On the fluoridation front

The following article on fluoridation, along with the title, is reproduced from the October 1961, issue of Prevention magazine. Because our files bulge with contradictor statements about what other countries are doing about water fluoridation, we decided to find out for ourselves. Here are some of the replies we got from letters addressed to the public health departments of the indicated countries.

GREECE — no fluoridation..!.

POLAND — no water fluoridation, some experimental work giving fluoride tablets to children.

DENMARK — no artificial water fluoridation although about 55,000 Danes drink water already containing natural fluorides...

BELGIUM — no fluoridation; one experiment has been started.

SWITZERLAND — fluoride tablet experiments in 3 cities. One city fluoridated water in 1960, another will begin in "the near future". Fluoridated kitchen salt available. Fluoridated milk available and experiments are being conducted with this...

ENGLAND — Fluoridation has been in operation for 4½ to 5 years in 3 areas... No decisions have been made since it is felt that sufficient time has not yet elapsed.

SWEDEN — One city fluoridated as an experiment. Because of different opinions on the matter, no proposals have been made. An excellent mature presentation of both sides of the question was prepared and published in the Swedish Dental Journal. Opinions highly critical of fluoridation are presented here as well as those supporting it...

FRANCE — In France there exists no provision for public distribution of fluoridated water... in fact, the studies pertinent to this subject have not as yet proved irrefutably the harmlessness of prolonged consumption of water to which fluorine has been added, even in small and rigorously controlled dosage...

It has been decided therefore, that it is preferable for the administration of fluorine to remain a prerogative of each individual, in conformity with dosage recommended by the individual's doctors and dentists.

Supplementary studies are presently being made, but the results up to now do not indicate contemplation of a change in the point of view of the public health department.

WEST GERMANY — One city is experimenting with water fluoridation. According to the Union of Gas and Water Experts, the addition of fluorides to drinking water, is not the practical method, but other methods would be preferable"...

ITALY — Measures for water fluoridation have not been taken. "The majority of the directors of the Dental University Department think that:

"1) The adjustment of fluorine level in water to 1 ppm seems to have preventive value only for children from birth to first adolescence, while older age groups are not affected in regard to their caries prevalence...

"2) Taking into account the percentage of adult people suffering from diseases, which can affect the water balance and provoke a greater intake of water, at the same time, the presence among a certain number of aged people of lesions damaging the normal kidney's power of fluorine elimination, it seems that the exposure of this section of the total population to the risk of toxic accumulations of fluorine without a corresponding preventive value is not worthwhile.

"3) The toxicological studies on fluorine have to be intensified in order to be sure about the lack of toxic effects from a lifetime contact with the element.

These are all the answers we have received up to now. We think they show a maturity and a good sense that is almost completely lacking in the approach to water fluoridation of the American Public Health Service and the American Dental Association.

A Welsh researcher protests

Sometime ago PREVENTION published an article about the fine ideas on cancer causes of Dr. R. A. Holman of the Royal Infirmary, Tardiff, Wales. We were glad to find a letter on fluoridation from him in the pages of The British Medical Journal for April 15, 1961.

Here are some of Dr. Holman's comments: "Your leading article states that there is little doubt that caries (tooth decay) can be prevented to a large extent by the elimination of our so-called civilized diet. I agree wholeheartedly with this, but would also couple with it the elimination of the large number of chemical agents (many of which are enzymic poisons) which civilized man has allowed to pollute his food and drink. I do not agree that a reversal of the position is impracticable. Many eminent workers, including the Nobel Prize winners, Alexis Carrel, and Szent-Gyorgir and more recently René Dubos have şaid that until we intelligently reform some of our habits of civilization there will be no measurable reduction in the prevalence of the diseases peculiar to our time. In view of the widespread concern bath in medical and non-medical circles about the mounting chemical adulteration of air, food and drink; it is my opinion that the time is ripe for the control of these hazards which have largely replaced the bacterial hazards so prevalent towards the end of the last century.

He goes on, "It is pertinent to consider the advisability of using sodium fluoride. Apart from the ethical side of regularly dosing thousands of people without their consent, and the debatable advantages to be gained by adults; the question of the long-term effects-needs much more investigation."

Dr. Halmay, then proceeds to discuss a subject in which he is a recognized authority: the relation of enzyme deficirncy to health and especially to cancer-susceptibility. He says, "Fluoride, is a well-known inhibitor (destroyer) of several enzyme systems. In some respects sodium fluoride's act in the body as a whole like potassium cyanide. This is to be expected since both fluoride and cyanide can form... compounds with the enzyme Catalase, resulting in its inhibition (that is, preventing this enzymes from doing its job). Catalase poisoning has been linked with the development of viruses and the causation of a number of diseases, including cancer. One of the well-established facts about cancer is that as the tumor grows the cells become progressively deficient in catalase and the total body catalase is lowered. Many observers have suggested that agents which decrease the catalase in cells may predispose to turmor formation. Voisin has said, 'the method most likely' to solve the problem of cancer is to ask why the cancer cell is lacking in catalase, and try to prevent this impoverishment taking place. Since fluoride can inhibit catalase and since it is a cumulative poison, the danger of increasing the cancer-inducing potential in humans must be considered. Although there is not to my knowledge any good positive evidence as yet linking fluoride with known cancer cases, the whole question of fluoride intake from food, water, insecticides, and industrial processes should be much more thoroughly investigated."...

More arguments against fluorides

Another Englishman wrote a fine fetter to "The Lancet (another English medical publication) which appeared in the April 1, 1961 issue: C. G. Dobbs, also of Wales wrote that he had inquired about the medical inspection given inhabitants of areas where fluoridation was being tested in England. He was told that a "medicali check-up" was being given." This supposedly - thorough and decisive check-up consisted of asking the local doctors to report any abnormal physical condition which they thought "might be attributed to fluorine".

Mr. Dobbs goes on, "Since skeletal fluorosis is the only recognizable effect upon adults of a high fluoride level intake and this is quite irrelevant at a fluoridation level of 1 part per million (or so I am assured by the advocates of fluoridation) the result must, of course, be negative and the whole procedure quite pointless and without bearing on the questions of the safety or desirability of increasing the intake of this substance permanently, by every member of the population. He continues, "This sort of argument can be applied to any type of pollution which it may be convenient to impose for some special purpose: a moderate increase in smoke, provided there is no obvious or statistically significant increase in bronchitis; a further increase in radiation, throwing the onus on 'objectors' among the public to prove that any single case of Leukemia was specifically caused by it, and so on. What alarms me is that our public health authorities, from the Minister downwards, does not seem to realize that the effects of every generalized increase in one toxic factor are hopelessly confused with those of every other operative factor, and that the impossibility of distinguishing them is not evidence for the safety of such an increase.

"In the face of the appalling increase in chronic diseases far more deadly than dental caries, such a deliberate increase in pollution of the water supply can only create alarm, increase nervous stress and destroy confidence in the public health service. As for the approval of "an impressive array of scientific bodies", referred to by Dr. Alcook (in an earlier issue of The Lancet) this, I am afraid, is just what the layman is by now driven, cynically to expect. It reflects: primarily, the successful activities of their more politician-like members. When I want a well balanced and considered opinion of health matters, I consult an individual doctor, not the British Medical Association, or any other Collectivity."