Concentration, Dose and Dosage
(with acknowledgements to Paul Connett)
These three terms when understood correctly help us to clarify our relationship with fluoridation.
The concentration of fluoride is the amount of fluoride contained in a given quantity of water.
Typically it is given as milligrams per litre or as parts per million. Most fluoridated water has a fluoride concentration of one part per million (1:1,000,000) Recall that lead (which is less toxic than fluoride) has a maximum permitted concentration in water of one part in sixty seven million (1:67,000,000).
The dose of fluoride is the actual amount of fluoride ingested - determined initially by the amount of water drunk each day. Fluoridated water delivers 1 mg of fluoride per day for every litre consumed. Already we can see the potential for considerable variation in dose depending on water consumption.
We need to remember, also, that swallowing fluoridated toothpaste delivers an extra dose of 1.5 - 2 mg of fluoride each time we brush our teeth.
We need to remember also that total exposure to fluoride through diet has increased considerably since 1945 when 1:1,000,000 was determined to be the optimum dose. (No research has ever been uncovered or presented that would form the basis for such a determination.)
Fluoride is measurably present in wine, red meat, tea, beer, seafood, and in any beverage that uses fluoridated water added to concentrate, or as part of the production process. Most diets include considerably more of the above foods than they did in the post-war austerity of 1945. It is also present in many anti-depressants, such as prozac, or as insecticide residues on many vegetables and fruits.
So, a daily dose of fluoride is going to vary considerably from person to person depending on how much water they drink, and on how much toothpaste they swallow, even on on the number of fluoride based tranquillisers they use.
That's dose. Now we consider dosage.
Dosage is dose related to body weight. You don't give kids adult doses of most pharmaceutical drugs. Yet a 20kg child is receiving a dosage 4 times greater than an 80kg adult who ingests the same amount of fluoride. Given the greater likelihood that children will swallow toothpaste, especially if it's in bubblegum flavour or similar, we could be looking at a child dosage many times greater than typical adult exposure.
This is not responsible medication. The recent NRC report acknowledges the validity of research linking fluoride to cancer, to reduced IQ and to increased risk of hip fracture. It recommends strongly that the maximum permitted contaminant level of fluoride in water be reduced from its present 4 parts per million.
Even if you allow the validity of the present optimum concentration of 1:1,000,000 — remember the maximum permitted concentration for lead is 1:67,000,000 — that will leave a very, very narrow margin between "optimum" concentration and toxic concentration, and one that variations in dosage between one individual and the next are clearly going to exceed.
When we consider this alongside Canadian research which suggests any benefit provided by fluoride is obtained from topical application - eg mouth washes, brushing teeth without swallowing - rather than from ingestion, it's plain folly. In topical applications, fluoride affects teeth only, it is totally under the control of the individual, and it does not accumulate systemically over time.
We don't have all the complications which ensue from a lifetime of fluoride poisoning - and more and more of these complications are coming to light in impeccably researched papers. Following the release of the NRC review, these can no longer be dismissed as "fringe" or "crank" research.
The battle against fluoride is far from being won. Given the history of the damages suits against tobacco companies, toothpaste companies are going to fight liability all the way to the highest courts in the land. But we can at least act locally to get fluoride out of our water supply and out of our made-from concentrate beverages.
Remember, most of the world outside of America is now consuming fluoride-free water. Communities that used to fluoridate have abandoned the practice, with a number of countries actually legislating to prevent fluoridation.
You may not change the world, but you can work to ensure the health of your immediate community by getting fluoride out of the water if it' s there, and keeping it out if it's not.
The Politics of Fluoride
The Science of Fluoride
Fluoride and the Law