For various reasons the poor have the most tooth decay and are most affected by dental fluorosis, particularly Blacks and Hispanics. Alveda King and Andrew Young lead the effort to end Fluoride-Gate. LULAC – League of Latin American Citizens – regards fluoridation as a civil rights violation.
The National Research Council 1993 Review (NRC, 1993) reported four earlier studies showing that ethnicity plays a role in the effects of fluoride:
• Russell (1962), in the Grand Rapids fluoridation study, noted that fluorosis was twice as prevalent among African-American children as white children.
• In the Texas surveys in the 1980s, the odds ratio for African-American children having dental fluorosis, compared with Hispanic and non-Hispanic white children, was 2.3 (Butler et al., 1985).
• Dental fluorosis also tended to be more severe among African-American children than white children in the Georgia study (Williams and Zwemer, 1990), although the difference was not statistically significant.
• In Kenya, prevalence and number of severe cases were unexpectedly high when related to fluoride concentrations in drinking water (Manji et al., 1986), although nutritional factors could have confounded these results. The reasons for these findings are unknown and do not seem to have been explored further.
Data published in CDC’s Morbidity and Mortality Weekly Report in 2005 (Beltrán-Aguilar et al., 2005) show that Black and Mexican Americans have significantly higher levels of the worst forms of dental fluorosis than do Whites, as shown in Table 1.
See: Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis — United States, 1988–1994 and 1999–2002
Among children aged 2–11 years, 41% had caries experience in their primary teeth (Table 2). Mexican-American children had higher caries experience (54.9%), compared with black (43.3%) or non-Hispanic white children (37.9%); children from families with incomes >200% of the FPL had lower caries experience (30.7%) compared with lower income groups (45.2% for those with family incomes >100% but <200% of the FPL and 55.3% for those with family incomes <100% of the FPL). Overall, no change was observed in the prevalence of dental caries in primary teeth among children from 1988–1994 to 1999–2002 (Table 2, Figure 1).
Environmental Justice – from Fluoride Action Network’s 50 Reasons to Oppose Fluoridation:
- Low-income families penalized by fluoridation. Those most likely to suffer from poor nutrition, and thus more likely to be more vulnerable to fluoride’s toxic effects, are the poor, who unfortunately, are the very people being targeted by new fluoridation programs. While at heightened risk, poor families are least able to afford avoiding fluoride once it is added to the water supply. No financial support is being offered to these families to help them get alternative water supplies or to help pay the costs of treating unsightly cases of dental fluorosis.
- Black and Hispanic children are more vulnerable to fluoride’s toxicity. According to the CDC’s national survey of dental fluorosis, black and Mexican-American children have significantly higher rates of dental fluorosis than white children (Beltran-Aguilar 2005, Table 23). The recognition that minority children appear to be more vulnerable to toxic effects of fluoride, combined with the fact that low-income families are less able to avoid drinking fluoridated water, has prompted prominent leaders in the environmental-justice movement to oppose mandatory fluoridation in Georgia. In a statement issued in May 2011, the Rev. Andrew Young, a colleague of Martin Luther King, Jr., and former Mayor of Atlanta and former US Ambassador to the United Nations, stated:
“I am most deeply concerned for poor families who have babies: if they cannot afford unfluoridated water for their babies’ milk formula, do their babies not count? Of course they do. This is an issue of fairness, civil rights, and compassion. We must find better ways to prevent cavities, such as helping those most at risk for cavities obtain access to the services of a dentist…My father was a dentist. I formerly was a strong believer in the benefits of water fluoridation for preventing cavities. But many things that we began to do 50 or more years ago we now no longer do, because we have learned further information that changes our practices and policies. So it is with fluoridation.” (see: http://www2.fluoridealert.org/Alert/United-States/Georgia/Atlanta-Civil-Rights-Leaders-Callfor- Halt-to-Water-Fluoridation)
- Minorities are not being warned about their vulnerabilities to fluoride. The CDC is not warning black and Mexican-American children that they have higher rates of dental fluorosis than Caucasian children (see #38). This extra vulnerability may extend to other toxic effects of fluoride. Black Americans have higher rates of lactose intolerance, kidney problems and diabetes, all of which may exacerbate fluoride’s toxicity.
- Tooth decay reflects low-income not low-fluoride intake. Since dental decay is most concentrated in poor communities, we should be spending our efforts trying to increase the access to dental care for low-income families. The highest rates of tooth decay today can be found in low-income areas that have been fluoridated for many years. The real “Oral Health Crisis” that exists today in the United States, is not a lack of fluoride but poverty and lack of dental insurance. The Surgeon General has estimated that 80% of dentists in the US do not treat children on Medicaid.