dental J, 1998, 94: 417. 
12. DIESENDORF M., Anglesey Fluoridation Trials Re-Examined, Fluoride, 1989, 22: 2. 
13. DISNEY J.A. et al., A Case Study in Contesting the Conventional Wisdom: school-Based Fluoride Mouthrinse Programs in the 
USA, Com Den Oral Epidem, 1990, 18. 
14. ISMAIL A.I. et al., Prevalence of Dental Caries and Dental Fluorosis in Students, 11–17 Years of Age, in Fluoridated and 
Non-Fluoridated Cities in Quebec, Caries Research, 1990, 24. 
15. KALSBEEK H., VERRIPS G.H.W., Dental Caries Prevalence and the Use of Fluorides in Different European Countries, 
J. Dent Res, 69 (Spec Iss), 1990. 
16. KÜNZEL W., FISCHER T., Rise and Fall of Caries Prevalence in German Towns with Different F Concentrations in Drinking 
Water, Caries Research 1997, 31: 3. 
17. MARTHALER T.M. et al., The Prevalence of Dental Caries in Europe 1990–1995, Caries Res, 1996, 30: 4. 
18. MIYAZAKI H., MORIMOTO M., Changes in Caries Prevalence in Japan. Eur J Oral Sci, 1996, 104 (4 Pt 2). 
19. MAUPOME G. et al., Patterns of Dental Caries following the Cessation of Water Fluoridation. Community Dent Oral 
Epidemiol 2001 Feb; 29 (1): 37–47. 
20. RIORDAN P.J., Fluoride Supplements for Young Children: an Analysis of the Literature Focusing on Benefits and Risks, Comm 
Dent & Oral Epidemi, 1999, 27 (1): 72–83. 
21. Robert Wood Johnson Foundation, Report 2, National Preventive Dentistry Demonstration Program 1983 (no benefit to topical 
treatments in a four-year test in ten differing communities). 
22. SEPPA L. et al., Caries Frequency in Permanent Teeth before and after Discontinuation of Water Fluoridation in Kuopio, 
Finland, Comm Dent Oral Epid 1998, 26: 4. 
23. SUTTON P.R.N., The failure of the fluoridation, Fluoride, 1990, 23: 1. 
24. TEOTIA S.P.S., TEOTIA M., Dental Caries: A Disorder of High Fluoride And Low Dietary Calcium Interactions (30 years of 
Personal Research), Fluoride, 1994, 27: 2. 
25. Van RIJKOM H.M. et al., A Meta-analysis of Clinical Studies on the Caries-inhibiting Effect of Fluoride Gel Treatment, Pediatr 
Dent, 1995, 17: 4. 
26. YIAMOUYIANNIS J.A., Water Fluoridation and Tooth Decay: Results from the 1986–1987 National Survey of U.S. School-
children, Fluoride Journal of the International Society for Fluoride Research, 1990, 23, 55–56. 
27. ZIEGELBECKER R., ZIEGELBECKER R.C., WHO Data on Dental Caries and Natural Water Fluoride Levels, Fluoride, 
1993, 26: 4. 
28. AKINIWA KENJI, Re-examination of Acute Toxicity of Fluoride, Fluoride, 1997, 30: 2, 89–104. 
29. FOULKES R.G., Case Report: Mass Fluoride Poisoning, Hooper Bay, Alaska, a Review of the Final Report of the Alaska 
Department of Health and Human Services, April 12, 1993, Fluoride 1994, 27: 1, 32–36. 
30. GESSNER B.D. et al., Acute Fluoride Poisoning from a Public Water System, NEJM, 1994, 330: 2. 
31. PENMAN A.D. et al., Outbreak of Acute Fluoride Poisoning caused by a Fluoride Overfeed, Mississippi, Public Health Rep, 
1997, 12 (5). 
32. WHITFORD G.M., The Physiological and Toxicological Characteristics of Fluoride, J. Dent Res, 1990, 69: Spec Iss. 
33. WHITFORD G.M., Fluoride in Dental Products: Safety Considerations, J Dent Res 1987, 66: 5. 
34. FOULKES R.G., Inorganic Fluorides, Canadian Environmental Protection Act (Priority Substances List Assessment Report, 
Government of Canada 1993, Fluoride, 1995, 28: 1 29–3295. 
35. Government of Canada Review, Pursuant to the Canadian Environmental Protection Act (CEPA), Priority Substances List 
Assessment Report, Inorganic Fluorides, ISBN 0-662-21070-9, (1993), 1–72. 
36. GRITSAN N.P. et al., Correlation among Heavy Metals and Fluoride in Soil, Air and Plants in Relation to Environmental 
Damage, Fluoride, 1995, 28: 4. 
37. Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Fluorides, Hydrogen Fluoride, and 
Fluorine (F). U.S. Department of Health & Human Services, Public Health Service. ATSDR/TP–91/17, 1993. 
9 Fluoride – the danger that we must avoid 69
38. Fluoride Action Network. Estimated Minimum Lethal Dose of Fluoride. Fluoride Health Effects Database, 2005. 
39. Food & Drug Administration. Letter from Melinda K. Plaisier, Associate Commissioner for Legislation, FDA, to Congressman 
Ken Calvert. Dec 21, 2000. 
40. KELLY J.V., Letter to Senator Robert Smith, Chairman of Environment and Public Works Committee, U.S. Senate, August 14, 
2000. 
41. RIORDAN P.J., Fluoride Supplements for Young Children: an Analysis of the Literature focusing on Benefits and Risks, Comm 
Dent & Oral Epidemil, 1999, 27 (1): 72–83. 
42. Van WINKLE S. et al., Water and Formula Fluoride Concentrations: Significance for Infants Fed Formula, Pediatr Dent, 1995, 
17 (4). 
43. U.S. Dept. of Health and Human Services, National Institutesof Health, Dental Sealants in the Prevention of Tooth Decay, 
(Conference Summary, 4:11, Dec. 5–7, 1983). 
44. BRATTHALL D. et al., Reasons for the Caries Decline: what do the Experts believe? European Journal of Oral Science, 1996, 
104: 416–22. 
45. DIESENDORF M., The Mystery of Declining Tooth Decay. Nature, 1986, 322: 125–129. 
46. GLASS R.L., Secular Changes in Caries Prevalence in two Massachusetts Towns. Caries Research, 1981, 15: 445–50. 
47. GRAY A.S., Fluoridation: Time for a New Base Line? Journal of the Canadian Dental Association, 1987, 53: 763–5. 
48. HAUGEJORDEN O., Using the DMF Gender Difference to assess the “Major” Role of Fluoride Toothpastes in the Caries 
Decline in Industrialized Countries: a Meta-analysis. Community Dentistry and Oral Epidemiolog, 1996, 24 (6): 369–75. 
49. KALSBEEK H., VERRIPS G.H., Dental Caries Prevalence and the Use of Fluorides in Different European Countries. Journal 
of Dental Research, 1990, 69 (Spec Iss): 728–32. 
50. LEVERETT D.H., Fluorides and the Changing Prevalence of Dental Caries. Science, 1982, 217 (4554): 26–30. 
 The other bibliographical references – from 51 to 208 – can be obtained from the author. 
Received January 5, 2012

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