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Fluorides are properly defined as binary compounds or salts of fluorine and another element. Examples of fluorides include sodium fluoride and calcium fluoride. Both are white solids. Sodium fluoride readily dissolves in water, but calcium fluoride does not. Since the mid-1940s, sodium fluoride has been added to drinking water supplies and to a variety of dental products, including toothpastes and mouth rinses. Other fluoride compounds that are commonly used for water fluoridation are fluorosilicic acid and sodium fluorosilicate.
Water fluoridation has been carried out on the premise that fluoride's primary benefit to teeth comes from ingestion. However, the consensus among dental researchers today is that fluoride's limited benefit in preventing dental caries is topical not systemic. Health concerns expressed by opponents have largely been dismissed until recently. Now, evidence is mounting that in an era of fluoridated toothpastes and other consumer dental fluoride products, the potential risks from consuming fluoridated water outweigh any potential benefits.
Fluoride is a neurotoxin and is bio-accumulative in the body. The widespread distribution of fluoride in the environment through drinking water, dental products, food and in industry has been shown to cause numerous detrimental health effects. Though most controversy revolves around water fluoridation, fluoride is used in several other industrial applications.
Toothpaste Warning
Fluoride is not biochemically needed in the body or necessary for any human metabolic pathway. Not only has been shown to be a neurological toxin, it is an endocrine disrupting substance and in high or accumulative doses can damage the brain, bones, thyroid gland, pineal gland, affect fertility, and is linked to nerve diseases like Parkinson’s. Fluoride toxicity has been shown to cause or exacerbate diabetes, nutrient deficiencies, and kidney disease. Despite commercial ads, there is no such thing as ‘fluoride deficiency.’ Aside from the toxicological concern, the ethical issue is that these silicofluorides, widely used in water fluoridation, are unlicensed medicinal substances, administered to large populations without informed consent or supervision by a qualified medical practitioner.
Water fluoridation started at a time when asbestos lined our pipes, lead was added to gasoline, PCBs filled our transformers and DDT was deemed so “safe and effective” that officials felt no qualms spraying kids in school classrooms and seated at picnic tables. One by one all these chemicals have been banned, but water fluoridation remains untouched. Since the Public Health Service endorsed fluoridation in the 1940s, over 2/3 of United States reservoirs have been fluoridated with sodium fluoride and hydrofluosilicic acid (efforts are continually being made to significantly increase this proportion), the waste by-products of the aluminum and phosphate fertilizer industries. Substances that would cost these industries millions to store at Class 1 Hazardous Waste Sites, are instead sold to communities at great profit and added into our drinking water. Currently, the United States has more people drinking fluoridated water than the rest of the world combined. Most developed nations, including all of Japan, China and 97% of western Europe, do not fluoridate their water.
Healthy adult kidneys excrete only 50 to 60% of the fluoride ingested each day (Marier & Rose 1971). Infants and children excrete less fluoride from their kidneys and take up to 80% of ingested fluoride into their bones (Ekstrand 1994). Not only does fluoride accumulate in the body, largely in calcifying tissues such as the bones, but it also targets and accumulates in the pineal gland. When fluoride accumulates in our pineal gland, it possibly lowers the production of melatonin, a very important regulatory hormone (Luke, 1997, 2001).
Too much fluoride over a long time when teeth are forming under the gums can cause dental fluorosis. Dental fluorosis is a developmental disturbance of enamel which occurs during enamel forming. It is caused by systemic overexposure to fluoride during the first six years of life, when the enamel of the crowns of permanent teeth is formed. The enamel contains more protein, is porous, opaque and less transparent. Clinical manifestation varies from (quantitative) narrow, white horizontally running lines, larger patches or yellow to light brown colored areas of porous enamel, to (qualitative) loss of enamel in varying degrees.
The fluoride concentration in bone steadily increases over a lifetime (US National Research Council). Thus, fluoride accumulates in our bones and has been shown to make them more brittle and prone to fracture. Essentially, excess fluoride severely damages bone matrix formation and prevents hardening of bones. The weight of evidence from animal studies, clinical studies and epidemiological studies on this is overwhelming. Lifetime exposure to fluoride will contribute to higher rates of hip fracture in the elderly. There are also concerns about a possible connection between fluoridation and osteosarcoma in young men (Bassin 2006; Cohn, 1992), as well as water fluoridation and the current epidemic of hypothyroidism. Fluoride is a halogen and can compete with iodine -another halogen - on thyroid receptors. This can inhibit the thyroid’s ability to utilize iodine to create thyroxin. By far the most damming research on fluoride toxicity has focused on its detrimental effect on cognitive development and decreased IQ in children.
It has been shown by several researchers that water fluoridation is ineffective in reducing caries and that the decline in caries observed in various countries is not due to fluorides, but rather to improved hygiene and nutrition. This is supported by the fact that irrespective of whether the country ever fluoridated its water, rates of dental caries have declined. Indeed, most western countries do not fluoridate their water and yet their tooth decay rates have declined at the same rate as the U.S. and other fluoridated countries.
Some of the earliest opponents of water fluoridation were biochemists precisely because of fluoride’s known poisonous interactions with enzymes, the proteins which act as the catalysts for over 10,000 or so chemical reactions in the body. Dr. James Sumner, for example, who won a Nobel Prize for his work with crystallization of enzymes, said in the 1950s,
“We ought to go slowly. Everybody knows fluorine and fluorides are very poisonous substances and we use them in enzyme chemistry to poison enzymes, those vital agents in the body. That is the reason things are poisoned, because the enzymes are poisoned and that is why animals and plants die.”
There has been 13 other Nobel Laureates who have objected to fluoridation of water.
Perhaps the most worrisome concern is animal research suggests high levels of fluoride may be toxic to brain and nerve cells. Human epidemiological studies have identified possible links to learning, memory, and cognition deficits, though most have focused on populations with fluoride exposures higher than those typically provided by U.S. water supplies. A 2019 report by the National Toxicology Program (National Institute of Environmental Health Sciences National Institutes of Health) concluded that ‘fluoride is presumed to be a cognitive neurodevelopmental hazard to humans. This conclusion is based on a consistent pattern of findings in human studies across several different populations showing that higher fluoride exposure is associated with decreased IQ or other cognitive impairments in children. Additionally, randomized safety studies done on fluoride supplementation are scarce, very scarce. There is no accurate assessment of just how much fluoride individuals are taking into their bodies from water, dental procedures, and an array of other sources (see below).
In fact, the amount of fluoride now regularly consumed by many people in fluoridated areas exceeds the doses repeatedly linked to IQ loss and other neurotoxic effects; with certain subpopulations standing at elevated risk of harm, including infants, young children, elderly populations, and those with dietary deficiencies, renal impairment, and/or genetic predispositions.
Historically, there has been a delay, often of several decades, between the recognition of the adverse effects of a substance, such as DDT, asbestos and tobacco, and the reduction of exposure to it in the environment. The concern is emerging that as increased knowledge is obtained about the detrimental effects of fluoride from treated water and foods, it will be seen in a much less favorable light than it is viewed in today.
Other Sources of Fluoride
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Workplace exposure: Fluoride is an air contaminant in certain industrial workplaces. As a result, workers in many industries - including the aluminum, fertilizer, iron, oil refining, semi-conductor, and steel industries - can be routinely exposed to high levels of fluoride exposure. Thus, airborne fluorides can be a substantial daily source of fluoride intake for certain industrial workers.
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Dental products: Many dental products now contain fluoride, including over 95% of toothpaste. Studies show that a significant number of children swallow more fluoride from toothpaste alone than is recommended as a total daily ingestion.
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Processed beverages and foods: Even if you do not live in a community that adds fluoride to its water supply, you will still be exposed to fluoridated drinking water. This is because once fluoride is added en masse to water it ends up in almost all processed beverages and foods. In the U.S., studies have shown that sodas, juices, sports drinks, beers, and many other processed foods, including infant foods, now have elevated fluoride levels.
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Pesticides: Due bto its neurotoxicity, fluoride (sulfuryl fluoride) has been used as a pesticide and fumigant on stored grain, such as wheat and oats; dried fruit; coffee and cocoa beans; and other foods. It is also used for treatment of bed bugs, termites, rats, and mice. As a result, some food products, particularly grape products, dried fruit, dried beans, cocoa powder, and walnuts, may contain high levels of sulfuryl fluoride. When breathed in, sulfuryl fluoride is rapidly absorbed into the body. There, it breaks down into sulfate, fluoride, and fluorosulfate. These components move in the blood stream to many parts of the body. Collectively, these include the lungs, kidney, spleen, nasal tissues, and brain.
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Fluorinated pharmaceuticals: Many pharmaceuticals are fluorinated, meaning they contain a carbon-fluorine bond. Although the carbon-fluoride bond in most drugs is strong enough to resist breaking down into fluoride within the body, this is not always the case as research has found that some fluorinated drugs, including Ciprofloxacin, do break down into fluoride and can thus be a major source of fluoride exposure for some individuals. (Ciprofloxacin differs from other quinolones in that it structurally has a fluorine atom at the 6-25 position)
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Mechanically deboned meat: Foods made with mechanically separated meat (e.g., chicken fingers, nuggets, etc.) contain elevated levels of fluoride due to the contamination from bone particles that occurs during the mechanical deboning processed. Mechanically processed chicken meats exhibit the highest levels.
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Tea drinks: Tea is a hyperaccumulator of fluoride as tea plants hyper-absorb fluoride from the soil. As a result, tea leaves–particularly old tea leaves–contain elevated levels of fluoride. Brewed black tea averages about 3 to 4 parts ppm fluoride, while commercial iced tea drinks contain between 1 and 4 ppm. As a result of these elevated levels, numerous studies have linked excessive tea consumption to a bone disease (skeletal fluorosis) caused by too much fluoride intake.
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General Information on Fluoride Toxicity
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Akinrinade, Ibukun Dorcas, Adejoke Elizabeth Memudu, and Olalekan Michael Ogundele. "Fluoride and aluminum disturb neuronal morphology, transport functions, cholinesterase, lysosomal and cell cycle activities." Pathophysiology 22, no. 2 (2015): 105-115.
Alhusaini, Ahlam, Laila Faddaa, Hanaa M. Ali, Iman Hassan, Nagla F. El Orabi, and Yieldiz Bassiouni. "Amelioration of the Protein Expression of Cox2, NF κ B, and STAT-3 by Some Antioxidants in the Liver of Sodium Fluoride–Intoxicated Rats." Dose-Response 16, no. 3 (2018): 1559325818800153.
Barbier, Olivier, Laura Arreola-Mendoza, and Luz María Del Razo. "Molecular mechanisms of fluoride toxicity." Chemico-biological interactions 188, no. 2 (2010): 319-333.
Bassin, Elise B., David Wypij, Roger B. Davis, and Murray A. Mittleman. "Age-specific fluoride exposure in drinking water and osteosarcoma (United States)." Cancer Causes & Control 17, no. 4 (2006): 421-428.
Bayley, T. A., J. E. Harrison, T. M. Murray, R. G. Josse, W. Sturtridge, K. P. H. Pritzker, A. Strauss, R. Vieth, and S. Goodwin. "Fluoride‐induced fractures: Relation to osteogenic effect." Journal of Bone and Mineral Research 5, no. S1 (1990): S217-S222.
Bayless, J. Mark, and Norman Tinanoff. "Diagnosis and treatment of acute fluoride toxicity." Journal of the American Dental Association (1939) 110, no. 2 (1985): 209-211.
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Camargo, J. A. (2003). Fluoride toxicity to aquatic organisms: a review. Chemosphere, 50(3), 251-264.
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Chinoy, N. J., and M. R. Memon. "Beneficial effects of some vitamins and calcium on fluoride and aluminum toxicity on gastrocnemius muscle and liver of male mice." Fluoride 34, no. 1 (2001): 21-33.
Cohn, Perry D. "A brief report on the association of drinking water fluoridation and the incidence of osteosarcoma among young males." Trenton, NJ: New Jersey Department of Health and Environmental Health Services (1992).
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Li, Liang. "The biochemistry and physiology of metallic fluoride: action, mechanism, and implications." Critical Reviews in Oral Biology & Medicine 14, no. 2 (2003): 100-114.
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Marier, John R., and Dyson Rose. Environmental fluoride. Ottawa: National Research Council of Canada, 1971.
McDonagh, Marian S., Penny F. Whiting, Paul M. Wilson, Alex J. Sutton, Ivor Chestnutt, Jan Cooper, Kate Misso, Matthew Bradley, Elizabeth Treasure, and Jos Kleijnen. "A Systematic review of water fluoridation." Bmj 321, no. 7265 (2000): 855-859.
Shanmugam, Thangapandiyan, Miltonprabu Selvaraj, and Senthilraja Poomalai. "Epigallocatechin gallate potentially abrogates fluoride induced lung oxidative stress, inflammation via Nrf2/Keap1 signaling pathway in rats: An in-vivo and in-silico study." International immunopharmacology 39 (2016): 128-139.
Shashi, A., and S. P. Thapar. "Histopathology of fluoride-induced hepatotoxicity in rabbits." Fluoride 34, no. 1 (2001): 34-42.
Shivarajashankara, Y. M., A. R. Shivashankara, S. Hanumanth Rao, and P. Gopalakrishna Bhat. "Oxidative stress in children with endemic skeletal fluorosis." Fluoride 34, no. 2 (2001): 103-107.
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Viswanathan, Gopalan. Contribution of Infant Formula and Tea on Daily Fluoride Intake and Prevalence of Fluorosis Among Infants and Children. Food Quality: Balancing Health and Disease 13 (2018): 339.
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Whitford, Gary M. "The physiological and toxicological characteristics of fluoride." Journal of Dental Research 69, no. 2_suppl (1990): 539-549.
Cognitive Impairment, Reduced IQ and Neurological Development
Fluoride is a powerful central nervous system toxin and adversely affects brain functioning even at low doses. It can induce neuron apoptosis and decreased cerebral functions, plus impaired memory and learning ability. Findings published over 20 years clearly show an inverse association between high fluoride exposure and children’s intelligence. Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low-exposure or control areas. Studies also demonstrate fluoride to be a developmental neurotoxicant that affects children’s brain maturation at exposures much below those that can cause toxicity in adults.
Numerous studies indicate that both high and low fluoride exposure can affect the normal development and function of the cerebrum as well as the entire nervous system, causing a decrease in intellectual ability. The abundance of research demonstrating fluoride’s detrimental effect on children’s neurological development and IQ is one of the most serious concerns surrounding water fluoridation.
Aravind, A., R. S. Dhanya, Ajay Narayan, George Sam, V. J. Adarsh, and M. Kiran. "Effect of fluoridated water on intelligence in 10-12-year-old school children." Journal of International Society of Preventive & Community Dentistry 6, no. Suppl 3 (2016): S237.
Bashash, Morteza, Deena Thomas, Howard Hu, E. Angeles Martinez-Mier, Brisa N. Sanchez, Niladri Basu, Karen E. Peterson et al. Prenatal fluoride exposure and cognitive outcomes in children at 4 and 6–12 years of age in Mexico. Environmental health perspectives 125, no. 9 (2017): 097017.
Bashash, Morteza, Maelle Marchand, Howard Hu, Christine Till, E. Angeles Martinez-Mier, Brisa N. Sanchez, Niladri Basu et al. Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years of age in Mexico City. Environment international 121 (2018): 658-666.
Choi, Anna L., Ying Zhang, Guifan Sun, David C. Bellinger, Kanglin Wang, Xiao Jing Yang, Jin Shu Li, Quanmei Zheng, Yuanli Fu, and Philippe Grandjean. Association of lifetime exposure to fluoride and cognitive functions in Chinese children: a pilot study. Neurotoxicology and teratology 47 (2015): 96-101.
Choi, Anna L., Guifan Sun, Ying Zhang, and Philippe Grandjean. "Developmental fluoride neurotoxicity: a systematic review and meta-analysis." Environmental health perspectives 120, no. 10 (2012): 1362-1368.
Cui, Yushan, Bin Zhang, Jing Ma, Yang Wang, Liang Zhao, Changchun Hou, Jingwen Yu et al. "Dopamine receptor D2 gene polymorphism, urine fluoride, and intelligence impairment of children in China: a school-based cross-sectional study." Ecotoxicology and environmental safety 165 (2018): 270-277.
Das, Kousik, and Naba Kumar Mondal. "Dental fluorosis and urinary fluoride concentration as a reflection of fluoride exposure and its impact on IQ level and BMI of children of Laxmisagar, Simlapal Block of Bankura District, WB, India." Environmental monitoring and assessment 188, no. 4 (2016): 218.
Ding, Yunpeng, Huixin Sun, Hepeng Han, Wei Wang, Xiaohong Ji, Xuehui Liu, and Dianjun Sun. The relationships between low levels of urine fluoride on children's intelligence, dental fluorosis in endemic fluorosis areas in Hulunbuir, Inner Mongolia, China. Journal of hazardous materials 186, no. 2-3 (2011): 1942-1946.
El-lethey, Heba S., Mervet M. Kamel, and Iman B. Shaheed. "Neurobehavioral toxicity produced by sodium fluoride in drinking water of laboratory rats." J Am Sci 6, no. 5 (2010): 54-63.
Eswar, Pranati, L. Nagesh, and C. G. Devaraj. "Intelligence quotients of 12-14 year old school children in a high and a low fluoride village in India." Fluoride 44, no. 3 (2011): 168.
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Gao, Qin, Yan-Jie Liu, and Zhi-Zhong Guan. "Decreased learning and memory ability in rats with fluorosis: increased oxidative stress and reduced cholinesterase activity in the brain." Fluoride 42, no. 4 (2009): 277.
Grandjean, Philippe. "Developmental fluoride neurotoxicity: an updated review." Environmental Health 18, no. 1 (2019): 1-17.
Green, Rivka, Bruce Lanphear, Richard Hornung, David Flora, E. Angeles Martinez-Mier, Raichel Neufeld, Pierre Ayotte, Gina Muckle, and Christine Till. Association between maternal fluoride exposure during pregnancy and IQ scores in offspring in Canada. JAMA pediatrics (2019).
Jiménez, L. Valdez, OD López Guzmán, M. Cervantes Flores, R. Costilla-Salazar, J. Calderón Hernández, Y. Alcaraz Contreras, and D. O. Rocha-Amador. In utero exposure to fluoride and cognitive development delay in infants. Neurotoxicology 59 (2017): 65-70.
Karimzade, S., M. Aghaei, and A. H. Mahvi. "Investigation of intelligence quotient in 9–12-year-old children exposed to high-and low-drinking water fluoride in West Azerbaijan Province, Iran." Fluoride 47, no. 1 (2014): 9-14.
Kazi, Tasneem Gul, Kapil Dev Brahman, Hassan Imran Afridi, Faheem Shah, and Mohammad Balal Arain. Effects of high fluoride content in livestock drinking water on milk samples of different cattle in endemic area of Pakistan: risk assessment for children. Environmental Science and Pollution Research(2018): 1-6.
Khan, Suleman Abbas, Rahul Kumar Singh, Saumya Navit, Dheera Chadha, Nikita Johri, Pragati Navit, Anshul Sharma, and Rachana Bahuguna. "Relationship between dental fluorosis and intelligence quotient of school going children in and around Lucknow District: a cross-sectional study." Journal of clinical and diagnostic research: JCDR 9, no. 11 (2015): ZC10.
Kundu, Hansa, P. Basavaraj, Ashish Singla, Ritu Gupta, Khushboo Singh, and Swati Jain. "Effect of fluoride in drinking water on children's intelligence in high and low fluoride areas of Delhi." Journal of Indian Association of Public Health Dentistry 13, no. 2 (2015): 116.
Li, Jing, Li Yao, Qing-Liang Shao, and Chun-Yan Wu. "Effects of high fluoride level on neonatal neurobehavioral development." Fluoride 41, no. 2 (2008): 165-70.
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Mondal, D., G. Dutta, and S. Gupta. "Inferring the fluoride hydrogeochemistry and effect of consuming fluoride-contaminated drinking water on human health in some endemic areas of Birbhum district, West Bengal." Environmental geochemistry and health 38, no. 2 (2016): 557-576.
Mustafa, Damra E., and Umsalma Mohamed Younis. "The Relationship Between Fluoride Levels In Drinking Water and the Schooling Performance of Children in Rural Areas of Khartoum, Sudan." Fluoride 51, no. 2 (2018).
Na, Wei, Li Yi, Deng Jie, Xu Shiqing, and Guan Zhizhong. "The effects of comprehensive control measures on intelligence of school-age children in coal-burning-borne endemic fluorosis areas." Chinese Journal of Endemiology 33, no. 3 (2014): 321.
Nagarajappa, Ramesh, Piyush Pujara, Archana J. Sharda, Kailash Asawa, Mridula Tak, Pankaj Aapaliya, and Nikhil Bhanushali. "Comparative assessment of intelligence quotient among children living in high and low fluoride areas of Kutch, India-a pilot study." Iranian journal of public health 42, no. 8 (2013): 813.
Poureslami, Hamid Reza, Azadeh Horri, and Behshid Garrusi. A comparative study of the IQ of children age 7–9 in a high and a low fluoride water city in Iran. Fluoride 44, no. 3 (2011): 163-7.
Qin, Liansheng, Shuyi Huo, Ruiliang Chen, Yinzi Chang, and Mingyu Zhao. "Using the Raven’s Standard Progressive Matrices to determine the effects of the level of fluoride in drinking water on the intellectual ability of school-age children." Fluoride 41, no. 2 (2008): 115-119.
Razdan, Priyanka, Basavaraj Patthi, Jishnu Krishna Kumar, Nikhil Agnihotri, Prajakta Chaudhari, and Monika Prasad. "Effect of fluoride concentration in drinking water on intelligence quotient of 12–14-year-old children in Mathura district: A cross-sectional study." Journal of International Society of Preventive & Community Dentistry 7, no. 5 (2017): 252.
Ren, Dali, Kecheng Li, and Dawei Liu. "A study of the intellectual ability of 8-14 year-old children in high fluoride, low iodine areas." Fluoride 41, no. 4 (2008): 319-20.
Rocha-Amador, Diana, Maria Elena Navarro, Leticia Carrizales, Raúl Morales, and Jaqueline Calderón. "Decreased intelligence in children and exposure to fluoride and arsenic in drinking water." Cadernos de saúde pública 23 (2007): S579-S587.
Saxena, Sudhanshu, Anjali Sahay, and Pankaj Goel. "Effect of fluoride exposure on the intelligence of school children in Madhya Pradesh, India." Journal of neurosciences in rural practice 3, no. 2 (2012): 144.
Sebastian, Shibu Thomas, and S. Sunitha. "A cross-sectional study to assess the intelligence quotient (IQ) of school going children aged 10-12 years in villages of Mysore district, India with different fluoride levels." Journal of Indian Society of Pedodontics and Preventive Dentistry 33, no. 4 (2015): 307.
Seraj, B., M. Shahrabi, M. Shadfar, R. Ahmadi, M. Fallahzadeh, H. Farrokh Eslamlu, and M. J. Kharazifard. "Effect of high-water fluoride concentration on the intellectual development of children in Makoo/Iran." Journal of dentistry (Tehran, Iran) 9, no. 3 (2012): 221.
Seraj, B., M. Shahrabi, M. Falahzade, F. Falahzade, and N. Akhondi. "Effect of high fluoride concentration in drinking water on children’s intelligence." Journal of dental medicine 19, no. 2 (2006): 80-86.
Shivaprakash, P. K., Kushagra Ohri, and Hina Noorani. "Relation between dental fluorosis and intelligence quotient in school children of Bagalkot district." Journal of Indian Society of Pedodontics and Preventive Dentistry 29, no. 2 (2011): 117.
SINGH, VIVEK PRATAP, DUSHYANT SINGH CHAUHAN, SANDEEP TRIPATHI, VIKAS GAUR, ANURAG TOMAR, and MUKESH TIWARI. "Acetylcholinesterase Activity in Fluorosis Adversely Affects Mental Well-being—An Experimental Study in Rural Rajasthan." European Acad Res 2, no. 4 (2014): 5857-69.
Sudhir, K. M., GN Dr Chandu, G. M. Prashant, and VV Subba Reddy. "Effect of fluoride exposure on Intelligence Quotient (IQ) among 13-15-year-old school children of known endemic area of fluorosis, Nalgonda District, Andhra Pradesh." PUBLIC HEALTH 2009, no. 13 (2009).
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Till, Christine, Rivka Green, David Flora, Richard Hornung, E. Angeles Martinez-Mier, Maddy Blazer, Linda Farmus, Pierre Ayotte, Gina Muckle, and Bruce Lanphear. "Fluoride exposure from infant formula and child IQ in a Canadian birth cohort."
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Trivedi, M. H., R. J. Verma, N. J. Chinoy, R. S. Patel, and N. G. Sathawara. Effect of high fluoride water on intelligence of school children in India. Fluoride 40, no. 3 (2007): 178-183.
Trivedi, M. H., N. P. Sangai, R. S. Patel, M. Payak, and S. J. Vyas. "Assessment of groundwater quality with special reference to fluoride and its impact on IQ of schoolchildren in six villages of the Mundra region, Kachchh, Gujarat, India." Fluoride 45, no. 4 (2012): 377-83.
Wang, Jundong, Yaming Ge, Hongmei Ning, and Shaolin Wang. "Effects of high fluoride and low iodine on biochemical indexes of the brain and learning-memory of offspring rats." Fluoride 37, no. 3 (2004): 201-8.
Wang, San-Xiang, Zheng-Hui Wang, Xiao-Tian Cheng, Jun Li, Zhi-Ping Sang, Xiang-Dong Zhang, Ling-Ling Han, Xiao-Yan Qiao, Zhao-Ming Wu, and Zhi-Quan Wang. "Arsenic and fluoride exposure in drinking water: children’s IQ and growth in Shanyin county, Shanxi province, China." Environmental health perspectives 115, no. 4 (2007): 643-647.
Xiang, Q., Y. Liang, L. Chen, C. Wang, B. Chen, X. Chen, M. Zhou, and P. R. Shanghai. Effect of fluoride in drinking water on children's intelligence. Fluoride 36, no. 2 (2003): 84-94.
Yang, Yingkui, Xiuhong Wang, Xiaowei Guo, and Peiying Hu. "The effects of high levels of fluoride and iodine on child intellectual ability and the metabolism of fluoride and iodine." Fluoride 41, no. 4 (2008): 336-339.
Yu, Xingchen, Jingwen Chen, Yonggang Li, Hongliang Liu, Changchun Hou, Qiang Zeng, Yushan Cui et al. "Threshold effects of moderately excessive fluoride exposure on children's health: a potential association between dental fluorosis and loss of excellent intelligence." Environment international 118 (2018): 116-124.
Zhang, Shun, Xiaofei Zhang, Hongliang Liu, Weidong Qu, Zhizhong Guan, Qiang Zeng, Chunyang Jiang et al. "Modifying effect of COMT gene polymorphism and a predictive role for proteomics analysis in children’s intelligence in endemic fluorosis area in Tianjin, China." Toxicological Sciences 144, no. 2 (2015): 238-245.
Fertility
The effect of fluoride on male and female fertility has become an area of growing concern. Various studies show that fluoride causes adverse effects on both male and female fertility. Fluoride intake has been linked to lowered human birth rates and decreased testosterone concentrations. Infertility was found in an area of India where fluorosis is highly endemic. Furthermore, in vitro exposure of human sperm to fluoride produced a significant decline in sperm motility.
Chinoy, Niloufer J., and Murakonda V. Narayana. "In vitro fluoride toxicity in human spermatozoa." Reproductive Toxicology 8, no. 2 (1994): 155-159.
Elbetieha, Ahmed, Homa Darmani, and A. S. Al-Hiyasat. "Fertility effects of sodium fluoride in male mice." Fluoride 33, no. 3 (2000): 128-134.
Freni, Stan C. "Exposure to high fluoride concentrations in drinking water is associated with decreased birth rates." Journal of Toxicology and Environmental Health, Part A Current Issues 42, no. 1 (1994): 109-121.
Kour, Kulbir, and Jagdish Singh. "Histological finding of mice testes following fluoride ingestion." Fluoride 13, no. 4 (1980): 160-2.
Messer, H. H., W. D. Armstrong, and L. Singer. "Influence of fluoride intake on reproduction in mice." The Journal of nutrition 103, no. 9 (1973): 1319-1326.
Narayana, M. V., and N. J. Chinoy. "Effect of fluoride on rat testicular steroidogenesis." Fluoride 27, no. 1 (1994): 7-12.
Neelam, K., R. V. Suhasini, and R. Y. Sudhakar. "Incidence of prevalence of infertility among married male members of endemic fluorosis district of Andhra Pradesh." In Abstract Proc Conf Int Soc for Fluoride Res. 1987.
Ortiz-Pérez, Deogracias, Manuel Rodrı́guez-Martı́nez, Flavio Martı́nez, Vı́ctor H. Borja-Aburto, Julio Castelo, Juana I. Grimaldo, Esperanza de la Cruz, Leticia Carrizales, and Fernando Dı́az-Barriga. "Fluoride-induced disruption of reproductive hormones in men." Environmental Research 93, no. 1 (2003): 20-30.
Sharma, J. D., Mamta Solanki, and Deepmala Solanki. "Sodium fluoride toxicity on reproductive organs of female albino rats." Asian J. Exp. Sci 21, no. 2 (2007): 359-364.
Susheela, A. K., and A. Kumar. "A study of the effect of high concentrations of fluoride on the reproductive organs of male rabbits, using light and scanning electron microscopy." Reproduction 92, no. 2 (1991): 353-360.
Susheela, Andezhath K., and Poonam Jethanandani. "Circulating testosterone levels in skeletal fluorosis patients." Journal of Toxicology: Clinical Toxicology 34, no. 2 (1996): 183-189
Cardiovascular Effects
Research has demonstrated that fluoride is a cytotoxic agent inducing damage in myocardial tissues by oxidative stress. This also can contribute to the development of atherosclerosis, vascular stiffness, inflammatory mechanisms, and myocardial cell damage. Fluoride induced oxidative stress plays an important role in the progression of a variety of cardiac disorders such as cardiac failure and ischemia. Nicotinamide adenine dinucleotide phosphate-oxidase (NADPH oxidase), an important source of reactive oxidative species in the vasculature, is activated by high levels of fluoride exposure. The fluoride ion combines avidly with blood calcium and magnesium with resultant metabolic disorder and cardiovascular system damage. Fluoride toxicity can cause atherosclerosis at the molecular level and aortic stiffness and disturbed ventricular distensibility clinically.
Varol, Ercan, and Simge Varol. "Effect of fluoride toxicity on cardiovascular systems: role of oxidative stress." Archives of toxicology 86, no. 10 (2012): 1627-1627.
Varol, Ercan, Selahattin Akcay, I. Hakki Ersoy, Banu Kale Koroglu, and Simge Varol. "Impact of chronic fluorosis on left ventricular diastolic and global functions." Science of the total environment 408, no. 11 (2010): 2295-2298.
Yan, Xiaoyan, Qiurong Ren, Xianhui Hao, Na Chang, Guoqiang Xu, Lihua Wu, and Ruiying Cheng. "Sodium fluoride induces apoptosis and alters the cardiac arrest rate in primary cardiomyocytes." Fluoride 48, no. 3 (2015): 234.
Neurotoxicity
Blaylock, Russell L. "Excitotoxicity: a possible central mechanism in fluoride neurotoxicity." Fluoride 37, no. 4 (2004): 301-314.
Chirumari, Krishnaiah, and Pratap Karnati Reddy. "Dose-dependent effects of fluoride on neurochemical milieu in the hippocampus and neocortex of rat brain." Fluoride 40, no. 2 (2007): 101-110.
Dong, Zhong, Changwu Wan, Xiaolei Zhang, and Jialiu Liu. "Determination of the contents of amino-acid and monoamine neurotransmitters in fetal brains from a fluorosis-endemic area." J Guiyang Med Coll 18 (1993): 241-5.
Long, Yi-Guo, Ya-Nan Wang, Jia Chen, Su-Fen Jiang, Agneta Nordberg, and Zhi-Zhong Guan. "Chronic fluoride toxicity decreases the number of nicotinic acetylcholine receptors in rat brain." Neurotoxicology and teratology 24, no. 6 (2002): 751-757.
Reddy, P. Yugandhar, K. Pratap Reddy, and K. Praveen Kumar. "Neurodegenerative changes in different regions of brain, spinal cord and sciatic nerve of rats treated with sodium fluoride." Journal of Medical & Allied Sciences 1, no. 1 (2011): 30.
Shashi, A. Histopathological investigation of fluoride-induced neurotoxicity in rabbits. Fluoride 36, no. 2 (2003): 95-105.
Vani, M. Lakshmi, and K. Pratap Reddy. "Effects of fluoride accumulation on some enzymes of brain and gastrocnemius muscle of mice." Fluoride 33, no. 1 (2000): 17-26.
Varner, Julie A., Karl F. Jensen, William Horvath, and Robert L. Isaacson. "Chronic administration of aluminum–fluoride or sodium–fluoride to rats in drinking water: alterations in neuronal and cerebrovascular integrity." Brain research 784, no. 1-2 (1998): 284-298.
Wang, Y., Z. Guan, and K. Xiao. "Changes of coenzyme Q content in brain tissues of rats with fluorosis." Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 31, no. 6 (1997): 330-333.
Pineal Gland
In the 1990s, a British scientist, Jennifer Luke, discovered that fluoride not only accumulates in the bones, but also at strikingly high levels in the pineal gland where it accumulates calcifications. The pineal gland is located between the two hemispheres of the brain. Hormonal secretions from the pineal gland participate in the control of reproductive function. In turn gonadal steroids, gonadotrophins and prolactin modify pineal metabolic activity and change the rate of synthesis of pineal hormones. In some religions the pineal gland it is considered a “spiritual center of intuition.” It is also responsible for the synthesis and secretion of the important hormone melatonin. Melatonin maintains the body’s circadian rhythm (sleep-wake cycle), regulates the onset of puberty in females, and helps protect the body from cell damage caused by free radicals. Preliminary animal experiments found that fluoride reduced melatonin levels and shortened the time to puberty. (Luke, 1997). Based on this and other evidence, the National Research Council has stated that “fluoride is likely to cause decreased melatonin production and to have other effects on normal pineal function, which in turn could contribute to a variety of effects in humans” (NRC, 2006, p. 256).
Luke, Jennifer. "Fluoride deposition in the aged human pineal gland." Caries Research 35, no. 2 (2001): 125-128.
Luke, Jennifer Anne. "The effect of fluoride on the physiology of the pineal gland." PhD diss., University of Surrey, 1997.
Thyroid
Fluoride exposure has been shown to cause cumulative effects in animals, not only in parental generations, but also in subsequent generations, resulting in decreased thyroid hormone, and associated learning and memory impairments in addition to variation in neuronal cytoarchitecture.
Basha, Piler Mahaboob, Puja Rai, and Shabana Begum. "Fluoride toxicity and status of serum thyroid hormones, brain histopathology, and learning memory in rats: a multigenerational assessment." Biological trace element research 144, no. 1-3 (2011): 1083-1094.
Wang, H., Z. Yang, B. Zhou, H. Gao, X. Yan, and J. Wang. "Fluoride-induced thyroid dysfunction in rats: roles of dietary protein and calcium level." Toxicology and industrial health 25, no. 1 (2009): 49-57.
Ethics
The use of fluoridation as a prophylactic medical intervention without the fully informed consent of the public violates numerous articles of international conventions aimed at the protection of human rights with respect to State-sponsored medical interventions and health care. This practice violates medical ethics and undoubtedly constitutes medical malpractice.
Balog, Douglas A. "Fluoridation of public water systems: valid exercise of state police power or constitutional violation." Pace Envtl. L. Rev. 14 (1996): 645.
Cohen, Howard, and David Locker. "The science and ethics of water fluoridation." Journal-Canadian Dental Association 67, no. 10 (2001): 578-579.
Cross, Douglas W., and Robert J. Carton. "Fluoridation: a violation of medical ethics and human rights." International journal of occupational and environmental health 9, no. 1 (2003): 24-29.