Fluoride Water Information by Ray Sahelian, M.D.

Fluoride is a mineral in drinking water. In the United States fluoride is deliberately added to drinking water to strengthen teeth. But can this fluoride in drinking water be excessive and lead to damage to bones and teeth? Hundreds of thousands of people in the United States may consume water that is at or above the government's standard because of naturally occurring fluoride. Children exposed to the government's current maximum fluoride limit risk developing severe tooth enamel fluorosis, a condition characterized by discoloration, enamel loss and pitting of the teeth. The EPA allows up to 4 milligrams of fluoride per liter of drinking water.

Fluoride Danger
Rodent studies show excess fluoride in the water leads to oxidative stress, DNA damage and apoptosis. Danger of fluoride can be reduced by using less toothpaste with fluoride.

Fluoride Toothpaste
Fluoride toothpastes may prevent and control dental caries. Fluoride toothpastes may also be a risk factor in dental fluorosis. There is a debate in the scientific community regarding the appropriate use of fluoride in toothpaste in order to maximize the benefit and minimise the risk of excess fluoride exposure. Three factors have an important influence on the anticaries efficacy of fluoride toothpaste, namely concentration, frequency of brushing and post brushing rinsing behavior. The evidence suggests that low-fluoride (<600 ppm F) toothpastes provide less caries protection than standard (1,000 ppm F) or high (1,500 ppm F) concentration formulations. However, low-fluoride toothpastes are appropriate for very young children (under 7 years) at low caries risk, particularly if living in fluoridated areas. For other young children, a standard concentrations of fluoride could be used except in communities where the water supply has adequate amounts of fluoride. Small amounts of toothpaste are comparable in efficacy to large amounts. The risk of fluorosis is associated with the ingestion of high doses of fluoride during tooth development and consequently mostly young children are at risk. The variability in the dose of fluoride ingested is mainly a function of the amount used, less so its concentration. To minimise fluorosis risk, parents should be advised to use only a pea-sized amount of toothpaste and encourage spitting out of excess. It is concluded that by using fluoride toothpastes appropriately, the benefits can be maximised and the risks of fluorosis minimised. However, since there is concern that some communities may have more fluoride in their water than necessary, it may be a cautious approach for the time being to use low fluoride toothpastes until more information is gathered.

Absorption of Fluoride
F
luoride from salt (sodium fluoride) or fluoride in water is absorbed from the stomach and intestines. Because fluoridated salt is almost always ingested with food, absorption from the gastrointestinal tract may be delayed or reduced and, therefore, peak plasma concentrations are lower than when fluoride is ingested with water. The amount of ingested fluoride that is finally absorbed, however, is not appreciably affected unless the meal is composed mainly of components with high calcium concentrations. In this case, the extent of fluoride absorption can be reduced by as much as 50%. Fluoridated salt is ingested less frequently than fluoridated water.

Measuring Fluoride Level
Fingernail fluoride concentrations reflect fluoride exposures from drinking water, toothpaste and the work environment.

Fluoride Questions
Q. Dear Dr. Sahelian, please refer to the following website. I have been studying about the detrimental effects of fluoride in our water and other sources of fluoride contamination. It turns out tea just naturally absorbs fluoride, especially green tea. So despite its various health benefits, there are apparently some serious drawbacks as well. It will be very hard for me to accept advice to drink it without the possibility of contamination by this poison. I don’t know if you are aware of this situation or not. I hope this helps you to understand more of what we are constantly up against in our food supplies. This article comes from a man trying to sell his brand of tea, claiming it is lower in fluoride because of the way it is processed. http://www.foodnavigator-usa.com/news/ng.asp?id=58604-calls-for-fda I hope this will enlighten you and your staff to this situation. Imagine a well meaning consumer hoping to improve his/her health only to be adding to their problems. What about athletes and construction workers drinking huge amounts of water with toxic fluoride in it and then drinking green tea or other teas with huge additional amounts of fluoride in it? It is no wonder why we have osteoporosis and hypothyroidism at escalating levels in this country. Thank you for all you do to help your readers navigate the world of nutrition and supplements. I have been reading your newsletters and ordering products formulated by you for several years now. You are a breath of fresh air.
   A. Thank you for the positive feedback. Some studies have shown that drinking tea has health promoting potential. I think we have to look at the final result (health promotion with drinking tea) rather than analyze every single mineral or substance in a food or drink. Japanese have been drinking green tea for a long time, and if it is true that it has a high fluoride level, apparently it is not affecting their longevity. I also believe in alternating a variety of teas and not just drink the same one from the same company all the time. I have at least a dozen different herbal teas on my kitchen counter. I also think it is important to ingest a variety of fluids, not just tea. For instance coffee, vegetable juices, diluted fruit juices, etc. But, thanks for bringing the connection of fluoride and green tea to our attention, we will keep a close eye on what additional studies indicate.

Fluoride content in tea and its relationship with tea quality.
J Agric Food Chem. 2004 Jul 14;52(14):4472-6. Department of Tea Science, Zhejiang University, 268 Kaixuan Road, Hangzhou 310027, People's Republic of China.
The tea plant is known as a fluorine accumulator. Fluoride content in fresh leaves collected from 14 plantations in China was investigated. The fluoride increased with maturity, and the fluoride variation was remarkable in the tender shoots. Furthermore, significant negative relationships were observed between fluoride content and the content of the quality parameters total polyphenols and amino acids. These substances are rich in young leaves and poor in mature ones. With regard to quality of tea products, the relationship with fluoride content was studied using 12 brands of tea products in four categories: green tea, oolong tea, black tea, and jasmine tea collected from six provinces. The fluoride level increased with the decline in quality and showed good correlation with the quality grades. The results suggest that the fluoride content could be used as a quality indicator for tea evaluation.

Fluoride questions and emails
Q. I was shocked when I recently learned that the chemicals used to fluoridate most of America' s water supply were never approved by the FDA as fit for human consumption. They are industrial grade waste products - fluorosilicate compounds. Fluoride is a potent toxin ranging between lead and arsenic in acute toxicity. Fluoride exposure is excessive as it is found in food (pesticide residue), beverages made with fluoridated water, also in wine and tea in addition to dental products. New studies have linked it with serious health concerns - The publication in 2006 of a 500-page review of fluoride toxicology by a distinguished panel appointed by the National Research Council - (part of the US National Academy of Sciences) lists them: bone fractures, decreased thyroid function, impaired glucose tolerance, brain cell damage, lowered IQ, kidney damage, arthritic-like conditions, symptoms characteristic of Alzheimer's disease and cancer. Isn't it about time the American people learn what's in their water and why it shouldn't be?
   A. I have not studied the fluoride problem in enough detail to have a well thought out opinion at this time.

Q. There is a company that sells a tincture of tamarind herb. What are your thoughts on tamarind as a detox for too much fluoride.
   A. I have come across one human research regarding the use of tamarind herb and its effect on fluoride levels in the body.