We no longer paint with lead paint, use asbestos in buildings, or dump our raw sewage in the Congaree River. However the intentional contamination of our water supply with what is now 1.1 million lbs. of fluoridation chemicals per year just keeps going, with little public attention or protest.

The year was 1965 when Columbia city council voted unanimously to add one part per million of fluoride to our water supply – a program which continues to this day. Back then, lead was still used in house paints and as an additive in gasoline despite 20 years of knowledge that lead exposure was causing brain damage in many children. Asbestos was still in widespread use for fireproofing and insulation, despite knowledge of the lung diseases it caused. Here at home, Columbia was still dumping its raw sewage into the Congaree River, causing drivers on the Gervais St. bridge to roll up their windows because of the stench.  We no longer paint with lead paint, use asbestos in buildings, or dump our raw sewage in the Congaree River. However the intentional contamination of our water supply with what is now 1.1 million lbs. of fluoridation chemicals per year just keeps going, with little public attention or protest.

1965: Debate raged over initial fluoridation of Columbia water supply 
It wasn’t always that way. Water fluoridation was actually one of the major issues of the 1950s and 60s, both locally and across the U.S.  When Columbia city council called a public hearing on water fluoridation to take place on Feb. 18, 1965, the Columbia Record headlined the fluoridation controversy as a “Politician’s Nightmare.”  The Record predicted that the fluoridation hearing “promises to be one of the liveliest and most interesting in years.” Even with special rules in force to limit debate, the hearing lasted almost 3 hours in a Columbia city chambers packed with close to 200 people.

Speaking in support of water fluoridation at that hearing were representatives of local medical and dental societies and local health officials, along with representatives of the PTA, the Columbia League of Women Voters, and the Richland Sertoma Club. Speaking against fluoridation were members of the Columbia Pure Water Committee, an ad hoc citizens group, along with a representative of the Church of Christian Scientists.

In addition, both sides of the debate featured a member of the prominent Gibbes family. Mrs. Robert Gibbes, speaking in favor of fluoridation, was followed by Mrs. Heyward Gibbes, speaking in opposition.

On April 6, 1965 – nearly two months later - city council voted unanimously to fluoridate, denying a last minute appeal for a referendum by the Columbia Pure Water Committee.  (At that time, both Greenville and Charleston voters had recently rejected fluoridation in referenda.)  Mayor Lester Bates denied the call for a referendum, saying that, “We do not think that this is a matter for a vote as it would only divide our people.”

Before the city council vote, Mayor Bates read a prepared statement, declaring that “council could not ignore … expert professional opinion presented by so many respected dentists and physicians … in our communities.” Mrs. T.C. Baker of the Columbia Pure Water Committee responded that “the public does not know anything about fluoridation, only the propaganda that comes from Washington. The public has not had the opportunity to hear the other side.” It is an argument still being made by fluoridation opponents today.

Following the vote, letters of protest appeared in the Columbia Record. Opponents of fluoridation were giving city council an earful as well. In a May 14, 1965 letter thanking the Columbia League of Women Voters for supporting fluoridation, Councilman Hyman Rubin noted that, “attacks upon fluoridation through mail to city officials and on ‘open mike’ continue. This is not an easy matter to terminate…”

Opponents of fluoridation made their last stand in the state courts. On May 12, 1965 Carlton Hall, a sufferer from severe spinal arthritis, filed a lawsuit against the city of Columbia, seeking an injunction against fluoridation of city water, claiming that it violated his constitutional right to due process and equal protection.  (High fluoride consumption was even then linked an arthritis-like condition called skeletal fluorosis.)

The lead witness for the city of Columbia in support of fluoridation was Dr. Charles James, representing the Columbia Medical Society and the Richland County Medical Society. On the question of fluoride’s safety, Dr. James testified that fluoride “has stood the test of time,” pointing out that Conway has high natural levels of fluoride in the groundwater it uses for its water supply. He admitted that fluoride was a poison, but only “in the same sense that sodium chloride is a poison, salt is a poison.” Dr. James asserted that fluoride “is essential to the body,” comparing it at one point to a vitamin and later to a nutrient (iron). He even claimed at one point that tooth decay was a deficiency disease caused by a lack of fluoride – an assertion he later qualified.

As for any long term effects, Dr. James testified that, “The long range effect on individuals has been adequately investigated now, and the so-called cumulative effect has been of little importance.” What was the margin of safety for water fluoridation? Dr. James claimed that there was a large margin of safety, that it would take “8 to 20 times the recommended amount [of 1 part per million to] …produce certain changes in the bone. If you give 50 times, you can affect the mentality [sic].”

What we know about fluoride today Effects on brain chemistry
Compare Dr. James’ 1965 testimony with what is now known about fluoride, according to the recently published “Fluoride in Drinking Water, A Scientific Review of EPA Standards” by the National Research Council (a division of the National Academies). Here is how the NRC review describes the current state of knowledge on the neurochemical and biochemical changes produced by fluoride:

“Because of the great affinity between fluoride and aluminum, it is possible that the greatest impairments of structure and function [of the brain due to fluoride in drinking water] come about through the actions of charged and uncharged AlFx complexes … It appears that many of fluoride’s effects, and those of the aluminofluoride complexes, are mediated by the action of Gp, a protein of the G family. G proteins release many of the best known transmitters of the central nervous system. … The AlFx binds to GDP and ADP altering their ability to form the triphosphate molecules essential for providing energies to the brain. Thus, AlFx not only provides false messages throughout the nervous system, but at the same time, diminishes the energy essential to brain function. More research is needed to clarify fluoride’s biochemical effect on the brain.”

The NRC review did point out that because “the brain is a highly redundant and dispersed communication system, … observable alterations in mental and motor actions might require the formation of a multitude of false messages in a number of brain circuits acting over a long period of time.”
The NRC review also had this to say about a possible relationship between fluoride and dementia:

“The possibility exists that chronic exposure to AlFx can produce aluminum inclusions with blood vessels [in the brain] …  [which] could cause turbulence in the blood flow and reduced transfer of glucose and O2  to the intercellular fluids. …  Fluorides also increase the production of free radicals in the brain through several different biological pathways. These changes have a bearing on the possibility that fluorides act to increase the risk of Alzeimer’s disease … Histopathological changes similar to those traditionally associated with Alzeimer’s disease in people have been seen in rats chronically exposed to AlFx.”
In contrast to Dr. James’ testimony 40 years ago that it would take “50 times the recommended amount [i.e., water containing 50 ppm fluoride] … to affect the mentality,” the recent NRC review looked at three Chinese studies performed over the last 12 years which suggest that the threshold of such effects may be less than a factor of 2.5. The cited studies compared the performance on IQ tests of children living in villages with differing fluoride concentrations in the drinking water. In the study considered by the NRC review to have “the strongest design,” children drinking water with 2.47 ppm fluoride were compared with children drinking water containing 0.36 ppm fluoride.  IQ scores of both males and females declined with increasing fluoride concentration in the water. The NRC review concluded that “although the studies lacked sufficient detail … to fully assess their quality and relevance to U.S. populations, the consistency of the collective results warrant additional research on the effects of fluoride on intelligence.”

Reports of reduced thyroid function, low IQ, bone cancer
Dr. James’ claims about fluoridation’s margin of safety look even more tenuous when examining research on thyroid effects.  The recent NRC review cites research showing reduced thyroid function at fluoride doses of 0.05-0.10 mg/kg of body weight/day, down to 0.03 mg/kg/day for people with deficient iodine in their diets. How does this relate to the doses of fluoride that Americans drinking fluoridated water receive?  According to exposure assessments presented in the NRC review, average fluoride exposure for almost all age groups drinking fluoridated water exceeds 0.03 mg/kg/day. Average fluoride exposure for non-nursing infants drinking formula made with fluoridated water is listed as 0.087 – 0.115 mg/kg/day, well into the threshold for thyroid effects. High water intake individuals such as outdoor workers receive 0.084 mg/kg/day, and adults with uncontrolled diabetes receive 0.084 - 0.164 mg/kg/day, with even higher exposure levels for diabetic children.

The NRC review even speculates that impaired thyroid function might explain the results of the Chinese IQ studies:

“Subclinical hypothyroidism is associated with increased cholesterol concentrations, increased incidence of depression,  … cognitive dysfunction, and, in pregnant women, decreased IQ of their offspring.” 

Fluoride can also affect other parts of the endocrine system. Because fluoride concentrates in the pineal gland, the NRC review states that, “Fluoride is likely to cause decreased melatonin production and to have other effects on normal pineal function, which could contribute to a variety of effects in humans.

Whether fluoride affects pineal function remains to be demonstrated in humans,” – i.e., more research is needed.  The NRC review also notes that, “Impaired glucose tolerance in humans has been reported in separate studies at fluoride uptakes of 0.07–0.4 mg/kg/day,” which, at least at the low end, is in the range of exposures from fluoridated water.  Wide variability of  response to fluoride exposures was found, which “could be due to differences in age, sex, nutrient uptake [especially iodine and selenium], general dietary status, and other factors.”

Since a large percentage of the fluoride you ingest is stored in your bones, attention has traditionally focused on fluoride’s effects on bones and joints. This was the case at the trial here in 1965, in which the plaintiff maintained that drinking fluoridated water would make his arthritis worse. A well-documented long-term effect of drinking water containing high levels of fluoride is skeletal fluorosis, which is endemic in parts of India where the groundwater is high in fluoride. Severe cases of skeletal fluorosis are crippling and milder cases produce arthritis-like symptoms. 

According to the NRC review, “The [NRC] committee found that bone fluoride concentrations estimated to be achieved from lifetime exposure to fluoride at 4 mg/l and 2 mg/l (i.e., 2ppm - twice the standard fluoridation rate) fall within or exceed the range historically associated with stage II (arthritis-like) and stage III (crippling) skeletal fluorosis.  However, this comparison alone is not sufficient evidence to conclude that individuals exposed to fluoride at those concentrations are at risk of stage II skeletal fluorosis.”

This contrasts with the testimony of pro-fluoridation physicians at the trial here in Columbia 42 years ago. Dr. Charles James, representing the local medical societies, testified that, “As far as all the evidence thus far presented has shown, [the intake of fluoride into the system of one having arthritis] would have no effect whatsoever, if anything, perhaps a beneficial effect.”

The Columbia city health officer at that time, Dr. Charles Sloan, went even further, testifying that “there is some evidence being presented by a medical group in New England that fluorides are effective in helping to prevent and possibly helping to alleviate the arthritis of old age. I am impressed with this to such an extent that I take a double dose of sodium fluoride every day myself.”

Since fluoride is stored in the bones, this has long been considered a likely site for any carcinogenic effects of fluoride. In fact, a 2001 study from Harvard Medical School found a 5-7 fold increase in osteosarcoma (a rare, often-fatal bone cancer) in young men associated with exposure to fluoridated water in their 6th, 7th, and 8th years of life. It took a front page expose in the Wall Street Journal (July 22, 2005) to finally get the study published in 2006. This study provides evidence for but does not prove a definite relationship between fluoridation and osteosarcoma in young men.

Fluoridation’s disappearing rationale
At the time of Columbia’s fluoridation trial in 1965 the belief was that water fluoridation reduced cavities by being ingested by small children and then incorporated into developing teeth at the time of their eruption. At the trial, the lead witness testifying in support of fluoridation admitted that fluoridation would be of dental benefit only to children up to 8 years old. Although fluoride toothpaste had been available since the 1950s, it was then considered relatively ineffective in reducing cavities. Testifying in support of fluoridation at the trial, Dr. William Draffin, a past president of the South Carolina Dental Association, stated that:

“I’ve had occasion … to see where topical applications (i.e., fluoride toothpastes and gels) are applied,  … and this is not nearly as effective a measure as results from areas where the individual has naturally fluoridated water.”

However, since at least the early 1990s this notion has been turned on its head - i.e., it is now well accepted that the primary anti-caries activity of fluoride is by contact with the outside of the teeth.

Even the U.S. Centers for Disease Control, the primary government agency promoting fluoridation today, admits this:

“Fluoride’s caries preventative properties were initially attributed to changes in enamel during tooth development … because of a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. However, laboratory and epidemiological research suggests that fluoride prevents dental caries primarily after eruption of the tooth into the mouth, and its actions are primarily topical [i.e., from contact with the tooth surface] for both adults and children.”

This begs the question: if fluoride is most effective applied directly to the surface of the teeth, how much difference can 1 part per million of fluoride in drinking water make, in comparison to the 1,000 parts per million of fluoride brushed onto the teeth in toothpaste? 

The largest U.S. study, commissioned by the National Institute for Dental Research in 1990, did find a reduction in dental caries in fluoridated areas, but it was microscopic – 0.6 decayed, missing, or filled surfaces per person, where each tooth has 5 surfaces. Even this small difference has been challenged based on an independent analysis of the study’s raw data.  Other large-scale studies done in Australia and New Zealand have found even smaller reductions in cavities, or no significant difference at all.

Yet at the 1965 trial here in Columbia, witnesses in support of fluoridation repeatedly testified that tooth decay could be reduced by 60-65 percent by fluoridating the city water supply.  This assertion was well accepted at the time based on two studies by H. Trendley Dean that launched the fluoridation campaign after World War II – studies that have since been challenged as flawed. 

In fact, the rate of dental caries in the U.S. has dropped dramatically since the campaign to fluoridate America’s drinking water began in earnest in 1951. However, this reduction in cavities has not been limited to localities or even countries where drinking water is fluoridated.  European countries without fluoridation have shown comparable declines in dental caries over the same period, presumably due to better diets, better dental hygiene, and the advent of fluoride toothpaste.