Opposition to water fluoridation refers to activism against the
fluoridationWater fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water has fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride...
of public
water suppliesWater supply is the process of self-provision or provision by third parties in the water industry, commonly a public utility, of water resources of various qualities to different users. Irrigation is covered separately.- Global access to water:...
. The controversy occurs mainly in English-speaking countries, as
Continental EuropeContinental Europe, also referred to as mainland Europe or simply the Continent, is the continent of Europe, explicitly excluding European islands and, at times, peninsulas. Notably, in British and Irish English usage, the term means Europe excluding the United Kingdom, the Isle of Man, the Channel...
does not practice water fluoridation, although some continental countries fluoridate salt. At the recommended concentration of 0.7 – 1.2 mg/L (0.7 for hot climate, 1.2 in cool climates) the only apparent side-effect appears to be
dental fluorosisDental fluorosis is a health condition caused by a child receiving too much fluoride during tooth development. The critical period of exposure is between 1 and 4 years old; children over age 8 are not at risk. In its mild form, which is the most common, fluorosis appears as tiny white streaks or...
, but those organizations and individuals opposed raise concerns that the intake is not easily controlled, and that children, small individuals, and others may be more susceptible to health problems. Those opposed also argue that water fluoridation imposes ethical issues, may cause serious health problems, is not effective enough to justify the costs. Opposition to fluoridation has existed since its initiation in the 1940s. During the 1950s and 1960s, some opponents of water fluoridation also put forward
conspiracy theoriesConspiracy theory is a term that originally was a neutral descriptor for any conspiracy claim. However, it has come almost exclusively to refer to any fringe theory which explains a historical or current event as the result of a secret plot by usually powerful Machiavellian conspirators.Conspiracy...
describing fluoridation as a communist plot to undermine public health. Sociologists have typically viewed opposition to water fluoridation as irrational, while critics of this position have argued that this rests on an uncritical attitude toward scientific knowledge.
Ethics
Many who oppose water fluoridation consider it to be a form of compulsory mass
medicationA pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
. They argue that consent of all water consumers cannot be achieved, nor can water suppliers accurately control the exact levels of fluoride that individuals receive, nor monitor their response. It is also argued that, because of the alleged negative health effects of such level of fluoride exposure, mandatory fluoridation of public water supplies is a breach of ethics and a human rights violation.
In the
United KingdomThe United Kingdom of Great Britain and Northern Ireland is a sovereign state located off the northwestern coast of continental Europe. It is an island country, spanning an archipelago including Great Britain, the northeastern part of Ireland, and many small islands...
the
Green PartyThe Green Party of England and Wales is the principal Green political party in England and Wales which includes among its regional divisions the semi-autonomous Wales Green Party. The party is unrepresented in the House of Commons, but did have a life peer in the House of Lords until his death...
refers to fluoride as a poison, claims that water fluoridation violates Article 35 of the European Charter of Fundamental Rights, is banned by the UK poisons act of 1972, violates Articles 3 and 8 of the
Human Rights ActA Human Rights Act is a piece of legislation that sets out individual rights and freedoms under law. Many countries have similar rights enshrined into law; the countries with this naming convention tend to be Commonwealth countries. For specific variations see the articles for relevant act in the...
and raises issues under the United Nations Convention on the Rights of the Child.
Water fluoridation has also been criticized by Cross and Carton for violating the
Nuremberg CodeThe Nuremberg Code is a set of research ethics principles for human experimentation set as a result of the Subsequent Nuremberg Trials at the end of the Second World War.- Background :...
and the Council of Europe's Biomedical Convention of 1999. Dentistry professor David Locker and philosopher Howard Cohen argued that the moral status for advocating water fluoridation is "at best indeterminate" and could even be considered immoral because it infringes upon autonomy based on uncertain evidence, with possible negative effects.
The precautionary principle
In an analysis published in the March 2006 issue of the
Journal of Evidence Based Dental Practice, the authors examine the water fluoridation controversy in the context of the
precautionary principleThe precautionary principle is a moral and political principle which states that if an action or policy might cause severe or irreversible harm to the public or to the environment, in the absence of a scientific consensus that harm would not ensue, the burden of proof falls on those who would...
. The authors note that:
- There are other ways of delivering fluoride besides the water supply;
- Fluoride does not need to be swallowed to prevent tooth decay;
- Tooth decay has dropped at the same rate in countries with, and without, water fluoridation;
- People are now receiving fluoride from many other sources besides the water supply;
- Studies indicate fluoride’s potential to cause a wide range of adverse, systemic effects;
- Since fluoridation affects so many people, “one might accept a lower level of proof before taking preventive actions.”
Potential health risks
Fluoride's adverse effects depend on total fluoride dosage from all sources. At the commonly recommended dosage, the only clear adverse effect is
dental fluorosisDental fluorosis is a health condition caused by a child receiving too much fluoride during tooth development. The critical period of exposure is between 1 and 4 years old; children over age 8 are not at risk. In its mild form, which is the most common, fluorosis appears as tiny white streaks or...
, which can alter the appearance of children's teeth during
tooth developmentTooth development or odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. Although many diverse species have teeth, non-human tooth development is largely the same as in humans...
; this is mostly mild and is unlikely to represent any real effect on public health. Fluoridation has little effect on risk of
bone fractureA bone fracture is a medical condition in which there is a break in the continuity of the bone...
(broken bones); it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation. A major Australian study found no clear association between fluoridation and
cancerCancer is a class of diseases in which a group of cells display uncontrolled growth , invasion , and sometimes metastasis...
or deaths due to cancer, both for cancer in general and also specifically for bone cancer and
osteosarcomaOsteosarcoma is the second most common primary malignancy of bone behind multiple myeloma. Osteosarcoma accounts for 20% of primary bone malignancies. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee...
, and other adverse effects lack sufficient evidence to reach a confident conclusion. Several studies cited by opponents of community fluoridation have found associations, consistently finding that osteosarcoma rates are significantly higher in male children with raised fluoride levels.
Constant ingestion of high levels of fluoride can cause adverse effects including severe dental fluorosis,
skeletal fluorosisSkeletal fluorosis is a bone disease caused by excessive consumption of fluoride. In advanced cases, skeletal fluorosis causes pain and damage to bones and joints.-Causes:...
, and weakened bones; the WHO has a guideline of 1.5 mg/L. In 2006, a 12-person U.S. National Research Council (NRC) committee reviewed the health risks associated with fluoride in the water and unanimously concluded that the
maximum contaminant levelMaximum Contaminant Levels are standards that are set by the United States Environmental Protection Agency for drinking water quality in Title 40 of the Code of Federal Regulations. A Maximum Contaminant Level is the legal threshold limit on the amount of a hazardous substance that is allowed in...
of 4 mg/L should be lowered. Although it did not comment on water fluoridation's safety, three of the panel members expressed their opposition to water fluoridation after the study and the chair, John Doull, suggested that the issue should be reexamined. Because the report recommended lowering the MCL, opponents argue that fluoridation has a lower margin of safety than previously realized.
Because water fluoridation provided is not individually controlled, opponents express concern for vulnerable populations such as children, nutritionally deficient individuals, and renally-impaired individuals. The National Research Council states that children have a higher daily average intake than adults per kg of bodyweight. Those who perspire heavily or have kidney problems consume more water and thus also have a greater intake. Of the following health problems,
osteosarcomaOsteosarcoma is the second most common primary malignancy of bone behind multiple myeloma. Osteosarcoma accounts for 20% of primary bone malignancies. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee...
, a rare bone disease affecting male children, is strictly associated with the recommended dosage of fluoride. The weight of the evidence does not support a relationship. However, a study performed as a doctoral thesis, which is described as the most rigorous yet by the Washington Post, found a relationship among young boys, but then the Harvard professor who advised the doctoral students determined that the results were not highly correlative enough to have evidentiary value; the professor then was investigated but exonerated by the federal government's Office of Research Integrity (ORI).
An epidemiological connection between silicofluorides, an industrial byproduct which is used to fluoridate much of the U.S. water, and lead was observed in a 2000 study. A 2006 U.S. CDC-funded study was unable to replicate the results, which the original researchers responded to in a 2007 rebuttal. Aside from the lead connection, concerns are raised as to whether silicofluorides might have different effects on the body than sodium fluorides, and silicofluorides have not been rigorously tested for safety.
Efficacy
The available evidence shows that water fluoridation is effective in reducing cavities (see effectiveness section of the main article). The most comprehensive
systematic reviewA systematic review is a literature review focused on a single question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...
found that fluoridation was
statistically associatedIn statistics, an association is any relationship between two measured quantities that renders them statistically dependent. The term "association" refers broadly to any such relationship, whereas the narrower term "correlation" refers to a linear relationship between two quantities.There are many...
with a decreased proportion of children with cavities (the
medianIn probability theory and statistics, a median is described as the number separating the higher half of a sample, a population, or a probability distribution, from the lower half. The median of a finite list of numbers can be found by arranging all the observations from lowest value to highest...
of
meanIn statistics, mean has two related meanings:* the arithmetic mean .* the expected value of a random variable, which is also called the population mean....
decreases was 14.6%, the
rangeIn descriptive statistics, the range is the length of the smallest interval which contains all the data. It is calculated by subtracting the smallest observation from the greatest and provides an indication of statistical dispersion.It is measured in the same units as the data...
−5 to 64%), and with a decrease in decayed,
missingTooth loss is when one or more teeth come loose and fall out. Tooth loss is normal for deciduous teeth , when they are replaced by a person's adult teeth. Otherwise, losing teeth is undesirable and is the result of injury or disease, such as mouth trauma, tooth injury, tooth decay, and gum disease...
, and
filledA dental restoration or dental filling is a dental restorative material used to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. It is also lost intentionally during tooth preparation to improve the...
primary teeth (the median of mean decreases was 2.25 teeth, the range 0.5 to 4.4 teeth), which is roughly equivalent to preventing 40% of cavities. The review found that the evidence was of moderate quality: many studies did not attempt to reduce observer bias, control for confounding factors, report variance measures, or use appropriate analysis. The effect is largely due to the topical effect of fluoride ions in the mouth rather than the systemic effect of ingestion.
Fluoridation opponents have challenged the efficacy of fluoridation, although their arguments have been accused of bias. A large study of water fluoridation's efficacy was conducted by the National Institute of Dental Research in 1988, which officially found "20 percent fewer decayed tooth surfaces" corresponding to "less than one cavity per child". Opponents argued that the study had errors, and the data was reanalyzed by fluoridation opponent John A. Yiamouyiannis, whose results indicated no statistically significant difference in tooth decay rates among children in fluoridated and nonfluoridated communities. Conversely, fluoridation proponents argued that Yiamouyiannis' work had errors.
In 1986 fluoridation opponent
Mark DiesendorfMark Diesendorf teaches Environmental Studies at the University of New South Wales, Australia. He was formerly Professor of Environmental Science at...
pointed out the substantial declines in tooth decay in nonfluoridated European countries. Although fluoridation may still be a relevant public health measure among the poor and disadvantaged, it may be unnecessary for preventing tooth decay, particularly in industrialized countries where tooth decay is rare.
Statements against
Since 1985, the
United States Environmental Protection AgencyThe U.S. Environmental Protection Agency is an agency of the federal government of the United States charged to regulate chemicals and protect human health by safeguarding the natural environment: air, water, and land...
(EPA) headquarters' union has expressed concerns about fluoride. In 2005, eleven EPA employee unions, representing over 7000 environmental and public health professionals of the Civil Service, called for a halt on drinking water fluoridation programs across the USA and asked EPA management to recognize fluoride as posing a serious risk of causing
cancerCancer is a class of diseases in which a group of cells display uncontrolled growth , invasion , and sometimes metastasis...
in people. Among the union's concerns are what they contend is a cover-up of evidence from
Harvard School of Dental MedicineHarvard School of Dental Medicine is one of the graduate schools of Harvard University. It is an American dental school located in the Longwood Medical Area in Boston, Massachusetts. In addition to the DMD degree, HSDM offers specialty training programs, advanced training programs, a Ph.D...
linking fluoridation with an elevated risk of
osteosarcomaOsteosarcoma is the second most common primary malignancy of bone behind multiple myeloma. Osteosarcoma accounts for 20% of primary bone malignancies. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee...
in boys, a rare but fatal bone cancer. However, the professor accused of the cover-up was exonerated by the federal Office of Research Integrity.
In addition, over 1,730 health industry professionals, including one Nobel prize winner in medicine (
Arvid CarlssonArvid Carlsson is a Swedish scientist who is best known for his work with the neurotransmitter dopamine and its effects in Parkinson's disease...
), doctors, dentists, scientists and researchers from a variety of disciplines are calling for an end to water fluoridation in an online petition to Congress. The petition signers express concern for
vulnerableVulnerable may refer to:*Vulnerability*Vulnerable species* Vulnerable , by Tricky* Vulnerable * "Vulnerable"...
groups like "small children, above average water drinkers, diabetics, and people with poor
kidneyThe kidneys are paired organs, which have the production of urine as their primary function. Kidneys are seen in many types of animals, including vertebrates and some invertebrates. They are part of the urinary system, but have several secondary functions concerned with homeostatic functions. ...
function," who they believe may already be overdosing on fluoride. Another concern that the petition signers share is, "The admission by federal agencies, in response to questions from a Congressional subcommittee in 1999-2000, that the industrial grade waste products used to fluoridate over 90% of America's drinking water supplies (fluorosilicate compounds) have never been subjected to toxicological testing nor received FDA approval for human ingestion." The petition was sponsored by the
Fluoride Action NetworkThe Fluoride Action Network is an international coalition dedicated to raising awareness of the health effects of fluoride ingestion , which it believes to be problematic due to fluoride's toxicity. It was founded in May 2000 and is based in Canton, New York, United States. St. Lawrence University...
of
Canton, New YorkCanton, New York is a town and a village in the U.S. state of New York. Both are located in St. Lawrence County, New York.*Canton , New York*Canton , New York...
, the most active anti-fluoridation organization in North America.
Dr.
Hardy LimebackHardy Limeback, PhD, DDS, is an associate professor and head of preventative dentistry at the University of Toronto, as well as a part-time dentist. He is the former President of the Canadian Association of Dental Research. He received his PhD in in collagen biochemistry and his DDS from the...
, BSc, PhD,
DDSThe Doctor of Dental Surgery is an academic degree awarded to dentists, along with the Doctor of Dental Medicine , Bachelor of Dentistry , Bachelor of Dental Surgery/Chirurgiae , Bachelor of Dental Science , Bachelor of Dental Medicine , Licentiate in Dental Surgery , Doctor of Dentistry ,...
was one of the 12 scientists who served on the
National Academy of SciencesThe National Academy of Sciences is a corporation in the United States whose members serve pro bono as "advisers to the nation on science, engineering, and medicine."The group holds a congressional charter under Title 36 of the United States Code....
panel that issued the aforementioned report,
Fluoride in Drinking Water: A Scientific Review of the EPA's Standards. Dr. Limeback is an associate professor of dentistry and head of the preventive dentistry program at the
University of TorontoThe University of Toronto is a public research university in Toronto, Ontario, Canada, situated north of the city's Financial District on the grounds that surround Queen's Park. The university was founded by royal charter in 1827 as King's College, the first institution of higher learning in the...
. He detailed his concerns in an April 2000 letter titled,
"Why I am now officially opposed to adding fluoride to drinking water".
In a presentation to the California Assembly Committee of Environmental Safety and Toxic Materials, Dr. Richard Foulkes, B.A., M.D., former special consultant to the Minister of Health of
British ColumbiaBritish Columbia is the westernmost of Canada's provinces and is famed for its natural beauty, as reflected in its Latin motto, Splendor sine occasu . In 1871, it became the sixth province of Canada.The capital of British Columbia is Victoria, the 15th largest metropolitan region in Canada...
, revealed:
The [water fluoridation] studies that were presented to me were selected and showed only positive results. Studies that were in existence at that time that did not fit the concept that they were "selling," were either omitted or declared to be "bad science." The endorsements had been won by coercion and the self-interest of professional elites. Some of the basic "facts" presented to me were, I found out later, of dubious validity. We are brought up to respect these persons in whom we have placed our trust to safeguard the public interest. It is difficult for each of us to accept that these may be misplaced.
On April 15, 2008, the United States
National Kidney FoundationThe National Kidney Foundation, Inc. is a major voluntary health organization in the United States. Its mission is to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs...
(NKF) updated their position on fluoridation for the first time since 1981. The foundation's position stated, however, that there is insufficient evidence to recommend fluoride-free drinking water for patients with renal disease, and did not voice opposition to water fluoridation.
The International Chiropractors Association opposes mass water fluoridation, considering it "possibly harmful and deprivation of the rights of citizens to be free from unwelcome mass medication."
Use throughout the world
Water fluoridation is used in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
,
United KingdomThe United Kingdom of Great Britain and Northern Ireland is a sovereign state located off the northwestern coast of continental Europe. It is an island country, spanning an archipelago including Great Britain, the northeastern part of Ireland, and many small islands...
,
IrelandIreland is the third-largest island in Europe and the twentieth-largest island in the world. It lies to the north-west of continental Europe and is surrounded by hundreds of islands and islets. To the east of Ireland, separated by the Irish Sea, is the island of Great Britain...
,
CanadaCanada is a country occupying most of northern North America, extending from the Atlantic Ocean in the east to the Pacific Ocean in the west and northward into the Arctic Ocean...
, and
AustraliaAustralia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the continental mainland , the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans...
, and a handful of other countries. The following developed nations previously fluoridated their water, but stopped the practice, with the years when water fluoridation started and stopped in parentheses:
- Federal Republic of Germany (1952-1971)
- Sweden (1952-1971)
- Netherlands (1953-1976)
- Czechoslovakia (1955-1990)
- German Democratic Republic (1959-1990)
- Soviet Union (1960-1990)
- Finland (1959-1993)
- Japan (1952-1972)
In 1986 the journal
NatureNature is a prominent British scientific journal, first published on 4 November 1869. Most scientific journals are now highly specialized, and Nature is among the few journals that still publish original research articles across a wide range of scientific...
reported,
"Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries."
In areas with complex water sources, water fluoridation is more difficult and more costly. Alternative fluoridation methods have been proposed, and implemented in some parts of the world. The
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health...
(WHO) is currently assessing the effects of fluoridated toothpaste, milk fluoridation and salt fluoridation in
AfricaAfrica is the world's second-largest and second most-populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area. With a billion people in 61 territories, it accounts for about 14.8% of the...
,
AsiaAsia is the world's largest and most populous continent, located in the eastern and northern hemispheres. It covers 8.6% of the earth's total surface area and with approximately 4 billion people, it hosts 60% of the world's current human population.Asia is traditionally defined as part of the...
, and
EuropeEurope is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally divided from Asia to its east by the water divide of the Ural Mountains, the Ural River, the Caspian Sea, the Caucasus Mountains , and the Black Sea to the southeast...
. The WHO supports fluoridation of water in some areas, and encourages removal of fluoride where fluoride content in water is too high.
History
The use of fluorides for prevention of
dental cariesDental caries, also known as tooth decay or cavity, is a disease wherein bacterial processes damage hard tooth structure . These tissues progressively break down, producing dental cavities . Two groups of bacteria are responsible for initiating caries: Streptococcus mutans and Lactobacilli...
(cavities) was discussed in the 19th century in
EuropeEurope is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally divided from Asia to its east by the water divide of the Ural Mountains, the Ural River, the Caspian Sea, the Caucasus Mountains , and the Black Sea to the southeast...
.
The first occurrence of fluoridated drinking water was found in Germany's Nazi concentration camps during
world war IIWorld War II, or the Second World War , was a global military conflict which involved a majority of the world's nations, including all great powers, organized into two opposing military alliances: the Allies and the Axis...
, which were maintained partly by I.G. Farben..
After the discovery in early controlled trials that water fluoridation reduced cavities, health organizations and agencies in the U.S. began to recommend that water be fluoridated.
The first large confrontation and defeat occurred in Wisconsin in 1950. Persistent objections arose then, where opponents questioned the ethics, safety, and efficacy of fluoridation. New Zealand was the second country to fluoridate, and similar controversies arose there. Fears about fluoride were likely exacerbated by the reputation of fluoride compounds as insect poisons and by early literature which tended to use terms such as "toxic" and "low grade chronic fluoride poisoning" to describe mottling from consumption of 6 mg/L of fluoride prior to tooth eruption, a level of consumption not expected to occur under controlled fluoridation. When voted upon, the outcomes tend to be negative, and thus fluoridation has had a history of gaining through administrative orders in North America. Theories for why the public tends to reject fluoridation include "alienation from mainstream" society, but evidence for that is weak. Another interpretation is confusion introduced during the referendum. Some studies of the sociology of opposition to water fluoridation have been criticized for having an uncritical attitude toward scientific knowledge.
Outside of
North AmericaNorth America is the northern continent of the Americas, situated in the Earth's northern hemisphere and in the western hemisphere. It is bordered on the north by the Arctic Ocean, on the east by the North Atlantic Ocean, on the southeast by the Caribbean Sea, and on the west by the North Pacific...
, water fluoridation was adopted in European countries, but in the late 1970s and early 1980s,
DenmarkDenmark is a Scandinavian country in Northern Europe and the senior member of the Kingdom of Denmark. It is the southernmost of the Nordic countries; southwest of Sweden and south of Norway, and it is bordered to the south by Germany. Denmark borders both the Baltic and the North Sea...
and
SwedenSweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe...
banned fluoridation when government panels found insufficient evidence of safety, and the Netherlands banned water fluoridation when "a group of medical practitioners presented evidence" that it caused negative effects in a percentage of the population.
Conspiracy theories
Water fluoridation has frequently been the subject of conspiracy theories. During the "
Red ScareIn US history, the term Red Scare denotes two distinct periods of strong anti-communism: the First Red Scare, from 1917 to 1920, and the Second Red Scare, from 1947 to 1957. The Scares were characterized by the fear that communism would upset the capitalist social order in the United States; the...
" in the United States during the late 1940s and 1950s, and to a lesser extent in the 1960s, activists on the
far rightFar right, extreme right, hard right, ultra-right or radical right are terms used to discuss the qualitative or quantitative position a group or person occupies within a political spectrum...
of American politics routinely asserted that fluoridation was part of a far-reaching plot to impose a socialist or communist regime. They also opposed other public health programs, notably mass
vaccinationVaccination is the administration of antigenic material to produce immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by a pathogen. Vaccination is generally considered to be the most effective and cost-effective method of preventing infectious diseases...
and
mental healthMental health is a term used to describe either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life...
services. Their views were influenced by opposition to a number of major social and political changes that had happened in recent years: the growth of internationalism, particularly the UN and its programs; the introduction of social welfare provisions, particularly the various programs established by the
New DealThe New Deal was the name that United States President Franklin D. Roosevelt gave to his complex package of economic programs 1933-36 with the goals of what historians call the 3 Rs, of giving Relief to the unemployed and badly hurt farmers, Reform of business and financial practices, and promoting...
; and government efforts to reduce perceived inequalities in the
social structure of the United StatesThere is considerable controversy regarding social class in the United States, and it remains a concept with many competing definitions. Many Americans believe in a simple three-class model that includes the "rich", the "middle class", and the "poor." More complex models that have been proposed...
.
Some took the view that fluoridation was only the first stage of a plan to control the American people. Fluoridation, it was claimed, was merely a stepping-stone on the way to implementing more ambitious programs. Others asserted the existence of a plot by communists and the
United NationsThe United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and the achieving of world peace...
to "deplete the brainpower and sap the strength of a generation of American children". Dr. Charles Bett, a prominent anti-fluoridationist, charged that fluoridation was "better THAN USING THE ATOM BOMB because the atom bomb has to be made, has to be transported to the place it is to be set off while POISONOUS FLUORINE has been placed right beside the water supplies by the Americans themselves ready to be dumped into the water mains whenever a Communist desires!" Similarly, a right-wing newsletter, the
American Capsule News, claimed that "the Soviet General Staff is very happy about it. Anytime they get ready to strike, and their
5th columnA fifth column is a group of people who clandestinely undermine a larger group, such as a nation, from within, to the aid of an external enemy.- Origin :...
takes over, there are tons and tons of this poison "standing by" municipal and military water systems ready to be poured in within 15 minutes."
This viewpoint led to major controversies over public health programs in the US, most notably in the case of the
Alaska Mental Health Enabling ActThe Alaska Mental Health Enabling Act of 1956 was an Act of Congress passed to improve mental health care in the United States territory of Alaska. It became the focus of a major political controversy after opponents nicknamed it the "Siberia Bill" and denounced it as being part of a communist...
controversy of 1956. In the case of fluoridation, the controversy had a direct impact on local programs. During the 1950s and 1960s, referendums on introducing fluoridation were defeated in over a thousand
FloridaFlorida is a state located in the southeastern region of the United States, bordering Alabama to the northwest and Georgia to the north. It was the 27th state admitted to the United States...
communities. Although the opposition was overcome in time, it was not until as late as the 1990s that fluoridated water was drunk by the majority of the population of the United States.
The communist conspiracy argument declined in influence by the mid-1960s, becoming associated in the public mind with irrational fear and paranoia. It was lampooned in
Stanley KubrickStanley Kubrick was an American director, writer, producer, and photographer of films, who lived in England during most of the last 40 years of his career...
's 1964 film
Dr. Strangelove, in which the character General Jack D. Ripper initiates a nuclear war in the hope of thwarting a communist plot to "sap and impurify" the "precious bodily fluids" of the American people with fluoridated water. Similar satires appeared in other movies, such as 1967's
In Like FlintIn Like Flint is a 1967 film directed by Gordon Douglas, the sequel to the parody spy film Our Man Flint . It posits an international feminist conspiracy to depose the ruling American patriarchy with a feminist matriarchy. To achieve and establish it, they kidnap and replace the U.S. President,...
, in which a character's fear of fluoridation is used to indicate that he is insane. Even some anti-fluoridationists recognized the damage that the conspiracy theorists were causing; Dr. Frederick Exner, an anti-fluoridation campaigner in the early 1960s, told a conference: "most people are not prepared to believe that fluoridation is a communist plot, and if you say it is, you are successfully ridiculed by the promoters. It is being done, effectively, every day ... some of the people on our side are the fluoridators' '
fifth columnA fifth column is a group of people who clandestinely undermine a larger group, such as a nation, from within, to the aid of an external enemy.- Origin :...
'."
Republic of Ireland
In
Ryan v. Attorney General (1965), the Supreme Court of Ireland held that water fluoridation did not infringe the plaintiff's right to bodily integrity. However, the court found that such a right to bodily integrity did exist, despite the fact that it was not explicitly mentioned in the
Constitution of IrelandThe Constitution of Ireland is the second constitution of independent Ireland and replaced the Constitution of the Irish Free State. It came into force on 29 December 1937 after having been passed by a national plebiscite on 1 July 1937....
, thus establishing the doctrine of
unenumerated rightsUnenumerated rights are sometimes defined as legal rights inferred from other legal rights that are officiated in a retrievable form codified by law institutions, such as in written constitutions, but are not themselves expressly coded or "enumerated" among the extant writ of the law. Alternative...
in Irish constitutional law.
United States
Fluoridation has been the subject of many
court casesA legal case is a dispute between opposing parties resolved by a court, or by some equivalent legal process. A legal case may be either civil or criminal...
wherein activists have sued municipalities, asserting that their rights to consent to medical treatment and
due processDue process alternatively due process of law or the process that is due, is the principle that the government must respect all of the legal rights that are owed to a person according to the law...
are infringed by mandatory water fluoridation. Individuals have sued municipalities for a number of illnesses that they believe were caused by fluoridation of the city's water supply. In most of these cases, the courts have held in favor of cities, finding no or only a tenuous connection between health problems and widespread water fluoridation. To date, no federal appellate court or state court of last resort (i.e., state supreme court) has found water fluoridation to be unlawful.
External links