by Paul Connett
A. Bohatyrewicz, “Effects of Fluoride on Mechanical Properties of Femoral Bone in Growing Rats, ” Fluoride 32, no. 2 (1999): 47–54, http://fluoridealert.org/re/bohatyrewicz-1999.pdf.
T. W. Burnell, E. R. Peo Jr. , A. J. Lewis, and J. D. Crenshaw, “Effect of Dietary Fluorine on Growth, Blood and Bone Characteristics of Growing-Finishing Pigs, ” Journal of Animal Science 63, no. 6 (1986): 2053–67.
M. M. Chan, R. B. Rucker, F. Zeman, and R. S. Riggins, “Effect of Fluoride on Bone Formation and Strength in Japanese Quail, ” Journal of Nutrition 103, no. 10 (1973): 1431–40.
I. Gedalia, A. Frumkin, and H. Zukerman, “Effects of Estrogen on Bone Composition in Rats at Low and High Fluoride Intake, ” Endocrinology 75 (1964): 201–5.
M. H. Lafage, R. Balena, M. A. Battle, et al. , “Comparison of Alendronate and Sodium Fluoride Effects on Cancellous and Cortical Bone in Minipigs. A One-Year Study, ” The Journal of Clinical Investigation 95, no. 5 (1995): 2127–33.
L. Mosekilde, J. Kragstrup, and A. Richards, “Compressive Strength, Ash Weight, and Volume of Vertebral Trabecular Bone in Experimental Fluorosis in Pigs, ” Calcified Tissue International 40, no. 6 (1987): 318–22.
R. S. Riggins, R. C. Rucker, M. M. Chan, et al. , “The Effect of Fluoride Supplementation on the Strength of Osteopenic Bone, ” Clinical Orthopaedics, no. 114 (1976): 352–57.
R. S. Riggins, F. Zeman, and D. Moon, “The Effects of Sodium Fluoride on Bone Breaking Strength, ” Calcified Tissue Research 14, no. 4 (1974): 283–89.
J. C. Robin, B. Schepart, H. Calkins, et al. , “Studies on Osteoporosis III. Effect of Estrogens and Fluoride, ” Journal of Medicine 11, no. 1 (1980): 1–14.
H. Roeckert, “X-ray Absorption and X-ray Fluorescence Micro-Analyses of Mineralized Tissue of Rats Which Have Ingested Fluoridated Water, ” Acta Pathologica et Microbiologica Scandinavica 59 (1963): 32–38.
H. Roeckert and H. Sunzel, “Skeletal Lesions Following Ingestion of Fluoridated Water, ” Experientia 15 (1960): 155–56.
C. H. Søgaard, L. Mosekilde, W. Schwartz, et al. , “Effects of Fluoride on Rat Vertebral Body Biomechanical Competence and Bone Mass, ” Bone 16, no. 1 (1995): 163–9.
C. H. Turner, M. P. Akhter, and R. P. Heaney, “The Effects of Fluoridated Water on Bone Strength, ” Journal of Orthopaedic Research 10, no. 4 (1992): 581–87.
C. H. Turner and A. J. Dunipace, “On Fluoride and Bone Strength” (letter), Calcified Tissue International 53, no. 4 (1993): 289–90.
C. H. Turner, L. P. Garetto, A. J. Dunipace, et al. , “Fluoride Treatment Increased Serum IGF-1, Bone Turnover, and Bone Mass, But Not Bone Strength, in Rabbits, ” Calcified Tissue International 61, no. 1 (1997): 77–83.
C. H. Turner, K. Hasegawa, W. Zhang, et al. , “Fluoride Reduces Bone Strength in Older Rats, ” Journal of Dental Research 74, no. 8 (1995): 1475–81, http://jdr.sagepub.com/cgi/reprint/74/8/1475.
C. H. Turner, W. R. Hinckley, M. E. Wilson, et al. , “Combined Effects of Diets with Reduced Calcium and Phosphate and Increased Fluoride Intake on Vertebral Bone Strength and Histology in Rats, ” Calcified Tissue International 69, no. 1 (2001): 51–57.
C. H. Turner, I. Owan, E. J. Brizendine, et al. , “High Fluoride Intakes Cause Osteomalacia and Diminished Bone Strength in Rats with Renal Deficiency, ” Bone 19, no. 6 (1996): 595–601.
B. Uslu, “Effect of Fluoride on Collagen Synthesis in the Rat, ” Research and Experimental Medicine 182, no. 1 (1983): 7–12.
I. Wolinsky, A. Simkin, and K. Guggenheim, “Effects of Fluoride on Metabolism and Mechanical Properties of Rat Bone, ” American Journal of Physiology 223, no. 1 (1972): 46–50.
Nineteen studies on the possible association of hip fracture and fluoridated water published since 1990
Studies reporting an association between fluoridated water (1 ppm fluoride) and hip fracture
C. Cooper, C. Wickham, R. F. Lacey, and D. J. Barker, “Water Fluoride Concentration and Fracture of the Proximal Femur, ” Journal of Epidemiology and Community Health 44, no. 1 (1990): 17–19; and C. Cooper, C. A. Wickham, D. J. Barker, and S. J. Jacobsen, “Water Fluoridation and Hip Fracture” (letter, a reanalysis of data presented in 1990 paper), Journal of the American Medical Association 266, no. 4 (1990): 513–14.
C. Danielson, J. L. Lyon, M. Egger, and G. K. Goodenough, “Hip Fractures and Fluoridation in Utah’s Elderly Population, ” Journal of the American Medical Association 268, no. 6 (1992): 746–48.
K. T. Hegmann et al. , “The Effects of Fluoridation on Degenerative Joint Disease (DJD) and Hip Fractures, ” abstract no. 71 of the 33rd Annual Meeting of the Society for Epidemiological Research, June 15–17, 2000, published in a supplement of American Journal of Epidemiology (2000): P S18.
S. J. Jacobsen, J. Goldberg, C. Cooper, and S. A. Lockwood, “The Association Between Water Fluoridation and Hip Fracture Among White Women and Men Aged 65 Years and Older. A National Ecologic Study, ” Annals of Epidemiology 2, no. 5 (1992): 617–26.
S. J. Jacobsen, J. Goldberg, T. P. Miles, et al. , “Regional Variation in the Incidence of Hip Fracture. US White Women Aged 65 Years and Older, ” Journal of the American Medical Association 264, no. 4 (1990): 500–502.
H. Jacqmin-Gadda, D. Commenges, and J. F. Dartigues, “Fluorine Concentration in Drinking Water and Fractures in the Elderly” (letter), Journal of the American Medical Association 273, no. 10 (1995): 775–76.
H. Jacqmin-Gadda, A. Fourrier, D. Commenges, and J. F. Dartigues, “Risk Factors for Fractures in the Elderly, ” Epidemiology 9, no. 4 (1998): 417–23. (An elaboration of the 1995 study referred to in the JAMA letter. )
C. Keller, “Fluorides in Drinking Water” (unpublished results), discussed in S. L. Gordon and S. B. Corbin “Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health, ” Osteoporosis International 2 (1992): 109–17.
P. Kurttio, N. Gustavsson, T. Vartiainen, and J. Pekkanen, “Exposure to Natural Fluoride in Well Water and Hip Fracture: A Cohort Analysis in Finland, ” American Journal of Epidemiology 150, no. 8 (1999): 817–24.
D. S. May and M. G. Wilson, “Hip Fractures in Relation to Water Fluoridation: An Ecologic Analysis (unpublished data), discussed in S. L. Gordon and S. B. Corbin “Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health, ” Osteoporosis International 2 (1992): 109–17.
Studies reporting an association between water-fluoride levels higher than that of fluoridated water (4 ppm+) and hip fracture
Y. Li, C. Liang, C. W. Slemenda, et al. , “Effect of Long-Term Exposure to Fluoride in Drinking Water on Risks of Bone Fractures, ” Journal of Bone and Mineral Research 16, no. 5 (2001): 932–39.
M. F. Sowers, M. K. Clark, M. L. Jannausch, and R. B. Wallace, “A Prospective Study of Bone Mineral Content and Fracture in Communities with Differential Fluoride Exposure, ” American Journal of Epidemiology 133, no. 7 (1991): 649–60.
Studies reporting no association between water fluoride and hip fracture
Note that in four of these eight studies, an association was found between fluoride and some other form of fracture—e. g. wrist fracture. See notes and quotes below.
J. A. Cauley, P. A. Murphy, T. J. Riley, and A. M. Buhari, “Effects of Fluoridated Drinking Water on Bone Mass and Fractures: The Study of Osteoporotic Fractures, ” Journal of Bone and Mineral Research 10, no. 7 (1995): 1076–86.
D. Feskanich, W. Owusu, D. J. Hunter, et al. , “Use of Toenail Fluoride Levels as an Indicator for the Risk of Hip and Forearm Fractures in Women, ” Epidemiology 9, no. 4 (1998): 412–16. Note: While this study didn’t find an association between water fluoride and hip fracture, it did find an association—albeit not statistically significant 1. 6 (0. 8–3. 1)—between fluoride exposure and elevated rates of forearm fracture.
S. Hillier, C. Cooper, S. Kellingray, et al. , “Fluoride in Drinking Water and Risk of Hip Fracture in the UK: A Case Control Study, ” The Lancet 335, no. 9200 (2000): 265–69.
S. J. J
acobsen, W. M. O’Fallon, and L. J. Melton III, “Hip Fracture Incidence Before and After the Fluoridation of the Public Water Supply, Rochester, Minnesota, ” American Journal of Public Health 83, no. 5 (1993): 743–45, http://ajph.aphapublications.org/cgi/reprint/83/5/743.pdf.
M. R. Karagas, J. A. Baron, J. A. Barrett, and S. J. Jacobsen, “Patterns of Fracture Among the United States Elderly: Geographic and Fluoride Effects, ” Annals of Epidemiology 6, no. 3 (1996): 209–16. Note: As with Feskanich, et al. (1998), this study didn’t find an association between fluoridation and hip fracture, but it did find an association between fluoridation and distal forearm fracture, as well as proximal humerus fracture. “Independent of geographic effects, men in fluoridated areas had modestly higher rates of fractures of the distal forearm and proximal humerus than did men in nonfluoridated areas. ”
R. Lehmann, M. Wapniarz, B. Hofmann, et al. , “Drinking Water Fluoridation: Bone Mineral Density and Hip Fracture Incidence, ” Bone 22, no. 3 (1998): 273–78.
K. R. Phipps, E. S. Orwoll, J. D. Mason, and J. A Cauley, “Community Water Fluoridation, Bone Mineral Density and Fractures: Prospective Study of Effects in Older Women, ” British Medical Journal 321, no. 7265 (2000): 860–64. Note: As with Feskanich, et al. (1998) and Karagas, et al. (1996), this study didn’t find an association between water fluoride and hip fracture, but it did find an association between water fluoride and other types of fracture—in this case, wrist fracture. “There was a non-significant trend toward an increased risk of wrist fracture. ”
M. E. Suarez-Almazor, G. Flowerdew, L. D. Saunders, et al. , “The Fluoridation of Drinking Water and Hip Fracture Hospitalization Rates in Two Canadian Communities, ” American Journal of Public Health 83, no. 5 (1993): 689–93, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1694711/pdf/amjph00529-0067.pdf. Note: While the authors of this study conclude that there is no association between fluoridation and hip fracture, their own data reveals a statistically significant increase in hip fracture for men living in the fluoridated area. According to the authors, “Although a statistically significant increase in the risk of hip fracture was observed among Edmonton men, this increase was relatively small (RR=1. 12). ”
Endnotes
Links to the references in the endnotes and appendices can be accessed at http://fluoridealert.org/caseagainstfluoride.refs.html.
Introduction
1. R. A. Freeze and J. A. Lehr, The Fluoride Wars: How a Modest Public Health Measure Became America’s Longest-Running Political Melodrama (Hoboken, NJ: John Wiley, 2009).
2. E. D. Beltrán-Aguilar, B. F. Gooch, A. Kingman, et al. , “Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis—United States, 1988–1994 and 1999–2002, ” Morbidity and Mortality Weekly Report 54, no. 3 (August 26, 2005): 1–44, http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5403a1.htm.
3. World Health Organization, “EURO incl. DMFT for 12-year-olds, ” WHO Oral Health Country/Area Profile Programme, WHO Headquarters Geneva, Oral Health Programme, Malmo University, Sweden, http://www.whocollab.od.mah.se/euro.html.
Note: WHO has changed and updated its Web site several times over the last five years.
The table on this page gives statistics by European country for DMFT (decayed/missing/ filled teeth) for twelve-year-olds, as of March 3, 2010.
4. National Research Council of the National Academies, Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (Washington, DC: National Academies Press, 2006), http://books.nap.edu/openbook.php?record_id=11571.
5. Ibid.
6. Ibid.
7. R. J. Carton, “Review of the 2006 United States National Research Council Report: Fluoride in Drinking Water, ” Fluoride 39, no. 3 (2006): 163–72, http://www.fluoridealert.org/health/epa/nrc/carton-2006.pdf.
8. National Research Council, Fluoride in Drinking Water, 10 (n. 4 above).
9. Centers for Disease Control and Prevention, “Ten Great Public Health Achievements: United States, 1900–1999, ” Morbidity and Mortality Weekly Report 48, no. 12 (April 2, 1999): 241–43, http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm.
10. Centers for Disease Control and Prevention, “Achievements in Public Health, 1900–1999: Fluoridation of Drinking Water to Prevent Dental Caries, ” Mortality and Morbidity Weekly Review 48, no. 41 (October 22, 1999): 933–40, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm. Note: The authors of this report were Scott Tomar and Susan Griffin, as cited in Tomar’s curriculum vitae, paper number 27 on page 27, http://fluoridealert.org/re/tomar.scott.cv.ref.27.pdf.
11. M. W. Easley, “Community Fluoridation in America: The Unprincipled Opposition, ” 1999, posted on Dental Watch, http://www.dentalwatch.org/fl/opposition.pdf.
12. American Dental Association, Fluoridation Facts, an update commemorating the sixtieth anniversary of community water fluoridation, 2005, http://www.ada.org/sections/professionalresources/pdfs/fluoridation_facts.pdf.
13. M. W. Easley, “Community Fluoridation in America: The Unprincipled Opposition, ” (n. 11 above).
Chapter 1
1. American Medical Association, “Patient Physician Relationship Topics: Informed Consent, ” http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/informed-consent.shtml.
2. U. S. Department of Health and Human Services, Oral Health in America: A Report of the Surgeon General (Rockville, MD: U. S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000), http://fluoridealert.org/teeth/surgeon.general-2000.pdf.
3. Institute of Medicine, Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (Washington, DC: Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, National Academy Press, 1997), http://www.nap.edu/openbook.php?record_id=5776.
4. Letter coauthored by Bruce Alberts, president of the National Academy of Sciences, and Kenneth Shine, president of the Institute of Medicine, to Albert W. Burgstahler and others, November 20, 1998, http://www.fluoridation.com/fraud.htm.
5. Letter from Melinda K. Plaisier, FDA associate commissioner for legislation, to the Honorable Ken Calvert, chairman, Subcommittee on Energy and Environment, Committee on Science, U. S. House of Representatives, Washington, DC, December 21, 2000, http://www.fluoridealert.org/re/fda.letter.to.calvert.dec.2000.pdf.
6. At the Web site of the National Association of Pharmacy Regulatory Authorities, http://www.napra.org/, search the National Drug Schedules for “sodium fluoride” or “fluoride and its salts. ”
7. K. K. Cheng, I. Chalmers, and T. A. Sheldon, et al. , “Adding Fluoride to Water Supplies, ” British Medical Journal 335, no. 7622 (2007): 699–702.
8. Centers for Disease Control and Prevention, “Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States, ” Morbidity and Mortality Weekly Report 50, no. RR14 (August 17, 2001): 1–42, http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm.
9. American Dental Association, “Pediatric Journal Highlights Need for Translational Research, Medical-Dental Collaboration to Improve Children’s Oral Health, ” 2009, http://www.ada.org/prof/resources/topics/science_pediatric_research.asp.
10. Letter from John V. Kelly, New Jersey assemblyman, 36th District, to Dr. David Kessler, commissioner of the Food and Drug Administration, June 3, 1993, http://www.fluoridealert.org/re/kelly.1993.pdf.
11. M. S. McDonagh, P. F. Whiting, P. M. Wilson, et al. , “Systematic Review of Water Fluoridation, ” British Medical Journal 321, no. 7265 (2000): 855–59, http://www.bmj.com/cgi/content/full/321/7265/855. Note: The full report that this paper summarizes is commonly known as the York Review and is accessible at http://fluoridealert.org/re/york.review.2000.pdf.
12. E. Baldwin, video interview by Kevin Hurley, in “Professional Perspectives on Water Fluoridation, ” produced by Michael Connett for Fluoride Action Network, 2009, http
://www.fluoridealert.org/prof.dvd.html.
13. Letter from Dr. Arvid Carlsson to the South Central Strategic Health Authority, UK, February 2009, http://www.fluoridealert.org/southhampton.html.
14. U. S. Environmental Protection Agency, “Pesticides and Food: Why Children May Be Especially Sensitive to Pesticides, ” 2008, http://www.epa.gov/pesticides/food/pest.htm.
15. U. S. Environmental Protection Agency, “National Primary Drinking Water Regulations: Fluoride. Final Rule, ” Federal Register 50, no. 220 (November 14, 1985), http://fluoridealert.org/scher/epa-1985.pdf. Note: The MCL established on April 2, 1986 (51 FR 11396), finalizes regulations proposed in the Federal Register of May 14, 1985 (50 FR 20164), http://fluoridealert.org/scher/epa-1985.pdf.
16. Integrated Risk Information System, “Fluorine (Soluble Fluoride) (CASRN 7782–41– 4), ” Environmental Protection Agency, http://www.epa.gov/iris/subst/0053.htm.
