Talk:Fluoride toxicity/Archive 1

Archive 1

Untitled

For an October 2004 deletion debate over this page see Wikipedia:Votes for deletion/Fluoride poisoning

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• It seems obvious that this page was created in order to argue against public fluoridation of drinking water - a topic of debate in some parts of the U.S., and perhaps elsewhere. I took all that out, leaving virtually nothing, because Wikipedia is not a debate forum (or, at least, it shouldn't be). Please edit this to be an encyclopedia article, using facts, not surmizes, and trying to be NPOV. DavidWBrooks 21:37, 29 Sep 2004 (UTC)
  • David is INCORRECT. This article was created SOLELY because somebody asked me today about this issue and I searched for it in Wikipedia and did not find proper answers. So I decided to create the article and will work on it in the coming days. Whoever wants to contribute, feel free to do so.--AAAAA 23:35, 29 Sep 2004 (UTC)
  • I changed the redirect by Rhobyte because I think this topic "Fluoride poisoning" deserves a separate article from the "Water fluoridation". I might move some info from the Water Fluoridation article to this one. --AAAAA 23:35, 29 Sep 2004 (UTC)
    • I changed it back. This article contains a single sentence of information, and any discussion of fluoride poisoning is well within the scope of Water fluoridation and Fluoride. Rhobite 00:44, Sep 30, 2004 (UTC)

I apologize for my over-hasty statements. The original article read to me as if it was meant to become an anti-fluoridation argument; I certainly shouldn't attribute motive to others. - DavidWBrooks 01:34, 30 Sep 2004 (UTC)

That's my reading of the initial article as well. Water fluoridation also needs some help. Perhaps we need four separate articles:

• Fluoride should be about fluoride (d'oh).
• Water fluoridation should be about the techniques and history, not focussed purely on the debate as it is currently.
• A separate article is IMO merited on the debate, containing all three headed sections of the current Water fluoridation article.
• Fluoride poisoning should be about the currently accepted medical and scientific opinions, with attributed mention of any held in dispute by particular causes and movements.

Comments? Andrewa 05:42, 30 Sep 2004 (UTC)

• • I agree 100% with with Andrewa. Also, whoever reads this, please start colaborating with the article. Any help will be appreciated.--AAAAA 11:00, 30 Sep 2004 (UTC)
  • Agree. It will be regrettable to split up Water fluoridation, but with the arguments on policy you will never be able to add anything else. Also I'd like to note that fluoride, which you correctly note should be about fluoride chemistry, currently has very little of that. I t would probably also be a good idea to interlink them (like This article is about X. See Y for discussion on ...) to discourage topical spillover. Securiger 02:52, 7 Oct 2004 (UTC)

SB: I agree with the 4-way split.

I also think the fluoride poisoning article has merit; fluoride poisoning may occur from many causes other than fluoridation. There are also some villages in India full of crippling skeletal fluorosis cases that demand some kind of article all by themselves.

I do have an issue, though.

Fluoridation is widely regarded as safe and scientific by the US(even if there are dissents), but is widely regarded as unsafe and unscientific by most of the world (i.e. only 1% of europe fluoridates, Japan and China ban it, etc). There are a dozen or so medicine/chemistry nobel prize winners who oppose fluoridation as unsafe, and none who support it.

I'm however having difficulty having the people accept that the USA's scientific claims are often POV and shouldn't be mistaken for a worldwide widely accepted scientific NPOV. Despite the fact some 'vitamin dictionnaries' from the US and Canada claim "fluoride deficiency" causes teeth damage! The fact is you will not find Hypofluoremia(fluoride deficiency) in Taber's Cyclopedic Medical Dictionary simply because, strictly speaking, there is no such thing as human Fluoride Deficiency. [1]

If it's not possible to get a deficiency of it, therefore the non-debate articles will have to mention it's a medication.

I intend to make a very short mention (1 phrase) of the opposing views of Europe, Asia, Japan, etc. as part of some of the non-debate articles(as well as mention the status as a medication), with a link to the debate article. I think the non-debate fluoridation article needs to mention those two points to remain NPOV; the view of fluoride as a supplement and the illusion of worldwide scientific agreement are too strong to be left ignored.

The rest of the debate should be in the debate article, though.

(I have a habit of announcing changes in the talk pages before actually modifying the article - to avoid edit wars; I notice that others often just modify the article. Is one or the other practice better?)

• Please DO add or correct whatever you like. For me: THE BIGGER THE BETTER. If you can, include A LOT of information. I personally like big articles. Small articles you can find anywhere on the internet.

Well I tend to pre-announce major changes if they directly oppose something someone else has done, make less controversial major changes straight away but often with an added explanation on the talk pages, and just do minor changes straight away. My subjective impression is that it does help avoid edit wars.

Anyway, if by "non-debate fluoridation article" you mean this page (fluoride poisoning), then I really hope you'll reconsider. This article should not be about fluoridation at all, it should be about the toxicology of fluoride ions. There is no debate on the subject; it is a well studied, well understood subject and there is no need for any POVness as long as everyone just sticks to the facts. If you start bringing the fluoridation debate in here, it is bound to spill over and turn this article into a mess as well. Just link to this one from water fluoridation; you will be able to point out that fluoride is indeed quite poisonous, they will point out that the dose makes the poison, and so on. Securiger 02:52, 7 Oct 2004 (UTC)

Organofluorine compounds

"Organofluorine compounds do not contain soluble fluoride and thus are not toxic because of fluorine. Organofluorines include many kinds of compounds such as Teflon and fluoxetine." These lines need immediate citation or removal, otherwise it's just one-sided opinion. Also, what about when organofluorines(particularly Teflon) are heated? Doesn't that free the fluoride or at least produce vapors (possibly toxic?)? Wiki is not a debate forum, but it should at least explain that the topic is currently debated and list both view points, with appropriate studies and research cited on both sides. This of course should be presented in a neutral, balanced and unbiased way, but it still needs to present them. Presenting only one side of the issue at hand is, in itself, biased. It should be the individual's decision to decide which parts they agree with until the issue is wholly resolved. ♠♣VashTexan (talk) 15:51, 21 April 2008 (UTC)♥♦

There are no "sides", "bias" or even "argument" with respect to this fact. Fluoride poisoning cannot be caused by materials that release no fluoride ions when ingested, whether or not they contain fluorine. There's no way around this; you can't have fluoride poisoning without fluoride. For example, fluorine-containing drugs aren't heated before ingestion, and do not release fluoride when metabolized. (Quite the contrary, the problems caused by organofluorine drugs are that they are too stable.) PTFE does not release fluorides (there are chemical reasons for this), and fluorides are not volatile. Perhaps you're thinking about the issues with that PTFE is known to release degradation products above 260 C. The vapors are less toxic than those given by ordinary cooking oils, and they aren't fluorides in the sense of fluoride poisoning. To compare, highest actually useful temperatures in cooking are around 200-230 C, above which foods begin to scorch and smoke on the pan. (see PTFE#Safety) It is generally very difficult to get organofluorines to react at all, even with the most reactive reagents known. --Vuo (talk) 19:18, 20 August 2008 (UTC)

This Article Is Too Blunt; It Needs To Be More Euphemistic and Roundabout by way of Medical Jargon

"In high concentrations, soluble fluoride salts are mildly toxic: 5-10 grams of sodium fluoride are required to kill most adult humans; a lethal dose is approximately 70 mg per kilogram of body mass"

This first sentence should read: "In VERY high concentrations, soluble fluoride salts CAN BE mildly toxic: 5-10 grams of sodium fluoride WOULD BE required to INDUCE MORTALITY IN most adult humans; A DOSE EXCEEDING 70 mg per kilogram of body mass CAN POTENTIALLY INDUCE MORTALITY"

The beauty of scientific euphemism is that, when something is politically unpopular yet true, the 'expert' gets to have his cake and eat it too. If, some years down the road, fluorides (re)gain worldwide recognition as poisons and are banned from human consumption (as has already happened in Belgium and elsewhere), the 'experts' whose positions are reflected in sentences such as the one above have the comfort of having TECHNICALLY spoken the truth. In the meantime, however, those same 'experts' are free of blame for criminal understatements about the toxicity of chemicals they are responsible for explaining to the world, because those understatements were made by way of SCIENTIFIC JARGON, which it is the 'scientists prerogative to use for understatement or overstatement as he sees fit.

I can only wish that criminally misleading articles like this could not exist on Wikipedia. It could be left to other websites to explain the issue; it could be left to the pharma-giants and their cronies in government medical organizations to criminally understate politically-incorrect truths - at least they have an excuse; their salaries and even careers depend on the understatements. But Wikipedia is just too popular; it needs to be brought into the fold, else people would be 'misled' into 'hysteria' by 'non-scientists' preaching 'pseudoscience' and detracting from the proliferation of perfectly 'safe and effective' substances which just so happen to be 'healthy for our economy' as well.

Zinbielnov —Preceding unsigned comment added by 76.10.170.203 (talk) 19:53, 19 August 2008 (UTC)

This isn't the forum to discuss the issue in general. Offhand, I can't think of any use of fluoride salts that involves eating them in amounts capable of causing acute fluoride poisoning. --Vuo (talk) 18:38, 20 August 2008 (UTC)

Mentioning organofluoride in lede?

There has been and may be some back and forth on the mentioning organofluorine compounds in the lede. Many readers will not understand that "organofluorides" (sufficiently pervasive jargon that it is a wikipedia redirect) do not release fluoride ions and thus are are not subject to the concerns raised in this article. Often, article ledes indicate potential areas of confusion to guide the non-specialised reader.--Smokefoot (talk) 23:58, 31 December 2008 (UTC)

Thanks for explaining your concern, but, IMHO, it is not helpful to "violate" WP:lead to this end. -Shootbamboo (talk) 00:17, 1 January 2009 (UTC)

It's a definition issue. When people have something that contains fluorine, they might look up 'fluorine' and end up on this page. However, the toxicity of organofluorines is entirely compound-dependent and not related to fluoride release. (The exception is when fluoride is explicitly a leaving group as in carbonyl fluoride.) --Vuo (talk) 10:02, 1 January 2009 (UTC)

I agree with Vuo, that while the three of us might have specialist knowledge, the mention of organofluoride compounds is logical. In a perfect world, readers would have advanced appeciation of the difference between fluoride salts and the (usually) rock-like C-F bond. Rather than getting into a revert battle, we could ask for others' opinions.--Smokefoot (talk) 14:12, 1 January 2009 (UTC)

I respectfully disagree that I am raising a definition issue. It is a policy issue. -Shootbamboo (talk) 16:19, 1 January 2009 (UTC)

I don't think they should be mentioned in the lead. The section under possible sources is the place to clarify this, and it does a decent job. It looks like the last sentence in that section should clarify that those chemicals do not release fluoride. It might also be appropriate to mention that these chemicals may have various different toxicities arising from their own chemical properties. II | (t - c) 20:59, 1 January 2009 (UTC)

Rename page

It seems logical to rename the page Fluoride toxicity instead of Fluoride poisoning. Poisoning has the POV of acute toxicity but this page also addresses chronic toxicity. Therefore, it seems appropriate to rename the page with the more general Fluoride toxicity to be inclusive off all aspects addressed. -Shootbamboo (talk) 21:49, 25 January 2009 (UTC)

Agreed. II | (t - c) 19:02, 4 March 2009 (UTC)

I agree too; I didn't realize this discussion was ongoing, when I remarked the same over there. Xasodfuih (talk) 19:17, 4 March 2009 (UTC)

Alternatively, we could split the article in two: one dealing with long-term effects of exposure above recommended level, and another article dealing with acute poisoning. Xasodfuih (talk) 19:34, 4 March 2009 (UTC)

Agree with rename. Broader title is more accurate.YobMod 13:03, 4 May 2009 (UTC)

Glaring Inconsistency

At the very end when they talk about the definitive paper, they describe it as being about fluoriNe - not fluoriDe. Either this is a typo or the paper is completely irrelevant to this topic. —Preceding unsigned comment added by PurrfectPeach (talk • contribs) 04:38, 14 March 2010 (UTC)

It doesn't make a difference in this case. Read the review referenced. --vuo (talk) 13:14, 14 March 2010 (UTC)

The journal "Fuoride" is not recognized by PubMed

PubMed, an archive overseen by the US National Institutes of Health, archives thousands of biomedical and related journal citations and abstracts, regardless of nationality: "Participation in PMC is open to any life sciences journal that meets NLM's standards for the archive. A journal must qualify on two levels: the scientific quality of the publication and the technical quality of its digital files." The journal "Fluoride" is not recognized by PubMed and one wonders if citations to this journal are therefore credible sources.--Smokefoot (talk) 14:52, 14 March 2010 (UTC)

Corrections please

Thanks for your attention to the facts of this subject and apparent willingness to get to the bottom of this issue.

Could I request some small additional changes to this page - all located at head of article.

1. "Fluoride is taken out of circulation by the body and trace amounts bound in bone" is incorrect and should say "Fluoride is taken out of circulation by the body and stored in bone" because the levels in affected bone are not 'trace' amounts but can be quite large ('000's ppm).

2. "The only generally accepted adverse effect of low concentration water fluoridation at this time is dental fluorosis" - should add "and skeletal fluorosis".

3. "Fluoride in small amount is beneficial to teeth see Fluoride therapy". This stamement is incorrect because it implies that consumed fluoride is beneficial when it is now generally accepted (in scientific terms) that fluoride is not safe to consume but can/might benefit teeth when applied topically. Could you please amend this statement to say "Fluoride is presumed to be beneficial to teeth when applied to the tooth surface" or similar.

Thanks LisaChris 01:13, 7 January 2006 (UTC)

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The IQ lowering effects of fluoride should be included in "Fluoride Toxicity".

http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104912

Citation: Choi AL, Sun G, Zhang Y, Grandjean P 2012. Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis. Environ Health Perspect :-. http://dx.doi.org/10.1289/ehp.1104912

Received: 30 December 2011; Accepted: 20 July 2012; Online: 20 July 2012

Fluoride isn't a nutrient. In 1979 the FDA required the deletion of all government references previously classifying fluoride as "essential or probably essential", (Federal Register, March 16, 1979, page 16006). — Preceding unsigned comment added by 99.61.178.14 (talk) 00:29, 26 July 2012 (UTC)

Tox data on sodium fluoride

Here is some published data the toxicity of sodium fluoride, which is representative of other soluble fluoride salts.

• From Ullmann's Encyclopedia of Industrial Chemistry "the lethal dose for a 70-kg human is estimated to be 5 – 10 g of sodium fluoride [168]." 168 refers to "H. C. Hodge, F. A. Smith in J. H. Simons (ed.): Fluorine Chemistry, vol. 4, Academic Press, New York 1965.
• Sax Dangerous Properties of Industrial Materials (ISBN: 9780471701347) has an article on NaF doi:10.1002/0471701343.sdp22673, which lists about 20 studies spanning 1920's-1985. The studies from 1980 are:
  • Merck Index; an Encyclopedia of Chemicals, Drugs, and Biologicals. 11 (1989), 1361: oral-human LDLo:71 mg/kg (abbreviations = ?).
  • Farm Chemicals Handbook (Meister Publishing, Willoughy, OH) 1989, C264: unr-man LDLo:75 mg/kg (abbreviations = ?))
  • IARC Monographs on the Evaluation of Carcinogenic Risk of Chemicals to Man. (World Health Organization, Internation Agency for Research on Cancer, Lyon, France) 27 (1982), 237: ivn-mus LD50:50,830 (not sure what this means, intervenous something)
  • Mutation Research 139 (1984), 193: dns-hmn:fbr 100 mg/L (abbreviations = ?)
  • Shika Gakuho Journal of Dentistry. 80 (1980), 1519. orl-mus LD50:57 mg/kg (abbreviations = ?)
  • Water Research 14 (1980), 1613. dnr-bcs 86 mg/L (abbreviations = ?)

A few years ago an editor named User:Itub (now pretty retired from Wiki) reported on some talk page about fluoride toxicity in response to some strangeness from conspiracy theorists on this topic. I need to relocate that discussion.--Smokefoot (talk) 01:56, 19 May 2011 (UTC)

You need to post studies by Dr. Phyllis Mullenix, Dr. Dean Burk, and Dr. A. K. Shusheela (of India)... unless Wikipedia has a political agenda. They are three experts on fluoride compounds that you have ignored. There are many other studies as well, documenting the toxicity of fluoride. In fact, there are over 500 peer-reviewed studies showing the adverse effects of fluoride compounds on the human body...many on PubMed also. — Preceding unsigned comment added by 99.61.178.14 (talk) 03:47, 24 June 2012 (UTC)

Fluoride Action Network is an unlikely source for usefully convincing information. It is presided over by retired prof who had a very thin scholarly record and haled from non-research institution, and his son - how embarrrasing Dr. Phyllis Mullenix - who is featured at the FAN site - has no scholarly appointment that I could find. High level scholars are unlikely to allow association for the FAN group, which is not prestigious in a scholarly style. Dean Burk died a long time ago, having been discredited for advocating laetrile, which is now known to be quackery. If there is a conspiracy for fluoridation, you will get nowhere (that is the nature of successful conspiracies) and if FAN is a collection of conspiracy theorists, you're unlikely to have traction in Wikipedia. So either way, I dont see the point of your messages. --Smokefoot (talk) 18:56, 24 June 2012 (UTC)

I don't get my information from the FAN site. But if they happen to acknowledge a pertinent study, I see no reason to discredit it simply due to it being acknowledged by the FAN website. Discrediting someone as simply a "retired" professor you clearly disapprove of doesn't mean every study he may mention has been discredited. This mindset sounds very biased to me. Dr. Phyllis Mullenix has studies published on PubMed (i.e. PMID 16350475 & PMID 7760776). Her studies have also been mentioned in the (2006) National Research Council's Report on Fluoridation (NRC). Have you read "Fluoride in Drinking Water: A Scientific Review of EPA Standards"? You can find it at: www.nap.edu/catalog/11571.html This report was paid for by the CDC. It is free to read online. Strange that Dr. Mullenix' studies meet the qualifications for PubMed and the 2006 National Research Council's Report on Fluoridation but don't qualify for Wikipedia. Dr. Dean Burk was a biochemist and retired chief chemist at the U.S National Cancer Institute. I am unable to find where he was discredited due to studies on fluoride, or its link to cancer in the cities he studied. Laetrile and fluoride are two different subjects.

Have you also debunked and discredited "Fluoride in Drinking Water: A Scientific Review of EPA Standards"? I believe it was also mentioned on the FAN website but was actually bought and paid for by the CDC. Just because the FAN website acknowledges it does not discredit it. — Preceding unsigned comment added by 99.61.178.14 (talk) 01:06, 5 July 2012 (UTC) Fluoride has been repeatedly shown to lower the IQ's of children in several studies. Doesn't this deserve at least a slight mention under "Fluoride Toxicity"? See the latest Harvard study: http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1104912 — Preceding unsigned comment added by 99.61.178.14 (talk) 23:53, 25 July 2012 (UTC)

Diagnosis and treatment?

Could someone maybe add some information on the testing and treatment procedures? — Preceding unsigned comment added by 114.198.97.208 (talk) 12:48, 28 February 2013 (UTC)

Chronic Toxicity

The following qualifies as weasel-words: "chronic ingestion in excess of 12 mg/day are expected to cause adverse effects, and an intake that high is possible when fluoride levels are around 4 mg/L.". Almost looks as if the author first naively figured the only measurement of F was in aqueous solution (he indicates that it is measured in a concentration of Liters), and then made the error of Denying the antecedent.

However, what is written is meaningless and misleading; it fits the bill of Weasel Words and should be removed. 67.169.93.56 (talk) 05:38, 10 September 2012 (UTC)Xkit

It's in the source given. Also, I don't see any weasel words or formal fallacies. If you're interested, you could review the sourced text and suggest a change more in line with the source or explain why the source is not correct. TippyGoomba (talk) 04:47, 11 September 2012 (UTC)

That part of the wikipedia entry has a mistake, but that mistake isn't stated in the source, which is wrong in another way.

The source's mistake is that of quantifying the maximum total F intake solely upon water consumption. But the article page's author seems to have also misread their misstatement:

"However, people living in an area where the drinking water contains fluoride at 4 mg/L who consume 2-3 L of water per day will ingest as much as 12 mg fluoride per day on a chronic basis "

"As much as 12 mg per day" ... Total, or from water alone? A glaring oversight.

Is water the only source of fluoride? Is the fluoride levels from other sources completely negligible? (Other sources include tea, processed foods, foods cooked with fluoridated water (potatoes, pasta, grains), leafy vegetables watered with fluoridated water, produce sprayed with cryolite, machine-processed meats, dental products, fluoride treatments, and fluoride pills (yes they still exist))).

The second mistake of the wikipedia article (mentioned earlier) is not based on the source.

(and I'm sure somebody'll come and call "reading" "original research").67.169.93.56 (talk) 16:50, 14 September 2012 (UTC)

Would you be able to suggest another paraphrasing of the content which, in your judgement, better reflects the original source? TippyGoomba (talk) 04:14, 15 September 2012 (UTC)

I would limit it to: "Adverse effects on the kidney. Within the recommended dose, no effects are expected, but chronic ingestion in excess of 12 mg/day are expected to cause adverse effects." Because total daily fluoride consumption depends on many factors. Total fluoride intake cannot be precisely calculated from F concentration of water alone. What do you think?67.169.93.56 (talk) 05:08, 16 September 2012 (UTC)

Can someone research and state who is in charge of doing lab work on each individuals fluoride levels in areas that fluoridate tap water? Fluoride levels in the human body cannot be determined by counting cavities. It requires lab analysis of blood, urine, hair, nails, bone, etc. "Dental and public health administrators should be aware of the TOTAL fluoride exposure in the population before introducing any additional fluoride programme for caries prevention." (Fluorides and Oral Health, WHO, 1994). — Preceding unsigned comment added by 99.61.178.14 (talk) 22:12, 5 April 2013 (UTC)

bioaccumulation and the impact on aquatic ecosystems

So far, this article doesn't mention the fact that fluoride bioaccumulates, which is significant when discussing toxicity, i think? Although it does mention that if it ingestion exceeds a certain figure, the kidneys fail to adequately filter out the fluoride from the body. Anyways, seems like something that could use more attention to me. I'm also curious if water fluoridation's effect on marine life (notably coral reefs) would be suitable here? or is this article specifically anthropocentric? If not, is there a more suitable article for this topic, or perhaps it's already covered elsewhere?AnieHall (talk) 07:23, 11 March 2013 (UTC)

Good sources are always welcome. A good guide is WP:SECONDARY and WP:MEDRS. Be aware that the internet is loaded with conspiratorial nonsense about the effects of fluoride, so you will need to break away from the crap and get to real books and real journals by accredited organizations. Fluoride is an anion of relatively low toxicity as the article states - the LD50 is on the scale of a few grams. The thrust of this article concerns those unfortunate people who live in areas where the ground water has high fluoride concentration, leading to a chronic effect. I am unaware of any reliable (dental textbook, medical reviews) on bioaccumulation. --Smokefoot (talk) 13:25, 11 March 2013 (UTC)

Yes, fluoride does bio-accumulate in the body. See "Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride" (1997), Institute of Medicine (IOM)

"For healthy, young, or middle-aged adults, approximately 50 percent of absorbed fluoride is retained by uptake in calcified tissues, and 50 percent is excreted in the urine. For young children, as much as 80 percent can be retained owing to increased uptake by the developing skeleton and teeth (Ekstrand et al., 1994a, b)." — Preceding unsigned comment added by 99.61.178.14 (talk) 21:33, 5 April 2013 (UTC)

@Smokefoot - They aren't using Calcium Fluoride for water fluoridation (LD50 = 4250 mg/kg). They are using Hexafluorosilicic Acid (LD50 = 70 mg/kg) for water fluoridation. Prior to that they used Sodium Fluoride (LD50 = 52 mg/kg) for water fluoridation. There is a huge difference in the toxicity levels of naturally occurring Calcium Fluoride and the chemicals currently used in water fluoridation. — Preceding unsigned comment added by 99.61.178.14 (talk) 03:30, 7 April 2013 (UTC)

Suggest changes and provide sources. This is not for general discussion of the topic. See WP:NOTFORUM. TippyGoomba (talk) 04:10, 7 April 2013 (UTC)

Can you please add some information regarding CLAIMED connection to cancer?

"Genotoxicity tests indicate the potential for fluoride to cause mutations, affect the structure of chromosomes and other genomic material; affect DNA replication, repair, and the cell cycle; and/or transform cultured cell lines to enable them to cause tumors when implanted into host animals."

See "Fluoride in Drinking Water: A Scientific Review of EPA's Standards, (2006), Board on Environmental Studies and Toxicology . — Preceding unsigned comment added by 99.61.178.14 (talk) 18:57, 9 April 2013 (UTC)

In the section of the report that you link to, the conclusion is that existing studies are of unknown relevance to human health: "Overall, the results in in vitro systems summarized above are inconsistent and do not strongly indicate the presence or absence of genotoxic potential for fluoride". In general, if there are studies whose relevance is not yet known, that is not something that Wikipedia should report on until there is sufficient study to make useful conclusions. -- Ed (Edgar181) 20:39, 9 April 2013 (UTC)

There are other papers on PubMed which also link fluoride to cancer.

"Clastogenic activity of sodium fluoride in great ape cells". "Conflicting evidence has been reported concerning the mutagenicity of sodium fluoride (NaF), especially clastogenicity at concentrations of more than 1 mM. NaF is known to induce chromosome aberrations at these concentrations in human cells, but not in most rodent cells. We considered that such species-specific difference in chromosomal sensitivity would be derived from the phylogenetic distance between rodents and man. To clarify the role of interspecies differences, we investigated the chromosomal sensitivity to NaF in cell lines from various primates, which diverged into many species, including rodent-like prosimians and human-like great apes. The results showed that the clastogenicity of NaF was limited to human and great ape cells."

"Relationship between fluoride concentration in drinking water and mortality rate from uterine cancer in Okinawa prefecture, Japan". "The Okinawa Islands located in the southern-most part of Japan were under U.S. administration from 1945 to 1972. During that time, fluoride was added to the drinking water supplies in most regions. The relationship between fluoride concentration in drinking water and uterine cancer mortality rate was studied in 20 municipalities of Okinawa and the data were analyzed using correlation and multivariate statistics. A significant positive correlation was found between fluoride concentration in drinking water and uterine cancer mortality in 20 municipalities "

"Age-specific fluoride exposure in drinking water and osteosarcoma (United States).". "We explored age-specific and gender-specific effects of fluoride level in drinking water and the incidence of osteosarcoma. ..." "Our exploratory analysis found an association between fluoride exposure in drinking water during childhood and the incidence of osteosarcoma among males but not consistently among females."

"Regression analysis of cancer incidence rates and water fluoride in the U.S.A. based on WHO data...". "...cancers of the oral cavity and pharynx, colon and rectum, hepato-biliary and urinary organs were positively associated with Fluoridated Drinking water (FD). This was also the case for bone cancers in male, in line with results of rat experiments. Brain tumors and T-cell system Hodgkin's disease, Non-Hodgkin lymphoma, multiple myeloma, melanoma of the skin and monocytic leukaemia were also correlated with Fluoridated Drinking water."

"Is there a need of extra fluoride in children?". "Fluoride consumption by human beings increases the general cancer death rate, disrupts the synthesis of collagen and leads to the breakdown of collagen in bone, tendon, muscle, skin, cartilage, lungs, kidney and trachea, causing disruptive effect on tissues in the body. It inhibits antibody formation, disturbs immune system and makes the child prone to malignancy. Fluoride has been categorized as a protoplasmic poison..."

Seems odd not to at least mention it in passing. — Preceding unsigned comment added by 99.61.178.14 (talk) 03:00, 10 April 2013 (UTC)

Which of those are systematic reviews? See WP:MEDS. TippyGoomba (talk) 03:23, 10 April 2013 (UTC)

@TippyGoomba - The words "systematic reviews" do not exist on the page WP:MEDS so I really don't know what you are referring to. — Preceding unsigned comment added by 99.61.178.14 (talk) 06:29, 10 April 2013 (UTC)

Apologies, I meant WP:MEDRS. TippyGoomba (talk) 15:25, 10 April 2013 (UTC)

Can you please be more specific? PubMed is considered an excellent source of information. Just citing WP:MEDRS is pretty vague. — Preceding unsigned comment added by 99.61.178.14 (talk) 18:34, 10 April 2013 (UTC)

99.61.178.14, I have left you a note on your User Talk page here: User_talk:99.61.178.14#Request_to_adhere_to_WP:MEDRS_and_WP:TPG. Be sure to read it, it requests that you read WP:MEDRS, in addition to WP:TPG. As you have provided many links to sources concerning biomedical information, and you continue to be active in Wikipedia's water fluoridation articles, it is your responsibility to become familiar with Wikipedia's guidelines regarding biomedical sourcing. WP:MEDRS is required reading for you. You will be able to answer your own question once you read WP:MEDRS, paying special attention to where it talks about "secondary sources." Zad68 18:56, 10 April 2013 (UTC)

Proposed merge

I have proposed a merge between Fluoride-induced nephrotoxicity in this article, as I feel the content would be better covered within the scope of this article rather than separately. If needed, this article could be split at a later date. LT90001 (talk) 07:05, 28 August 2013 (UTC)

I have completed this merge and hope this article's quality continues to improve in the future. LT90001 (talk) 01:16, 1 September 2013 (UTC)

Cleanup needed

This article is overly reliant on primary and non-MEDRS compliant sources. It needs a good pruning. -- Brangifer (talk) 16:24, 28 June 2014 (UTC)

Are you suggesting to only use literature reviews, such as these? prokaryotes (talk) 01:20, 29 June 2014 (UTC)

that's how wikipedia is supposed to be done, yes. you start with recent, reliable secondary sources, read them, and edit content here based on them. editors generally bring primary sources like we find deployed in this article, when they have already formed their story, and go hunting for support for it, or see an article in the popular press that supports their story. that is backwards.Jytdog (talk) 01:25, 29 June 2014 (UTC)

I briefly looked at the safety section over at Fluoride and this article, but can't see a lot of differences ( at least not with a quick look). Though i guess this needs more time to check on case per case basis each research statement and search for the best source. It is not always easy to find a source which may or may not be compliant here, but im not a frequent medical editor. So far i have no opinion on the proposed changes by Rangifer, but my main goal would be to have an extensive overview, for best information. prokaryotes (talk) 01:30, 29 June 2014 (UTC)

Hypersensitivity

I feel there needs to be some Wiki documentation somewhere regarding fluoride allergy or hypersensitivity. Not sure where to put it, and not sure I have the best references:

Some children and adults have an allergic reaction or chemical sensitivity to fluoride. These reactions can be triggered by topical exposure, as well as by ingestion. The FDA requires that dental products with fluoride contain the following warning, “following adverse reactions are possible in individuals hypersensitive to fluoride: eczema, atopic dermatitis, urticaria, gastric distress, headache and weakness.” (Sample: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=e20b7cc8-5682-4e66-b5d5-5fa1035c0b77)

Some people with other vulnerabilities may also find that fluoridated water is an added stress on their system. The United States National Kidney Foundation stated on 15 April 2008 "Individuals with CKD [Chronic kidney disease] should be notified of the potential risk of fluoride exposure by providing information on the NKF website including a link to the report in brief of the NRC and the Kidney Health Australia position paper."

• ref name=NRC2006>National Research Council (2006). Fluoride in Drinking Water: A Scientific Review of EPA's Standards. Washington, DC: National Academies Press. ISBN 0-309-10128-X. {{cite book}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help). See also the CDC statement on the NRC report.
• "The risks of consumption of fluoridated water for people with chronic kidney disease". Kidney Health Australia. 2007.
• "2011 Review of Kidney Health Australia fluoride position statement".

Additional research is recommended.

Does someone want to work on bettering this to include in this article? If not here, where? Seabreezes1 (talk) 22:10, 18 August 2014 (UTC)

The article already mentions effects on the kidneys.

The idea of "fluoride hypersensitivity" is new to me, and I'm not seeing support for it in reliable sources. The FDA label provided by a product manufacturer for an unapproved drug isn't a reliable source for this sort of information. The fact that it's so hard to find reliable sourcing about it makes me think it should not be included. I did find this [2] from the NCCEH, which says, "3. Opposition to Fluoridation - Other health outcomes suspected to be associated with community water fluoridation include: heart disease, cancer, birth defects, kidney problems, skeletal changes, allergies, goiters, ulcers, anemia, and spontaneous abortion. However, these associations are not supported by the scientific literature." (empasis added)

What was easy to find, though, was loads of mentions of it by anti-fluoridation activists. Just Google search on "hypersensitivity to fluoride" and you get the usual list of activist websites: Flouride Alert, Natural News, Fluoridation.com, etc. From this I conclude there aren't reliable sources to support it, and it's a bad idea to try to base content on stuff from activist websites. Zad68 22:55, 18 August 2014 (UTC)

I just did a search for reviews on pubmed and found very little. The most recent (!) thing I could find was this: Kaminsky LS et al. Fluoride: benefits and risks of exposure. Crit Rev Oral Biol Med. 1990;1(4):261-81. PMID 2129630. That is behind a paywall. Here is the short section on "Hypersensitivity":

Hypersensitivity reactions have been reported following exposure to fluoridated water, toothpastes, and fluoride supplements. Symptoms include skin rash, inflammation of oral mucosa, gastrointestinal irritation, and headache, which subsided after discontinued use of these products. Most reactions occurred following doses of about 0.5 to 1 mg fluoride in fluoride drops, tablets, or toothpaste. In a preliminary double-blind study, adverse reactions to ingestion of drinking water containing fluoride at 1 mg/1 were reported to occur in "certain" of 60 individuals selected from a group of 300 test subjects with suspected sensitivity to fluoride. However, this study did not report the rate of false-positive or false-negative reactions among subjects, and test subjects believed that they were sensitive to fluoride, which could have biased the results. A review of these studies by the National Academy of Sciences noted several methodological deficiencies, including the lack of control subjects, study selection bias, and uncontrolled exposure to other agents in fluoride dentrifices and/or supplements. The available data suggest that some individuals may react idiosyncratically to fluoride; however, the prevalence of these reactions among the population is unknown. Further studies on possible hypersensitivity reactions to fluoride and the prevalence of these reactions among the general population are required.

The NAS report they cite is this: National Research Council. Drinking Water and Health, Volume 1. Washington, DC: The National Academies Press, 1977. And the part of the report where the authors discuss (and generally debunk) the notion of "fluoride hypersensitivity" starts on this page. Zad68 is on the money.Jytdog (talk) 23:27, 18 August 2014 (UTC)

RESPONSE: There is a type of dismissal among folks regarding lots of allergies. Plus folks often tend to subconsciously avoid things that are problematic, i.e. not using these things. I had a 3 years of mouth and throat issues until I found a brand of dental products I "liked." When my dentist insisted I use a fluoridated rinse instead of my preferred brand, I quickly discovered by using and not using it a few times what my reactions to it were - and some of them were bizarre. It took me a lot longer to associate my low grade chronic problems with my water, which is filtered with a high grade filtration system, which sadly cannot remove fluoride. However, the hypersensitive might well be the canaries in the coal mine. Why do so many people buy bottled water? I wonder if they are self-treating?

It's sad that the extremists on the topic are tarring the more conservative with the looney brush. This is one reason I strongly believe that there should be a mention of the less exciting and under-appreciated collateral damage of water fluoridation programs. Here are a few more sources I just found. What do you think?

Moolenburgh (24) described ... COPYVIO removed Zad68

Source: http://www.fluoridation.com/adverse.htm

And from the same site:

Shea JJ, Gillespie SM, Waldbott GL, Allergy to Fluoride, Annals of Allergy, 1967 July, 25, 388- 391

[Abstract -- Six children and... COPYVIO removed Zad68

Reputable? Seabreezes1 (talk) 12:09, 19 August 2014 (UTC)

I'm sorry to hear about your health problems, but am glad you seem to be better now.

It's unfair to complain about being painted with the "looney brush" and then immediately follow that up with a large amount of stuff that comes from the very paint can (fluoridation.com) the looney brush is frequently dipped in!

Fundamentally the underlying sources you're pointing to at fluoridation.com do not meet Wikipedia's guidelines for biomedical sourcing. See WP:MEDRS. Pay particularly close attention to WP:MEDDATE, discussion of primary vs. secondary sources, and standards for journal quality. Zad68 12:55, 19 August 2014 (UTC)

@ZAD68 Am a bit confused by your comments. Although, yes, I garnered some of the resources from the bibliography from the anti-fluoride sites, the primary research itself and where it is published, i.e. Annals of Allergies, National Institute of Health, PDR, etc. are reputable. The question with recency, however, is an issue. I suspect the noise from the more extreme complaints discourage the moderate among us. Seabreezes1 (talk) 14:21, 19 August 2014 (UTC)

OK let's just stick to sources (journal articles identified by PubMed PMID, not a link to an activist website) and proposed content then. Per WP:MEDRS primary sources are strongly discouraged and generally are not to be used if the subject is covered by a good-quality secondary source instead. Can you gather the sources and propose content, that'll make this discussion productive. Thanks... Zad68 14:27, 19 August 2014 (UTC)

RESPONSE: @Zad68 Will try. Might be beyond my capacity. Was hoping to find some curious minds with more medical research expertise than I possess. Seabreezes1 (talk) 15:47, 19 August 2014 (UTC)

Very good, Seabreezes1. Just pointing out that both myself and Jytdog are experienced medical editors and have a good idea of what decent sourcing looks like. We both looked for appropriate sourcing to support the proposed content but didn't find it. Not to say it doesn't exist, but so far, "curious minds with more medical research expertise" did give it a go. Zad68 16:09, 19 August 2014 (UTC)

quick note. Seabreezes your very first statement above is not true about toothpaste with flouride. The regulations for toothpaste labelling are here - nothing there even close to "Some children and adults have an allergic reaction or chemical sensitivity to fluoride....." The most reasonable thing I could think of adding to this article would be something very brief like: "A few individuals may be hypersensitive to flouride, but no biological basis for this is known, nor is there clear data on prevalence. Most studies of this issue to date have been flawed and their results are not scientifically valid." and cite the 1990 review and the NAC book. This wildly fails MEDDATE but this is case where I would consider WP:IAR, but only with consensus to do so. Jytdog (talk) 17:06, 19 August 2014 (UTC)

RESPONSE: I'm glad you're thinking about wording. Thank you :) I'd suggest your draft above is a bit too negative. Here's draft 2:

"Some children and adults report an allergic reaction or chemical sensitivity to fluoride with reactions that include skin irritation, internal distress and fatigue. The biological basis for this hypersensitivity is not known, nor is there recent data on the prevalence of reactions. More research is required."

Acceptable? Could throw in the word idiosyncratic if you like, too. 73.167.68.12 (talk) 23:01, 19 August 2014 (UTC)

Jytdog I'm quite strongly against using a 1990 review, especially as there has been a lot of research done since then and there are lots more sources. What is the "NAC book"? Sorry I can't find the referent. Zad68 04:24, 20 August 2014 (UTC)

Hi Zad. Sorry, I meant the NAS book that I cited above - it is even older, from 1977. I withdraw my proposal! So here is a case where we say nothing, until an up to date review or statement from a major medical or science body comes out. I do not think we should source anything on this topic from a primary source. Jytdog (talk) 04:32, 20 August 2014 (UTC)

FWIW: Since there doesn't seem to be much research on this topic in the last 50 years, I wrote the allergy research departments of Harvard, Stanford, Johns Hopkin, McGill, and the University of Melbourne suggesting that this might be a timely research topic. Maybe a couple of them will do some research and then review each others papers. Seabreezes1 (talk) 13:18, 20 August 2014 (UTC)

Seabreezes1 that's one of the most fantastic and productive responses I've ever heard! I do hope you get a response and that your concern is addressed in an upcoming high-quality review article we can use. Thanks. Zad68 21:08, 20 August 2014 (UTC)

Zad68 Thanks.... so far Johns Hopkins and Univ Melbourne had responded that they are forwarding my request to the appropriate persons :) Now we wait.Seabreezes1 (talk) 16:31, 21 August 2014 (UTC)

Absorption Rates

Would the 2006 NRC/NAS review of EPA fluoride standards be an adequate medical source for this Wiki page? Their primary concern was the fluoride absorption rates of vulnerable populations such as infants and young children as well as those with compromised health. See:

• Brief http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf
• Summary http://www.nap.edu/nap-cgi/report.cgi?record_id=11571&type=pdfxsum

Seabreezes1 (talk) 20:53, 3 September 2014 (UTC)

That source actually already is in use in the article in the section Bones and apparently without complaints. You have new content to add based on it? Zad68 21:45, 3 September 2014 (UTC)

I suggest language to the effect that vulnerable populations may absorb toxic levels of fluoride from both water fluoridation and other sources due to a kidney insufficiency for processing fluoride. Infants and children are also at heightened risk for exceeding the perceived safe dose of fluoride and vulnerable to kidney congestion and other toxicity effects. The NRC recommends further research on lower doses of fluoride and risk assessment at an individual rather than community level. Seabreezes1 (talk) 11:55, 4 September 2014 (UTC)

Might also add that these concerns along with the realization that the benefits of fluoride are primarily topical while the development of dental fluorosis is primarily caused by fluoride ingestion prior to age 8 has prompted medical professionals to discontinue routine prescription of fluoride supplements for children and caution parents about overuse of fluoridated water for infant formula and in children's diet. Seabreezes1 (talk) — Preceding undated comment added 12:10, 4 September 2014 (UTC)

No feedback on above? I also have another suggestion regarding fairness. In History, it makes it seem that Kaj Roholm's strong position towards protecting humans and nature from exposure to fluoride should be articulated. Here's the research:

Rohom's 1937 paper: https://archive.org/details/FluorineIntoxication

• On Page 317 he says that fluoride is neither necessary nor beneficial to teeth.
• On Page 318 he says man is more sensitive than rats, and that .07 per day is too much
• Last paragraph on page 319 is horrifying...
• Last paragraph on page 321 includes:
  • Recognition of chronic fluorine intoxication as an occupation disease rating for compensation
  • Prohibition against employment of females and young people on work with fluorine compounds developing dust or vapor
  • Demand that industrial establishments should neutralize waste products containing fluorine
  • A prohibition against the presence of fluorine in patent medicine may be necessary

Seabreezes1 (talk) 19:12, 11 September 2014 (UTC)

I don't think using Roholm for these types of things is a good idea. Roholm's views on fluoride for teeth are basically irrelevant as it is far outdated. The major focus of Roholm's research was apparently occupational exposure in cryolite factories. If you want to add a little about the early public health issues related to this occupational exposure, that might be OK although you should try to find a contemporary, or at least newer source, rather than drawing directly from such an old source. Disclosure: I added the reference to Roholm. I also added the reference to NRC 2006 report, which is cited no less than 7 times, and thus I'm surprised that above you bring up "adding" it to the article. I appreciate that we have a shared interest in the topic, but please give the article at least one slow and careful read. II | (t - c) 13:49, 12 September 2014 (UTC)

Thanks. Sorry if I overlooked a new NRC reference. It may be my point of view showing, but I feel many of the references, including the one to Roholm and NRC, seem to indicate a bottom line support for a begnin attitude towards fluoride rather than the concern of the NRC for the exposure of sensitive subpopulations and the total opposition of Roholm to allowing any fluoride to find its way into man and the natural environment. Seabreezes1 (talk) 14:56, 12 September 2014 (UTC)

Seabreezes there are no recent secondary sources that support this. As before. Sorry but that is where the science stands. Jytdog (talk) 15:07, 12 September 2014 (UTC)