NTP Study Strengthens Evidence Showing Fluoridated Water is a Safe Way to Prevent Tooth Decay, But Critics Ignore the Study They Once Welcomed

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A study led by researchers at the federal government’s National Toxicology Program (NTP) has found no link between elevated levels of fluoride and cognitive harms. Released in February, the NTP study examined rats that consumed food and water with varying exposures of fluoride during their prenatal development through their adulthood. At these exposures, the researchers reported that they “observed no exposure-related differences in motor, sensory, or learning and memory performance” for any of the nine different tests they conducted.

Although fluoride critics often assert that fluoridation is harmful to the thyroid, the NTP study revealed that thyroid hormone levels were not altered by exposure to levels as high as 10 or 20 parts per million (PPM) of fluoride.

Critics’ Noteworthy Silence

When the NTP study was first announced, the Fluoride Action Network (FAN)—the leading anti-fluoride group in the U.S. — welcomed the news with a headline declaring that the study’s findings “could end fluoridation.” FAN cited the NTP’s “cutting edge scientific tools” and wrote that the NTP’s decision to conduct a study “puts a lie to [proponents’] claims” about fluoridation.

The American Fluoridation Society (AFS) noted that FAN has been distinctly quiet since the NTP study results were publicly released.

“Critics of community water fluoridation were thrilled when the NTP said they would conduct a thorough study of this issue,” said AFS President Johnny Johnson. “However, they have been as quiet as a church mouse since the NTP’s findings were made public. Once again, they choose to ignore the studies that don’t fit into their fear-based mindset.”

The NTP research studied rats that consumed water with three different concentrations of fluoride (0, 10 and 20 PPM) and two different fluoride levels in food: 20.5 PPM (a standard diet) and 3.24 PPM (low-fluoride diet). The only side effect found by the NTP study was inflammation of the prostate gland, which was observed only at a fluoride exposure that was far above the level of human exposure by drinking fluoridating water.

In addition to the NTP study, research published in 2015 by the Journal of Public Health found no link at all between fluoridation and IQ scores. This 2015 study was conducted in New Zealand, where fluoridation programs are common. The New Zealand study examined a large sample of people and examined IQ scores collected over a 31-year period.

Few public health topics have been researched as thoroughly as CWF. In fact, the database maintained by the U.S. National Library of Medicine contains more than 56,000 studies or research papers on fluoride. And the Library’s records include more than 6,400 studies that focus specifically on fluoridation.

Two other recent reports reinforce the safety of fluoridated water. In a report issued this March, Public Health England reviewed the evidence surrounding fluoridation and reached this conclusion: “The findings of this report agree with the view that water fluoridation is an effective and safe public health measure to reduce the frequency and severity of dental decay, and narrow differences in dental health between more and less deprived children and young people.”

In April, the Food Safety Authority of Ireland (FSAI) issued a report stating that “there is currently no scientific basis for concerns about the safety of children and adults” due to fluoride exposure from foods and drinks.

For more information, visit americanfluoridationsociety.org.

The FDA’s New Fluoridation Website is Your Go-to Source for the Facts!

By Dr. Johnny Johnson, American Fluoridation Society President

Quick! Answer the following questions within 30 seconds:

1. The patient in your chair goes into cardiac arrest. What is the first phone call you make?
2. What is the concentration of your preferred local anesthetic?
3. Is your community water fluoridated?
4. What is the recommended level of fluoride for community water fluoridation (CWF)?

I bet that the first two questions took you a split second to answer. The third question may have been just as quick. The fourth? Maybe quick, maybe not.

How can you be 100 percent sure that you are correct in your answers? Well, the Florida Dental Association (FDA) would like to introduce you to our new and outstanding fluoridation website: www.floridafluoridation.org!

As dentists, we are expected to be the experts in water fluoridation — and we should be. The proper level of fluoride in drinking water is critical in knocking out at least 25 percent of cavities that adults and children will ever get. It also reduces the severity of those cavities.

The FDA’s fluoridation website is the best website that I have seen anywhere in the U.S. — or in the world for that matter! I know because I have worked with many of you in protecting, restarting and/or initiating CWF in your communities. And we have been an awesome force in ensuring that all of our residents — rich or poor, regardless of age, race, ethnicity, level of education or access to dental care — continue to receive this safe and effective public health benefit.

There are many great resources for information on CWF. However, when it comes to concise information that is user-friendly and state-based, the FDA’s website is primo!  The information is easy to find, concise and presented for both professionals and the public to use.

I challenge you to do these three things:

1. Immediately — right now! — find out what the fluoride level is in your community’s water.1,2,3,4
2. Pull up the FDA’s water fluoridation website.
3. Hang up a poster on CWF in your office — please!

An ounce of prevention is worth a pound of cure. CWF is the best bang for the buck for everyone in our state to benefit from the cavity reductions without a single behavioral change.

If you have any questions, challenges or needs, the FDA and I are here to help you. No question is dumb; the only dumb question is the one not asked. We are here to serve you. Call on us. Thank you for fighting the GREAT fight.

Dr. Johnson is a pediatric dentist in Palm Harbor, Fla. and the president of the American Fluoridation Society. He can be reached at drjohnnyjohnson@gmail.com.


1 My Water’s Fluoride (annual water quality report)
2 Dr. Johnny Johnson
3 Florida Department of Health
4 American Dental Association, American Fluoridation Society, Campaign for Dental Health

Fluoride Critics Use Flint to Push Their Own Agenda

Florida Dental Association (FDA) member Dr. Johnny Johnson is what you might call a fluoridation expert. He is the co-founder and president of the American Fluoridation Society (AFS), an organization that recently was created to debunk myths and clarify the evidence behind fluoridation’s safety and benefits.

In light of the water crisis in Flint, Mich., Dr. Johnson submitted an article to Dentistry Today to help educate and reassure the public that everything possible is being done to identify and resolve this issue. In addition, the AFS is working with other communities around the U.S. and the globe to help them understand this problem. His article, “Fluoride Critics Use Flint to Push Their Own Agenda,” was published on Dentistry Today on March 21, 2016 and can be found by going to http://bit.ly/1q4xfUm.

Dr. Johnson can be reached at Johnny@americanfluoridationsociety.com.

The 70th Anniversary of Community Water Fluoridation

By Dr. Johnny Johnson Jr.

This year, the 70th anniversary of community water fluoridation (CWF) in the United States was celebrated on Jan. 25, signifying the hard work of many individuals over the years.

The first city in the U.S. to optimally fluoridate the water was Grand Rapids, Mich. in 1945. It didn’t take long to notice the dental benefits of 1.0 ppm of fluoride in the water. The reduction in the number and severity of cavities in children became rapidly apparent to both parents and clinicians. This was a major breakthrough at a public health level. Four years later, Gainesville followed suit and was the first city in Florida to fluoridate its water.

Seventy years is a huge anniversary, and I expected to see fireworks on that day — at least in Gainesville, where I was having lunch with my two daughters. We proudly toasted our lunch with a clear glass of fluoridated tap water to mark the 70th anniversary. However, the lack of fanfare inside and outside the dental community was rather disappointing to me, given the huge impact that CWF has made in our country’s dental and medical health. Had this just become another item in our lives that we took for granted?

We know it was important, yet it isn’t considered a milestone? Sadly, this seems to be my take on the feedback that I get on CWF from our communities, our parents and grandparents, colleagues and other health care providers. CWF is taken for granted as something that will always be there, but it will continue to expand because it is the right thing to do.

CWF is a fantastic public health measure. Nowhere else do we see a decrease in communicable and preventable disease by simply adjusting a natural mineral in the water to optimal levels for dental health. This adjustment, just a slight tick up from what the natural background level of fluoride is in our water, causes absolutely no adverse health effects whatsoever at that level.

However, with CWF’s great benefits and lack of risks, why are we not at 100 percent of our state community water systems being fluoridated? Have we taken this public health measure for granted and resolved in our minds that it is always going to be there? We absolutely know what occurs when it is stopped. The reduction in cavities for adults and children of at least 25 percent over their lifetimes returns within three to five years to their pre-CWF levels. Again, most of us think that this fact is something that everybody knows and understands, especially in the medical and dental fields, so why would it happen at all? Well, let’s look at a simple parallel that is occurring right now.

Around the turn of the century, the number one cause of death for children was communicable and preventable diseases of childhood: measles, mumps, rubella and whooping cough, among others. Generations of parents grew up with the vaccinations that prevented these diseases and firmly believed that vaccinating their children was the right thing to do. It became an expected standard, just as CWF is now, as the correct thing to do and it would continue.

Let’s just take a quick look at the immunization situation right now. In a few short years of parents being scared by claims of harm — including autism — a growing number of people have begun to refuse immunizations for their children. In some communities in the U.S., like some in California, it is not unusual for 30-50 percent of the children to not be immunized. What we are starting to see now is a safe and proven public health measure being withheld from children, which is resulting in the return of preventable childhood diseases. Not only are these children being infected with a disease that we declared eradicated a few short years ago (measles), these children may then pass it on to infants whose immune systems have not yet developed, as well as immunocompromised patients, the elderly and some who have had less than a full-strength dose of the vaccine. So, what’s the parallel to CWF?

Nationally, CWF of community water systems is nearing 75 percent. The number of people that are served by CWS has steadily grown in the U.S. by millions every year. Although some communities have discontinued CWF for various reasons, the number of people who have access continues to grow every year. Unfortunately, we now have a serious issue with a small group of people with an internet presence that are spreading unsubstantiated information about CWF just as they do about vaccinations. The regrettable result is that the unsuspecting public surfing the internet comes across this misinformation so often that they are beginning to think that it is correct.

I find it unsettling that every city and community in our state is constantly being bombarded with anti-fluoridation misinformation by email. This type of constant attack was difficult to accomplish in the past before the internet. But now it is a matter of routine for this information to be disseminated to our fluoridation decision makers — our elected officials — on a regular basis. It is my hope that we achieve as close to 100 percent daily access to CWF as possible in my lifetime. We absolutely cannot allow the clock to be turned back by our complacency. No one else is going to come running to our aid when challenges to CWF come knocking at the door. The responsibility lies with you and your community to advocate for access to CWF by educating residents, professionals and community decision makers.

CWF is socially equitable. It is a non-partisan issue. It works for everyone regardless of socio-economic status, race, education or religious beliefs. We need to promote water fluoridation in our community and with our friends and families. Here are some quick important facts to remember about CWF:

  1. It’s Safe: It reduces cavities for everyone by simply drinking the water. It causes no adverse health effects for anyone at optimal levels.
  2. It’s Effective: It reduces cavities by 25 percent or greater for adults and children over their lifetime. The benefits of cavity reductions do not require a single modification to a person’s behavior — you just need to drink the water!
  3. It’s Cost-effective: For every $1 invested in CWF, $38 in dental treatment costs is avoided per person each year! Where in our lives can we get any return on investment like that? Additionally, CWF is the gold standard for delivering fluoride to everyone in a community.

Now, get out there and defend and promote CWF in your backyard. If you need help, just ask me. I will always be there for you!

Dr. Johnson can be reached at drjohnnyjohnson@gmail.com.