For decades, public health agencies, dentists, and scientists have stated that severe dental fluorosis was an adverse health effect. The National Academy of Sciences is charged by the federal government with providing independent, objective advice to the nation on matter related to science and technology. The National Research Council (NRC) is part of the National Academy of Sciences and has written several reports on fluoride.
The 1977 NRC report stated: “Only two adverse health effects were identified including dental fluorosis and skeletal fluorosis ‘occurring when fluoride is at levels in excess of the concentrations recommended for good oral health.'”
In 1993, the NRC said regarding people with severe dental fluorosis: “their enamel can become brittle enough to fracture at the incisal edges and cusp tips. Caries might begin in the broken enamel, and, even if it does not, teeth in this condition often require treatment to restore function.” Besides the loss of tooth function, teeth with severe fluorosis cause a loss of self-esteem in children and adults who become embarrassed about the ugly appearance of their teeth. No government program or dental insurance helps people with fluorosis.
The effort to overturn scientific recognition of an adverse health effect
In the 1980s, Surgeon General C. Everett Koop somehow came to believe that severe dental fluorosis was not an adverse health effect. It is possible that he took that position because he was a strong advocate of fluoridation. Koop led an effort to overrule EPA scientists who were going to set water regulations to reduce the risk of severe fluorosis. Fluoridation advocates wanted a new higher regulatory level than previously allowed to make fluoridation look safer and win more political battles to increase fluoridation in the U.S. The EPA administrator agreed with Koop and raised the regulatory level for fluoride in water.
No EPA scientists have ever come forward to say they agree with setting the Maximum Contaminant Level (MCL) and Maximum Contaminant Level Goal (MCLG) at 4 parts per million (ppm). At that level, many children will develop severe dental fluorosis. If the EPA admitted that severe dental fluorosis was an adverse health effect, current laws would compel them to set a lower level than 4 ppm.
In 2006, another NRC committee reported on fluoride. Once again, they decided that severe dental fluorosis was an adverse health effect. A very small minority of that committee disagreed with that decision. One of them apparently was public health dentist Jayanth V. Kumar of New York. He is an important advocate of fluoridation with published research and high level government positions.
EPA ignores the advice of the National Research Council
The 2006 NRC committee was advising the EPA on their regulations for fluoride in drinking water. But the EPA continues to ignore the NRC advice to lower the regulated limits.
The MCL for water contaminants is set with economics in mind as well as health effects. The MCLG is a non-enforced level set to protect health. For example, arsenic is thought to cause cancer. But it is very expensive to remove it from water supplies. So the MCL for arsenic is 10 parts per billion. The MCLG for arsenic is 0.
For fluoride, both the MCL and the MCLG were set at 4 ppm. By setting the MCLG at 4 ppm, the EPA makes fluoride look safe when at that level many children will develop severe dental fluorosis. According to the majority of scientists, severe dental fluorosis means a loss of tooth function as well as a very ugly cosmetic appearance.