This story examines the ethical issues of water fluoridation. Fluoridation in the United State began in the early 1945. Grand Rapids, Michigan became the first city to implement community water fluoridation. By 2008, more than 72 percent of the U.S water supplies have been fluoridated (CDC, 2010). While claims have been made that fluoride added into water can be beneficial to prevent and even reverse tooth decay, more studies have shown it’s causing more harm than good. The U.S. Food and Drug Administration (FDA) classifies fluoride as a drug when used to prevent or mitigate disease. Adding fluoride to water for the sole purpose of preventing tooth decay is a form of medical treatment. This raises ethical questions of fluoridation being forced upon the population without the people’s consent and without due regard for the unique medical circumstances of those who may be adversely affected.
Student Researcher: Jiakai Lin, Indian River State College
Faculty Evaluator: Elliot D. Cohen, Ph.D., Indian River State College
Carlsson, A. (2000). Water fluoridation. Retrieved from http://www.fluoridealert.org/issues/water/medical-ethics/
Carlsson, A. (2001, August). Nobel Laureate Opposes Fluoride. Retrieved from http://www.slweb.org/carlsson.html
CDC. (2010). 2008 Water Fluoridation Statistics. Retrieved from http://www.cdc.gov/fluoridation/statistics/2008stats.htm
Connet, P. (2011, August). 50 reasons to oppose fluoridation. Retrieved from http://www.fluoridation.com/fluorideindrinkingwater.htm
Mercola, J. (2011, January). The Toxin So Dangerous. Retrieved from http://articles.mercola.com/sites/articles/archive/2011/01/22/does-fluoride-really-fight- cavities.aspx
Wikipedia.com. (2012). Arvid Carlsson. Retrieved from http://en.wikipedia.org/wiki/Arvid_Carlsson#cite_ref-Barondes_1-2
Wikipedia.com. (2012). Fluoridation by Country. Retrieved from http://en.wikipedia.org/wiki/Fluoridation_by_country
Fluoridation is unethical. Unlike all other water treatment processes, fluoridation does not treat
the water itself, but the person consuming it. The FDA accepts fluoride as a drug, not a nutrient, when used to prevent disease. By definition, therefore, fluoridating water is a form of mass medication. No doctor can force a patient to take a particular medicine. Fluoridation violates medical ethics in depriving the individual of his or her right to informed consent to medication. The safety and effectiveness of fluoridated water has never been demonstrated by randomized controlled trials which is a gold standard required for a drug to enter the market (Carlsson, 2000).
Safety of fluoridation also raises questions due to the lack of studies done. Meanwhile, many other studies have shown the dangers of fluoride and why we should avoid fluoridated water at all cost. The danger of using fluoridated water outweighs the benefit of preventing tooth decay (Mercola, 2011). Dr. Pual Connett, Dr. Arvid Carlsson and many of others have done extensive studies on fluoride and the effects it has on the human body. Dr. Pual Connett, the 2000 Nobel Laureate in Medicine and Physiology, is one of the scientists who helped keep fluoridation out of Sweden. In “50 Reasons to Oppose Fluoridation,” Dr. Connett stated 50 reasons why we should avoid fluoridation.
Some of his concerns of fluoridation were accumulation of fluoride over time. It can be harmful to every organ in the body especially infants and kids who cannot filter out fluoride as fast as an adult. Dosage of fluoride cannot be controlled once it is mix into water. Once fluoride is added into water it is impossible to control the dose each individual receives because everyone drink different amount of waters each day. We also get fluoride from many other sources beside in our water each day. We are exposed to fluoride through food and beverages processed with fluoridated water, fluoridated dental products, pesticide residues and more. Over time the
buildup of fluoride can attack mostly any part of the body such as the brain, pineal gland, thyroid, bone, kidney and more (connett, 2011).
Dr. Arvid Carlsson is a Swedish scientist, also awarded with Nobel Prize in Physiology and Medicine in 2000. His standpoint on fluoridation is identical with Dr. Connett. Dr. Carlsson also took part in the debate in Sweden, opposing fluoridation of drinking water. He believes water fluoridation violates modern pharmacological principles which indicate that medication should be tailored to individuals (Wikipedia, 2012). As explained by the American Medical Association, the doctor must inform the patient of the medicine’s benefits, side effects, and alternatives and then allow the patient to decide whether to take it or not. He feels fluoridation is an outdated one size fits all approach to medicine. In modern pharmacology, it is well known that individuals respond very differently to the same dose of a given drug. A drug that might be safe for this particular person may be toxic to someone else. This rule applies to fluoride as well (Carlsson, 2001).
He described fluoridation as delivering fluoride for a lifetime without oversight of a doctor. There is no systematic or comprehensive program to track level of fluoride building in people’s tissues, or to monitor the side effects that may be occurring. Furthermore, fluoridation has never been proven safe or effective. Although fluoridation has been going on for over 60 years and consumed by more than 180 million Americans on a daily basis, there has never been a single randomized controlled trail to insure public safety (Carlsson, 2000). In recent years, sky rocketing increase of dental fluorosis has become more recognized by scientists worldwide as the first clinical sign of fluoride poisoning. This clearly indicates fluoride ingestion is out of control.
For over 60 years, the safety of fluoridation has been a concern. Several countries that have started fluoridation have stopped or rejected the idea due to potential dangers of fluoride.
Some of these countries include China, Austria, Belgium, Finland, Germany, Denmark, etc. Many of these countries felt it’s not worth taking the risk of adding fluoride into water while there’s plenty of better ways to prevent tooth decay. There’s only 5 percent of the world population drinking fluoridated water and more than 50 percent of these people live in North America (Wikipedia, 2012). Despite numerous countries banning fluoride from their water, U.S. government remains confident fluoride will cause no harm. With no test or study done on fluoride’s long term effect this raises ethical issues. It is unethical to perform mandatory fluoridation for people who do not want their water to be fluoridated. It’s a mass medication of public water supplies with an uncontrolled dose of fluoride. The risks of fluoridated water are clear and backed up by several studies. Nobody is safe unless we take action and join in on existing movements on banning fluoridation.