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Whatever You Do, Don't Stop Paying Attention to the Fluoridation Debate

The science on fluoridation of drinking water gets less settled all  the time.
The science on fluoridation of drinking water gets less settled all the time.
Wikipedia

I have a column in the newspaper this week about drinking water fluoridation and a controversy that kicked up recently when three Dallas City Council members responded politely to an anti-fluoridation activist. Dallas Morning News columnist Jacquielynn Floyd was acerbic, choleric and apoplectic, invoking the Red Scare, Howdy Doody and Davy Crockett to convey the insult she felt the anti-fluoridationists had inflicted on the city by casting doubt on the practice of putting fluoride in the water to prevent tooth decay.

Right after she lambasted the council members for not lambasting the activists, the local dental society issued a statement calling the activists fear-mongers and urging public officials not to listen to them. I say in my piece in the paper that the dentists behind that one may have been out of dental school too long.

You may have to be certain age to understand the furor of dentists and pundits when confronted with any criticism of fluoridation. I'm that age and a half, so I do get it. Putting fluoride in drinking water was one of the grand symbolic gestures of the 1950s, when polio was being cured and science and technology were rampant on a field of seemingly endless victories. The people who rose up against fluoride really were the troglodytes, and everyone who has gone through dental school since then has been taught to deride and despise them.

See also: In Dallas, an Anti-Fluoride Movement for Once Not Dismissed

But this is no longer a dental school issue. In my column I refer you to an article in the February issue of the Lancet, the medical journal that has chronicled every major medical breakthrough from Louis Pasteur's discovery of the principle of vaccination to the discovery of a possible cause for SARS disease. The article, "Neurobehavioral effects of developmental toxicity," is a global survey of research on neurotoxins and human brain development.

One thing I learned from it -- something I sure missed if it has been in the news much -- is that fluoride is one of six chemicals added since 2006 to a list of what are now 11 known causes of diminished or deformed brain development in human fetuses and infants.

There's a big caveat to be stated right here. The authors of this paper make no claims up or down about the safety of water fluoridation in the United States. The studies they refer to measuring human I.Q. loss associated with fluoride were all carried out in China, and the authors point out that fluoride dosages to which children are exposed there may well be higher than what children and pregnant women experience here from drinking water.

But they also point out that no one knows what a safe fluoride dose is for a developing brain, and experience with other, better-known neurotoxins, lead for example, indicate that developing brains are permanently damaged by much smaller doses than those associated with adult poisoning: "Joint analyses that gathered data for lead-associated I.Q. deficits from seven international studies support the conclusion that no safe level of exposure to lead exists," they report.

One problem is that compared with gross physical birth defects caused by chemicals, developmental brain damage is barely on public health radar, according to the authors. They say: "David P. Rall, former director of the U.S. National Institute of Environmental Health Sciences, once noted that, 'if thalidomide had caused a 10-point loss of I.Q. instead of obvious birth defects of the limbs, it would probably still be on the market.'"

In addition to fluoride, the authors cite substances that interfere with what is called "endocrine signaling" in fetal and early childhood brain development. They do not name the type of endocrine disruptors that weresprayed on us from airplanes last summer as part of the campaign against West Nile, but my understanding from the scientists I talked to about it then is that an endocrine disruptor is an endocrine disruptor. It can cause a developing brain to miss a hormonal signal intended to trigger a certain step in development, and once one of those waypoints has been missed, it can never be recouped. There is no going back. That brain is permanently damaged.

Let me re-state an important reality about the Lancet article: It does not say that American water fluoridation is harmful. It does state two things emphatically, however: Fluoride exposure has been scientifically linked to permanent I.Q. deficits in children in China, and we have no idea what it's doing to children here because we haven't done the studies here.

So, look, I love my own dentist. I have always regarded dentists as solid pillars of any community I have lived in, and I know that their profession, practice and research are all based on science. I don't love Jacquielynn Floyd, but I like her stuff a lot. But it's absolutely wrong to think we can afford to shut down the debate on fluoride or any other neurotoxin because of a cultural association with people who worry about neurotoxins. This isn't coonskin caps and anti-communism. This is all new, powerful and urgent. Not worrying about it would be the crazy thing.


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