The toxic toothpaste
Fluoride is good for teeth but it can also be harmful

By Simon Crompton

Like most parents, Beverly Cooke encouraged her daughter Alysia to use fluoride toothpaste. From the age of 18 months Alysia’s tooth-cleaning was supervised, and she never used more than the recommended pea-sized amount of toothpaste.

At nine, Alysia started to have leg pains, flu-like symptoms and constant headaches. Her condition mystified specialists until a doctor at an orthopaedic clinic noticed her teeth were mottled brown. He suspected dental fluorosis, a condition caused by over-exposure to fluoride that can cause crumbling of the enamel and permanent damage to teeth.

Tests revealed high levels of fluoride in Alysia’s system, even though she lived in the Gower Peninsula in Wales, an area with unfluoridated water. As soon as she stopped using fluoride toothpaste her symptoms disappeared and now, aged 11, she has problems only if she visits areas where the water is fluoridated.

Alysia’s extreme sensitivity is rare but, according to the latest evidence, side-effects from fluoride exposure are not. A government-commissioned study has revealed that 48 per cent of children who drink fluoridated water show signs of fluorosis.

Campaigners and parents are increasingly angry that the risks are not better publicised. In America, they point out, there is a mandatory warning on every tube of fluoridated toothpaste: “In case of accidental ingestion, seek professional assistance or contact a poison centre immediately.”

Why are British consumers not given this information?

Tony Lees, from Herefordshire, a dentist for 40 years, believes that fluoride should be banned from toothpastes and water. The marginal benefit it displays for teeth does not outweigh its general dangers, he says.

“In the scale of toxicity, fluorides fall between arsenic and lead,” he says. “Dental fluorosis is not just a cosmetic problem, but the visible sign of chronic fluoride poisoning, and children are more vulnerable than adults.”

Anyone overdosing on fluoride, he says, is in danger of developing chronic skeletal fluorosis, which can weaken bones and cause arthritis.

Anti-fluoride campaigners have also pointed to isolated studies and anecdotal evidence indicating that exposure to fluoride may be linked to thyroid problems, bone cancers and hip fractures. “The danger with toothpaste is that large amounts are easily swallowed,” says Lees. “This is made worse for children by manufacturers who give it tempting flavours.” But Lees is a lone voice. Most dentists are convinced that fluoride is good for teeth and that there is no evidence that it does harm — apart from the occasional case of cosmetic dental fluorosis. They point out that in the ten years after fluoride toothpastes were introduced in 1973, dental disease in children fell so dramatically that some dentistry schools had to be closed.

Mike Lennon, the Professor of Dental Public Health at the University of Liverpool and a spokesman for the British Dental Association, acknowledges that until the early Nineties some overenthusiastic parents were encouraging children to use too much fluoride toothpaste. Toothpaste manufacturers were not taking into account the tendency of children under the age of two to swallow everything that goes into their mouths. But now there are “low-dose” toothpastes for children, and he believes families in Britain are better educated about using the right amount.

He thinks that it would be wrong to scare parents by publicising the risk of fluorosis or by putting warnings on tubes. “There is no doubt that fluoride has a huge benefit. The only risk is dental fluorosis, where you would have to swallow very high levels, and I know of no evidence of any risk to health.”

The available evidence on the risks and benefits of fluoride, however, belies the strength of assertion by both professionals and campaigners, making the correct course for parents far from clear. A new government-commissioned study by the University of York on the benefits of water fluoridation has proved only that existing research — supporting its use and warning of its dangers — is of such low quality that it should not dictate policy.

The fact that the British Dental Association receives money from the toothpaste industry for endorsing fluoride-based products, among other things, is hardly likely to inspire confidence. Nor is the organisational quirk which means that toothpaste safety is controlled by the body regulating cosmetics, not medicines.

What everyone agrees on is that parents should try to ensure that their child’s intake of fluoride is controlled. In the 10 per cent of Britain where water is fluoridated, this may mean taking care that a child uses small amounts of a low-dose children’s toothpaste, and steering clear of fluoride mouthwashes and other products containing fluoride.

Professor Lennon advises that it is safe in most areas for children to use a small, pea-sized amount of the family toothpaste twice a day. “You need to take advice from your dentist, who will make an assessment of many factors, including your child’s diet and how assiduously you use toothpaste.”

Of Related Interest:

The following excerpts are from the tv news program "Don't Swallow Your Toothpaste" which aired on England's Channel 4 "Health Alert" series June 19, 1997. To see more excerpts from this program, visit: www.fluoridealert.org/DSYT.htm

Denise Quail Mother of child with severe fluorosis

Quail: If I had known what fluoride did to the teeth I would never have let her have fluoride toothpaste. As a baby she used to put a little bit on her thumb when she went to bed and suck it and I just thought it would be ok. I had no idea what effect there would be from fluoride. There were no warnings on the toothpaste tube at all.

Jenny Mathews Mother of children with fluorosis

Jenny Mathews: We first became aware that Amanda might have a problem with her teeth when we visited a dentist just before she was six. Her second teeth were just starting to come through and we noticed that they had brown patches on them.

Amanda Mathews Child with fluorosis		Amanda: When I first saw that my teeth were discolored, I was teased quite a lot, especially in the middle school by people. They used to say, 'oh you don't clean your teeth or anything' and they used to call me 'shit teeth' which did upset me, even though I knew it was fluorosis. Ch. 4: Fluorosis is a mottling of the enamel of the second teeth caused by fluoride. The authorities blame children for swallowing their toothpaste...
Alan Mathews Father of Children with fluorosis		Alan Mathews: Our dentist has said that they can have veneers when their teeth have stopped growing... I believe the cost is something like 150 pounds a tooth. But we understand that once you have that done, you've really got to have them replaced about every seven years. They grind the front of the teeth off, and forever more you've got that work to be done.
Dr. Paul Connett Professor, Chemistry St. Lawrence University		Connett: It's clear that when you got to the point of damaging your tooth, you've got to be worried about what it's doing to your bones or what it will do to your bones in the future. So I think it's far more sensible, and wise, to think of this as an indication that there may be something else going on.

Prof. Michael Lennon Chairman British Fluoridation Society		Lennon: Nobody wants children to have unsightly teeth. When a mother's been careful to control a child's diet, has been using fluoride toothpaste from a very early age, of course it's very disappointing for the teeth to come through initially with white marks and then they may become brown in the course of time. That's undesirable. I think there have been cases where children have been abusing fluoride toothpaste and we should stop them, we should give the mothers advice, we should label the toothpaste tubes and so on; and that has been done. And I think the public are generally aware of the need to control the amount of fluoride toothpaste children get.
Dr. Peter Mansfield National Pure Water Association		Mansfield: One of the troubles with fluoride in this country is that we get a lot of it already before we get it from the water supply. The fluoride toothpaste is quite an important source because of the very concentrated fluoride in it... We're a great country of tea drinkers and tea leaves have lots of fluoride, variable between brands, but lots. And after that is probably water, but not necessarily out of the tap. Much of that water will have come as the reconstituting fluid for juice concentrates. And also of course the pesticide residues on fruit and vegetables, processed or fresh, will contain quite a bit of fluoride.

Dr. John Hein Retired Dental Director Colgate		Hein: When the fluoride dentrifice first came out, there was a great deal of effort to convince the public that they should use fluoride dentrifices. So some of the ads were maybe a little too excessive in terms of promising benefits from what people would get...[I]f it hadn't been for this effort of the advertizers to get these products out, the widespread use of fluoride dentrifices probably would never have taken place.

Dr. John Hein Retired Dental Director Colgate

Ch. 4: John Hein was the person who developed MFP, the form of fluoride still regularly used in toothpaste. Hein: You gotta hit people over the head to get their attention. Nobody was being hurt by 'em. I did my best to tone them down while I was dental director at Colgate. But fighting Madison Avenue is not an easy thing to do when you're this dental director over in the lab. (smiles)

		Hein: I think if we were starting all over again, and had no research data at all, we probably could not come around to getting fluoridation accepted today, because people would say it's just too close, we can't possibly do it.

Dr. Peter Mansfield National Pure Water Association		Mansfield: Firstly, the problem is yet to come. We're only watching it building up now. Even in America, they're only beginning to see the really crippling stages, and they are already admitting to serious degrees of fluorosis of the teeth, which after all is the shop window of the bones.

Dr. Phyllis Mullenix Neurotoxicologist		Ch. 4: A scientist at a leading dental research institute in Boston, Dr. Phyllis Mullenix, exposed rats to fluoride to work out its effects on the human brain and the central nervous system. Dr. Mullenix: What we did is we exposed them, let them drink the fluoride in the water for 6 to 20 weeks. The pattern that we saw typically is what we see with other neurotoxic agents that are well known to cause a hypoactivity or a memory problem or an IQ problem. When I first presented the results of these studies, one of the individuals sitting and listening to the results, he says 'do you have any idea what you're saying?...You're telling us that we're reducing the IQ of children.' And basically I said, yes.

Dr. Paul Connett Professor, Chemistry St. Lawrence University

Connett: In my view fluoride is where lead was in the early '70s. That argument lasted about ten years and it was finally proven that, yes, low levels of lead, lower than [what] cause[s] visible symptoms, was in fact damaging a child's mental development. I think the same thing we're going to find with fluoride.