May 6, 1995
Does fluoridation save money? This is one of the many spurious claims made by fluoridation exponents. One would think that the parties making such a claim would be obliged to back it up with adequate proof. The fact is, they can't. Numerous reviews have attempted to find evidence of financial savings and all have turned up empty. Several examples follow.
The National Dental Caries Prevalence Survey of 1979-80 (NIH Pub. 82-2245) failed to demonstrate any advantage of artificial fluoridation.
Does fluoridation increase medical costs? This question concerns the known toxicity of fluoride. My particular interest is fluoride's effect on bones. It is widely known that fluoride treatments for osteoporosis result in increased incidence of hip fracture. The deleterious effect fluoride on bones is now beyond dispute. The question is, does fluoride at the level of water fluoridation also damage bones?
A 1993 report by the National Research Council claimed claimed to have reviewed the available literature and concluded that, though the results were mixed, there was no reason to change fluoride's present maximum contaminant level (MCL) of 4 mg/L. Among references comparing hip fracture incidence relative to fluoridation status, the NRC reported seven studies showing increased fracture risk, three reporting no difference, and none reporting any benefit. The three references that reported no difference were all small studies of elderly women with only brief exposure (six years or less) to fluoridated water. These are obviously not relevant to the question of life-long fluoridation exposure. That leaves seven much better studies showing an increased risk of hip fracture from fluoridated water.
More recently, a report in the JAMA, 8 March 1995, from the University of Bordeaux compared hip fracture incidence among subjects aged 65 years or older in 75 parishes of southwestern France. The fluoride (natural) level of the community water supplies varied from 0.05 to 1.83 mg/L (ppm), much lower than our MCL for fluoride. After adjustment for a number of other potential variables, it was found that women living in communities having more than 0.11 mg/L (ppm), much lower than our MCL for fluoride. After adjustment for a number of other potential variables, it was found that women living in communities having more than 0.11 mg/L of fluoride in their drinking water were found to have a risk of hip fracture 86% greater than those living in the less fluoridated areas.
Thus, the mass of available and relevant scientific literature indicates that fluoridation increases the risk of hip fracture among the elderly. Treating osteoporotic fractures incurs a cost pf $10 billion per year in the US. The additional cost of rest home and nursing home care that follows is probably much larger, not to mention the cost in terms of human suffering. Surely, this is reason enough to desist in fluoridating our water.
There are still remaining many questions about other toxic effects of fluoride, including the strong evidence that fluoridation increases the incidence of bone cancer (osteosarcoma) among young males. Fluoride is a potent enzyme inhibitor at all detectable levels, more toxic than lead. To put it in drinking water will not serve the health of the public nor will it reduce medical or dental costs.