Should NJ add fluoride to water?
Legislators will vote on mandate popular in other states
by Adriana Rambay Fernández
Reporter staff writer
Feb 26, 2012 | 4759 views | 3 3 comments | 9 9 recommendations | email to a friend | print
BENEFIT OR DETRIMENT? The NJ legislation will decide whether to fluoridate the water system. The practice has been implemented in states across the country as a measure to prevent tooth decay.
BENEFIT OR DETRIMENT? The NJ legislation will decide whether to fluoridate the water system. The practice has been implemented in states across the country as a measure to prevent tooth decay.

Heated debate has ensued in the last few weeks about pending legislation to inject fluoride into New Jersey's water. The legislation has passed through both legislative health committees and will soon move to the Assembly floor for a vote.

Sponsors of the bi-partisan legislation have said that adding fluoride to public water will reduce the prevalence of tooth decay, but opponents argue against the measure, citing the cost, potential health risks, and lack of choice in the matter if the state mandates the practice.

Local advocacy groups are attempting to thwart the legislature’s efforts to “medicate the water supply,” calling fluoride a toxic chemical that can not be regulated once it enters the public water system.

Introduced in the 1940s

New Jersey ranks 49 out of 50 states, second to last to Hawaii, in its percentage of population that drinks fluoridated public water at the Centers for Disease Control and Prevention’s (CDC) recommended therapeutic level of one part per million, according to the New Jersey American Dental Association.

Michigan was the first state to fluoridate the water supply in 1945 after scientists discovered that people living near water supplies with higher levels of fluoride had less cavities. Fluoride was introduced into the New York City water supply in 1964.

In the 1970s, Jersey City water was fluoridated for a number of years before the practice was stopped due to opposition. As a Jersey City councilman in 2002, current Mayor Jerramiah Healy sought to return fluoridation and introduced a resolution that was never enacted upon.

Only 13 percent of New Jerseyans drink fluoridated water, according to data from the CDC. Several communities in Gloucester, Monmouth, and Somerset counties, among others, currently fluoridate their water.

Link to tooth decay

Almost all water contains fluoride, which is a naturally occurring mineral. But at low levels it is not sufficient enough to prevent tooth decay. Studies have shown that fluoridation of water can reduce tooth decay by about 60 percent. Despite the prevalence of fluoride in a number of products such as toothpaste, mouthwash, and gels, the CDC continues to recommend fluoridating water and listed it as one of the 10 most valuable public health measures of the 20th century.

Senator Vitale (D-Middlesex) said in a statement, “By fluoridating our public water supplies we can directly improve the dental health of all New Jerseyans in the least expensive and most effective way possible. He is the chairman of the Senate Health Committee and sponsor of the bill.


Michigan was the first state to fluoridate the water supply in 1945.


Fear of risks

There are some downsides of fluoridation, even according to the CDC.

According to the CDC, children under age 8 and younger exposed to excessive amounts of fluoride have an increased chance of developing pits in the tooth enamel. Excessive consumption of fluoride over a lifetime may increase the likelihood of bone fractures, and may lead to pain and tenderness of the bone, a condition called skeletal fluorosis. According to the EPA, it is likely that some children 8 and younger are exposed to too much fluoride, at least occasionally while their teeth are forming, because of their high fluid intake relative to their body weight and/or because of high natural levels of fluoride in their local drinking water.

However, the CDC claims that as long as you follow toothbrush guidelines for your child, it is highly unlikely that they will become overexposed to fluoride. Children under 2 years of age should not brush with fluoride.

Fluoride opponents argue that there is very little control over how much fluoride a person consumes, due to its availability in teas and products made with fluoridated water. They say it shouldn’t be increased for everyone regardless of age and health. They also claim that the benefits of fluoride are topical, and thus provides little benefit if ingested in water.

Costly, or cost-saving?

The New Jersey Dental Association, using CDC estimates, determined that fluoridating New Jersey’s public water supply would net an estimated savings of $108 million annually, or more than $2 million per week, in dental treatment costs.

On the other hand, some Water Utility companies oppose the use of fluoride due to the added cost they estimate in the hundreds of thousands to millions – a cost that could be passed to costumers.

“Start-up capital expenses would be $1 billion to $2 billion on the drinking water side and $3 billion to $5 billion on the wastewater treatment side,” said Ron Farr of the North Jersey District Water Supply Commission during a Senate hearing last month.

Assemblyman Herb Conaway, a major sponsor of the bill – who has fought for fluoridation for eight years – said it saves money in other ways. "Water fluoridation is a safe and effective way to prevent cavities in children and adults and saves money that would otherwise be spent on dental care by families and governments,” he said.

Conaway is a practicing physician and chairman of the Assembly Health Committee.

Proponents like Conaway also claim the costs fluoridation would benefit low-income families who cannot afford regular dentist check-ups.

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February 27, 2012
More THOUGHTS sprung from the birth-of-fluoridation era:


Life Magazine ad -10/27/1947

February 26, 2012
Yes there are scientists on both sides of the fluoridation issue but it is easy to tell the difference. One side reads the literature the other doesn’t!

When I co-authored the book The Case Against Fluoride (Chelsea Green, 2010) with two other scientists, I had hoped that it would raise the level of debate on this contentious issue. Sadly it has not done so. After 15 months promoters of fluoridation have been unable to muster one single scientific response to this text even though every argument was made transparent and every fact was documented with 80 pages of references to the scientific literature. Despite this, promoters still continue to push fluoridation, claiming that opponents have no science to support their case!

However the good news is that since our book was published 43 communities in Canada, US and NZ have stopped fluoridation. That means 3 million people have liberated themselves from this most foolish of public health practices. Thus it is extremely puzzling why NJ should be considering MANDATORY fluoridation for the whole state. This is madness not only from a scientific point of view but an ethical one as well.

I am surprised that a doctor in the NJ legislature should be pushing mandatory fluoridation. It is a clear violation of modern medical ethics because it violates the patient's right to informed consent to medicication. In fact, if a doctor was to FORCE a patient to drink fluoridated water he could lose his license - no matter how good he THOUGHT fluoride was.

Those who take the trouble to read our book will find that the scientific evidence that ingesting fluoride lowers tooth decay is very weak. Indeed, the largest survey of tooth decay ever conducted in the US found a very meager saving of six tenths of one permanent tooth surface out of 128 tooth surfaces in a child’s mouth. Even that saving was not shown to be statistically significant (Brunelle and Carlos, 1990). Meanwhile, the World Health Organization reports no difference in tooth decay in 12-year-olds whether they have grown up in fluoridated or non-fluoridated (the vast majority) countries.

Both these results are understandable when one notes that even avid promoters of water fluoridation like the Oral Health Division of the CDC now admit that the benefits of fluoride are largely topical not systemic (CDC, 1999, 2001). In other words fluoride works on the outside of the enamel not from inside the body.

Why would anyone want to swallow fluoride when there is no process in the body that has ever been shown to need fluoride, and many that are harmed by it? If you want fluoride to react with the surface of your tooth enamel then brush with fluoridated toothpaste and spit it out. This way you avoid exposing other tissues in the body to a poisonous substance and, as far as society as a whole is concerned, you avoid forcing it on people who don’t want it.

While promoters argue that 1 ppm is so small it couldn’t possibly harm anyone it should be noted that 1 ppm is not small when it comes to fluoride. It is actually 250 times the level in mothers milk (0.004 ppm, NRC, 2006, p.40).

Meanwhile, the evidence that drinking uncontrolled amounts of fluoridated water at 1 ppm, (as well as getting fluoride from many other sources) can cause harm is mounting. In 2010, the CDC admitted that 41% of American children aged 12-15 had a condition called dental fluorosis (a discoloration and mottling of the enamel), an indicator that they have been overexposed to fluoride (CDC, 2010). Moreover, a greater number of Black and Mexican-American children suffer from this condition (CDC, 2005).

Even more troubling is the fact that fluoridation may actually be killing a few young men each year. No study has yet refuted the Harvard study that found that boys exposed to fluoridated water in their sixth to eighth years had a 500-700% increased risk of succumbing to osteosarcoma, which is a frequently fatal bone disease (Bassin et al., 2006).

Nor have there have any studies performed in fluoridated countries that balance out the 25 studies that have found a lowered IQ associated with modest exposure to fluoride. One well-conducted study found a threshold at 1.9 ppm, leaving no margin of safety to protect all of America’s children from this end point (Xiang et al., 2003).

What parent in their right mind would risk their child’s mental development to save -at most- 0.6 of one tooth surface?

Paul Connett, PhD

Director, the Fluoride Action Network,


February 26, 2012
-- All baby foods contain fluoride, according to research presented at the 2012 annual meeting of the International Association of Dental Research.

-- Commonly-consumed infant fruit juices contain fluoride, some at levels higher than recommended for pubic water supplies, according to research was presented 3/17/2011 at the International Association for Dental Research annual meeting in San Diego

-- HHS Assistant Secretary for Health, Dr. Howard Koh, says all infant formulas, either concentrated or ready-to-feed, already contain some fluoride and, when routinely mixed with fluoridated water, increase the risk of dental fluorosis (discolored teeth), in a video commentary published on, March 8, 2011

Infant formula must not be mixed with fluoridated water References