Controversy surrounds the classification of fluoride as an essential element. Although fluoride is incorporated into bone and tooth tissue in humans, it is unclear if this is necessary for correct tissue growth. Proponents of the fluoridation of water claim that teeth and bone are strengthened by the addition of fluoride to the water supply. However, fluoride is ubiquitous in food and drink naturally, and little evidence suggests that supplemental fluoride is beneficial beyond the food borne intake. Children are particularly susceptible to dental fluorosis because at a young age the crowns of the permanent teeth are undergoing calcification, and exposure to additional fluoride in water and dental products increases the risk of toxicity significantly. Indeed, increases in the rates of dental fluorosis suggest that fluoride levels in children may be problematic and that supplementation of additional fluoride to that found in the diet may be unnecessary. Assessing the fluoride intakes of children is therefore important form a safety point of view.
For example, in one study1 researchers assessed the fluoride intakes of children living in areas of 0.05 to 1.04 parts per million (ppm) water fluoridation. This was achieved by assessing the fluoride intake from 44 foods and drinking water. The results showed that in cities with fluoridation of above 0.7 ppm fluoride, a 6 month old infant and 2 year old child would have a total fluoride intake of roughly 0.418 mg per day (0.052 mg/kg) and 0.621 mg per day (0.050 mg/kg), respectively. The data indicated that the mean fluoride intake did not exceed 0.08 mg/kg, with most of the tested subjects being within the ‘optimal’ range of between 0.05 to 0.07 mg/kg. However, the ingestion of fluoridated water and fluoride containing dentifrices did cause some of the subjects to exceed the 0.1 mg/kg fluoride required to significantly increase the risk of dental fluorosis. This risk might be increased further in some children if the rate of ingestion of fluoride was such that plasma levels rose in peaks due to inconsistent ingestion patterns.
Because intakes of over 0.1 mg/kg are sufficient to cause dental fluorosis in some children during periods of crown calcification, a percentage of the children in this study were at high risk of dental fluorosis. Fluoride is already ubiquitous in food and drinks, and so the need to expose children to additional fluoride in the water supply and dental products should be questioned. Further, by exposing children to this medication, the adult population, who most certainly do not require this levels of fluoride, are medicated for no reason whatsoever. The ethical problems with fluoridation of water are therefore substantial, and it is incredulous that such a system has been allowed to be implemented. If individual children requires fluoride supplements for particular reasons, there are cheap and effective ways to administer them (although it is not established that this is indeed the case). A mass medication system that not only unnecessarily exposes the adult population to a known toxin, but also increases the risk of children to dental fluorosis, must be seriously flawed.
RdB
