48 comments to “Fluoride in the Water: Too Much of a Good Thing?”

  1. Daniel

    Thank you for sharing this informative article. skeletal fluorosis worst cases that leads to crippling deformities of the joints and spine isnt cool at all, more need to be done to create awareness of fluoride exposure to prevent this kind of cases..

  2. Daniel

    This is very informative and great article.

  3. James Robert Deal

    From Attorney Deal:

    If McKay found less tooth decay in Colorado, it was not because of the fluoride but because the water was rich in calcium and magnesium.

    Fluoridation if just another profitable fraud. The body needs no fluoride. How absurd to adjust fluoride levels so that it will only cause a small amount of fluorosis. Why should we have any fluorosis?

    Fluoridation materials are filth.

    Fluorosilicic acid leaches lead from plumbing.

    Fluoride toothpaste is another profitable fraud. There are other, better ways to deal with tooth decay. Fluoride does not belong in toothpaste. Dentists should not apply it to their patients. It is all a profitable fraud. Any small benefit which some studies might show is far outweighed by the contraindications.

    Did you know that the final polish that the dental hygeneist applies is highly concentrated fluoride? Ask for pure pumice.


  4. John Mueller

    Here is the court order document in the lawsuit against the EPA:
    Notice the court’s heading for the document, “ORDER DENYING DEFENDANT’S MOTION TO DISMISS”
    Dr. Slott’s ignorance displayed by placing my referenced term, court order, in quotation marks reflects a clear lack credibility in his comments.
    For reviewing nonprofit organizations such as the Fluoride Action Network (FAN), and the American Fluoridation Society (AFS) which Dr. Slott proudly represents, GuideStar.org is the recognized, established and reliable reference site to review organizations’ missions, operations, financials, principal employees’ compensations etc. FAN evidently has no problem with GuideStar’s requests for data. AFS, on the other hand, may have issues. In GuideStar’s report on AFS as a nonprofit, its first substantive utterance is “Uh-oh! Looks like this nonprofit hasn’t claimed their profile yet.” That comment precedes the multiple “Response not provided” iterations in subsequent categories. How legitimate is the AFS?
    Dr. Slott’s prolific writings, or shall we say torturous verbosity, claiming “irrelevant” or “lies” or character assasinations when facts going counter to his “science” cannot be refuted, raise serious questions as to the legitimacy of pro-fluoridation’s underpinnings.

  5. John Mueller

    Bill Potter,
    We must understand that, just as Dr. Slott says the job of the water treatment plant operator is to do what he is told according to policy set by his municipality’s leadership, so Slott’s job as a dentist is also to do as he is told – in his case by the ADA. He is simply doing his best, as is Mr. Fierstien, as he dumps sodium fluorosilicate into his town’s drinking water out of bags labeled “POISON” with the ominous skull and crossbones. They think they’re preventing dangerous dental disease in those populations they’ve taken under their wing, armed with studies with predetermined conclusions and paid for to tout those conclusions (propaganda). Disinfection of water with chlorine has prevented certain diseases to a level of eradication – no apologetics needed. The ADA’s “Fluoridation Facts” on the other hand is nothing but a document providing a textbook example of apologetics in its entirety. The 72 years of “science” that says fluoridation is “safe and effective” is 72 years of apologetics, claiming support only from studies of low quality at best, as determined by Cochrane.

  6. William Potter

    by the way, do you notice in the close-ups of Rey in the latest Star Wars, her mild dental fluorosis?

  7. Bill Potter

    It is very unprofessional for Slott to assume blood fluoride levels are not important.
    That is the whole point!
    How can Cx43 studies (important to understanding dental fluorosis) not be correlated to Cx43 brain developmental studies.
    Come on, do your literature searches!

  8. Steven Slott

    Bill Potter

    What is “very interesting” is how uninformed antifluoridationists continue to believe that half-truths, misinformation, and misrepresented science somehow constitute “facts”. What is also “very interesting” is how these activists demand the sudden cessation of a public health initiative which has prevented significant amounts of dangerous dental infection in hundreds of millions of individuals over the past 72 years with no adverse effects to those individuals, based on nothing but these “facts”, speculation, and the erroneous personal opinions of these activists. What they fail to understand is that in making such a demand, the responsibility is theirs to provide valid evidence to support their demand. They have provided no such evidence.

    In regard to Potters claims:

    1. I have not “turned into anything”. Advocating for improved health of all citizens is an ongoing effort and responsibility of healthcare professionals from the very beginning of their careers.

    2. There are no valid, peer-reviewed scientific studies by Grandjean, or anyone else, which demonstrate any adverse effects from the bioaccumulation, “subtle” or otherwise, of fluoride from consumption of optimally fluoridated water in addition to that ingested from all other normal sources of fluoride intake.

    That which is ignored about studies such as by “Grandjean and others”, is their irrelevance to optimally fluoridated water in the US. Antifluoridationists pluck out-of-context quotes from these studies, misrepresent the conclusions of these studies, and make false claims about these studies, in order to claim “support” for their nonsensical claims about water fluoridation.

    An excellent example of this is Grandjean’s and Choi’s 2011 meta-analysis to which Potter refers here. This meta-analysis was a review of 27 Chinese studies dug out of obscure Chinese journals by researchers Phillippe Grandjean and Anna Choi. These studies were of the effects of high levels of fluoride (as high as 11.5 ppm) in the well-water of various Chinese, Mongolian, and Iranian villages.

    By the admission of Grandjean and Choi, themselves, these studies had key information missing, inadequate control for confounders, and questionable methodologies. These 27 studies were so seriously flawed that Grandjean and Choi were led to issue a public statement in March, 2012 that the studies should not be used to judge water fluoridation in the US. This obviously has not stopped antifluoridationists from doing so anyway.

    “These results do not allow us to make any judgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the U.S. On the other hand, neither can it be concluded that no risk is present. We therefore recommend further research to clarify what role fluoride exposure levels may play in possible adverse effects on brain development, so that future risk assessments can properly take into regard this possible hazard.”

    –Anna Choi, research scientist in the Department of Environmental Health at HSPH, lead author, and Philippe Grandjean, adjunct professor of environmental health at HSPH, senior author.

    3. Water fluoridation is not about “blood fluoride levels”. It is about the observation in countless peer-reviewed scientific studies that at a certain concentration of fluoride in public drinking water supplies, a significant amount of serious dental infection is prevented in entire populations served by that water, with no adverse effects to anyone.

    When the simple adjustment of the concentration of an existing mineral in water supplies can prevent serious disease in entire populations, it is ludicrous not to do so. It is even more ludicrous to suddenly demand blood testing for that mineral which individuals have been ingesting in water since the beginning of time.

    4. The effects of fluoride are both topical and systemic. The systemic effects are demonstrated in the mild to very mild dental fluorosis which is the only dental fluorosis in any manner associated with optimally fluoridated water. Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse. Dental fluorosis can only occur systemically.

    —-The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH

    Additionally, saliva with fluoride incorporated into it provides a constant bathing if the teeth in a low concentration of fluoride all throughout the day, a very effective means of dental decay prevention. Incorporation of fluoride into saliva occurs systemically.

    —-Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States
    United States Centers for Disease Control
    Recommendations and Reports
    August 17, 2001/50(RR14);1-42

    5. There is no valid, peer-reviewed scientific evidence of any adverse effects on anyone resultant of bioaccumulation of fluoride from optimally fluoridated water.

    In order to credibly demand proof of no toxicological harm from optimally fluoridated water, there must first be valid evidence that such harm may exist. There is no such evidence.

    6. If Potter, or anyone else, desires not to drink fluoride, they are completely free not to drink it. Entirely their choice.

    Steven D. Slott, DDS

  9. Steven Slott

    John Mueller

    The only “court order” was denial of the EPA motion to dismiss the case. So what? All that means is that FAN will be allowed to waste more court time and resources arguing its “case” that fluoridated water causes an “unreasonable risk of harm”…..a case that antifluoridationists have never been able to make, and never will, because there is no harm to anyone from optimally fluoridated water. FAN will present nothing but the same arguments which the EPA has already dismantled once, and will do so again for the sake of the court.

    The motion simply sought for the court to save time and money for everyone by concluding now that there is no case, exactly as it will after FAN wastes time with its anecdotes, groundless claims, and irrelevant studies……..just as has occurred countlessly through the decades with antifluoridationists who continue to deny the facts, evidence, and peer-reviewed science.

    Steven D. Slott, DDS

  10. Bill Potter

    It is very interesting to see how former (?) dentists like Slott, who have turned into pro-fluoridation activists, can ignore environmental studies by Grandjean and others, who suggest that subtle cummulative effects related to excessive fluoride intake are significant. The importance of blood fluoride level measurements are swept under the carpet by the pro-fluoridation activists. Now that NHANES blood fluoride data is finally available, for at least some individuals, it is up to those that are promoting fluoridation to finally put their data to the test…
    To start, what is the dental decay rate vs blood fluoride levels? Is it significant? Or as concluded by many others, fluoride works topically, and ingestion is not required. How can this basic question still be unanswered?
    And to continue, at what level of blood fluoride do the chronic commulative effects of fluoride toxicity begin? This is an important health question that has not been answered, rather remarably considering the wide-spread exposure levels and strong evidence of genetic susceptibility differences.
    Please stop the recriminations, and just show me the peer-reviewed evidenced of efficacy vs toxicity, using data of blood fluoride! Otherwise, stop pushing for us to drink fluoride!

  11. John Mueller

    This court order was filed yesterday: http://fluoridealert.org/wp-content/uploads/tsca.12-21-17.denies-epa-motion-to-dismiss.pdf
    It is the latest good news in the lawsuit mentioned in some of the comments below. It may spell the beginning of the end of artificial fluoridation at the federal EPA rule-making level.

  12. John Mueller

    Merry Christmas to any and all who have chosen to participate in and/or follow this exchange.
    Thank you, Fair Warning, for indulging it as it has unfolded.
    May the grace, love and peace from the reason for the season be with us now and always.

  13. Steven Slott

    John Mueller

    John, you just can’t help yourself, can you? You start out by “First, I do not lie”…..then proceed to state one lie after another. Your ”higher standard” has obviously plateaued about four stories underground.

    1. Dental fluorosis is composed of several distinct levels, with the only one that could even be remotely be considered to be “harm” is the severe level. As noted on page 114 of that same report of the 2006 NRC Committee which you misrepresent in this comment, severe dental fluorosis does not occur in communities with a water fluoride content below 2.0 ppm. Water is fluoridated at 0.7 ppm, one third that level. This same committee considered only severe dental fluorosis to be an adverse effect. Very mild, mild, and moderate are nothing more than cosmetic effects. As Dave Fierstein noted, the only level of dental fluorosis which may be associated with optimally fluoridated water is mild to very mild, a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. Those with mild dental fluorosis are generally not even aware of it.

    There is no valid, peer-reviewed scientific evidence to support your unsubstantiated speculation that dental fluorosis “may indicate other potential harm to other parts of the body.” That type of groundless speculation is yet another tactic frequently employed by irresponsible fluoridation opponents.

    2. Your claim that It is a “joke” to claim that the establishment of the original optimal level of fluoride in drinking water is yet further example of your complete lack of understanding of this issue.

    “The architect of these first fluoride studies was Dr. H. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health (NIH). Dean began investigating the epidemiology of fluorosis in 1931. One of his primary research concerns was determining how high fluoride levels could be in drinking water before fluorosis occurred. To determine this, Dean enlisted the help of Dr. Elias Elvove, a senior chemist at the NIH. Dean gave Elvove the hardscrabble task of developing a more accurate method to measure fluoride levels in drinking water. Elvove labored long and hard in his laboratory, and within two years he reported back to Dean with success. He had developed a state-of-the-art method to measure fluoride levels in water with an accuracy of 0.1 parts per million (ppm). With this new method in tow, Dean and his staff set out across the country to compare fluoride levels in drinking water. By the late 1930s, he and his staff had made a critical discovery. Namely, fluoride levels of up to 1.0 ppm in drinking water did not cause enamel fluorosis in most people and only mild enamel fluorosis in a small percentage of people.”

    —The Story of Fluoridation
    National Institute of Dental and Craniofacial Research

    In order to allow for different levels of water consumption, the optimal was set as a range of
    0.7-1.2 ppm which encompassed that 1.0 ppm optimal level.

    3. In 2011, the CDC recommended that optimal range of fluoride in drinking water be eliminated and replaced by a single point on that range. This recommendation was made in response to recent scientific evidence which had demonstrated that, due to air conditioning and other modern amenities, there no longer exists any significant difference in water consumption resultant of climate changes. After several years of evaluation, the DHHS determined that given the greater availability of fluoride from multiple sources now, than when the optimal was originally set, the optimal could be reset at the low end of the previous range, with no significant loss of dental decay prevention. In 2015 DHHS eliminated the optimal range and reset the optimal at 0.7 ppm.

    4. The “major part of the body of science” clearly demonstrating the safety and effectiveness of optimally fluoridated water are the countless peer-reviewed studies demonstrating its effectiveness in the prevention of significant amounts dental decay in entire populations, and the fact that after 72 years, hundreds of millions having chronically ingested optimally fluoridate water during that time, there have been no proven adverse effects of this initiative. Zero.

    5. The 2006 NRC Committee on Fluoride in Drinking Water was charged to evaluate the adequacy of the EPA primary and secondary MCLs for fluoride, 4.0 ppm and 2.0 ppm respectively, to protect against adverse effects. As noted on page 352 of that report, the final recommendation of this Committee was for the primary MCL to be lowered from 4.0 ppm. The sole reasons cited by the Committee for this recommendation were the risk of severe dental fluorosis, bone fracture, and skeletal fluorosis, with chronic ingestion of water with a fluoride content of 4.0 ppm or greater. Nothing else. Had this Committee deemed there to be any other concerns with fluoride at this level, it would have been responsible for stating so and recommending accordingly. It did not.

    Additionally, the NRC Committee made no recommendation to lower the secondary MCL of 2.0 ppm. Water is fluoridated at 0.7 ppm. one third the level which the 2006 NRC Committee on Fluoride in Drinking Water made no recommendation to lower.

    In March of 2013, Dr. John Doull, Chair of the 2006 NRC Committee on Fluoride in Drinking Water made the following statement:

    “I do not believe there is any valid, scientific reason for fearing adverse health conditions from the consumption of water fluoridated at the optimal level”

    —John Doull, MD, PhD, Chair of the National Academy of Sciences, National Research Council 2006 Committee Report on Fluoride in Drinking Water

    6. There have been no valid, peer-reviewed scientific studies, relevant to water fluoridation in the US, demonstrating harm from fluoride at the optimal level at which water is fluoridated. This complete lack of evidence is why “the EPA has placed fluoride in drinking water on their back burner.” Your unsubstantiated claims notwithstanding, there is no reason to do otherwise.

    7. Sure, we all believe what we choose to believe. This is no more clearly evidenced than by the unchangeable mindset of fluoridation opponents, such as you, which is so ingrained in skewed personal ideology against fluoridation, that no amount of facts, evidence, and peer-reviewed science presented to them will change that mindset. After having had all your arguments clearly refuted with facts and evidence, that you are still flailing away, your objection now having been reduced to dependence on ridiculous claims of “morals, ethics, and high standards” is excellent demonstration of that mindset.

    As Moynihan stated, “you are welcome to your own opinions but not your own facts”. You obviously do not understand the difference between your own opinions and the facts.

    8. Your attempted disparagement of Griffin’s 2011 peer-reviewed cost-effectiveness study is unqualified, and obviously of no merit. The reality is that there are numerous studies, including Griffin’s, which demonstrate a cost savings of $24-$60, or more, per $1 spent on fluoridation. I will be glad to cite the studies if you so desire.

    9. Dave Fierstein has clearly exposed your claim that “There is no money to be gained by any of us seeking that same endpoint” to be yet one more in your ever increasing list of lies fabricated from that “higher standard” of yours.

    You very nicely example the dishonesty, hypocrisy, and lack of knowledge of even basics facts of fluoridation, so typical of fluoridation opponents, John.

    Steven D. Slott, DDS

  14. David Fierstien

    John Mueller, let’s start with this: “I have nothing to gain from trying to end fluoridation. Nor does anyone similarly opposing it. There is no money to be gained by any of us seeking that same endpoint.”

    Mercola LLC. funds the Fluoride Action Network. According to Dr. Stephen Barrett: “The money for (Mercola’s) donations was funneled from Mercola.com Health Resources LLC through Mercola’s nonprofit Natural Health Resources Foundation, which showed the following grants on its tax returns . . . American Environmental Health Studies Project (2011) $10,000 . . (2012) $10,000 . . . (2013) $25,000 . . . (2014) $20,000 (TOTAL) $65,000.”

    “Fluoride Action Network (FAN), the leading promoter of misinformation about fluoridation. Its donations are funneled through the nonprofit American Environmental Health Studies Project.” https://www.quackwatch.org/11Ind/mercola.html

    Of course that doesn’t include Mercola’s other donations like $25,000 for “Fluoride Awareness Week.” ( http://fluoridealert.org/news/mercola-com-to-donate-25000-for-fluoride-awareness-week/ ) Nor does it include other donations from, for example, David Green, the first person to comment under this article. He sells bottled water for a living. Mercola, as I have mentioned, sells very expensive fluoride free toothpaste, very very expensive home water filtration units, and Chlorella which is sold as a fluoride detox.

    The paranoia that the Fluoride Action Network generates about fluoride and safe tap water help these donors sell their expensive products. And, as Dr. Barrett has noted, allows for the funneling of funds through a tax shelter.

    Then there is this from you: When I asked for a documented example of harm to any person from drinking optimally fluoridated water, you said, “dental fluorosis is manifest harm in and of itself from overexposure to fluoride to which optimally fluoridated water is a major contributor, and may indicate other potential harm to other parts of the body.”

    Have you ever wondered why no one with dental fluorosis has ever sued because of water fluoridation? Answer: Because the only degrees of DF associated with optimally fluoridated water are Very Mild and Mild. This condition does not diminish quality of life. The condition is characterized by barely noticeable white flecks, so unnoticeable in fact that teeth are dried and put under special lighting for the condition to be photographed. Moreover, teeth with this condition are healthier and more resistant to decay:

    This study’s findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis.”
    https://www.ncbi.nlm.nih.gov/pubmed/19571049 That is why people don’t sue over mild dental fluorosis.

    Your quote: ” . . the study purporting to show “every $1 spent on fluoridation saves $38 in dental treatment costs.” I suggest you research that yourself,” Response: I don’t have to. I know for a fact that the cost of water fluoridation equals about $1 per person per year. How much does it cost at your municipality per capita per year? Since numerous studies have shown a decrease in caries (as Dr. Slott has provided), the savings is obvious.

    And, finally, there is this: “First, I do not lie.”

    Of course you don’t. That’s why you first told us what current shipments of FSA to your facility consisted of, you know, currently, . . . then, when asked why, if you believe you are poisoning people, why are you doing it, . . . then you said that was two years ago. You’re retired now, . . . then when asked where you had worked (so I could check it out myself), you failed to provide an answer.

    Of course, the reason I ask is to verify your motives. If water fluoridation is ended in your distribution system, that would mean less work, less analysis, less responsibility, less cost . . and probably not a reduction in your water rates.

    Of course you don’t lie.

  15. John Mueller

    David Fierstien,
    First, I do not lie.
    Second, dental fluorosis is manifest harm in and of itself from overexposure to fluoride to which optimally fluoridated water is a major contributor, and may indicate other potential harm to other parts of the body. If DHHS did not recognize it as harm or objectionable in some way, then there would have been no reason to reduce the recommended optimum level to a flat 0.7 ppm from the previous range of from 0.7 to 1.2 ppm. And to claim that initial range was established scientifically is a joke. How scientific is estimating how much water people are expected to drink depending on the climate where they live? But that is a major part of the body of “science” Dr. Slott is holding up with the mantra of “fluoridation is safe and effective.”
    Third, and final, the NRC’s 2006 report raised enough questions on what fluoride exposure levels may or may not be safe. Numerous studies have been published since then indicating potential harm, and yet the EPA has placed fluoride in drinking water on their back burner. Why?
    Finally, we all believe what we choose to believe and who we choose to believe. If I see a red flag, I will usually question the motivation behind it. The ADA’s published “Fluoridation Facts” gave me some of the first red flags, especially endnote #355, the study purporting to show “every $1 spent on fluoridation saves $38 in dental treatment costs.” I suggest you research that yourself, and dig deep into the “science” that generated that quantifying conclusion.
    I have nothing to gain from trying to end fluoridation. Nor does anyone similarly opposing it. There is no money to be gained by any of us seeking that same endpoint. That is what I choose to believe, a personal ideology. And the spirit and intent of the SDWA, I also choose to believe, is the higher standard at issue here.
    Good day, sir.

  16. Steven Slott

    John, clearly your contempt is for those who do not agree with your erroneous personal opinions and interpretations. The SDWA is not defined by what John Mueller personally deems to be its “spirit and intent”. If you want to change federal law, then run for Congress. Deeming it to be whatever seems to fit with your personal ideology is obviously meaningless and irrelevant.

    Attempting to portray themselves as victims by alleging “ad hominem attack” is a diversionary tactic frequently employed by fluoridation opponents when they have had all of their arguments refuted, their fabrications revealed, and their objections exposed as having no foundation in fact, evidence, or peer-reviewed science.

    Steven D. Slott, DDS

  17. John Mueller

    Dr. Slott,
    My only contempt regarding the regulations is for the institution that abuses them by violating the spirit and intent by which they were promulgated, and for those who feel the most effective defence of that institution is with ad hominem attacks on others with opposing ideologies.
    Good day, sir.

  18. David Fierstien

    John Mueller,

    The comment that jumped out at me, from your rather apologetic declaration, was this: “By that acknowledgement, Dr. Slott is also implicitly recognizing us “fear mongers” as holding to a higher moral and ethical standard.”

    Ethical standard? That’s a laugh. This is your quote: “The FSA is tyipically delivered at between 23% to 25% strength, and the AFI (available fluoride ion) for FSA is 0.792.” . . . . “Is,” as in Present Tense.

    This is also your quote: “I retired from the referenced municipality almost two years ago.” I find it odd that someone with your advanced experience, training, and education would make the mistake of confusing Past Tense with Present Tense.

    Moreover, you never referenced any municipality. Perhaps you could alleviate my suspicions and actually reference that municipality. That way I wouldn’t think you were just trying to cut costs and the work load, in hopes of charging your customers the same water rates and increasing your profit. Please, for my own peace of mind, where “did” you work? I’d love to be able to see for myself that you aren’t lying.

    Nevertheless, this is also your quote: “My arguments are based on science, personal hands-on experience, formal training, and facts gleaned from 8+ years of studying fluoridation’s history and science . . ” And you retired 2 years ago? My math tells me that even if you weren’t lying about being retired, you still believed you were poisoning people for 6 years . . and you willingly, knowingly did it. I would love to continue discussing your “higher moral and ethical standard,” but there is more to discuss.

    As expected, you could not cite one documented case of any human being who has ever been harmed in any way by drinking optimally fluoridated water. Nor could you cite the lawsuit that would have naturally followed from such an event. That is because no human being has ever been harmed by drinking optimally fluoridated water.

    Your quote: ” . . the petition you cited focused on fluoride and the evidence of its toxicity. Arsenic content in fluoridating chemicals was not mentioned.”

    Ah yes. You are quite right. First, since arsenic in the fluoride additive is your major concern, it is odd that the Fluoride Action Network, in its petition to the EPA to end water fluoridation, never mentioned this. That is why the EPA, in that document, never addressed it. Out of Nine arguments that FAN put forth, arsenic was never mentioned, and yet this is your major concern. You would think that “FAN” would have put their most compelling arguments forward first. But it appears even FAN doesn’t put your little arsenic argument at the top of its list of Gish Galloping arguments.

    However, William Hirzy did file a petition with the EPA based solely on the “arsenic” argument. You must know this, because you have been studying this issue for 8+ years. Hirzy’s petition was also rejected by the EPA. And you are telling us that somehow, you have more insight into the “spirit” of the SDWA than the EPA, which is responsible for the SDWA? I find it odd that someone like you, who has such a “seasoned understanding of the spirit and intent of the SDWA” would be in disagreement with the Agency which oversees the SDWA.

    John, what was that municipality again? And why is it that with all this alleged harm that you people claim exists from optimally fluoridated water . . . why can’t you ever seem to provide actual examples of harm?

  19. Steven Slott

    John Mueller

    No, John, I did not state that your arguments are “based on ideals”. Again, you seem not to understand that your fabrications are easily verified as such by viewing the comments still clearly visible on this page.

    What I stated was that your objection to fluoridation is not grounded in science, it is grounded in personal ideology. It is the same skewed ideology against fluoridation that has existed amongst activists since the anti-government paranoia of ultra conservative groups such as the John Birch Society at the very beginning of fluoridation in the 1940s. That you believe this to be a “compliment” of some sort, and consider your science denial to be “holding to a higher moral and ethical standard” is not surprising in the least. Do you also consider your fabrications and intentional efforts to mislead the public with nonsense you’ve gleaned from antifluoridationist groups as “holding to a higher moral and ethical standard”, as well?

    As far as your claim of a lawsuit by “FAN”, the EPA policy is that any of its decisions on submitted petitions may be appealed. Upon the rejection of its latest meritless petition to the EPA, “FAN” chose to take that option, and appealed the decision. The appeal filed in federal court by “FAN” is nothing but a conglomeration of anecdotal tales from antifluoridationists and the same arguments which were soundly rejected with facts and evidence provided in a 40 page document by EPA reviewers. That document may be viewed in entirety on the Federal Register of the US government:


    Evidently “FAN” believes the federal court system can be swayed by nonsensical anecdotes, and will find some alternative set of facts existing in a fantasy world somewhere or another, which inexplicably were not considered by the EPA in its original rejection.

    Steven D. Slott, DDS

  20. Steven Slott

    John Mueller

    1. As can easily be noted in your comments, the only science you cite is in irrelevant claims about the contaminant level in raw, undiluted HFA, which you, yourself, have admitted fall way below EPA mandated maximum allowable levels of safety for drinking water.

    Other than that, your arguments have been nothing but your own personal opinions and interpretations, all of which have been clearly refuted on this page by facts and evidence.

    Given that your arguments are the same discredited ones constantly attempted by fluoridation opponents, verbatim, all over the US and elsewhere, it is clear that your “8+ years of studying fluoridation’s history and science” has been limited to misinformation from antifluoridation groups and their websites.

    2. There are no “sides” to the issue of water fluoridation, and there is no “spin” from fluoridation advocates. There are simply the facts, evidence, and peer-reviewed science clearly supporting the safety and effectiveness of the initiative……and the false statements, unsubstantiated claims, misrepresented science, and misinformation of fluoridation opponents seeking to impose their decades-old ideology against fluoridation onto entire populations, to the detriment of the health and well-being of those populations.

    3. Perhaps you don’t realize that all of our comments are still clearly visible on this page. I’m fine with the ability of intelligent readers to easily ascertain that all of your arguments and misinformation have indeed been refuted with facts and evidence. Denial of facts, evidence, and peer-reviewed science is characteristic of the overwhelming majority of fluoridation opponents.

    4. The one who is adapting EPA policy to his own “projections or interpretations” is obviously you. You seem not to understand that EPA policy is not determined by your personal opinions.

    From the EPA:

    “MCLGs are non-enforceable public health goals. MCLGs consider only public health and not the limits of detection and treatment technology effectiveness. Therefore, they sometimes are set at levels which water systems cannot meet because of technological limitations.”

    “The MCL is set as close to the MCLG as feasible. Taking cost into consideration, EPA must determine the feasible MCL or treatment technique. This is defined by SDWA as the level that may be achieved with:
    • use of the best available technology or treatment approaches
    • other means which EPA finds are available (after examination for efficiency under field conditions, not solely under laboratory conditions)”


    5. Your contempt for drinking water regulations, and the water utilities which comply with them, is so noted.

    6. As far as your “IRREFUTABLE FACTS” :

    a. The contaminant content of raw, undiluted substances routinely added to public water supplies is irrelevant, regardless of any “analytical reports” you claim to have been given to you by your friends.

    All drinking water must meet all of the stringent, EPA mandated quality requirements under Standard 60 of NSF International. Standard 60 requires that no contaminant exist in water at the tap in excess of 10% of the EPA MCL for that contaminant. Water fluoridated with HFA easily meets all of those requirements.

    For proper education on EPA requirements for contaminants, and precise levels of any detected contaminants in optimally fluoridated water at the tap, I recommend you refer to the “Fact Sheet on Fluoridation Substances” on the website of NSF International.

    b. For information on the difference between the non-mandated EPA goal for contaminants and its mandated, safe and attainable maximum allowable level of contaminants, see my previous comments. They are self explanatory.

    As far as the likely undesirability of a zero level of arsenic:

    “Definition of specific biochemical functions in higher animals (including humans) for the ultratrace elements boron, silicon, vanadium, nickel, and arsenic still has not been achieved although all of these elements have been described as being essential nutrients.”

    —Nutritional requirements for boron, silicon, vanadium, nickel, and arsenic: current knowledge and speculation.

    Nielsen FH.
    FASEB J. 1991 Sep;5(12):2661-7.

    c. Water fluoridation is simply the adjustment of existing fluoride concentration in public water supplies up to that level at which the prevention of significant amounts of very serious bacterial dental infection has been observed, in countless peer-reviewed studies, to occur in populations served by those supplies. The fluoride added is identical to that which already exists in water.

    You are certainly free to attempt your “medication” argument in court if you so choose. However, given the zero success of that nonsense in court through the decades, I don’t much like your chances with that.

    d. Whatever is the FDA “criteria” for anything is irrelevant to water fluoridation. The FDA has no jurisdiction over the contents of public drinking water supplies. That jurisdiction falls entirely under that of the EPA.

    e. If you believe the United States Department of Health and Human Resources to be putting forth “half-truths” and “propaganda” in regard to its official recommended optimal level of 0.7 ppm fluoride in drinking water, you are certainly free to take valid documentation supporting your allegation to the proper authorities. Bear in mind that your unsubstantiated personal opinion does not qualify as such.

    7. Whether fluoride is an essential nutrient is irrelevant to the prevention of dental disease by water fluoridation. For informational purposes, however, in regard to your claim that fluoride is not an essential nutrient:

    “This report focuses on five nutrients—calcium, phosphorus, magnesium, vitamin D, and fluoride, all of which play a key role in the development and maintenance of bone and other calcified tissues.”

    —-Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US); 1997. Preface.

    “Fluoride is regarded as an essential nutrient now well known to be effective in the maintenance of a tooth enamel that is more resistant to decay.”

    —-Fluoride as a Nutrient
    American Academy of Pediatrics
    Committee on Nutrition
    Pediatrics, vol. 49, No 3, March 1972

    “Fluoride is a normal constituent of the human body, involved in the mineralisation of both teeth and bones (Fairley et al 1983, Varughese & Moreno 1981). The fluoride concentration in bones and teeth is about 10,000 times that in body fluids and soft tissues (Bergmann & Bergmann 1991, 1995). Nearly 99% of the body’s fluoride is bound strongly to calcified tissues. Fluoride in bone appears to exist in both rapidly- and slowly-exchangeable pools. Because of its role in the prevention of dental caries, fluoride has been classified as essential to human health (Bergmann & Bergmann 1991, FNB:IOM 1997)8”

    —–Australian Government
    National Health and Medical Research Council

    8. Adverse effects and fatalities from accidents resultant of mishandling and misuse of countless substances, and/or “equipment malfunctions”, are certainly unfortunate and undesirable. However, they are no more reason to deprive entire populations of the disease preventive benefits of water fluoridation, than are they to deny populations the disease preventive benefits of chlorine, ammonia, or any of the myriad other substances routinely added to public water supplies.

    9. As a water treatment engineer, you have no qualifications to render any credible opinion on the best means of prevention of oral disease, nor, obviously, are you aware of the ongoing efforts that have been occurring for the last century in this regard. Your superficial “solution” to the overwhelming problem with untreated dental infection would certainly be nice, but has no basis in reality.

    Steven D. Slott, DDS

  21. John Mueller

    David Fierstien,
    I retired from the referenced municipality almost two years ago. I shared my knowledge with and made my objections known to select fellow employees at various levels above and below me, as well as to the water department manager, the utility board, and the mayor. I pursued every possible legitimate and procedurally correct avenue to revoke the 50+ year old fluoridation city ordinance. I became concerned, if not legitimately paranoid that if I did not retire, they may choose to terminate me.
    As for SDWA, the petition you cited focused on fluoride and the evidence of its toxicity. Arsenic content in fluoridating chemicals was not mentioned. And, FYI, a lawsuit is in progress as a result of the EPA denying the petition. A formal complaint has been filed with the U.S. District Court of the Northern California District.
    Please know that understanding and answering to the SDWA regulatory requirements for assuring “safety” of the drinking water was foundational to my engineering career in the public sector for many years, along with understanding the water treatment processes in detail down to the electronegativities, specific gravities, Van see Waals attractive forces, filtration and adsorption, and other mechanisms involved in removing pathogenic and other harmful substances from the water. With an engineering degree, my practical training, experience, licensing and certifications in that specific field began in California in the ‘90s while employed with one of the 300 largest systems in the U.S. required to collect data under the EPA’s Information Collection Rule, promulgated in 1996. Under public funding primarily from revenues from water bills, bonds, and other financing for public water utility operations and maintenance, immediate, short-term and long-term regulatory compliance is the ultimate objective, and hence the prevailing overarching mindset. I myself once stated in a memorandum to my manager after seeing the FSA’s arsenic contamination, “ . . . but we’re below the MCL [for arsenic] so we’re okay.” I have since then changed my tune after “an attack of conscience” and as Dr. Slott has acknowleged, my arguments are based on ideals as with most of us opposing fluoridation. By that acknowledgement, Dr. Slott is also implicitly recognizing us “fear mongers” as holding to a higher moral and ethical standard. I am sure others will appreciate that impromptu complement coming from Dr. Slott, as I certainly do. Contrary to Dr. Slott’s claim of myriad chemicals used at treatment plants, the whole truth for Dr. Slott is that the number of different chemicals used to treat the water to an acceptable level of purity (a relative term, but essentially meets all primary drinking water quality standards per SDWA regulatory requirements) can be counted on one hand (plus one finger or thumb) for most plants utilizing conventional treatment processes. The raw water’s general flow path through the plant sequence is coagulation, flocculation, sedimentation, filtration, disinfection.
    I hope this answers your questions and concerns, and more.
    Again for ready reference, here is EPA’s definition of a maximum contaminant level goal: “The MCLG is the maximum level of a contaminant in drinking water at which no known or anticipated adverse effect on the health of persons would occur, allowing an adequate margin of safety.”
    In my mind, if the MCLG for arsenic is zero, i.e., there is no margin of safety for ANY arsenic in the drinking water, then why are we adding it after already having spent so much money and gone to great lengths to make it safe? I and many others have asked for data that quantifies the trade-off for fouling our own systems, but evidently it either does not exist or it has been successfully refuted.
    And finally, my seasoned understanding of the spirit and intent of the SDWA can be summed up by Googling “SDWA purpose”.
    The first item listed on my screen has “ . . . protects public drinking water supplies . . . to ensure drinking water safety.”
    Need I say more?

  22. John Mueller

    Dr. Slott,
    My arguments are based on science, personal hands-on experience, formal training, and facts gleaned from 8+ years of studying fluoridation’s history and science and the spin on both sides of the controversy. Contrary to your very imaginative claim, my arguments have not been refuted in any way. Please refer again to EPA’s definition of MCLG. Your hubris and professed insight into EPA’s policy setting procedures do not render their own published definition adaptive to your own projections or interpretations. From the typical water utility’s regulatory compliance mindset, myopic as may be in that regard, and which you obviously cannot see beyond, arsenic contamination below the MCL at the tap is not an issue. However:
    The IRREFUTABLE FACT remains that measurable quantities of arsenic are knowingly and routinely added to our tap water via fluoridation with FSA. (I have analytical reports, obtained by a dentist friend, from the Mosaic Company on their letterhead that show their FSA product has had 61 ppm arsenic in representative product sampling. That is a FACT.)
    The IRREFUTABLE FACT remains that the EPA’s MCLG for arsenic is zero.
    The IRREFUTABLE FACT remains that drinking water is artificially fluoridated with the sole declared intent to treat the consuming population for tooth decay, a disease.
    The IRREFUTABLE FACT remains that ingestion of a substance to treat a disease is medication, whereby fluoridation is medication; and by the FDA’s criteria fluoride is an unapproved drug, another IRREFUTABLE FACT.
    That fluoridation seeks to “optimize” the fluoride ion content of the tap water is your ONLY irrefutable fact – and a clear and distinct half-truth. Your claims are textbook defining examples of half-truths and misleading information – aka propaganda. Your “scientific” definition of fluoridation does not negate the irrefutable fact that the ion adjustment has one purpose and one purpose only – to treat the people who drink it for tooth decay. Fluoride is not an essential nutrient. If you disagree, then present evidence of illness or death of anyone from fluoride nutrient deficiency and fluoride nutrient deficiency alone. You are undoubtedly aware of fatal acute poisoning’s from excessive ingestion of fluoride intended for treating tooth decay – fluoridation equipment malfunctions, inadequately supervised treatment in the dentist chair, for example.
    It’s not a perfect world, of course, but fluoridation increases risk of harm. The best caries prevention is brushing the teeth, and proper diet and nutrition, and education on proper oral hygiene. As a dentist, you should know that, but apparently have forgotten.

  23. David Fierstien

    John Mueller, please clarify. Either you believe the fluoride additive is harmful to people, and you provided it to your customers anyway . . or you are not being honest here. Which of these statements applies to you??

  24. David Fierstien

    Quote from John Mueller: “Knowingly adding a regulated contaminant with an MCLG of zero to otherwise purified water violates the spirit and intent of the SDWA.”

    Response: The EPA, which as you must know oversees the SDWA, disagrees with you. I direct your attention to “Fluoride Chemicals in Drinking Water; TSCA Section 21 Petition; Reasons for Agency Response.” This was the EPA’s response to a 2016 petition submitted by your friend, Paul Connett and his Fluoride Action Network – and others.

    Somehow, you have gleaned “the spirit” of this very precise document which the EPA seems to have overlooked.

    My one sentence response which you asked for: Take them to court.

    Instead of effecting real change, you choose to generate unfounded paranoia among a population which doesn’t fully understand the science, and whose eyes you can pull the wool over by whining about it on the internet. I always like to ask why smart people like you choose to be deceptive and generate unfounded paranoia. Paul Connett and his Fluoride Action Network is easy. They accept funding from people who sell expensive fluoride free toothpaste, water filters, bottled water, (and I looked this one up – sure enough) fluoride detox.

    But you, a knowledgeable water engineer? What do you stand to gain? Less work . . less analysis . . less responsibility . . less cost, and if fluoride is eliminated from your municipality . . will you lower costs? Doubtful. As a servant of the public, you should be ashamed of yourself.

    So let’s recap, John. You claim that you fully believe the fluoridation chemicals that you have injected into your customers’ drinking water was harmful to them, and you did it anyway. Let me guess, “You were only following orders.” Where have I heard that before?

    Nevertheless, optimally fluoridated water has never harmed one human being who drinks it. Feel free to prove me wrong. Please cite one documented case of any human being who has ever been harmed by drinking optimally fluoridated water . . even for as much as a lifetime. And, also, please reference the lawsuit that would have naturally followed from a local government putting something poisonous into its citizens’ water and causing them physical harm.

    After all, even McDonald’s was successfully sued because its coffee was too hot. If anything merits a lawsuit, is the mass poisoning, and harming, of people through their drinking water. So let’s see the lawsuit.

  25. Steven Slott

    John Mueller

    Having had all your arguments refuted with facts and evidence, it is quite obvious that your objection to fluoridation is not grounded in science, but rather in personal ideology, as is the case with the vast majority of fluoridation opponents.

    As you admit in your comment, even your own calculations put the level of arsenic in tap water fluoridated with HFA at but 1.8% of the EPA maximum allowable level of safety (MCL), and but 18% of the stringent NSF International Standard 60 requirements. So, the real question is…….Given that you are fully aware that the level of arsenic in optimally fluoridated water at the tap is entirely safe, posing no risk to the health of anyone, why do you fear-monger about arsenic in raw, undiluted HFA, and seek to intentionally mislead readers with the EPA MCLG which I have fully explained in a previous comment?

    The “spirit and intent” of the SDWA is to ensure safe drinking water. It is not to ensure fluoride-free water, as you seem to believe. You have provided no evidence, whatsoever, that optimally fluoridated water is in any manner unsafe.

    As far as your “otherwise purified water”, check the annual water quality report of any public water system to see how “purified” is its water. Most is full of safe levels of contaminants.

    Steven D. Slott, DDS

  26. John Mueller

    David Fierstien,
    Fear not my math skills or capabilities; I never claimed the resulting arsenic at the tap due to FSA to be anywhere close to the MCL. To the contrary, my calculations have put that value at up to about 0.18 ppb, worst case. (The FSA is tyipically delivered at between 23% to 25% strength, and the AFI (available fluoride ion) for FSA is 0.792.) The different inaccuracies in your comment roughly cancel out, or are insignificant.
    I would challenge you or Dr. Slott to defend your fluoridation arguments in one sentence, as I can succinctly offer one of mine, again: Knowingly adding a regulated contaminant with an MCLG of zero to otherwise purified water violates the spirit and intent of the SDWA.

  27. Steven Slott

    John Mueller:

    1. There is nothing “reckless” about water fluoridation. It is the controlled introduction of additional fluoride ions to water systems whose existing fluoride concentration is below the optimal level of 0.7 ppm, such that maximum benefit will be received from those consuming those ions, without incurring adverse effects. As a water treatment engineer you should understand that if the introduction of any of the myriad substances routinely added to public water systems is done so in a “reckless” manner, that is a problem with the education, training, and oversight of the personnel performing those additions, not one with the substances themselves.

    2. The stale “medication” argument is nothing but nonsense sourced from antifluoridationist groups. Hopefully your use of this argument is not reflective of poor overall judgment on your part in relying on dubious sources for critical information in lieu of obtaining accurate information from reliable, respected sources.

    Fluoride has existed in water since the beginning of time. To suddenly proclaim it to be “medication” is obviously ludicrous……which is one reason why no court of last resort has ever affirmed the ridiculous “forced medication” argument in the countless times fluoridation opponents have wasted court time and resources trotting it in through the decades.

    3. The “informed consent” argument is another one gleaned from antifluoridationist groups. It is clear demonstration of the lack of understanding of both the fluoridation issue, and of the concept of informed consent.

    Informed consent applies to treatment rendered, not to the approval of the concentration level of existing minerals in public water supplies. Any who believe the drinking of a glass of water to be a treatment of some sort, requiring their informed consent, are entirely free to first inform themselves, then give or not give consent to themselves prior to “administering” that glass of water to themselves.

    4. There have been 892 Nobel laureates since the establishment of this award in 1895. These laureates were and are subject to erroneous ideas and outlying opinions just as is anyone else. Because an individual receives a Nobel prize in one area does not mean that he/she is an expert in all areas, nor does the erroneous personal opinion of one laureate represent the opinions of all such laureates. If you really want to compare the opinions of the small handful of fluoridation opponents worldwide who have any credibility at all, with the opinions of the volumes of highly respected individuals who fully support fluoridation, I will be glad to do so.

    5. If you understood fluoridation as well as a water treatment engineer should, you would realize that fluoridation is indeed, the simple adjustment of the level of existing fluoride ions in a public water system up to the level where maximum benefit will be attained by those consuming that water, with the occurrence of no adverse effects. Neither is there anything “simplistic” or “misleading” about this fact, nor are there any more “pharmocological principles” that apply to this process, than there are for the addition of chlorine, ammonia, or the myriad other substances routinely added to public water supplies.

    The hydrolysis of hydrofluorosilic acid is immediate and complete. Finney, in 2006, put to rest the speculation of intermediate formation during this process. Using NMR spectroscopy Finney determined there to be no intermediate formation from HFA hydrolysis down to a pH of 3.5. The pH of drinking water is ~7.

    —Reexamination of Hexafluorosilicate Hydrolysis By F NMR and pH Measurement
    William F. Finney, Erin Wilson, Andrew Callender, Michael D. Morris, and Larry W. Beck
    Environmental Science and Technology/ Vol 40, No. 8, 2006

    As clearly evidenced by the lack of any proven adverse effects of optimally fluoridated water, the level of fluoride ions in this water is too minuscule for there to be any problems of recombination with other substances after ingestion.

    6. Any problem with the uniformity of the chemical composition of water leaving water treatment plants is that with the education, training, and oversight of water treatment personnel, not with water fluoridation.

    7. For information on the intentions of the Creator, you’ll have to ask Him. However, the “one size fits all” concept is true not only for fluoride, but for chlorine, ammonia, and the myriad other substances routinely added to public water systems.

    Simply put, fluoridation is based on observations by researchers that at a certain concentration of fluoride in water supplies, greater resistance to dental decay occurs in the populations served by those supplies, with no adverse effects on that population. This “size” fits all within that population. In terms of adverse effects, when the maximum amount of a substance which can be ingested falls below the threshold of adverse effects, then the intake amount of that substance is of no concern in regard to adverse effects. This “size”, too, fits all.

    Prior to attaining the threshold of adverse effects of fluoride from optimally fluoridated water in conjunction with intake from all other normal sources of fluoride, water toxicity would be the concern, not fluoride. I will be glad to explain the science behind this if you so desire.

    8. Fluoridation was never promoted, or expected, to get all “childhood tooth decay problems under control”. The overwhelming problem with untreated dental decay is far too complex for one preventive measure to accomplish this. Fluoridation is simply the most cost-effective means we have to reduce a significant amount of this problem in entire populations. Because a preventive measure does not completely eradicate a disease problem is not a valid reason to oppose the utilization of that measure.

    That said, however, there are countless peer-reviewed scientific studies clearly demonstrating the effectiveness of fluoridation in the prevention of significant amounts of dental decay in entire populations. For the sake of space conservation here, I will provide but 2 as an example. I will gladly cite as many others as you would reasonably care to read.

    1) From a 2015 study by Blinkhorn, et al. :

    The children living in the well-established fluoridated area had less dental caries and a higher proportion free from disease when compared with the other two areas which were not fluoridated. Fluoridation demonstrated a clear benefit in terms of better oral health for young children.

    —The Dental Health of primary school children living in fluoridated, pre-fluoridated and non-fluoridated communities in New South Wales, Australia
    Anthony S Blinkhorn, Roy Byun, George Johnson, Pathik Metha, Meredith Kay, and Peter Lewis
    BMC Oral Health 2015, 15:9

    2) From a 2013 study by Kamel, et al. :

    Children with severe dental caries had statistically significantly lower numbers of lesions if they lived in a fluoridated area. The lower treatment need in such high-risk children has important implications for publicly-funded dental care.

    ——Community Dent Health. 2013 Mar;30(1):15-8.
    Fluoridation and dental caries severity in young children treated under general anaesthesia: an analysis of treatment records in a 10-year case series.
    Kamel MS, Thomson WM, Drummond BK.
    Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand.

    9. The job of water treatment personnel is irrelevant to the decision to fluoridate public water systems. These personnel do not “treat” anyone. They are responsible for the safe and economical operation, maintenance, and supervision of water distribution, water treatment, wastewater collection and wastewater treatment facilities, in accord with directives from local officials under whose jurisdictions those facilities reside, while ensuring full compliance with all pertinent local, state, and federal laws and regulations. As fluoridation violates no laws or regulations, it is not the job of water treatment personnel to determine the advisability of doing so or not. It is their job to carry out the directives of the local officials who are charged with overseeing those systems.

    Steven D. Slott, DDS

  28. David Fierstien

    In this comment’s section, John Mueller claims to be the senior engineer of a municipal water supply. That’s a little scary, considering his lack of mathematical skills.

    In discussing the fluoride additive, fluorosilicic acid, he says, “I saw arsenic concentrations in every shipment, ranging from 25 – 50 mg/L.” Then he says, “ . . knowingly contaminating the public drinking water with arsenic of any measurable concentration, . . “ Measurable concentration? Let’s do the math on that, John, and see if this is a measurable concentration.

    The product, fluorosilicic acid (FSA), is roughly 20% fluoride. Therefore, if there was no fluoride in the raw water (and there always is), and you wanted to reach a target of 1 mg/L (and really, you only want 70% of that – because the target is o.7 mg/L), you would have to add 5 parts per million of FSA. This is mathematically expressed as 0.000005.

    John says he saw arsenic from 25-50 parts per million (mg/L). Let’s err on the side of caution and use the larger of the two numbers, 50 ppm. This is mathematically expressed as 0.00005.

    Let’s do the math. 0.000005 x 0.00005 = 0.0000000003 or 3 parts per 10 billion. But this equation assumed we were putting in 1 ppm, but we want to achieve 0.7 ppm, the optimal level of fluoride. Therefore, 0.0000000003 x 0.7 = 0.0000000002.

    The EPA limit for arsenic in drinking water is 10 parts per billion (0.00000001). Therefore, John’s highest example of “arsenic” in FSA is 50 times lower than the very strict EPA Maximum Contaminant Level. It is actually more than 50 times lower because in this equation, we assumed there was zero fluoride in his raw water. However, there is always some fluoride in all drinking water. This means that nobody would ever add enough FSA which would equal 0.7 ppm. For example, if there was already 0.35 ppm F in the raw water, half the FSA used in this equation would be used, making his FSA 100 times lower than the EPA limit, lower than the measurable, analytical level of detection.

    John, according to a recent CBS report, your cell phone is far more dangerous to use than any arsenic from your highest case example. Are you going to stop using your cell phone? . . If your home was built prior to 2006, you are breathing far more arsenic from the treated lumber in your house than you would injest in a lifetime by drinking your worst-case example of fluoridated water. Are you going to tear down your house and rebuild it? . . . The raw water in your own distribution system almost certainly has more arsenic in it already than you are adding by using your worst-case example of FSA. Are you going to stop serving your customers water?

    John is being ridiculious and over-reactive, and he should know this as a trained engineer. If he doesn’t know it, he should be replaced. If he does know it, why is he being purposely deceptive?

  29. John Mueller

    Dr. Slott,
    It would appear that the real mystery here is why you, as a trained medical professional with apparent vast knowlege and insight, choose to promote reckless medication of the public masses without their informed consent while using the public water supply as the means for treating all individuals whether they need it or not, and which goes against all modern pharmacological principles according to at least one Nobel Prize recipient for medicine.
    The claim that artificial fluoridation is simply adjusting the fluoride ion concentration in the drinking water to an “optimum concentration” is misleading and simplistic at best. As you well know fluorine is the most reactive element on the Periodic Table. What guarantees can you or anyone offer that the fluoride ion does not react and bond with other elements or ions to form other harmful fluoridated compounds after dissociating from its fluorosilicic acid structure before and/or after ingestion into the human body? Is everyone’s body chemistry the same? Does all source water entering and then leaving the different water treatment plants around the country have the exact same chemical composition? Is the fluoride ion truly our Creator’s miracle substance to be used in a “one size fits all” application for preventing tooth decay? Please tell us, Dr. Slott, what fluoridating cities in the U.S. can boast that they have their childhood tooth decay problems under control and can attribute that achievement to their water fluoridation program. Please identify those cities and provide the supporting data showing their years of fluoridation and caries reduction per year since instituting community fluoridation.
    As for violating the spirit and intent of the Safe
    Drinking Water Act, the job of the water treatment professional, and the purpose of the drinking water treatment plant, is to treat the water to make it safe to drink, not treat the people who drink it.

  30. Steven Slott


    Fluorosilic acid does not exist in fluoridated water at the tap. It is simply a vehicle which delivers additional fluoride ions into water. Once it releases those ions, FSA no longer exists in that water. It is therefore not ingested. It is therefore of no concern, whatsoever.

    Why you seem to believe the prudent recovery, recycling, and productive use of our valuable natural resources while reducing water and air pollution, to be a negative, is a mystery. Perhaps you believe waste of our resources and pollution of the environment to be more desirable.

    Steven D. Slott, DDS

  31. David Fierstien

    In this comment section, Paul Connett, former Director of the Fluoride Action Network, says, “There are now over 300 animal and human studies that indicate that fluoride is neurotoxic, including the latest study described in this article. It is madness to DELIBERATELY add a known neurotoxic substance to the drinking water at levels (0.7 ppm) about 200 times higher than the natural levels in mothers’ milk (0.004 ppm).”

    That’s interesting, because in a personal email to me, dated October 12, 2014, he also said, “If I sometimes I have a tendency to overstate – then my co-authors did their level best to counteract that by understating everything.”

  32. Steven Slott


    While your skeletal fluorisis is unfortunate it is not attributable to optimally fluoridated water. If this disorder was attributable to fluoridated water, it would be rampant in the 74.5% fluoridated United States by now. Skeletal fluorosis is so rare in the US as to be nearly non-existent.

    Steven D. Slott, DDS

  33. Kathleen Krevetski

    Fluorosilicic Acid meets the criteria for classification as a hazardous waste due to its toxicity, reactivity and corrosivity . Our public water supply systems are providing a hazardous waste disposal system for Fluorosilicic acid per the policy expressed in a letter from EPA Deputy Administrator for Water, Rebecca Hanmer, to Leslie A. Russell dated March 30, 1980, insofar as it states:
    “ In regard to the use of fluosilicic acid (sic), this Agency(EPA) regards such use as an ideal environmental solution to a long-standing problem. By recovering by-product fluosilicic acid from fertilizer manufacturing, water and air pollution are minimized, and water utilities have a low-cost source of fluoride available to them.”

    Bring back commin sense please.

  34. Steven Slott

    In regard to the half-truths and misleading information provided by John Mueller:

    1. The EPA MCLG is a non-enforceable maximum contaminant level goal. It may or may be attainable. It may or may not be desirable. As a matter of policy, the EPA sets the MCLG at zero for any substance which may be carcinogenic, regardless the concentration at which carcinogenicity may occur. Arsenic can be carcinogenic at high levels. Thus, as a matter of policy, its MCLG is set at zero. However, given the ubiquity of arsenic throughout nature, and evidence that arsenic may be an essential nutrient, it is unlikely that a zero level of arsenic is either possible, or desired.

    —-Nutritional requirements for boron, silicon, vanadium, nickel, and arsenic: current knowledge and speculation.
    Nielsen FH.
    FASEB J. 1991 Sep;5(12):2661-7.

    The EPA MCL is that mandated maximum allowable level of a contaminant in drinking water which has been determined safe by the EPA, and which is attainable under current technology and other limitations. The MCL for arsenic is 10 parts per billion.

    2. The concentration of contaminants in raw, undiluted fluoridation substances is as irrelevant to the water received by consumers as are those contaminant concentrations in raw, undiluted chlorine, ammonia, and the myriad other substances routinely added to public drinking water supplies.

    All water at the tap must meet each of the stringent, EPA mandated, quality certification requirements under Standard 60 of NSF International, an independent laboratory testing organization. Standard 60 requires that no contaminant be present in water at the tap in excess of 10% of the EPA MCL for that contaminant. Water fluoridated with FSA easily meets all of those requirements. If it didn’t, it would not be allowed.

    In actuality, under stringent Standard 60 testing of fluoridated water, it takes 10 times the manufacturer’s recommended single use amount of FSA to detect any contaminants, whatsoever. Even in water with that excessive amount of FSA, arsenic is only detected in less than 50% of random samples. In that less than 50% of samples, the maximum amount of arsenic detected is only 0.6 parts per billion, which is but 60% of the maximum allowed under Standard 60, which is but 10% of the EPA MCL for arsenic. The amount of any other contaminants in fluoridated water at the tap is even less than arsenic, and much farther below Standard 60 maximum allowable levels.

    Obviously, the level of arsenic or any other contaminants in optimally fluoridated water at the tap, is of no concern.

    A detailed list of the contents of fluoridated water at the tap, including precise amounts of any detected contaminants, and the EPA mandated maximum allowable level for each, may be found in the “Fact Sheet on Fluoridation Substances” on the website of NSF International:


    3. There is no “waste” involved in water fluoridation. FSA is produced for very specific uses, one being for water fluoridation.

    Neither does FSA come from a “smokestack scrubber”. A scrubber in this context is a specialized apparatus which recovers valuable substances from gases as they pass through the apparatus. It “scrubs” the gases of usable substances which would otherwise be lost. It is a mystery why fluoridation opponents view this prudent conservation of our natural resources as some sort of negative.

    4. There is obviously no violation of any aspect of the Safe Drinking Water Act by water fluoridation. If there was, fluoridation would not be allowed. If Mr. Mueller cares to belabor the point then he needs to cite specifically what aspect of this act is being violated, and how.

    5. That which “egregiously violates not only the spirit and intent of the federal Safe Drinking Water Act, but also the public trust” is the misinterpretation of this act, and the public dissemination of misleading information and half-truths about optimally fluoridated tap water, by those who have little understanding of the facts of, or the science behind, the very valuable public health initiative of water fluoridation.

    Steven D. Slott, DDS

  35. Steven Slott

    Let’s look at the half-truths provided in these comments by Paul Connett, founder of the New York antifluoridationist faction, “fluoride action network”:

    1. Connett notes “300 animal and human studies that indicate fluoride is neurotoxic”. What he fails to note is the rejection by the EPA of the most recent meritless petition to end fluoridation filed by Connett’s “fan”, and other antifluoridationist groups. In its 40 page rejection, EPA reviewers, citing facts and evidence, systematically dismantled all arguments of the petitioners, explaining in detail the invalidity, irrelevance, and/or misrepresentation by petitioners, of those human and animal studies Connett cites as evidence of neurotoxicity.

    The EPA rejection can be viewed in entirety on the Federal Register of the US government:


    2. Connett refers to the recent Bashash Mexican study noted in the article. What he fails to mention is that the limitations cited in the study itself, render it inapplicable to optimally fluoridated water in the US.

    3. Connett refers to the fluoride content of “mothers’ milk” as if that should be the determining factor of proper levels of fluoride ingestion for infants. What he fails to note is that “mothers’ milk” is also deficient in Iron, Vitamin K, and Vitamin D to the point where supplementation is required for infants who are primarily breast fed. By Connett’s “logic”, nature intends for infants to be anemic, free bleeders, who develop rickets.

    4. Connett claims that it is “madness to DELIBERATELY add a known neurotoxic substance to the drinking water”. What he fails to note is that fluoride ions, identical to those which are added during fluoridation, have existed in water forever. Humans have been ingesting fluoride in drinking water since the beginning of time. What he also fails to note is that only that amount of fluoride ions are added which will adjust the existing fluoride level in a particular system to the optimal concentration of 0.7 ppm, a level for which there exists no valid, peer-reviewed scientific evidence of neurotoxicity.

    5. Connett assumes as fact unsubstantiated claims of adverse effects on the IQ of children from low-income families, while he ignores the well documented lifetimes of extreme pain, debilitation, development of serious medical conditions, and life-threatening infection, directly resultant of untreated dental decay which can be, and is, prevented by water fluoridation.

    6. Connett refers to fluoridation proponents as “zealots”. Well, let’s see whom are such “zealots”……the past 6 US Surgeons General, the Deans of the Harvard Schools of Medicine, Dentistry, and Public Health, the US CDC, the US National Academy of Medicine, the American Dental Association, the American Medical Association, the World Health Organization, the American Academy of Pediatrics, and over 100 more of the most highly respected healthcare and healthcare-related organizations in the world. The number of credible organizations worldwide which support Connett’s antifluoridation position? Zero.

    7. Connett then recommends visiting the filtered and edited information posted on the biased website of his own organization, and to read his non-peer-reviewed book of conspiracy nonsense. In doing so, he demonstrates the very telling fear of fluoridation opponents to refer people to accurate information from legitimate, well-respected sources, which has not first been filtered and edited through antifluoridation websites. In actuality, those who desire accurate information on fluoridation would be far better served by visiting the websites of the CDC, the EPA, the National Academy of Medicine, the American Dental Association, the World Health Organization, and the American Academy of Pediatrics.

    Steven D. Slott, DDS
    Communications Officer
    American Fluoridation Society

  36. John Mueller

    The toxicity of fluoride should not be the only concern with artificial water fluoridation. As a senior engineer at a municipal water utility serving about a half-million people, I was tasked with preparing the technical specifications for our fluorosilicic acid (FSA) purchasing contract renewal. (FSA is the most common fluoridation additive at large water treatment plants.) A chemical Certificate of Analysis (CofA) was required to accompany each tanker truckload of FSA upon delivery. Reviewing previous and subsequent CofAs over several contract years of deliveries (several each month), I saw arsenic concentrations in every shipment, ranging from 25 – 50 mg/L, also having learned FSA is typically sourced from phosphate fertilizer manufacturers’ smokestack scrubber waste streams. The EPA has determined the Maximum Contaminant Level Goal (MCLG) for arsenic is zero. By EPA’s definition, “The MCLG is the maximum level of a contaminant in drinking water at which no known or anticipated adverse effect on the health of persons would occur, allowing an adequate margin of safety.”
    In my opinion, as a licensed Professional Engineer (P.E.) and state certified water treatment plant operator with more than 20 years of water resources engineering in the public sector, knowingly contaminating the public drinking water with arsenic of any measurable concentration, arsenic being a recognized carcinogen with an existing MCLG of zero, egregiously violates not only the spirit and intent of the federal Safe Drinking Water Act, but also the public trust.

  37. Steven Slott

    If fluoridation opponents would adhere to truth and accuracy, the fluoridation discussions could be far less contentious, and more productive. The comments on this page from opponents provide excellent example of the lack of respect for truth which so characterizes these activists.

    Bill Osmunson, for instance, is the current head of the New York antifluoridationist faction, “FAN”. Let’s look at his claims:

    1. Osmunson claims that the FDA has not approved fluoride because “the evidence of efficacy is incomplete”. First of all, the efficacy evidence for water is far from “incomplete”. Countless peer-reviewed studies current through the present clearly demonstrate the effectiveness of fluoridation in the prevention of dental decay in entire populations. I will gladly cite a number of them.

    Second, the FDA grandfathered in substances such as fluoride, aspirin, and others, which had long histories of safety and effectiveness, rather than subjecting them to protracted and expensive testing only to conclude what is already known….they are safe and effective. As the FDA regulates retail consumable products, if it did not approve of fluoride, there would be untold miles of empty shelving in retail stores where fluoridated bottled water and dental products now reside.

    Third, the FDA has no jurisdiction over the contents of public drinking water supplies. This jurisdiction falls entirely under the US EPA, which mandates strict quality requirements for all water at the tap. Under Osmunson’s scenario, with FDA control, contaminants in fluoridated water would be tested for, and reported, by the producers of that fluoride. Under the current EPA jurisdiction, all water at the tap is required to meet all of the stringent quality certification requirements under Standard 60 of NSF International, an independent testing organization that reports its findings directly to the EPA. So, which scenario would be more subject to compromise….responsibility for testing of products left to the producers of those products…. or responsibility for testing of products left to to a top quality, independent testing organization which has no financial interest in the products?

    2. Osmunson claims that the CDC reported , in 1999, that “swallowing fluoride was unlikely to have benefit.” The following is precisely what the CDC stated in its 2001 report:

    The laboratory and epidemiologic research that has led to the better understanding of how fluoride prevents dental caries indicates that fluoride’s predominant effect is posteruptive and topical and that the effect depends on fluoride being in the right amount in the right place at the right time. Fluoride works primarily after teeth have erupted, especially when small amounts are maintained constantly in the mouth, specifically in dental plaque and saliva (37). Thus, adults also benefit from fluoride, rather than only children, as was previously assumed.”


    Fluoride becomes incorporated into saliva systemically.

    3. Osmunson claims that “the National Research Council 2006 reported theoretical benefit would be prior to eruption of the teeth, prior to age 8.”

    The 2006 NRC Committee was not charged with evaluating, and did not evaluate, efficacy of fluoride in the prevention of dental decay.

    The following is precisely what the 2006 NRC report stated in regard to assessment of effectiveness of benefit of fluoride:

    “Because fluoride is well known for its use in the prevention of dental caries, it is important to make the distinction here that EPA’s drinking-water guidelines are not recommendations about adding fluoride to drinking water to protect the public from dental caries. Guidelines for that purpose (0.7 to 1.2 mg/L) were established by the U.S. Public Health Service more than 40 years ago.”

    “The committee only considered adverse effects that might result from exposure to fluoride; it did not evaluate health risk from lack of exposure to fluoride or fluoride’s efficacy in preventing
    dental caries.”

    —-Fluoride in Drinking Water: A Scientific Review of EPA’s Standards
    pp. 2

    3. Osmunson claims that NHANES reported the incidence of dental fluorosis “to be over 60%”

    NHANES collects and releases data. It does not report on the incidence of dental fluorosis. To what Osmunson is referring is an interpretation of NHANES data by personnel of the “fluoride action network” who are not qualified to properly assess scientific data.

    In actuality, the only dental fluorosis which may be associated with optimally fluoridated water is mild to very mild, a barely detectable effect which causes no adversity on cosmetics, form, function, or health of teeth. This level of dental fluorosis is not considered an adverse effect, nor is there any valid, peer-reviewed scientific evidence that children, or anyone else, is being harmed by optimal level fluoride in drinking water.

    4. Osmunson claims that “Measured dental expenses for the population at large are not lower.”, when the peer-reviewed science demonstrates the opposite. Studies have clearly demonstrated a cost-savings of $15-$50 or more per $1 spent on fluoridation. I will be glad to cite those studies.

    5. Osmunson claims that “The harm just to the developing brain is serious, 5 to 6 IQ points lower even with low levels of fluoride in the water.” implying this to be occurring attributable to optimally fluoridated water.

    There is no valid, peer-reviewed scientific evidence to support his implication. The studies frequently cited as evidence for purported adverse effects on IQ are not applicable to optimally fluoridated water in the US.

    Steven D. Slott, DDS

  38. Artin

    I have been suffering from Skeletal Fluorosis since 2014. The only sources of Fluoride exposure that I have had was dental products and tab water. I have been drinking a lot of water though, way more than average due to high level of sports and activities. I ended up on disability for many months due to severity of my condition. I started recovering after learning about this condition and avoiding any contact with tab water including drinking, cooking and even showering with tab water.
    Why I have to suffer from this horrendous disease just because I am more active than others? Why no warning has been provided to me that drinking large quantity of tab water can be injurious to my health?

    Who takes responsibility for impact to quality of my life, loss of income and huge burden on insurance company and public health system caused by this long lasting disease that I suffered just because I was exposed to too much of it… while municipalities claim that it is 100% safe… shouldn’t they be held responsible for misleading the public?

  39. Donna Mayne

    We stopped artificial fluoridation in 2013 in Windsor ON and were told by promoters to expect a 25-50% increase in tooth decay. It never happened. Data from our Health Ministry actually showed an improvement in oral health scores for children in senior kindergarten and grade 2s.

  40. Bill Osmunson DDS MPH

    Centers for Disease Control (CDC) and American Dental Association (ADA) make no sense.

    Fluoride supplements (pills or liquid) are NOT Food and Drug Administration Center For Drug Evaluation and Research (FDA CDER) approved. The FDA denied approval because the evidence of efficacy is incomplete. The FDA has maintains fluoride is a drug and unapproved drugs are illegal. The CDC and ADA should not promote illegal, unapproved drugs. If fluoride is so safe as the CDC and ADA advertise, then the CDC and ADA should gain FDA CDER approval with a NDA, just like toothpaste has achieved.

    The CDC also reported in 1999 that swallowing fluoride was unlikely to have benefit. National Research Council 2006 report theoretical benefit would be prior to eruption of the teeth, prior to age 8.

    Don’t swallow fluoride.

  41. Bill Osmunson DDS MPH

    Dan Ross has provided a well thought out and researched article on one of the greatest Public Health Blunders of the 20th Century.
    For 25 years as a dentist I promoted water fluoridation, and then I read the research for myself.

    1. Many are ingesting too much. Dental fluorosis which is a biomarker, a positive sign of ingesting too much fluoride, is reported by NHANES 2012 at over 60%. Most children are now being harmed with too much fluoride. Simply turning off the fluoride pumps is easy, cheap and essential. However, that is probably not enough for many. Do not swallow fluoride toothpaste.

    2. Many are being harmed. Measured dental expenses for the population at large are not lower. The harm just to the developing brain is serious, 5 to 6 IQ points lower even with low levels of fluoride in the water.

    For more information, go to http://www.IAOMT.org and view their position paper. And visit http://www.fluoridealert.org to view research articles.
    Do not drink fluoridated water or swallow fluoride toothpaste.
    Bill Osmunson DDS MPH

  42. Paul Connett

    At my wife’s urging I got involved in fighting fluoridation in 1996. At that time my concern was the possibility that fluoride lowered IQ – a concern which has grown with every passing year. There are now over 300 animal and human studies that indicate that fluoride is neurotoxic, including the latest study described in this article. It is madness to DELIBERATELY add a known neurotoxic substance to the drinking water at levels (0.7 ppm) about 200 times higher than the natural levels in mothers’ milk (0.004 ppm). The last chidlren who need their IQ lowered are children from low-income families who are precisely those targeted by pro-fluoridation zealots. For those who would like more background on this contentious issue they should visit the website of the Fluoride Action Network (www.FluorideALERT.org ) and read the book I co-authored: The Case Against Fluoride (Chelsea Green, 2010).

    Paul Connett, PhD
    Director of the Fluoride Action Network (2000-2015)

  43. Renata Flores

    The John Birch Society was right. Only collectivists (aka communists) would believe mass-medicating the public through their water is a good idea. As a proud member of JBS I encourage everyone who loves America and the Constitution to check us out. Don’t believe the lying media.

  44. jwillie6

    Fluoride shouldn’t be prescribed by lobbied-legislators, delivered by water employees and dosed based on thirst and not age, health, weight and need. Everyone gets a different dose depending on the amount of water consumed.

    Fluoride should be prescribed to individuals by medical professionals, not by communities.

  45. regina imburgia

    Thank YOU for this great article! Real journalism is Not Dead!! I have been trying to show the Dallas City Council in Dallas, Texas the Fluoride Program is NOT Safe or Effective!! And the local media just puts out articles like this one a few weeks ago

  46. Dan Germouse

    Black and McKay wrote a long journal article which was published in 1916 about mottled enamel (which is now called dental fluorosis) and their search for the cause. McKay did not once mention a lower level of tooth decay in association with mottled enamel, and his section of the article covered many geographical areas, not just his own town of Colorado Springs. The geographical scope of Black’s section of the article was far more limited and he did make one mention of a low level of decay in mottled teeth, but attributed it to the children in the area spending a lot of time outdoors in the abundant sunshine, and also said that when decay did occur in mottled enamel the teeth were often lost because fillings did not hold properly. It was only when Alcoa became involved more than 20 years later that the claim that fluoride in drinking water prevents tooth decay was made.

  47. Dan Germouse

    The optimal fluoride concentration of drinking water is zero. There is no credible evidence that taking fluoride in water has ever prevented a single dental cavity. The forced-fluoridation fanatics often try to claim that the low rates of dental caries in western European countries which do not have artificially fluoridated public water supplies are due to naturally occurring fluoride in water, or some other kind of artificial fluoridation such as salt fluoridation. They are lying. They also rely on studies which do not measure individual fluoride exposure, are not randomised, are not blinded, are not clinical trials, do not properly account for confounding factors, are highly prone to systematic error, and are typically funded by corporations such as Colgate-Palmolive.

  48. David Green

    This is a very thorough and well written summary of the issue. I don’t know if there are any bottled water companies who are fluoridating a 2.4 ppm, but, if so, they are really putting themselves at risk of lawsuits.

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