Recent developments in the U.S. regarding water fluoridation are coming as a result of a significant ruling by U.S. District Judge Edward Chen in the case of Food & Water Watch, Inc., et al. v. United States Environmental Protection Agency (EPA), et al. In the Findings of Fact and Conclusions of law (linked to below) relating to this case, Judge Chen ruled that the fluoride added to drinking water could pose an unreasonable risk to the intellectual development of children.

This decision was influenced by mounting scientific research that shows a potential link between federally [and WHO] recommended fluoride levels in water and lower IQ in children. He stated highlighted that enough scientific evidence that water fluoridation directly causes IQ reduction in children to warrant regulatory action by the EPA.

See: Findings of Fact and Conclusions of law

The EPA has been ordered to further regulate fluoride in drinking water. This comes after the agency's previous dismissal of a citizens' petition to regulate fluoride was challenged in court, leading to this trial under the Toxic Substances Control Act (TSCA). The Act allows for such petitions if a chemical substance presents an unreasonable risk.

Following this ruling, some municipalities have started to suspend water fluoridation. It appears that many cities are acting out of caution, aiming to prevent any potential harm to their residents, especially children, while awaiting further guidance or regulation from the EPA.

This ruling has reignited the debate over water fluoridation, which has been praised as one of the greatest public health achievements for reducing tooth decay, even though it has never been studied or approved for that use by the FDA, but is now questioned regarding its broader health impacts such as IQ reduction in children. Especially in boys.

Local governments might also be responding to both legal implications of the ruling and public concern. The decision provides a legal basis for municipalities to reconsider their stance on fluoridation, potentially to avoid future liability or in response to community advocacy.

For decades, fluoride has been added to water supplies to prevent tooth decay. However, this practice has always had its critics, who have argued about the lack of informed consent and potential health risks beyond dental fluorosis, like neurodevelopmental issues, which are now being highlighted by the court.

Hydrofluorosilicic acid (often referred to as hydrofluorosilicic acid or HFA) is a compound commonly used in water fluoridation. There's a risk of accidental overfluoridation if the dilution process is not correctly managed, potentially leading to fluorosis, which in its mild form results in tooth discoloration, and in more severe cases, can affect bone health. The long-term effects of consuming even low levels of fluoride, point towards potential issues like skeletal fluorosis, thyroid problems, and concerns over neurodevelopmental impacts, especially with respect to male children.

The debate over hydrofluorosilicic acid in water fluoridation encompasses both its dental health benefits versus the potential risks of long-term exposure and the ethics of mass medication. While many public health bodies advocate for its use as a cost-effective method for reducing dental caries, the conversation around its safety continues, driven by both scientific research and public concern.

Future Implications

In fact, the EPA needs to reassess the safe levels of fluoride in drinking water, possibly lowering the current maximum allowable concentration or providing new guidelines. Hopefully, this will lead to widespread changes or cessations in community water fluoridation programs across the United States.

There also needs to be an push for more comprehensive studies on fluoride's effects, especially on neurodevelopment, to either confirm or refute these concerns definitively.

As a result of this case, there's a renewed public concern over fluoride's safety and support for the judge's decision, indicating a growing public interest in re-evaluating long-standing public health practices.

This ruling and the subsequent actions by municipalities represent a pivotal moment in public health policy, potentially leading to a significant shift in how water fluoridation is viewed and managed in the United States.

The Question of Ethics, Safety, and Efficacy

The practice of water fluoridation, which was once heralded as one of the 'greatest public health achievements of the 20th century,' stands on shaky ground when scrutinized under the lens of modern science and ethical considerations.

Here's why the fluoridation of our water supplies should be reconsidered:

1. Questionable Benefits: The original studies that promoted fluoridation as a panacea for dental caries are dated and did not account for the widespread use of fluoride in toothpaste and other dental products. Recent studies suggest that the benefits of water fluoridation are less pronounced than once believed, especially when considering the availability of fluoride from multiple sources. The reduction in dental caries attributed to fluoridation might now be marginal at best, due to these alternative fluoride sources and improved dental hygiene practices.

2. Neurodevelopmental Risks: Recent research, particularly from studies examining fluoride exposure during pregnancy, has raised alarms about potential neurodevelopmental harms. Evidence shows that fluoride [like vaccines that contain mercury-based preservatives like Thimeresol and aluminum] can cross the placental barrier, potentially impacting fetal brain development. Studies have linked higher fluoride exposure with lower IQ scores in children, indicating that fluoride might not be as benign as once thought, especially for vulnerable populations like fetuses, infants, and even older adults who don't have any teeth, for whom there is no dental benefit from fluoride.

3. Overdose and Fluorosis: With fluoride present in various products, including toothpaste, mouth rinses, and processed foods and beverages, adding it to water increases the risk of fluoride overdose. Dental fluorosis, a condition that results from excess fluoride intake during the tooth-forming years, is a visible marker of fluoride's systemic impact. More concerning are the potential skeletal effects, which might not be as visible but can lead to bone issues over time.

4. Ethical Concerns: Water fluoridation represents a form of mass medication without individual consent, infringing upon personal autonomy. This practice bypasses the principle of informed consent, a cornerstone of medical ethics. Moreover, it's indiscriminate, affecting everyone regardless of their need, age, health status, or the presence of adequate fluoride from other sources.

5. Lack of Control Over Dosage: Unlike medications, where dosage can be controlled, water fluoridation does not allow for individual dosage adjustment. People drink varying amounts of water, and thus, their fluoride intake varies, which could lead to potential overconsumption by some.

6. Environmental Impact: Hydrofluorosilicic acid, which is the fluoride added to water often comes from industrial waste products. Primarily, the aluminum manufacturing industry. This raises questions about the environmental ethics of using public water supplies (therefore, unsuspecting human beings) as a means to dispose of industrial byproducts, not to mention the broader environmental impact of fluoride compounds when they enter the water cycle.

7. The Precautionary Principle: Given the emerging scientific evidence on fluoride's potential neurotoxic effects, the precautionary principle should prevail. If there's a potential risk, especially one that could affect brain development, the onus should be on proving absolute safety beyond doubt, not on continuing a practice until it's proven harmful.

The narrative that water fluoridation is universally beneficial has been significantly challenged by contemporary science. The practice, rooted in mid-20th-century logic, fails to hold up under the scrutiny of 21st-century research standards and ethical considerations. It's time to reconsider this one-size-fits-all approach to public health, focusing instead on targeted fluoride treatments for those who might benefit, while protecting the population from unnecessary risk. The debate isn't just scientific; it's deeply ethical, demanding a reevaluation of how we balance public health initiatives with individual rights and scientific evidence.

#Fluoride