Many arguments from anti-fluoride activists misrepresent what the research shows. For decades, anti-fluoride activists have tried to link fluoride or fluoridated water to a long list of different health problems—from bone cancer to difficulty losing weight—but without offering solid evidence to back up these accusations. Here are some examples of the misleading or inaccurate statements that anti-fluoride groups make to attack fluoridation’s value and safety:

Claim #1

“Fluoride causes cancer.”

The Facts:

• For years, fluoridation opponents have made this argument, but the claim doesn’t stand up to the evidence. In 2011, a U.S. study found no link between fluoride and bone cancer. The design of this study was approved by the National Cancer Institute. The study is also considered very reliable because—unlike previous studies—it examined actual fluoride levels in bone.
• In October 2011, after lengthy review, a committee of California’s Office of Environment Health Hazard Assessment voted unanimously that the evidence did not support classifying fluoride as a cancer-causing substance.

Claim #2

“Fluoridation is harmful because it causes a condition called fluorosis.”

The Facts:

• Nearly all fluorosis in the U.S. is a mild, cosmetic condition that leaves faint white streaks on teeth. It does not cause pain, and it does not affect the health or function of the teeth. It’s so subtle that most people with mild fluorosis cannot detect it—only a dentist is likely to notice it.
• Dental fluorosis occurs among some people in all communities, even those that do not fluoridate their local water systems. For example, there is fluorosis in Norway, a country that does not fluoridate its public water systems. Fluorosis occurs when young children consume an excessive amount of fluoride from any source.
• Experts believe that the main reason for fluorosis is that some young children swallow fluoride toothpaste. Toothpaste contains a concentration of fluoride that is roughly 1,000 times higher than the level in fluoridated water. This is why parents of children under the age of 6 are advised to supervise their kids’ tooth-brushing and apply only a pea-sized amount of toothpaste to the toothbrush.
• Anti-fluoride websites display photos of people with a severe form of fluorosis who live in India and other places to paint an inaccurate picture of fluorosis. These people have severe fluorosis because some water supplies in their countries have extremely high, natural levels of fluoride. The fluoride in these water supplies in India are not adjusted down to the level used to fluoridate public water systems in the U.S.

Claim #4

“Europe doesn’t engage in fluoridation, so why should we?” This assertion by anti-fluoride activists is misleading because it ignores the fact that these nations use various means to provide fluoride to their citizens:

The Facts:

• Salt fluoridation is widely used in Europe. In fact, at least 70 million Europeans consume fluoridated salt, and this method of fluoridation reaches most of the population in Germany and Switzerland. These two countries have among the lowest rates of tooth decay in all of Europe. Fluoridated milk programs reach millions of additional Europeans.
• Fluoridated water is provided to 12 million Europeans, mostly reaching residents of Great Britain, Ireland, Spain and other countries.
• Italy has not tried to create a national system of water fluoridation, but there are logical reasons for this. First, the drinking of bottled water is well established in Italian culture. Second, a number of areas in Italy have water supplies with natural fluoride levels that already reach the optimal level that prevents decay.
• Technical challenges are a major reason why fluoridated water isn’t common in Europe. In France and Switzerland, water fluoridation is logistically difficult because there are tens of thousands of separate sources for drinking water. This is why these countries use salt fluoridation, fluoride-rinse programs and other ways to get fluoride to their people.

Claim #5

“Fluoride is a by-product from the phosphate fertilizer industry.” Opponents use this misleading message to associate fluoride with fertilizer.

The Facts:

• Fluoride is extracted from phosphate rock, and so is phosphoric acid—an ingredient in Coke and Pepsi. Neither one of them comes from fertilizer.
• Fluoride is extracted from the same phosphate rock that is later used to create fertilizers that will enrich soil. This is accomplished through an efficient process, and opponents are wrong to suggest that fluoride “comes from fertilizer.”
• The quality and safety of fluoride additives are ensured by Standard 60, a program commissioned by the Environmental Protection Agency (EPA). Standard 60 is a set of standards created and monitored by an independent committee of health experts. This committee provides regular reports to the EPA. More than 80 percent of fluoride additives are produced by U.S. companies, but no matter where they come from, Standard 60 uses on-site inspections and even surprise “spot checks” to confirm the additives meet quality and safety standards.

Claim #7

“There are highly fluoridated states that have higher decay rates than states where fluoridation is less common.” Opponents sometimes compare different states’ fluoridation rates and try to present this as proof that fluoridation doesn’t reduce tooth decay.

The Facts:

• This is an example of junk-science, and here’s why. Water fluoridation is a key factor in decay prevention, but other factors also influence decay rates. Research confirms that low-income people are more at risk for decay than upper income Americans. This makes sense because income status shapes how often a person visits a dentist, their diet and nutrition, and other factors.
• Comparing different states based solely on fluoridation rates ignores some key income differences. For example, West Virginia and Connecticut reach roughly the samepercentage of their residents with fluoridated water—91 percent and 90 percent, respectively. Yet the percentage of West Virginians living below the poverty line is nearly double the percentage of those living in Connecticut. West Virginians are also more likely to get their drinking water from wells, which are not fluoridated to the optimal level. This is why it’s misleading to do these apples-and-oranges comparisons.
• A more reliable comparison would examine decay-related problems of people from within the same state and the same income group. A 2010 New York study did precisely this—comparing Medicaid enrollees in counties where fluoridation was prevalent to enrollees in counties where most communities were not fluoridated. The study found that residents of counties where fluoridated water was rare needed 33 percent more fillings, root canals and extractions than those in counties where fluoridated water was common.

Claim #8

“There’s a link between fluoride and lower IQ scores.” Anti-fluoride activists have raised concerns about this, but their argument is based on junk science—flawed studies that were conducted in China and other countries.

The Facts:

• British researchers who evaluated these IQ studies found “basic errors” and wrote that different data were combined in a way “that does not give a valid or meaningful result.”
• These Chinese studies failed to rule out other factors, including arsenic exposure, the burning of high-fluoride coal inside homes and the eating of contaminated grain.
• Most of the foreign studies cited by anti-fluoride activists involved fluoride levels in drinking water that were more than triple the level recommended for fluoridation in the U.S.

Claim #10

“Fluoride can harm plants and animals that live in the wild.”

The Facts:

• The fluoride level in a fluoridated water system is not high enough to harm any plant or animal species.Anti-fluoride groups claim that runoff from fluoridated water can harm fish. But research shows that this runoff does not cause any harm to salmon. In fact, sea water—where salmon and other fish spend most of their lives—contains a concentration of fluoride that is 80 percent higher than the level recommended for fluoridation.

  There is no evidence that fluoridated water has a negative effect on plants, gardens or lawns, or plants. Research shows that even high levels of fluoride do not have a toxic effect on plants in ponds.