Dr. Patricia Berube speaks out on fluoridation.
This topic is not even about the hazards of fluoride as it is about choice...
Functional Periodontist Speaks Out on Fluoride
Dr. Patricia Berube weighs in on fluoride. As a functional periodontist, what she sees clinically matters.
"I am hard pressed to find anyone who does not equate dentistry with fluoride. At the beginning days of practice, when someone would inquire about what toothpaste to use, my standard response was “anything that is recommended by the ADA”. How times have changed, let me explain. In the past there was a time I did not question what was taught. I never looked at ingredients in food or hygiene products. Fast forward several years and my opinion has changed 180 degrees. Is it because of the skull and crossbones that is present on a tube of toothpaste? Is it the hundreds of cases of fluorosis that I have seen on permanent teeth?
Even when I worked for a pediatric dentist prior to dental school, it was astounding the amount of fluoride affected teeth we saw. What I am talking about is the whitish lesions on adult teeth. These are permanent and depending on the severity, can only be remedied by placing veneers or crowns, which involves breaking down precious tooth structure. Some teeth are so affected that they have turned a brownish color. If you research what fluorosis looks like, you will see it is very disconcerting. People say this is purely esthetic, but is it? Let’s discuss some facts.
· What is fluoride? According to CDC.gov, fluoride is a mineral that occurs naturally and is released from rocks into the soil, water, and air. Almost all water contains some fluoride, but usually not enough to prevent tooth decay.
· Is it an essential nutrient? No. The FDA determines whether or not any substance is essential. Fluoride is not an essential nutrient because no deficiency state that related to a health problem could be found. In animal studies the least exposed animals had the fewest cancers and least dental fluorosis. The Federal Register in 1979 stated that “the FDA removed all references to fluoride as a nutrient or probable nutrient”. In fact, fluoride as an additive, has never been approved as a drug suitable for anyone. In other guidelines the government has specifically excluded young children under age 3 from exposure.
· Fluoride is an unapproved drug for which the FDA has no evidence of safety or effectiveness. They have issued multiple regulatory letters demanding companies to stop manufacturing vitamins with fluoride and systemic tablets or drops.[i]
I had no idea how many products contained fluoride until I started to research and learn about what I had been recommending for all these years. Fluoride is present in:
· community water fluoridation,
· dental products such as dental cements, fillings, gels, varnishes,
· floss, mouthwash and toothpaste, soft drinks, juices, and alcoholic beverages. Fluorinated compounds are also present in:
· pharmaceutical drugs,
· chemicals in carpets,
· food packaging, paints, paper and related products.
There are also products made from hydrogen fluoride which include:
· electrical components,
· fluorescent light bulbs,
· high-octane gasoline,
· refrigerants, and
· etched metal and glass (such as that used in some electronic devices).
What levels of fluoride in water are deemed “safe”? For decades there have been disagreement on what the maximum contaminant level (MCL), for fluoride should be. It began at a low level, then it increased to 4 mg/L (ppm). This has been determined by the EPA. Due to lawsuits against the EPA to decrease the MCL, they enlisted the National Research Council (NRC) to evaluate fluoride risk. A report released in 2006 by the NRC noted that the EPA’s maximum contaminant level goal for fluoride should be lowered. Considering that a level determined to be too high is 4 ppm, fluoride is naturally present in soil and water, and many municipal water systems add 1 ppm, could the dose in your tap water be over a safe level?
Many of us assume fluoride added to water is pharmaceutically pure. This couldn’t be farther from the truth. It is very disconcerting to find out that “the fluoride that goes in our drinking water is almost exclusively raw industrial pollution from the Florida Phosphate Industry. It’s a waste that’s scrubbed from the smokestacks and trucked in tankers and dumped into reservoirs.
Many websites and research papers state that fluoride decreases caries by anywhere from 25 percent to 40 percent. But the facts just don’t support this. Not how the decrease in caries does not depend upon water fluoridation but corresponds well with dental care expenditures. A Cochrane review, which is a true evidence-based and scientifically valid assessment, water fluoridation evaluated in blinded studies have not found a statistically significant difference in permanent tooth decay regardless of drinking water with fluoride.
Fluoride may provide some benefit at reducing dental caries but what does it do to the rest of your body at the dose provided in municipal water? Why would fluoride be applied to the teeth by putting it into your body instead of directly on your teeth?
A reasonable body of research shows that people with dental fluorosis also have what is called skeletal fluorosis. This is a condition that is a “chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride either through water or from foods of endemic areas.” Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease. In a peer-reviewed document published in 1986, the authors noted that “fluoride is a cumulative toxin that affects the homeostasis of bone mineral metabolism.
The total quantity of ingested fluoride is the single most important factor which determines the clinical course of the disease which is characterized by immobilization of joints of the axial skeleton and of the major joints of the extremities. A combination of osteosclerosis, osteomalacia and osteoporosis of varying degrees as well as exostosis formation characterizes the bone lesions.”[ii] A subsequent study by the National Academy of Sciences in 2006 identified increased risk of bone and hip fractures from exposure to fluoride.[iii]
Other systemic conditions associated with fluoride include:
· behavioral problems,
· cardiovascular diseases
· digestive problems
· endocrine irregularities
· immune dysfunction
· renal system dysfunction,
· dermatological problems,
· learning difficulties,
· skeletal fluorosis, and
· thyroid deficiency.
A quote from a 2011 literature review establishes: “If we were to consider only fluoride’s affinity for calcium, we would understand fluoride’s far-reaching ability to cause damage to cells, organs, glands, and tissues.”[iv] A recent study from Canada in a journal called Nutrients, found that pregnant women who had low iodine levels and elevated fluoride had boys who suffered an average IQ loss that was 58% greater than the already significant IQ loss from elevated fluoride alone.[v] This is not the first study to look at the effects of fluoride on IQ. Thefluoridealert.org cites 64 studies at this time that links fluoride with reduced IQ in children.
Another item we can add to the list is the effects of fluoride on our bodies is on the pineal gland. Fluoride is known to calcify the pineal gland, which produces melatonin. Melatonin is the hormone that regulates the sleep-wake cycle. This study concluded that “fluoride exposure may contribute to changes in sleep cycle regulation and sleep behaviors among older adolescents in the US."[vi]
Again, as a functional periodontist, I evaluate and treat severe oral issues a dentist does not. Here is case study of a patient I have seen for over a decade. When I began seeing her, she was obese with a thyroid condition. She was referred to help manage her periodontal disease and she was placed on high dose fluoride to control caries. This is still common practice in most dental offices as the main way to help prevent dental cavities. During that time, she was diagnosed with an autoimmune disorder and her health deteriorated. I changed our recommendations away from excess fluoride as we noted that high dose fluoride may be affecting her systemic health deleteriously. Is it possible that fluoride overloaded her body and thyroid, affected her melatonin levels, thus her sleep, which impacted health in general? Her health has slowly begun to improve but it takes time to remove fluoride because it binds very strong to essentially everything. Since the thyroid is an energy hormone producing gland dependent upon iodine, supplementation may help people, like this lady, with multifactorial disease.
Every substance has the potential to be beneficial, cause no effect, or be toxic. The expression, "the dose makes the poison" applies. Also, in nature, everything response to the bell curve to some degree. This means, the response is log-linear. Figure below shows my estimation of the dose/toxicity relationship for fluoride. It is very apparent that adding fluoride to our water supply increases the fluoride concentration too close to or even at unsafe levels.
Figure. Estimated toxic response to fluoride based on concentration. Fluoride is added to municipal water supplies at 1 PPM. Not known in any water supply is the ambient fluoride concentration, thus the total amount of fluoride in the water - thus the potential toxicity of that water.
If fluoride is not an essential nutrient, nor even deemed safe to use, why is it added to the water? Again, I believe that this quest began with the goal of decreasing caries in children, while saving money on dental care. But the reality is, it turned into something different. At this point, personally, I don’t recommend it in my office. Even back when I worked in a pediatric dental office, I concluded that I’d rather fill my child’s cavity than to subject them to the unsightly lesions of toxic fluoride and the potential systemic effects. Knowing what I know now, the data supports my assertion in many more ways that are more important.
Fluoride is a very sticky substance chemically. This is not a guess, it is based on the periodic table of elements where fluorine is the most electronegative. This has health consequences, particularly in children. The fluoride sticks strongly to saliva which is then swallowed. On average, a person swallows a well over a quart of saliva a day. If your child brushes with fluoride toothpaste, even if they rinse, how much fluoride are they ingesting? An adult may be taking in the same amount of fluoride on a daily basis. However, if the adult weights 200 pounds and the child weighs 40 pounds, the toxicity impact on the child will be 500% greater. In this context, please re-read the systemic side effects of excess fluoride presented above.
Considering that many children now exceed the recommended daily fluoride intake from toothpaste alone, it is just not something I’m willing to take a chance on. Caries prevention, as far as I understand it, is maximizing Vitamin D levels, decreasing the consumption of sugar, improving the diet, and effective oral care including maintenance visits. While 97% of Europe has rejected fluoride in the water supply, the United States are lagging behind. The Fluoride Action Network is a fantastic group to join. Another way you can help is by investigating the contents of your local water and by making your feelings known to your local water boards. I was so happy to know that our water does not add any chemical forms of fluoride and only includes the elements found in nature. But you don’t know until you check.
Speaking of checking, I mentioned the role of Vitamin D deficiency and caries. I have two children and both have similar diets, yet one had three cavities when he was very young. I was perplexed, especially considering you could argue that he ate healthier foods and would down a salad with no complaints. Years ago, I had obtained a genetic test and noted that he had a SNP called VDR, which is a Vitamin D receptor defect and I began supplementing more Vitamin D. I never put two and two together until the lockdown and I was doing research on the role of Vitamin D deficiency and dental implant failures. It turns out that Vitamin D deficiency is related to many oral health disorders. In Botelho’s review, they note that Vitamin D deficiency can induce defective tooth mineralization, is associated with periodontitis and gingival inflammation and failure of procedures, and certain oral cancers and events of osteonecrosis.[i]
This simple “vitamin” has changed the way I practice, literally it seems overnight. Obtaining up to date Vitamin D levels is paramount for optimal oral health, in my opinion."
Be Well - Dr. Patricia Berube
The aggressive nature of fluoride and its overall lack of benefit to the key aspects of proper oral care make fluoridation conspiracy theories worth considering. Ignorant people suggested putting statin drugs in our water supply. The only thing that should be in our water is water.
My single suggested reference you should consider reading is by Kilmer S. McCully, M.D. I do not believe I have ever met someone with more integrity than Dr. McCully. In the 1960s, he knew the cholesterol theory of cardiovascular disease was incorrect. He clearly demonstrated that elevated homocysteine was deleterious to vessel health. He was at Harvard at the time. What did the evil empire do? Fired and blacklisted him. He had to travel two hours to find work until Harvard reinstated him 30 years later. Dr. McCully has written hundreds of papers mostly discussing disease mechanisms. This is not usual. The paper he wrote that includes information on fluoride is titled, " Environmental Pollution, Oxidative Stress and Thioretinaco Ozonide: Effects of Glyphosate, Fluoride and Electromagnetic Fields on Mitochondrial Dysfunction in Carcinogenesis, Atherogenesis and Aging."[ii]
[i] Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020 May 19;12(5):1471. doi: 10.3390/nu12051471. [ii] McCully, Kilmer S. "Environmental pollution, oxidative stress and thioretinaco ozonide: Effects of glyphosate, fluoride and electromagnetic fields on mitochondrial dysfunction in carcinogenesis, atherogenesis and aging." Annals of Clinical & Laboratory Science 50.3 (2020): 408-411.
[i] https://fluoridealert.org/news/fda-warning-to-kirkman-labs/, January 13, 2016. [ii] Krishnamachari KA. Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease. Prog Food Nutr Sci. 1986;10(3-4):279-314. PMID: 3295994. [iii] Dental Fluorosis: Evaluations of Key Studies, EPA Report No. 820-R-10-018) and the other skeletal effects (Fluoride-Related Skeletal Effects: Evaluations of Key Studies, EPA Report No. 820-R-10-017) [iv] Prystupa J. Fluorine--a current literature review. An NRC and ATSDR based review of safety standards for exposure to fluorine and fluorides. Toxicol Mech Methods. 2011 Feb;21(2):103-70. doi: 10.3109/15376516.2010.542931. PMID: 21288074. [v] Goodman CV, Hall M, Green R, Chevrier J, Ayotte P, Martinez-Mier EA, McGuckin T, Krzeczkowski J, Flora D, Hornung R, Lanphear B, Till C. Iodine Status Modifies the Association between Fluoride Exposure in Pregnancy and Preschool Boys' Intelligence. Nutrients. 2022 Jul 16;14(14):2920. doi: 10.3390/nu14142920. PMID: 35889877; PMCID: PMC9319869. [vi] Malin, A.J., Bose, S., Busgang, S.A. et al. Fluoride exposure and sleep patterns among older adolescents in the United States: a cross-sectional study of NHANES 2015–2016. Environ Health 18, 106 (2019). https://doi.org/10.1186/s12940-019-0546-7
Dr. Patty Berube - functional periodontist - presented on oral and whole body health. This webinar / video content is of critical importance for anyone over the age of 50. Silent oral pathogens are a major cause of degenerative chronic conditions. This has been known for centuries but it not commonly or properly evaluated in medicine today.
Benjamin Rush, MD - a founding father stated, "I am yet one more doctor who demonstrated that, when an infected tooth is removed, general health is restored."
Charles Mayo, MD - founder of the famous Mayo Clinic stated, “The next move in preventive medicine must come from the members of the dental profession; will they do it?”
She is doing it!
Here is the link: https://youtu.be/8bg7cfWKLZ8
Dr. Patricia Berube, DMD
Dr. Berube is a functionally oriented Periodontist. She has been practicing exclusively in Periodontics for almost 20 years. Periodontics is the study of the prevention and treatment of periodontal disease (or gum disease), in addition to surgical therapies including placement of dental implants for tooth replacement and all that entails. She also treats oral conditions in the mouth, is versed in oral/systemic connections and periodontal plastic procedures. After college, she completed dental school training at the University of Connecticut School of Dental Medicine to receive her DMD and entered a three-year Periodontics residency at the University of Texas Health Science Center at San Antonio where she also obtained her Periodontics certificate, as well as a Master’s degree. She soon became Board Certified in Periodontics. After her training, she worked in Boston until she moved back to Texas to open her own practice. She believes that this is when her education really began.
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