Ian Spohn, ND, is a staff naturopathic doctor for Energique who enjoys challenging the dogmas of both conventional and alternative medicine. He is a passionate supporter of the paleo diet and classical homeopathy.
Fluoride is not actually an essential nutrient. That is, your body could have not a single molecule of fluoride anywhere in it, and you would be completely healthy. So why is fluoride considered an important nutrient? It is a bit of a controversial issue, but it is conventionally held that exposing teeth to fluoride prevents tooth decay. So it is not a nutrient: it is more of a preventative medicine that is often added to the water supply for this reason. It is even added to infant formula, though I have yet to have it explained to me why an infant who doesn’t have any erupted teeth would need fluoride. This practice of fluoride fortification creates the widespread but false implication that tooth decay is due to a fluoride deficiency, but, of course, this is not actually true. It would be a bit like saying that having a heart attack is due to an aspirin deficiency, just because taking aspirin might help prevent it.
The root cause of tooth decay is not definitively known, though there are, of course, theories. For instance, tooth decay first became rampant in England after the British began importing sugar from the Caribbean. It was consumed in large quantities, despite not being a part of the traditional diet and despite its full consequences not being known, and it was around this time that tooth decay in England first became widespread. The theory is that sugar creates a sort of dysbiosis in the mouth, supporting the growth of bacteria which can metabolize sugar into acids that erode tooth enamel. Another theory of tooth decay comes from the pioneering work of a dentist named Weston A. Price. In the early 20th century, Doctor Price traveled the world studying traditional, by his standard primitive, cultures and was amazed to find that all the primitive peoples he studied had perfect teeth with few, if any, cavities, and this despite not having dentists and not even brushing their teeth. He then studied their diets and found that the traditional foods they ate had much higher levels of vitamins A, D, and K in their most bioactive forms than did the contemporary Western diet. What finally convinced him was the fact that when these native peoples were exposed to the Western diet through colonialism, they stopped eating their traditional foods and started getting tooth decay just like Westerners. He theorized that deficiency of vitamins D and K led to impaired calcium absorption, needed for strong teeth, and deficiency of vitamin A led to lower levels of enzymes in saliva that naturally inhibit bacterial growth, leading to the rampant tooth decay he saw in people eating a Western diet, where convenient processed foods had replaced traditional foods like animal organs, full-fat grass-fed dairy products, wild-caught shellfish, sprouted grains, and naturally fermented foods.[i] His theories never went mainstream, but in any case, it remains true that tooth decay is not due to a fluoride deficiency.
So what does fluoride actually do to the teeth? Basically, it displaces phosphate. The primary mineral in teeth and bones is calcium phosphate. Calcium phosphate has unique properties which make it perfect for bones and teeth: it is very hard and durable, and yet at the same time it is not brittle; that is, despite being hard it will still bend and give a little when exposed to sudden high forces. This allows it to provide firm structural support or a hard chewing surface, yet still be resistant to breaking under sudden tension, like landing from a high jump or biting down on something hard. Most people don’t know this, but healthy bones will actually bend and flex to quite an astonishing extent before they break, and healthy teeth, being made of the same material, have that same property. As a building material, calcium phosphate really only has one flaw, and that is it can easily be dissolved by acids. When teeth are exposed to fluoride, either from toothpaste, dental treatments, or systemic fluoride that eventually ends up depositing in bones and teeth, it displaces phosphate to make instead the mineral calcium fluoride.[ii] Calcium fluoride is highly resistant to acids; therefore, it protects enamel from being eroded by the acids generated by bacteria in response to sugar. It has its own drawback, however: though harder it is also more brittle than calcium phosphate. So while it makes teeth and bones harder, it does not necessarily make them stronger, as they will theoretically be more likely to crack, chip, crumble, fracture, or otherwise break under sudden stress. This is probably why fluoride exposure has been linked to increased bone fractures,[iii] probably also why nature did not design bones and teeth to be made out of calcium fluoride. Furthermore, fluoride has a notorious tendency to inappropriately harden and calcify soft tissues like tendons, ligaments, and, most notably, the pineal gland.[iv] So even if fluoride does make teeth more resistant to acidic erosion, it comes with the disadvantage of making them more brittle, in addition to having many other significant exposure risks. It also produces an unsightly mottled appearance of the teeth known as dental fluorosis.
SOURCES OF FLUORIDE EXPOSURE
- Tea: Everything natural that we eat and drink contains trace amounts of fluoride, since fluoride is a naturally occurring trace element. But regularly consuming something that is especially high in fluoride can contribute to increased fluoride exposure. One such plant that is high in fluoride, which is widely consumed on a regular basis throughout the world, is tea. The fluoride level in brewed green tea has been shown to exceed the safe level established for drinking water, above which level it can lower IQ and increase fracture risk.[v] This probably does not mean that you should never drink green tea, but consuming it daily or in high amounts would result in significant exposure. Oddly, milk has been shown to decrease fluoride’s absorption in the gastrointestinal tract, probably due to the calcium binding it and decreasing its bioavailability.[vi] Maybe the British were on to something about taking their tea with milk and sugar, though if they value their teeth they might, of course, do without the sugar.
- Prescription medications: Prescription medications represent a very significant and largely unrecognized source of fluoride exposure. The full list of fluoride-containing medications is quite overwhelming, but a partial listing of some of the more common fluoride-containing pharmaceuticals would include Haloperidol and Flurazepam (anti-anxiety), Fluoxetine and Paroxetine (anti-depressant), Atorvastatin and Fluvastatin (cholesterol-lowering), Fluticasone, Clobetasol, Betamethasone, and Dexamethasone (anti-inflammatory), Fluconazole (antifungal), Ciprofloxacin (antibiotic), Methoxyflurane (anesthetic), Celecoxib and Flurbiprofen (anti-rheumatic), and, of course, the entire fluoroquinolone class of anti-malarials. From a brief survey of the above drug names, it is surprising how many of them contain the prefix flu-, referring to the presence of fluoride. It is actually a discovery of drug chemists that adding fluoride to medications often allows them to target their desired receptors in the body more effectively,[vii] and this is why so many pharmaceutical drugs, which seem to have nothing to do with fluoride, do in fact contain it.
- Non-stick cookware: Many, though not all, types of non-stick cookware are coated with Teflon®, but what exactly is Teflon? Teflon is another name for polytetrafluoroethylene, a fluorinated compound created by chemists in the 1930s. There was a study back in 1975 which showed that boiling water in Teflon-coated pans caused a large increase in the water’s resulting fluoride level.[viii] There is therefore some concern that using Teflon-coated cookware can cause fluoride to leach into the food, resulting in increased systemic exposure. If you love the convenience of non-stick cookware but wish to reduce your fluoride exposure, there are pans available with ceramic coating that work similarly and are free of fluoride.
- Toothpaste and dental treatments: Most toothpaste contains fluoride, because topical exposure to fluoride is believed to create a surface layer of acid-resistant calcium fluoride on the teeth. However, if you don’t rinse your mouth out perfectly, then small amounts of toothpaste can be easily swallowed, resulting in systemic exposure. In fact, fluoridated toothpaste carries a warning on the label to contact poison control if swallowed because the acute dose of systemic fluoride this would provide is high enough to be considered dangerously toxic, especially to a child. Some dentists also use sodium fluoride paste or gel as a topical treatment to strengthen tooth enamel, which requires careful supervision as sodium fluoride is actually lethal in doses as low as 32mg/kg body weight.[ix]
- Water supply: Many communities in the U.S. add fluoride to drinking water supplies in an effort to prevent cavities on a population level. This idea began when a dentist named Frederick McKay noticed that children in the town of Colorado Springs, Colorado, were all getting horribly mottled teeth but, at the same time, had surprisingly few cavities. Looking for answers but unable at that time to determine the cause in Colorado Springs (it turned out to be high levels of fluoride in the spring water), he soon discovered that children in the town of Bauxite, Arkansas, were having the same problem. It turns out that an aluminum refinery upstream of the community had been dumping massive loads of toxic fluoride into the water supply, as fluoride is a waste product of refining aluminum from bauxite ore, the mining town’s namesake. From this originated the idea of intentionally dumping toxic aluminum refinement waste into the water supply as a way to prevent cavities in children, a practice first adopted by the town of Grand Rapids, Michigan, in 1945. It was nice for the aluminum refineries too, since now they could sell their toxic waste materials to municipalities nationwide for a profit, instead of just dumping them into the nearby water supply. Since fluoride is not an essential nutrient and is only useful to prevent a disease (dental caries), this practice has been challenged in courts for essentially constituting mass-medication. Since fluoride is wholly unnecessary to the body except to prevent a disease, it is by definition a medical treatment, and your right to consent to this medical treatment is denied if it is being added to your water supply. Or so the argument goes, although despite this courts have ruled that fluoridating public water supplies is still acceptable because, as they have argued back, no one is actually forcing you to drink tap water. One drawback inherent to this sort of mass-medication is that it is difficult to control the dose. People who work in hot climates or exercise a lot, and therefore need to drink more water, will be getting a higher dose of fluoride than most people, and since fluoride is toxic in high doses, this makes it a potential problem for anyone who drinks more than the usual amount of water.
HOW IS FLUORIDE NORMALLY DETOXIFIED?
In the body, eliminating fluoride is actually rather simple. It is normally excreted in its ionized form in the urine. Chemically, fluoride ions behave much like chloride ions, which are ubiquitous in cells and constantly subject to unintended loss through urine and sweat. So much chloride would be effortlessly lost from body fluids in this way that the kidneys must actively reabsorb chloride to keep levels adequate. Fluoride is lost naturally the same way as chloride, that is effortlessly, and hence normal urine contains appreciable amounts of fluoride. This makes fluoride relatively non-toxic in small amounts, which is a good thing because as a naturally occurring trace element, small quantities of fluoride are latent in most foods and water sources, even natural water that does not have fluoride added. Fluoride becomes a liability when it is ingested more rapidly than it can be excreted. In such a case, it can accumulate in the body. One place it tends to accumulate is in bones and teeth, because it binds with calcium, but it can also wreak havoc on the thyroid gland. This is because the thyroid gland takes up iodine, and as a halogen element fluoride is so similar to iodine that the body cannot always tell the difference. Yet it is not similar enough to effectively replace iodine in the production of thyroid hormones, and it has indeed been shown that higher exposure to fluoride leads to decreased thyroid hormone levels.[x] In fact, fluoride is so toxic to the thyroid that it has even been used to induce hypothyroidism in rodent models[xi] and was once even used as a medicine to treat an overactive thyroid,[xii] only to be abandoned because it was found to be too toxic. As thyroid disorders are rampant in our society, some have hypothesized that fluoride exposure is, in fact, a contributing cause of this epidemic, and epidemiologic studies have confirmed that hypothyroidism is more prevalent in areas with higher water fluoridation.[xiii] This has generated interest in potential approaches to help detoxify accumulated fluoride.
Even if fluoride has already accumulated in bones and teeth, the good news is it can still be eliminated. Basically, fluoride stored in bones and teeth will slowly leach back out into body fluids for elimination, provided that blood fluoride levels remain low enough to accommodate this gradual influx. So it is possible for the body to slowly detoxify even calcified fluoride. The question is, can anything be done to assist or accelerate this process? Maintaining the body in a state of relative alkalinity has been shown to enhance the release of fluoride from hard tissues,[xiv] and it is believed by some that a high intake of iodine and chloride (the latter from salt) can drive fluoride out of the body faster because these halogens compete with fluoride for the same ion transport channels, allowing less secreted fluoride to be reabsorbed in the kidneys, for example. It has indeed been shown that a high iodine intake will increase urinary fluoride excretion.[xv] As it is a halogen ion you can also, like chloride, lose fluoride through sweat, so regular use of a sauna might also help to eliminate it from the body. Anything that increases the activity of the kidneys, whether this be diuretics, simply drinking extra quantities of (non-fluoridated) water, or a kidney tonic herb like Solidago, which has been shown to increase the kidney’s glomerular filtration rate,[xvi] would also likely be useful to assist this process, on empirical grounds. It is widely supposed on the Internet that taking lecithin as a dietary supplement can decalcify your pineal gland by removing accumulating fluoride, reopening your third eye as it were, although there is not a shred of evidence available to support this. Would taking homeopathic calcium fluoride help? There is some evidence that homeopathic Arsenicum Album 30C can enhance the detoxification of arsenic at the cellular level in E. coli.[xvii] Although homeopathy’s detractors often dismiss positive results in homeopathic trials as the placebo effect, it is difficult to argue in this case that a unicellular organism, lacking a brain or nervous system like E. coli, would possibly be susceptible to benefiting from the placebo effect. One might therefore extrapolate these findings to humans in the case of calcium fluoride, though this specific use of homeopathy has never been directly tested. It may be noteworthy that the classical homeopathic indications for Calcarea Fluorica do resemble some of the symptoms of chronic fluoride exposure,[xviii] though, of course, none of this has ever been evaluated by the Food and Drug Administration.
[i] Price, Weston A. Nutrition and Physical Degeneration. 1939. Project Gutenberg Australia. Web. November 6 2019. http://gutenberg.net.au/ebooks02/0200251h.html
[ii] Ullah R, Zafar MS, Shahani N. Potential fluoride toxicity from oral medicaments: A review. Iran J Basic Med Sci. 2017;20(8):841–848. doi:10.22038/IJBMS.2017.9104
[iii] Li, Yiming, et al. Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. Journal of Bone and Mineral Research. May 2001;16(5):932-39. https://asbmr.onlinelibrary.wiley.com/doi/full/10.1359/jbmr.2001.16.5.932
[iv] Luke, Jennifer. Fluoride deposition in the aged human pineal gland. Caries Research. 2001 Mar-Apr;35(2):125-8. https://www.ncbi.nlm.nih.gov/pubmed/11275672
[v] Lung, S., Hsiao, P. & Chiang, K. Fluoride concentrations in three types of commercially packed tea drinks in Taiwan. J Expo Sci Environ Epidemiol 13, 66–73 (2003). https://doi.org/10.1038/sj.jea.7500259
[vi] Ullah, et al. 2017.
[vii] Edwards, Lin. New method of incorporating fluoride into drugs. https://phys.org/news/2013-09-method-incorporating-fluoride-drugs.html. Published September 6, 2013. Accessed January 23, 2020.
[viii] Full CA, Parkins FM. (1975). Effect of cooking vessel composition on fluoride. Journal of Dental Research 54: 192.
[ix] Whitford, GM. Fluoride in dental products: safety considerations. Journal of Dental Research. 1987 May;66(5):1056-60. https://www.ncbi.nlm.nih.gov/pubmed/3301934
[x] Kheradpisheh Z, Mirzaei M, Mahvi AH, et al. Impact of Drinking Water Fluoride on Human Thyroid Hormones: A Case- Control Study. Sci Rep. 2018;8(1):2674. Published 2018 Feb 8. doi:10.1038/s41598-018-20696-4
[xi] Wang H, Yang Z, Zhou B, Gao H, Yan X, Wang J. Fluoride-induced thyroid dysfunction in rats: roles of dietary protein and calcium level. Toxicol Ind Health. 2009 Feb;25(1):49-57. doi: 10.1177/0748233709102720.
[xii] Galletti PM, Joyet G. Effect of fluorine on thyroidal iodine metabolism in hyperthyroidism. J Clin
Endocrinol Metab 1958;18:1102-10.
[xiii] Peckham S, Lowery D, Spencer S. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. J Epidemiol Community Health. 2015 Jul;69(7):619-24. https://www.ncbi.nlm.nih.gov/pubmed/25714098/
[xiv] Ullah, et al. 2017.
[xv] Abraham GE. The historical background of the iodine project. The Original Internist. 2005;12:57-66. https://pdfs.semanticscholar.org/1609/8c32e6acf640db6c5c7bb8d44ef89e068172.pdf
[xvi] Weiss, Rudolf. Weiss’s Herbal Medicine, Classic Edition. Thieme Publishing, Stuttgart 1988.
[xvii] De A, Das D, Dutta S, et al. Potentiated homeopathic drug Arsenicum Album 30C inhibits intracellular reactive oxygen species generation and up-regulates expression of arsenic resistance gene in arsenite-exposed bacteria Escherichia coli. Zhong xi yi jie he xue bao = Journal of Chinese Integrative Medicine. 2012 Feb;10(2):210-227. DOI: 10.3736/jcim20120212.
Any homeopathic claims are based on traditional homeopathic practice, not accepted medical evidence. Not FDA evaluated.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.