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Dr. Richard Sauerheber
(B.A. Biology, Ph.D. Chemistry, University of California, San Diego)
Palomar College, STAR Center, San Marcos, CA 92078

November 13, 2012


To the Snohomish Health District Board:


I am responding to the speech which Dr. Mark Goldbaum made to the Board on October 9, 2012, on the subject of fluoridation and to the Powerpoint slides which Dr. Goldbaum submitted.


Dr. Goldbaum says that that over 50% of Snohomish County third graders have cavities, and 20-30% of 65 year olds have lost all permanent teeth (slide #2), and yet that Everett has been fluoridating Snohomish County waters since 1991. The magic bullet seems to have misfired. Yet the good Doctor argues that treating water with diluted industrial fluoride from a fertilizer off-product will reduce tooth decay when taken internally through ingestion for life without causing any harm to anyone – whether an infant, a fetus within a pregnant mother, a diabetic, or an old lady with osteoporosis. We wait for clarity.


Second, the National Research Council 2006 Report on Fluoride in Drinking Water examined vast studies of the health consequences of ingesting water with fluoride from 1 ppm and above and concluded unanimously that current allowed levels of fluoride in public water do not protect human health. In stark contradiction, Goldbaum claimed instead that the Report indicated there were zero adverse health effects of ingested fluoride!


Comments presented below, by request, clarify one of the slides Goldbaum presented August, 2012 entitled “Fluoridation is a Balanced Approach” (slide #16). Two graphed curves were presented without actual data points, attempting to indicate that populations drinking regular water without added fluoride is associated with 2.2 times higher incidence in teeth caries than that associated with fluoridated water at 0.7 ppm. This claim is not referenced and in fact is starkly contradicted by data presented on slide 9, where 14 year old children consuming non-fluoridated water lifetime had only 1 tooth caries incident above that in children consuming 0.7 ppm fluoride water.


Vast epidemiologic data published in numerous sources prove that tooth caries incidence is unrelated to level of fluoride in drinking water.  In fact, ingested fluoride cannot decrease caries because fluoride in saliva from treated water is only 0.02 ppm (NRC, 2006, p. 71), 75,000 times lower than in toothpaste. The fact that fluoride does not work systemically from the bloodstream was described by the Centers for Disease Control (MMWR, Aug., 2001), and yet slide #6 purports without citation that in pregnant mothers, fluoride (which crosses the placental barrier) is somehow perceived as helping teeth which develop years after birth.


The claim was made that fluoride exerts zero adverse health effects, but the data graphed in slide #16 disproves that claim, where abnormal tooth fluorosis with its unsightly enamel hypoplasia increases in incidence as a direct function of fluoride level in drinking water. Tooth fluorosis is the first visible sign of fluoride poisoning and is always accompanied with abnormal, permanent fluoride incorporation into bone. Fluoride accumulates in bone during lifelong consumption, weakening bone at 3,000 mg/kg (NRC), typically reached after decades of consuming water with 1 ppm fluoride (depending on total exposure to fluoride from all sources, and water hardness since calcium minimize fluoride assimilation into the bloodstream from the gastrointestinal tract). Published data demonstrating the adverse effects of ingested fluoridated water on brain function and morphology in humans and in research animals led the U.S. EPA to list synthetic fluoride as a development neurotoxin


The idea of drawing these two curves, one showing purported decreases in teeth decay, and the other showing the increased incidence of tooth fluorosis as a function of fluoride levels in water, was first invented in 1939 by Dean. Dean mistakenly attributed a lower teeth caries incidence in Texas children to fluoride, rather than to the calcium present in the natural hard water with 300 ppm calcium and magnesium. Dean apologized years later in a Chicago court for making this correlation graph having no scientific proof, but variants of the graph have nevertheless been used by fluoride promoters for 67 years to argue a purpose for taking fluoride ion internally. Fluoride is not a normal constituent of the bloodstream and no listing for this halogen exists in any detailed tables of blood constituent levels in Clinical Chemistry or Nursing textbooks, or the Merck Manual. There is no recommended daily allowance (RDA) for the ion, where the FDA correctly ruled that fluoride is not a mineral nutrient and in water is an uncontrolled use of an unapproved drug and that fluoride does not strengthen bone (as fluoride promoters had hoped).


The comprehensive analysis of Ziegelbecker (in Connett, The Case Against Fluoride, 2010), which included the original data misinterpreted by Dean, proved that fluoride levels in water bear no relation to caries incidence, and that scatter in the data led Dean to the false correlation in the first place. What was correct however is the strong correlation that is irrefutable, where tooth fluorosis increases as a function of progressively increasing fluoride water level from 0.3 ppm and above. The two curves taken together were hoped to intersect at a level of choice where fluorosis adverse effects would be minimized, while an effect on caries might be significant, so the idea that 1 ppm fluoride would be ‘optimal’ was set. Unfortunately, the average water level of calcium, the antidote to fluoride poisoning, in the U.S. varies widely, with an average of only 50 ppm. Thus it comes as no surprise that the CDC reported the U.S. is suffering from an endemic of abnormal tooth fluorosis, afflicting 41% of children aged 12-15 as of 2004. Toothpaste manufacturers argue this is the fault of water treated with industrial fluoride, since water is directly swallowed, and produces over 50% of all fluoride ion present in the bloodstream (NRC). Dental officials who still promote fluorosilicic acid infusions into public water supplies argue it is the fault of toothpaste, since water fluoride use began long before toothpaste fluoride was developed.  In reality, both sources are of course at fault in determining total exposure of our children to this unnatural synthetic fluoride. It is necessary to halt the infusion of industrial fluoride toxic calcium chelators into public drinking water supplies and to return to a sane policy of supplying regular fresh clean drinking water to all U.S. citizens. The world waits.



Additional disturbing problems with the presentation include:


The claim there is no known allergy or sensitivity to fluoride.  This is incorrect as reported in several textbooks and in the scientific literature, that documented sensitivity to fluoride occurs in approximately 1% of people (Feltman, R. and Kosel, G., Prenatal and Postnatal Ingestion of Fluoride—Fourteen Years of Investigation—Final Report, Journal of Dental Medicine, 16:190, 1961). This was confirmed further in the NRC 2006 report that described the controlled clinical trials conducted with human volunteers drinking only 1 ppm fluoride water, where 1% reported GI discomfort immediately after consumption. This author knows three individuals who are sensitive to silicofluoridated water used in ‘water fluoridation’ and one whose face swells each and every time dental fluoride gels are applied to her. The data from Waldbott is comprehensive (Fluoridation the Great Dilemma, Coronado Press, 1978) and includes a large number of references on sensitivity to fluoridated water, many being well controlled double blind studies (such as Grimbergen, A Double Blind Test for Determination of Intolerance to Fluoridated Water, Fluoride 7:146, 1974) and the studies of Petraborg, H., Chronic Fluoride Intoxication from Drinking Water, Fluoride 7:47,1974).


It is claimed on slide #17that fluoride is the safest fluoride. Ironically, industrial fluoridation of drinking water  is the least safe fluoride compound because 1) it is intended to be taken internally through swallowing, where the ion permeates all organs of the body and averages 0.21 ppm in the blood where it does not belong and where it incorporates permanently into bone and where it causes enamel hypoplasia (fluorosis) in 30% or more of children in 1 ppm treated cities; all other sources of fluoride listed in the slide are not intended to be swallowed. And 2) industrial fluoride lacks antidote calcium and islisted as a toxic substance on poisons registries with a lethal oral dose of 120 mg/g in mammals; calcium fluoride is not a listed toxic.


Entitled “Fluoridation is Safe”, slide #34 makes astoundingly incorrect claims that are not found in any reference. 1) ‘There are no negative effects on health in humans or animals from fluoridation’. There have been multiple deaths caused by water fluoridation due to accidental overfeeds (Gessner, New England Journal of Medicine, 330,1994).  Longterm effects at lower levels labeled ‘optimal’ are far too numerous to describe thoroughly, but include at 1 ppm fluoride, iron deficiency anemia, bone weakening after longterm consumption, mental IQ lowering due to blood fluoride above zero, the level it is supposed to be as a non-nutrient ion, and fluoride accumulates into atherosclerotic plaque in coronary disease victims. Salmon collapses have occurred on the Columbia River and the Sacramento River after fluoridated water discharges began, where salmon extreme fluoride sensitivity has been documented in fresh soft water. Salmon are unaffected by natural fluoride in the ocean due to its extremely high content of protective calcium, but which of course renders seawater undrinkable by humans.


2) The statement that there is no measurable increase in lead or arsenic due to fluoridation, and there is no measurable increase in fluoride from water discharges, are incomplete thoughts. After dilution, the added lead and arsenic, is then below that typically detectable with instruments lacking sensitivity to detect the increase that exists. The implication that it does not increase at all is false. Although the arsenic additions that accompany fluorosilicic acid infusion are currently not banned by the EPA, it is nevertheless illegal to add any known carcinogen into human drinking water (Delany clause of the Food Drug and Cosmetic Act), whether it is below the limits of detection by low-sensitive equipment or not. And overfeeds that occasionally occur in U.S. fluoridated cities indeed contain increased arsenic levels that are detectable. Fluoride levels in rivers after discharging fluoridated water also increase in the emission  plume that may, after dilution, be again undetectable with insensitive equipment, but salmon can be blocked from navigation at levels 2-3 times lower than already present in discharged waters (at 0.7-1  ppm).


Goldbaum sates that he ‘is convinced’ that fluoridation is ‘safe, effective and legal’ and consumes it regularly himself and gives it to his family. It is obvious that he is convinced, but why cannot other rational people who remain un-convinced and know the truth, have access to regular fresh clean non-drugged drinking water is they so choose? Free choice to have clean non-drugged drinking water is a right even guaranteed by the United Nations charter for all human beings. It is admirable that Golbaum is concerned about teeth health, but it is also necessary to clarify that caries prevention does not occur because of fluoride ingestion, as is evident in Snohomish County that is largely fluoridated but yet laden with caries incidence as he states. Caries are not caused by lack of fluoride, but by acid secretions from bacteria in the mouth from carbohydrate and free sugar. To prevent caries it is necessary to brush after consumption of any sugar and to have a diet with adequate calcium and vitamin D, necessary for strong teeth enamel in the formative years.  Strong enamel indeed lasts a lifetime, but fluoride is a toxic calcium chelator that can interfere with normal enamel formation to cause ugly tooth fluorosis with enamel hypoplasia. Many using fluoridated water are tricked into thinking their healthy teeth were the result of fluoride ingestion, this is no surprise. What is surprising is that vast scientific literature is excluded in the Goldbaum presentation and that the evidence cited for effectiveness is merely anecdotal, where coincidental lower rates of caries in one fluoridated location does not mean fluoride caused it, but rather better dental hygiene, better diet, or less consumption of sugar, were better possible explanations. The largest studies we have prove fluoride ingestion does not decrease caries and in fact fluoride incorporates into dentyne, but not enamel, where long term consumption causes teeth interiors to be crumbly (NRC, 2006).  Dr. Heard, D.D.S., Hereford, Texas first presumed fluoride in water caused fewer caries, until years later in those children he followed were found to have crumbly teeth interiors from the fluoride compromised dentyne.  Goldbaum is free to continue ingesting this ion, even though it is not a normal constituent of the bloodstream, but lifelong accumulation will be the result in later life that he alone must bear for his choice of action. The rest of society is to be left to choose the risks they wish to take in their own lives, for their own planned futures.


Everyone agrees that fluoride accumulates into bone during lifelong consumption. At 3,000 mg/kg bone is detectably weakened (NRC), even though fluoride promoters at one time had hoped fluoride would strengthen  bone. In Goldbaum’s exuberance to defend fluoride taken internally lifetime, he may be surprised to learn he is risking having later in life muscle and bone pain. This is largely the reason why the FDA has never approved any industrial fluoride for human ingestion in the U.S. and why the FDA in 1989 rejected approval based on controlled human clinical trials with sodium fluoride taken longterm conducted by the National Institutes of Health (Pollner, F., Medical World  News, Nov. 13, 1989). Although bone mass increased substantially (and abnormally) in the fluoride treated cohort, no effect on strengthening bone and preventing fractures was found, and in fact more non-vertebral skeletal lesions were reported in the treated group who also had a high incidence of painful lower extremity syndrome.  The toxic effects of fluoridated bone may not be manifest for 30 or more years when the bone is unable to accomodate any further fluoride, at which point consumed fluoride is stored in the soft tissues.  Decalcification of bone known as osteoporosis is also a fairly common condition past middle age. When it occurs and the bone is fluoridated, the fluoride can be released into soft tissues at a rate exceeding its elimination through the kidneys (Petraborg, H., Fluoride Poisons Enzymes).  Perhaps Dr. Goldbaum would be interested in examining the exhibit at the San Diego Museum of Man, Balboa Park, of fluoridated human femur bone with its bizarre pathologic calcium fluoride spicules that protrude from the surface, able to cause severe pain when muscle slid along it.  The degree of speculation depends not only on length of consumption of fluoridated water but also on whether the water is soft or not, since calcium minimizes fluoride assimilation after ingestion.





Richard Sauerheber, Ph.D.