Human Toxicity, Environmental Impact and Legal Implications of

HUMAN TOXICITY, ENVIRONMENTAL IMPACT AND LEGAL IMPLICATIONS OF WATER FLUORIDATION
age of 65. It has been reported that the potential mechanisms by which host
factors may influence onset and progression of periodontal disease directly or
indirectly include underlying low bone density in the oral cavity, bone loss,
genetic susceptibility and exposure to risk factors. 463
It has been reported that fluoride decreases cortical bone mineral density
and increases skeletal fragility. 464 , 465 Further studies by Philips et al. 466 reported
a negative association between drinking fluoridated water and cortical bone
mass and concluded that “increased fluoride may in fact be detrimental to
cortical bone mass." Consequently, as the jaw bone is composed of cortical
bone, it is evident that exposure to fluoride may be considered a risk factor
for the onset of periodontal disease.
It is alarming therefore that the European Food Safety Authority (EFSA) has
stated that an infant‘s retention of fluoride in bone can be as high as 90% of
the absorbed amount. 467
Several studies have shown that osteoporosis is also associated with jaw bone
quality, bone density, 468 the condition of the inferior mandibular cortex, 469470
and the alveolar bone condition. 471 There is increasing evidence also that
osteoporosis, and the underlying loss of bone mass characteristic of this
disease, is associated with periodontal disease and tooth loss. Current
evidence, including several prospective studies, supports an association of
osteoporosis with the onset and progression of periodontal disease in humans.
472 Systemic loss of bone density in osteoporosis, including that of the oral
cavity, may provide a host system that is increasingly susceptible to infectious
463 Wactawski-Wende J. Periodontal diseases and osteoporosis: association
and mechanisms. Ann Periodontol. 2001 Dec;6(1):197-208.
464 Riggs BL, et al. (1990). Effect of Fluoride treatment on the Fracture Rates in
Postmenopausal Women with Osteoporosis. New England Journal of Medicine.
322:802-809.
465 Sogaard CH, et al. (1995). Effects of fluoride on rat vertebral body biomechanical
competence and bone mass. Bone. 16(1): 163-9.
466 Phipps KR, Burt BA. (1990). Water-borne fluoride and cortical bone mass: A
comparison of two communities. Journal of Dental Research 69: 1256-1260.
467 Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies on a
request from the Commission related to the Tolerable Upper Intake Level of Fluoride.
The EFSA Journal (2005) 192, 1-65
468 Jacobs R, Ghyselen J, Koninckx P, van Steenberghe D. Long-term bone mass
evaluation of mandible and lumbar spine in a group of women receiving hormone
replacement therapy. Eur J Oral Sci 1996; 104:10-16.
469 Lee K, Taguchi A, Ishii K, Suei Y, Fujita M, et al. Visual assessment of the mandibular
cortex on panoramic radiographs to identify postmenopausal women with low bone
mineral densities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:226-31
470 Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M. Calcium and the risk for
periodontal disease. J Periodontol 2000; 71:1057-66.
471 Taguchi A, Tsuda M, Ohtsuka M, Kodama I, Sanada M, et al. Use of dental
panoramic radiographs in identifying younger postmenopausal women with
osteoporosis. Osteoporosis Int 2006; 17:387-94.
472 Wactawski-Wende J. Periodontal diseases and osteoporosis: association and
mechanisms. Ann Periodontol. 2001 Dec;6(1):197-208.
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