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Fluoridation News Quarterly

Vol 2 June 2019

American Fluoridation Society

Fluoridation News

Fluoride exists in water naturally. The public health initiative of water fluoridation is simply the adjustment of that fluoride to the level at which maximum dental decay benefit will be obtained with no adverse health effects.

In This Issue:

  • Comments From The President
  • Latest News
  • Recent Activities of AFS
  • AFS Training Program
  • Myth Busters
  • T-Shirt Info – “F Yeah!”
  • About the AFS

Board of Directors

President: Johnny Johnson, Jr,. DMD, MS

Vice-President: Myron Allukian, Jr,. DDS, MPH

Secretary: Jennifer Martinson, BS, RDH

Treasurer: Kurt L. Ferré, DDS

Communications Officer: Steven D. Slott, DDS

Board Emeritus:  Charles C. Haynie, MD, FACS

Scientific Advisory Committee

Dr. Michael Foley, MPH, PhD (Aus) –

Director of Research and Advocacy for Metro North Oral Health Services, Former Director of Brisbane Dental Hospital.

William Maas, DDS, MPH, MS –

Former Director, Division of Oral Health, U.S. Centers for Disease Control and Prevention

Jennifer Meyer, PhD, MPH, CPH, RN –

Assistant Professor of Health Sciences, University of Alaska Anchorage

Dr. John Morris (UK) –

University of Birmingham School of Dentistry, former national lead for water fluoridation with Public Health England and regional consultant for the Midlands and East of England.

Mark Moss, DDS, PhD –

Associate Professor, Department of Foundational Sciences, East Carolina School of Dentistry

Howard Pollick, BDS, MPH –

Director, Dental Public Health Residency, UCSF, Chair, California Fluoridation Advisory Council, California Dental Association Foundation.

Gary D. Slade, BDSc, DipDPH –

John W. Stamm Distinguished Professor of Dentistry at the UNC Adams School of Dentistry, Chapel Hill NC.

Timothy Wright, MS, DDS –

UNC School of Dentistry Department of Pediatric Dentistry
Help support our cause by donating to AFS today!

Comments From AFS President, Dr. Johnny Johnson

A funny thing happened recently. I was contacted by a community health worker whose city’s fluoridation status was being threatened with a cessation effort. She sent me some of the documents and asked for AFS’s help. Quite interestingly, the first one I opened was a recycled claim from 2012. It was a reminder that there’s no reason for each of you to reinvent the wheel by trying to tease out a new response to an old, discredited argument.

Our website has been highly praised by many public health advocates as being a website that covers all recent and newly released studies that have been abused by opponents. While your compliments are appreciated and reinvigorate us, we continually want to go further in simplifying your frontline efforts to defend, protect, and promote community water fluoridation (CWF).

The American Dental Association’s Fluoridation Facts (ADA-FF) is an outstanding document that covers commonly used claims and debunks them with the scientific facts and references. AFS works in harmony with the ADA-FF and ADA staff by being able to provide community CWF advocates with rapid responses to abuses of credible science. A few years back, we put together a document, similar to the ADA-FF, that allowed advocates to quickly look up new or newish claims with refutations and hyperlinks to the science. With the resurrection of old claims, new twists, and recently released articles, it looks like it’s time to dust off that document and update it.

AFS is committed to keeping you abreast of all of the new claims and assertions (“junk” is probably a better term) that is being distributed by CWF opponents. In this issue of the newsletter, we will give a few examples of documents used recently in an effort to end CWF in a community in Florida and elsewhere. Rest assured, we do our due diligence to assure that our facts are double-checked with the researchers (whose works are being abused) from the scientific community around the U.S. and the world.

AFS thanks all of our scientific researchers and experts worldwide, as well as the British Fluoridation Society who inspired our formation, in helping us to disseminate the truth and call out the distortions that opponents circulate. We owe the scientific community a huge “thank you” for allowing us to be the messengers of their works. We are one family.

Keep fighting the GREAT fight. It is a forest fire that is being doused with the hard work of our village of pro-CWF folks. We stand by you and are ready to help at every turn. Quickly we are being left with small brush fires to deal with. That is our goal. And we are getting there quickly, thanks to you!!!

Warm regards,


Anti Claim: Fluoride causes hardening of the arteries
Refutation by Interventional Radiologist
Recently used presentation by a city staff member to get water fluoridation stopped (they were

AFS President, Dr. Johnny Johnson

Latest News

Matt’s Perspective: New Research Reinforces That Water Fluoridation Matters

By Matt Jacob

“Bad teeth run in my family.” Have you heard a friend, neighbor or co-worker say something like that? I sure have. But the research does not support the view that genetics are a key factor in whether a child or adult experiences tooth decay. Environmental factors, including whether someone’s local water system is fluoridated, are the critical dynamics in maintaining a healthy mouth.

A new study builds on this understanding. This study, published in Pediatrics, examined the oral health of twins and looked for evidence of tooth decay among 6 year-old children. The researchers found that environmental factors—not genetics—were connected in crucial ways with dental health. The study identified four environmental factors that were linked with children having cavities. One of the four was the lack of water fluoridation.

This study is one of more than 6,500 research papers related to fluoridation that have been published by the U.S. National Library of Medicine. More than 60,000 studies have been published on fluoride. These numbers are worth noting given how often we hear fluoridation critics cite the need for “more research.”

Late last year, another study strengthened our understanding of fluoridation’s impact. The study examined tooth decay trends for low-income children in Juneau, Alaska’s capital city. As National Public Radio observed, when Juneau ceased water fluoridation in 2003, “science predicted more cavities. That prediction has now proven true.” As the study showed, after fluoridation ended, the average child enrolled in Medicaid needed one additional cavity-related procedure each year at a cost of about $300 more per child.

The Alaska study was the second one in the past few years that shined a light of what happens when a city’s water system ends the process of fluoridation. The first study examined the impact of cessation in Calgary, one of Canada’s largest cities. After Calgary stopped fluoridation in 2011, research showed a dramatic rise in tooth decay among second-grade children.

A Calgary woman who helps to manage a mobile dental clinic said that since cessation, it is no longer unusual for us “to see a child with almost full-mouth decay in the population that we’re looking at, and considering that we’re in Calgary, we shouldn’t be seeing that degree of disease here and we are.”

The disturbing results of this study led the Calgary City Council to vote earlier this year for another study and more data collection to understand how the 2011 decision affected residents’ health. Windsor, a large city in Ontario, was so alarmed by tooth decay trends following its own cessation decision that city councilors responded by voting to resume fluoridation.

Windsor officials had the courage to acknowledge that their city had made a big mistake when it stopped fluoridation. It’s up to all of us to make sure other communities don’t make the same mistake. When communities do stop, let’s not give up on them. We must continue to educate policymakers and civic leaders. Our ongoing commitment can help prevent cavities, toothaches and more serious infections for children and adults. Windsor’s reversal and the growing outcry among Calgary residents are a reminder that mistakes can be corrected.

  Matt Jacob, a communications consultant to AFS, owns Jacob Strategies LLC (



Dr. Myron Allukian, Jr: From Vietnam To Boston, Making A Difference In The Public Health

Dr. Myron Allukian, Jr. Vice President of the American Fluoridation Society was interviewed in the May 2019 issue of Contour, the American Student Dental Association (ASDA) Magazine, page 6-7.

In the article, Dr. Allukian recommends that all dental schools teach about fluoridation and that all dental students with their new and recall patients talk about fluoridation, whether or not their patients are from a fluoridated community.

View the entire article by CLICKING HERE.

CDC Reassesses NHANES Dental Fluorosis Data

In a recent report , the CDC reevaluated the latest NHANES data on dental fluorosis, due to the
abnormally high reported increase between the 2001-2004 and 2011-2014 reporting periods. In
doing so it determined that this data overstated the extent of dental fluorosis in the US,
concluding that the noted increase of mild or greater fluorosis from 10% in 2001-2004 to 46.9% in 2011-2014 was “not biologically plausible”.

Based on these analysis, we found that there was a significant increase in the prevalence of
mild or greater fluorosis in permanent first molars. The prevalence increased from about 10% in
children ages 6–9 in 2001–2004 to 46.9% in children ages 16–19 in 2011–2014. This increase
between surveys is unexpected, since the prevalence of fluorosis in the first permanent molar
should not change over time. We concluded therefore that this increase was biologically implausible.

Reasons hypothesized for this discrepancy were:

While it is not possible to determine what accounts for this apparent increase over time, the
results are consistent with changes in how both the dental examiner and the reference examiner
evaluated the level of fluorosis.

Given the wide use by fluoridation opponents of the NHANES data, this reassessment by the
CDC is important in allaying unfounded fears raised by opponents in their ongoing efforts to
undermine water fluoridation. The CDC strongly advised taking into consideration this
reevaluation in determining trends of dental fluorosis.

AFS Training Program

Dr. Johnny Johnson conducting an AFS Training

The AFS train-the-trainer program is for dental and medical professionals, oral health coalitions, state health departments, and interested advocates for oral health and water fluoriation.

The program is designed to create a cadre of dental professionals who will become trainers in their respective states with these objectives:

  • Enhance the fluoride-related knowledge of dental professionals in their states;
  • Provide guidance for dental professionals to have brief, productive conversations with patients and the public about fluoride and fluoridation;
  • Encourage dental professionals to identify health fairs, monthly health observances and other events as proactive opportunities to educate the public about fluoride and fluoridation;
  • Identify dental professionals who can serve as public spokespersons on CWF and/or provide testimony to state or local governmental bodies;
  • Engage dental professionals to approach CWF decision-makers to provide education and scientific materials, appropriately framed for the health literacy of the decision-makers;

Within the past year, the AFS has provided this valuable training in five states, with plans to increase this yearly.


Thyroid problems, kidney problems, cancer, and ADHD are all associated with fluoridated water.


A. There is no valid, peer-reviewed scientific evidence of any adverse effects on the thyroid from optimally fluoridated water.

The thyroid claim is based primarily on the Peckham, et al. study which has been widely discredited in the peer-reviewed scientific literature for its poor methodology, inadequate control for confounders, and reaching a conclusion not supported by the peer-reviewed scientific literature. Critiques of this study as well as studies demonstrating there to be no association of fluoridated water with adverse thyroid effects may be viewed here.

B. Peer-reviewed science has demonstrated there to be no adverse effect on those with chronic kidney disease from fluoridated water.

C. An abundance of peer-reviewed science has demonstrated there to be no association of fluoridated water with cancer.

Claims of association of fluoridated water with osteosarcoma (bone cancer) are based on one single doctoral dissertation by Eloise Bassin, which utilized preliminary data from a larger Harvard osteosarcoma study to surmise a limited association. The larger study found no such association. Bassin’s findings were refuted by the lead researcher of the larger study, Chester Douglass, DMD, PhD. In addition, dependence on Bassin ignores the volume of peer-reviewed studies which demonstrate there to be no association of fluoridated water with osteosarcoma.

D. There is no valid, peer-reviewed scientific evidence of any association of fluoridated water and ADHD. The ADHD claim is based upon the 2014 study of Malin/Till. This study has been widely discredited in the peer-reviewed science for its poor methodology, inadequate control for confounders, and reaching a conclusion not supported by the peer-reviewed science.


Fluoridated water should not be used to mix powdered infant formula


No credible organization has ever stated that fluoridated water should not be used to mix infant formula.

Due to the existing fluoride content of powdered infant formula, the use of optimally fluoridated water to reconstitute it chances mild dental fluorosis in developing teeth of the infant. This level of dental fluorosis is barely detectable and causes no adverse effect on cosmetics, form, function, or health of teeth. For those parents concerned with even mild dental fluorosis, however, in spite of the increased resistance to decay of these teeth, the American Dental Association and the US CDC have suggested they use non-fluoridated bottled water to reconstitute powdered formula, or simply use pre-mixed formula, most, if not all, of which is produced with low-fluoride content water.

From a 2010 statement of the American Dental Association:

Recommendations for infants who consume reconstituted infant formula as the main source of nutrition:

  • Continue use of liquid or powdered concentrate infant formulas reconstituted with optimally fluoridated drinking water while being cognizant of the potential risk for enamel fluorosis.
  • Use ready-to-feed formula or liquid or powdered concentrate formula reconstituted with water that is either fluoride-free or has low concentrations of fluoride when the potential risk for enamel fluorosis is a concern.


The dose of fluoride from fluoridated water is uncontrolled.


The intake, or “dose” of fluoride from optimally fluoridated water is very highly controlled.  In contrast, fluoride intake from non-fluoridated systems is far less controlled, and allows for far greater fluoride intake than that  from optimally fluoridated water.

First, it must be noted that  when the maximum  amount of a substance which can be ingested falls below the threshold of adverse effects, then “dose” is not an issue in regard to adverse effects.

Simply put, water is fluoridated at 0.7 mg/liter (ppm=mg/liter).  Thus, for every liter of fluoridated water consumed, the “dose” of fluoride intake is 0.7 mg.  The average daily water consumption by an adult is 2-3 liters per day. The US CDC estimates that of the total daily intake, or “dose”, of fluoride from all sources including dental products, 75% is from the water and beverages.

The National Academy of Medicine (formerly known as the US Institute of Medicine)  has established that the daily upper limit for fluoride intake from all sources, for adults, before adverse effects will occur, short or long term, is 10 mg. As can be noted from a simple math equation,  before the daily upper limit of fluoride intake could be attained in association with optimally fluoridated water, water toxicity would be the concern, not fluoride.

The range of safety between the minuscule few parts per million fluoride that are added to existing fluoride levels in your water, is so wide that “dose” is not an issue.

In contrast, the maximum level of fluoride in non-fluoridated systems is restricted only by the EPA maximum contaminant level (MCL) for fluoride, 4.0 ppm…..nearly 6 times that allowed in fluoridated systems.


Ineffectiveness of fluoridation is demonstrated by dental decay incidence in non-fluoridated countries.


The cause and preventive aspects involved in dental decay are myriad and diverse.  An attempt to assess the effectiveness of one preventive measure, fluoridation, based on raw dental decay incidence data which controls for none of these other variables, has no validity.

The claim that dental decay rates are similar in fluoridated and non-fluoridated countries is based upon a graph of skewed interpretation of raw World Health Organization data, created by personnel of the antifluoridation group, “fluoride action network”.  A clear explanation as to how this data has been graphically misrepresented by “fan” has been provided by New Zealand chemist, Ken Perrott, PhD.  This explanation may be found here.

AFS F-Yeah! T-Shirts

AFS T-Shirt: Fluoridation? F-Yeah!

The Story of the “F-Yeah!” Shirts

In May 2013, public health advocates in Portland, OR lost an emotional campaign to end their city’s distinction of being the the largest city in the United States that doesn’t fluoridate its public water supply.

Portland is the home to AFS Treasurer, Dr. Kurt Ferré, and a dental colleague who lives in the same neighborhood. It is also home to the sister of the colleague, who thought that the lawn sign with a smiley mouth for the pro-fluoridation campaign, was “too nice”. Being a high school chemistry teacher she took it upon herself to create a limited edition of her own, edgy, lawn sign for “Portlandia”. Taking the symbol for Fluorine from the Periodic Table she stenciled “Yeah!” to its right and placed the ballot measure number at the bottom. One of these creative lawn signs was placed in front of the home of her brother, the dentist friend of Dr. Ferré. Of course, Ferré noticed the sign immediately.

Win or lose there are always “lessons learned” from a political campaign. Dr. Ferré was asked to speak about the Portland fluoridation campaign at the 2014 National Oral Health Conference (NOHC) in Ft. Worth. Wanting to end his talk on a positive (and humorous) note, Dr. Ferré told the story of the “F Yeah!” lawn sign, held up the sign, and shouted “F Yeah! This was met with enthusiastic applause. A dental hygienist friend of Ferré’s immediately approached him afterwards and said, “Kurt, we need to make T-shirts with ‘F Yeah!’ on the fronts of them.

Since 2015 the AFS has had an exhibit booth at the NOHC spreading the word about the AFS “boots on the ground” advocacy for fluoridation, and selling tees. The edgy nature of the front of the tee has made for an excellent conversation starter, especially at dental and public health conferences. However, wearing the tee out in public was often met with blank stares. The board decided that the word “FLUORIDATION” placed above the F symbol might be a better configuration. The edgy “F Yeah!” would catch the attention of people, who would then notice the word “FLUORIDATION”.

While the new design will be the only one officially available from the AFS, as some Oregon public health colleagues have expressed a preference for the edginess of the original front logo, that logo will be available upon request.

The new tees are available on our website at a cost of $20.00 + $5.00 for shipping and handling.

About The American Fluoridation Society

The American Fluoridation Society was founded in 2014 by a group of concerned professionals anxious to see all residents of the United States served by community water systems enjoy the benefits of community water fluoridation (CWF). Equally important to this Society is to prevent rollback attempts by opponents of CWF, as well as to initiate CWF where it has not been previously available.