Health Canada Recommends Reducing Fluoride

Vittorio Hernandez - AHN News Writer
Ottawa, Ontario (AHN) - A Health Canada expert panel has recommended a reduction of exposure to fluoride, especially among young Canadians. Cuts on fluoride levels in drinking water, toothpaste and infant formula were among the measures suggested.
While fluoride is known to be a cavity fighter, the chemical has been linked by some public health advocates to lower intelligence, a rare type of bone cancer and mottling of children's teeth.

The panel concluded evidence does not support the connection between fluoride and cancer, but it still recommended lesser amounts of fluoride to lessen the risk of fluorosis among young children, said Steven Levy, a panel member.
Flourosis occurs when there is excess ingestion of fluoride during the years when the teeth are still being formed. Fluoride damages the enamel-forming cells and causes the sub-surface enamel of the teeth to increase in porosity.

Health Canada's recommendation is to reduce the fluoride level in drinking water to 0.7 parts per million from the present standard of 0.8 ppm to 1 ppm.
http://www.allheadlinenews.com/articles/7011775704

0.2m children under five die of water-borne diseases annually

By Atif Khan
ISLAMABAD: Around 99 percent of water supplied to the population is unfit for human consumption due to which over 200,000 children under five die from diarrhoea, typhoid fever, cholera and hepatitis A and E every year. Pakistan Council for Research in Water Resources (PCRWR) scientist Hifza Rasheed said this during a five-day training workshop titled “The challenges of sustainable water supply services” organised at the PCRWR Headquarters here on Monday. Sponsored by the Dutch government, the workshop was attended by a large number of mangers of water supply agencies from across the country. The key resource person was Jan Visscher from Netherlands. Explaining water-borne diseases, Hifza Rasheed said that contaminated water was responsible for 40 percent of all diseases in the country. She said water contained over 60,000 friendly and harmful bacteria nine of which caused dysentery, typhoid, cholera, gastroenteritis and leptospirosis. She said water table in Pakistani cities and villages contained arsenic that caused arsenicosis, a chronic illness resulting from drinking water. She said high levels of arsenic in water over a long period of time caused arsenic poisoning. Fluorosis is an abnormal condition caused by excessive intake of fluorine. The abnormality is chiefly characterized by mottling of teeth and the long-term intake of fluorine can lead to severe skeletal problems (skeletal fluorosis), including stiffness and pain in joints. She explained that water-borne diseases were any illness caused by drinking water contaminated by human or animal faeces containing pathogenic microorganisms. She said the untreated hospital waste contained hepatitis virus. Hifza Rasheed said that children were the main victims of this virus due to low immunity. The other viral diseases caused by contaminated water could be polio and meningitis, she added. The scientist said that improper disposal of sanitary waste and other chemical contaminations like factory wastes contaminated drinking water, which could cause different cancers. After initial discussion, Jan Visscher asked how could the managers of different water supply agencies help the government achieve the cherished goal of clean drinking water for everyone till 2015.
http://www.dailytimes.com.pk/default.asp?page=2008\07\29\story_29-7-2008_pg11_3

10 Funky Facts About Fluoride

From the Flouride Action Network

FLUORIDE is a toxic substance. The world’s top scientists are claiming that we’ve all been had by a tremendous and persistent sales job that still goes on to this day. Most people do not know that fluoride is toxic and that the claims about cavity prevention are bogus. Here are ten facts about fluoride, with a complete reference list of scientific sources at the end of this article…
1) 97% of western Europe has chosen fluoride-free water . This includes: Austria, Belgium, Denmark, Finland, France, Germany, Iceland, Italy, Luxembourg, Netherlands, Northern Ireland, Norway, Scotland, Sweden, and Switzerland. (While some European countries add fluoride to salt, the majority do not.) Thus, rather than mandating fluoride treatment for the whole population, western Europe allows individuals the right to choose, or refuse, fluoride.
2) Fluoride is the only chemical added to drinking water for the purpose of medication (to prevent tooth decay). All other treatment chemicals are added to treat the water (to improve the water’s quality and safety - which fluoride does not do). This is one of the reasons why most of Europe has rejected fluoridation. For instance:
In Germany, “The argumentation of the Federal Ministry of Health against a general permission of fluoridation of drinking water is the problematic nature of compulsion medication.”

In Belgium, it is “the fundamental position of the drinking water sector that it is not its task to deliver medicinal treatment to people. This is the sole responsibility of health services.”

In Luxembourg, “In our views, drinking water isn’t the suitable way for medicinal treatment and that people needing an addition of fluoride can decide by their own to use the most appropriate way.”
3) Contrary to previous belief, fluoride has minimal benefit when swallowed. When water fluoridation began in the 1940s and ’50s, dentists believed that fluoride needed to be swallowed in order to be most effective. This belief, however, has now been discredited by an extensive body of modern research (1).
According to the Centers for Disease Control, fluoride’s “predominant effect is posteruptive and topical” (2). In other words, any benefits that accrue from the use of fluoride, come from the direct application of fluoride to the outside of teeth (after they have erupted into the mouth) and not from ingestion. There is no need, therefore, to expose all other tissues to fluoride by swallowing it.

4) Fluoridated water is no longer recommended for babies. In November of 2006, the American Dental Association (ADA) advised that parents should avoid giving babies fluoridated water (3). Other dental researchers have made similar recommendations over the past decade (4).

Babies exposed to fluoride are at high risk of developing dental fluorosis - a permanent tooth defect caused by fluoride damaging the cells which form the teeth (5). Other tissues in the body may also be affected by early-life exposures to fluoride. According to a recent review published in the medical journal The Lancet, fluoride may damage the developing brain, causing learning deficits and other problems (6).

5) There are better ways of delivering fluoride than adding it to water. By adding fluoride to everyone’s tap water, many infants and other at-risk populations will be put in harm’s way. This is not only wrong, it is unnecessary. As western Europe has demonstrated, there are many equally effective and less-intrusive ways of delivering fluoride to people who actually want it. For example:

A) Topical fluoride products such as toothpaste and mouthrinses (which come with explicit instructions not to swallow) are readily available at all grocery stores and pharmacies. Thus, for those individuals who wish to use fluoride, it is very easy to find and very inexpensive to buy.

B) If there is concern that some people in the community cannot afford to purchase fluoride toothpaste (a family-size tube of toothpaste costs as little as $2 to $3), the money saved by not fluoridating the water can be spent subsidizing topical fluoride products (or non-fluoride alternatives) for those families in need.

C) The vast majority of fluoride added to water supplies is wasted, since over 99% of tap water is not actually consumed by a human being. It is used instead to wash cars, water the lawn, wash dishes, flush toilets, etc.

6) Ingestion of fluoride has little benefit, but many risks. Whereas fluoride’s benefits come from topical contact with teeth, its risks to health (which involve many more tissues than the teeth) result from being swallowed.

Adverse effects from fluoride ingestion have been associated with doses atttainable by people living in fluoridated areas. For example:

a) Risk to the brain. According to the National Research Council (NRC), fluoride can damage the brain. Animal studies conducted in the 1990s by EPA scientists found dementia-like effects at the same concentration (1 ppm) used to fluoridate water, while human studies have found adverse effects on IQ at levels as low as 0.9 ppm among children with nutrient deficiencies, and 1.8 ppm among children with adequate nutrient intake. (7-10)

b) Risk to the thyroid gland. According to the NRC, fluoride is an “endocrine disrupter.” Most notably, the NRC has warned that doses of fluoride (0.01-0.03 mg/kg/day) achievable by drinking fluoridated water, may reduce the function of the thyroid among individuals with low-iodine intake. Reduction of thyroid activity can lead to loss of mental acuity, depression and weight gain (11)

c) Risk to bones. According to the NRC, fluoride can diminish bone strength and increase the risk for bone fracture. While the NRC was unable to determine what level of fluoride is safe for bones, it noted that the best available information suggests that fracture risk may be increased at levels as low 1.5 ppm, which is only slightly higher than the concentration (0.7-1.2 ppm) added to water for fluoridation. (12)

d) Risk for bone cancer. Animal and human studies – including a recent study from a team of Harvard scientists – have found a connection between fluoride and a serious form of bone cancer (osteosarcoma) in males under the age of 20. The connection between fluoride and osteosarcoma has been described by the National Toxicology Program as “biologically plausible.” Up to half of adolescents who develop osteosarcoma die within a few years of diagnosis. (13-16)

e) Risk to kidney patients. People with kidney disease have a heightened susceptibility to fluoride toxicity. The heightened risk stems from an impaired ability to excrete fluoride from the body. As a result, toxic levels of fluoride can accumulate in the bones, intensify the toxicity of aluminum build-up, and cause or exacerbate a painful bone disease known as renal osteodystrophy. (17-19)

7) The industrial chemicals used to fluoridate water may present unique health risks not found with naturally-occurring fluoride complexes . The chemicals - fluorosilicic acid, sodium silicofluoride, and sodium fluoride - used to fluoridate drinking water are industrial waste products from the phosphate fertilizer industry. Of these chemicals, fluorosilicic acid (FSA) is the most widely used. FSA is a corrosive acid which has been linked to higher blood lead levels in children. A recent study from the University of North Carolina found that FSA can - in combination with chlorinated compounds - leach lead from brass joints in water pipes, while a recent study from the University of Maryland suggests that the effect of fluoridation chemicals on blood lead levels may be greatest in houses built prior to 1946. Lead is a neurotoxin that can cause learning disabilities and behavioral problems in children. (20-23)

Water fluoridation’s benefits to teeth have been exaggerated. Even proponents of water fluoridation admit that it is not as effective as it was once claimed to be. While proponents still believe in its effectiveness, a growing number of studies strongly question this assessment. (24-46) According to a systematic review published by the Ontario Ministry of Health and Long Term Care, “The magnitude of [fluoridation's] effect is not large in absolute terms, is often not statistically significant and may not be of clinical significance.” (36)

a) No difference exists in tooth decay between fluoridated & unfluoridated countries. While water fluoridation is often credited with causing the reduction in tooth decay that has occurred in the US over the past 50 years, the same reductions in tooth decay have occurred in all western countries, most of which have never added fluoride to their water. The vast majority of western Europe has rejected water fluoridation. Yet, according to comprehensive data from the World Health Organization, their tooth decay rates are just as low, and, in fact, often lower than the tooth decay rates in the US. (25, 35, 44)

b) Cavities do not increase when fluoridation stops. In contrast to earlier findings, five studies published since 2000 have reported no increase in tooth decay in communities which have ended fluoridation. (37-41)

c) Fluoridation does not prevent oral health crises in low-income areas. While some allege that fluoridation is especially effective for low-income communities, there is very little evidence to support this claim. According to a recent systematic review from the British government, “The evidence about [fluoridation] reducing inequalities in dental health was of poor quality, contradictory and unreliable.” (45) In the United States, severe dental crises are occurring in low-income areas irrespective of whether the community has fluoride added to its water supply. (46) In addition, several studies have confirmed that the incidence of severe tooth decay in children (“baby bottle tooth decay”) is not significantly different in fluoridated vs unfluoridated areas. (27,32,42) Thus, despite some emotionally-based claims to the contrary, water fluoridation does not prevent the oral health problems related to poverty and lack of dental-care access.

9) Fluoridation poses added burden and risk to low-income communities. Rather than being particularly beneficial to low-income communities, fluoridation is particularly burdensome and harmful. For example:

a) Low-income families are least able to avoid fluoridated water. Due to the high costs of buying bottled water or expensive water filters, low-income households will be least able to avoid fluoride once it’s added to the water. As a result, low-income families will be least capable of following ADA’s recommendation that infants should not receive fluoridated water. This may explain why African American children have been found to suffer the highest rates of disfiguring dental fluorosis in the US. (47)

b) Low-income families at greater risk of fluoride toxicity. In addition, it is now well established that individuals with inadequate nutrient intake have a significantly increased susceptibility to fluoride’s toxic effects. (48-51) Since nutrient deficiencies are most common in low-income communities, and since diseases known to increase susceptibility to fluoride are most prevalent in low-income areas (e.g. end-stage renal failure), it is likely that low-income communities will be at greatest risk from suffering adverse effects associated with fluoride exposure. According to Dr. Kathleen Thiessen, a member of the National Research Council’s review of fluoride toxicity: “I would expect low-income communities to be more vulnerable to at least some of the effects of drinking fluoridated water.” (51)

10) Due to other sources, many people are being over-exposed to fluoride . Unlike when water fluoridation first began, Americans are now receiving fluoride from many other sources* besides the water supply. As a result many people are now exceeding the recommended daily intake, putting them at elevated risk of suffering toxic effects. For example, many children ingest more fluoride from toothpaste alone than is considered “optimal” for a full day’s worth of ingestion. According to the Journal of Public Health Dentistry:

“Virtually all authors have noted that some children could ingest more fluoride from [toothpaste] alone than is recommended as a total daily fluoride ingestion.” (52)

Because of the increase in fluoride exposure from all sources combined, the rate of dental fluorosis (a visible indicator of over-exposure to fluoride during childhood) has increased significantly over the past 50 years. Whereas dental fluorosis used to impact less than 10% of children in the 1940s, the latest national survey found that it now affects over 30% of children. (47, 53)

* Sources of fluoride include: fluoride dental products, fluoride pesticides, fluorinated pharmaceuticals, processed foods made with fluoridated water, and tea.

http://nutritionresearchcenter.org/healthnews/?p=757

Fluoridated water now reaches nearly 70% of U.S. population

WASHINGTON, July 10 (Xinhua) -- Nearly 70 percent of U.S. residents who get water from community water systems now receive fluoridated water, according to a report published Thursday by the U.S. Centers for Disease Control and Prevention (CDC).
The proportion of the U.S. population receiving fluoridated water, about 184 million people, increased from 65.8 percent in 1992 to 69.2 percent in 2006, said the report.

The percentage of people served by community water systems with optimal levels (which are defined by the state and vary based on such things as the climate) of fluoridated water ranged from 8.4 percent in Hawaii to 100 percent in the District of Columbia, according to the report.
"Community water fluoridation is an equitable, cost-effective, and cost-saving method of delivering fluoride to most people," said William Maas, director of CDC's Division of Oral Health. "We've seen some marked improvements; however, there are still too many states that have not met the national goal. The national goal is that 75 percent of U.S. residents who are on community water systems be receiving fluoridated water by 2010."

Fluoride, a naturally occurring compound in the environment, can reduce or prevent tooth decay. Adding or maintaining tiny levels of fluoride in drinking water is a safe and effective public health measure to prevent and control tooth decay (dental caries). The second half of the 20th century saw a major decline in the prevalence and severity of dental caries, attributed in part to the increasing use of fluoride.

Based upon studies and a systematic review, the new report suggests that fluoridation resulted in a median 29.1 percent relative decrease in tooth decay in the United States.
Editor: Mu Xuequan
http://news.xinhuanet.com/english/2008-07/11/content_8525930.htm

Fluorosis - Causes, Symptoms, and Treatment

Definition
Fluorosis are describes as a state of toxicity of the trace element. It is occurring due to fluorine (commonly referred to in its ionic state as Fluoride) within an organism. Fluorosis is not limited to humans, and can affect any aspect of the ecosystem.

It could well be the result of fluorosis. It is mostly affect people in rural India with no access to safe drinking water. It's time to include it in the long list of urban lifestyle diseases.
Fluoride can affect bones and skeleton, due to this severe pain in major joints. 66 million people in India, including 6 million children, either affected or at high risk of fluorosis. This includes 6 million children in the 6-14 age groups.

Fluorosis is a crippling and painful disease due to caused by intake of fluoride. Fluoride can enter the body through drinking water, food, toothpaste, mouth rinses and other dental products; drugs, and fluoride dust and fumes from industries using fluoride containing salt and or hydrofluoric acid.
Dental fluorosis occurs in children who are exposed to a high intake of fluoride before the teeth fully mineralize. It is mainly accour in children before 12-14 years of age. The disease is more prevalent in rural areas where drinking water is use from wells or hand pumps. The disease is more likely to occur in areas where the drinking water has a fluoride content of more than 1ppm (part per million), and in children who have a poor intake of calcium.

Symptoms

Fluorosis may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of symptoms and whether they are indeed symptoms of fluorosis. The list of symptoms mentioned in various sources for Fluorosis includes :-
Chalky white teeth patches
Yellow stained teeth
Brown stained teeth
Discolored teeth
Weak teeth

Treatment

Many people with spinal stenosis can be effectively treated with conservative measures. But if you have disabling pain or your ability to walk is severely impaired, your doctor may recommend spinal surgery.
Vitamins C and D, and, salts of Calcium, Magnesium or Aluminum were prescribed in an attempt to reverse these effects. The choice of the reported therapy was logical. The presence of calcium in gut directly affects the absorption of fluoride ions and will also improve serum calcium levels. Vitamin D in low doses enhances calcium absorption and retention without causing hypercalcemia and thus directly affects the absorption of fluoride ions. It also inhibits the excessive release of parathyroid hormone thereby preventing excessive activation of osteoblasts thus preventing hyperosteoidosis and osteopenia.
http://www.marketingarticlebank.com

Ethiopia: Over 14 Million At Risk of Fluorosis - Ministry

More than 14 million Ethiopians may be potentially at risk of fluorosis, the Ministry of Water Resources announced at a workshop on Fluorosis Mitigation Learning Exchange held from from 4- 5 March 2008 in Addis Ababa. A recent assessment of Fluoride, Fluorosis and Defluoridation issues reported that, out of those at risk, approximately 85% may have already been exposed to high fluoride contamination. Excessive fluoride is the most serious water sanitation problem, mainly in the Ethiopian Rift Valley system affecting areas in Afar , Oromia, and the Southern Nations, Nationalities and peoples regional states, including some parts of Gambela Regional State. A high level National Fluorosis Mitigation Steering Committee composed of Ministers and Heads of relevant agencies has been re-established to coordinate fluorosis mitigation efforts in Ethiopia.

Source: Binyam Tamene, The Daily Monitor, allAfrica.com, 6 Mar 2008

http://washafrica.wordpress.com/2008/03/20/ethiopia-over-14-million-at-risk-of-fluorosis-ministry/

Environmental Geology

Survey:

Fluorine distribution in waters of Nalgonda District, Andhra Pradesh, India
Journal Environmental Geology
Publisher Springer Berlin / Heidelberg
ISSN 0943-0105 (Print) 1432-0495 (Online)
Issue Volume 21, Numbers 1-2 / April, 1993
DOI 10.1007/BF00775055
Pages 84-89
Subject Collection Earth and Environmental Science
SpringerLink Date Monday, December 13, 2004

A Study:
Abstract Geochemical and hydrochemical studies were conducted in Nalgonda District (A.P.), to explore the causes of high fluorine in waters, causing a widespread incidence of fluorosis in the local population. Samples of granitic rocks, soils, stream sediments, and waters were analyzed for F and other salient chemical parameters. Samples from the area of Hyderabad city were analyzed for comparison. The F content of waters in areas with endemic fluorosis ranges from 0.4 to 20 mg/l. The low calcium content of rocks and soils, and the presence of high levels of sodium bicarbonate in soils and waters are important factors favoring high levels of F in waters.
http://www.springerlink.com/content/j7074q47g4612829/

Skeletal Fluorosis

Skeletal Fluorosis

Dr. D. Raja Reddy., F.R.C.S., F.R.A.C.S. Apollo Hospital & Dr. Srikanth R.Deme., F.R.C.S.C

Introduction: Fluorine, a gaseous element is a halogen which being most electronegative and reactive of all elements does not occur in free form in nature। This element was isolated in 1886 by Nobel laureate Henri Moissan and it combines directly with most elements and indirectly with few to form fluorides. Fluorides are ubiquitous in nature and are present in rocks, soil, water, plants, foods and even air.

The relationship between fluoride and dental caries was first noted in the early part of the 20th century when it was observed that residents of certain areas of U.S.A. developed brown stains on their teeth. These stained teeth, though unsightly were highly resistant to dental decay and caries (Black and May 1916). In the 1930's it was discovered that the prevalence and severity of this type of mottled enamel was directly related to the amount of fluoride in the water (Smith et al. 1931). Subsequently it was recognized that fluoride consumption in optimal amounts in the water supply imparted protection against the development of dental caries without staining the teeth (Dean 1938). Another benefit of fluorides is that the incidence of osteoporosis seems to occur less frequently in regions with high fluoride content in water than in those in which the inhabitants consumed little fluoride. Although, the importance of this element to normal mineralization of hard tissues and formation of caries resistant enamel has been recognized, there has been as yet no conclusive evidence proving that it is an essential element for human health (McClure 1970). Indeed, fluoride deficiency syndrome is yet to be described. This may be due to the fact that human body requirement of this micronutrient must be small, which is met with naturally through food and water. Excessive ingestion of fluoride through water, food or dust causes acute toxicity or a debilitating disease called 'fluorosis' a term coined and first used by Cristiani and Gautier in 1925. Acute fluoride intoxication is rarely seen and results most frequently from accidental ingestion of large amounts of fluoride compounds. The acute lethal dose of fluoride for the 70 kg man is 2.5-5.0 grams. Chronic fluoride poisoning is more common and can affect animals as well as humans. Excessive intake during pre-eruptive stage of teeth leads to dental fluorosis and further continued ingestion over years and decades causes bony or skeletal fluorosis. Lastly crippling disease produces neurological manifestations. A disease in animals called 'gaddur' believed to have arisen from fluoride intoxication caused by periodic volcanic eruptions that have been taking place since 1000 AD is mentioned in Icelandic literature (Roholm 1937). A disease of the teeth and bones of horses and cattle called 'darmous' was known to have been prevalent in North African coast for centuries and later came to be identified as one caused by fluorides (Velu 1933).

All states of India except northeast reported cases of fluorosis and 25 to 30 million people are exposed to high fluoride intake and half a million suffer from skeletal fluorosis। In China 300 million people are living in endemic areas of fluorosis of whom 40 million have dental fluorosis and 3 million suffer from skeletal changes (Li and Cao 1994).

Total daily fluoride intake: The fluoride contents from all the sources determine the human intake of fluoride. In majority of endemic areas around the world, the main contribution is from water and only in few areas of India and China significant amounts come from foods and rarely the polluted air is the culprit. The estimated range of safe and adequate intake of fluorides for adults is 1.5 to 4.0 mg per day and it is less for children and those with renal disease. The daily intake of fluoride in endemic regions varies from 10 to 35 mg and can be even higher in summer months.

Dental fluorosis: Dental fluorosis mainly involves enamel but severe intoxications may affect dentine as well as pulp. Enamel fluorosis occurs when fluoride concentrations in or in the vicinity of the forming enamel are excessive during its pre-eruptive development. Mottling of teeth is one of the earliest and most easily recognizable features noticed in the first decade of life.
Both sexes are equally affected। It is the permanent teeth that are affected and they lose their normal creamy white translucent color and become rough, opaque and chalky white. Pitting and chipping are other marks of fluorosis. Brown or black pigment gets deposited on the defective enamel and once established tends to remain there permanently. Incidence of dental fluorosis in endemic areas exhibits a linear relationship to the fluoride content of water but it may also vary with other factors (Jolly et al 1968). Dental fluorosis does not obviously occur, when there has been no exposure to fluoride in the first decade of life.
http://images.google.co.in/imgres?imgurl=http://www.medvarsity.com/vmu1.2/dmr/dmrdata/cme/fluorosis/gifs/Map-1.gif&imgrefurl=http://www.medvarsity.com/vmu1.2/dmr/dmrdata/cme/fluorosis/Fluorosis.htm&h=649&w=419&sz=84&hl=en&start=19&um=1&tbnid=uHXpbJgq9TQ9BM:&tbnh=137&tbnw=88&prev=/images%3Fq%3Dfluorosis%26um%3D1%26hl%3Den%26client%3Dfirefox-a%26rls%3Dorg.mozilla:en-US:official%26sa%3DG