A Systematic Review of the Efficacy and Safety of Fluoridation

GENRE: Email letter

TITLE: A Systematic Review of the Efficacy and Safety of Fluoridation



DATE SENT: Tue, Jan 1, 2013 at 12:44 PM

STATUS: Awaiting response, as of 1st January, 2013

UPDATES: Any updates should be posted in the comments section below.

To: nhmrc@nhmrc.gov.au

Cc:  Minister.Plibersek@health.gov.au,
Holmes Tony <holmes@shoalhaven.nsw.gov.au>,

Bcc: Various lists

Dear Sir/Madam

I recently conducted a survey on the water quality as requested by the Shoalhaven Water Supplier (the council). As I had some concerns with fluoridation I was referred to a Factsheet located on the NSW Health Department’s Website, see:


This Factsheet, among other things, states:

What is the evidence for water fluoridation?

An overwhelming weight of scientific evidence supports community water fluoridation as a safe and effective measure in the prevention of dental decay. It has been endorsed by numerous organisations, including the World Health Organisation and the National Health and Medical Research Council.

What standards are met?

The quality of water supplied to these communities meets the requirements of the National Health and Medical Research Council’s Australian Drinking Water Guidelines.

Consequently, I visited your Website and came across the document: A systematic Review of the efficacy and safety of fluoridation, published in December 2007.

When I started to examine the contents of this publication, I soon discovered the Review uses the generic term, Fluoride, when discussing Fluoride and fluoridation. I found this confusing to say the least, as there are many types of Fluoride. There is Calcium Fluoride, which occurs naturally in water. There is Sodium Fluoride, Sodium Silicafluoride, Sodium Fluorosilicate, and others, falling within the generic term, Fluoride.

On closer examination, I noted Section 3.1 of the report discusses the types of Fluoride that occur naturally in water, as follows:

3.1.1 Fluoride levels in naturally-occurring water

Factors known to influence water

3.1.1Fluoride levels in naturally-occurring water Fluoride levels in surface waters vary widely according to geographical location and proximity to emission sources but are generally low, ranging from 0.01 to 1.5 mg/L. Concentrations in seawater commonly range from 1.2 to 1.5 mg/L. Freshwater concentrations are usually lower than seawater ranging from 0.01 to 0.3 mg/L.

Factors known to influence water Fluoride levels include the presence of natural rock rich in Fluoride (such as granites and geniuses and sediment of marine origin). Additionally, elevated inorganic Fluoride levels are often seen in regions where there is geothermal or volcanic activity.

Low levels of calcium in water supplies may also lead to higher levels of Fluoride solubility.

These comments imply that the Review is concerned with the type of Fluoride found naturally occurring in water systems, I.e. Calcium Fluoride. However, this is not the type of Fluoride that is being added to the council’s water supply. The information I have received from council states:

Shoalhaven has 4 distinct water supply systems in operation within the city. Sodium Fluoride (Kangaroo Valley Supply) and Sodium SilicaFluoride (Bamarang, Flatrock and Southern) is used as applicable. Fluoridation of public water supplies in New South Wales (NSW) is regulated by the Fluoridation of Public Water Supplies Act 1957, and the Fluoridation of Public Water Supplies Regulation 2007. The NSW Fluoridation Code of Practice 2011 forms part of this regulatory framework and it is NSW Health Policy to continue water fluoridation. Shoalhaven Water is required to fluoridate its supplies to a level determined by NSW Government Health.

As these types of Fluoride are not naturally occurring in water, I fail to see your Review having any relevance when considering the

efficacy and safety of fluoridation of the council’s water supply. The type of Fluoride used results from the production of aluminum and phosphate fertilizers. As these Fluorides can only come into existence through the processing of aluminum and phosphate fertilizers it would be deceptive and misleading to say they naturally occur in water.

Furthermore, as small amounts of Calcium Fluoride do occur naturally in water, it can be classified a Food Grade standard. However, the Sodium Fluoride being added to the council’s water supply must be Industry Grade standard. In your report there is no mention of the types of Fluorides being used by council. If I am mistaken, please advise the references and if so, what research and testing was carried out by the Review to ensure these Fluorides are of a Food Gradestandard (I.e. Fit for human consumption. They are classified as highly hazardous waste chemicals and must be handled with extreme caution, for example see:


I note in the Review there is no reference to industry grade Fluorides finding their way into our natural waterways as this is illegal. Nor is there any reference to them added to council water supplies

The comments in Section 3 discussed above make it clear the only naturally occurring Fluoride in water is Calcium Fluoride, and the Review’s concern is low levels of Calcium may also lead to higher levels of Fluoride sic (Calcium) solubiity.

As the Review is clearly concerned with the level of Calcium Fluoride in water supplies, it is irrelevant when considering the safety and efficacy of Sodium Fluoride, the type of Fluoride being dumped into the council’s water supply.

The report goes on to state:

“Though research into the beneficial effects of Fluoride began in the early 1900’s the first community fluoridation program did not begin until 1945 in Grand Rapids Michigan, USA. Three other studies followed in Newburgh, New York (USA) in May 1945, Brantford, Ontario (Canada) in June 1945, and Evanston, Illinois (USA) in February 1947. The results from these studies were used to establish the effectiveness and safety of fluoridation of public water supplies.”

As you know, these studies were based on the levels of Calcium Fluoride contained in the water and those studies did not consider the safety and efficacy ofSodium Fluoride because it was not being dumped into the water at that time.


The truth is children living in areas with higher Calcium Fluoride had mottled teeth, but very little tooth decay. This is not surprising as Calcium is good for strengthening teeth and bones, while Sodium depletes Calcium and consequently weakens teeth (primarily calcium) and bones, see:


According to this study salt (Sodium Chloride) is responsible for depriving the human body of Calcium and may well be one reason why so many Americans (who are forced to drink Sodium Fluoride, and ingest inorganic salt) are suffering from kidney stones and osteoporosis.

As the Review has noting to do with the safety and efficacy of Sodium Fluoride, please direct me to the link on your Website, containing the scientific research on the safety and efficacy of Sodium Fluoride, being added to the council’s water supply. The Review should have been titled, A systematic review of the efficacy and safety of Calcium Fluoride, published in December 2007.

Yours faithfully

John T


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