If you believe you or a member of your family has been affected by dental fluorosis and you would like to talk to someone in confidence, please call the National Register of Children with Dental Fluorosis on – 01159 652948

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” . . . the health and welfare of the public is not served by the addition of this substance (fluoride) to the public water supply . . . for which there is virtually no evidence of significant benefits . . . and substantial evidence of adverse effects.” – Statement by William J Hirzy, PhD, on behalf of the Union of government scientists at the United States Environmental Protection Agency, 2 July, 1997.

Dental fluorosis was first reported by two dentists in 1916 (1). By 1931 there was extreme concern about what was called ‘Colorado Brown Stain’ and ‘Texas Teeth’. It is now called ‘dental fluorosis’. In that year three independent groups of scientists showed conclusively that the areas with this condition had high levels of fluoride in their water(2-4).

Although fluoride was known to be the cause, water fluoridation was instituted as a public health measure to help limit dental caries in 1945.

Reports from China(5), Argentina(6), Britain(7), Italy(8) and Japan(9) have shown significant levels of mottling of teeth (fluorosis) in children drinking fluoride-contaminated water. The usually recommended level of 1 part per million produced fluorosis in 28 percent of children aged between 11 and 13 in a study carried out by the University of Rochester, USA(10).

However, with the advent of fluoridated dentifrices, fluoridated infant formulas, and commercially prepared beverages with fluoridated water, the incidence of dental fluorosis is increasing.

Scientists at the Dental Research Unit, Health Research Council, Wellington School of Medicine, New Zealand investigated fluoride exposures from juices and juice-flavored drinks manufactured with water. In the study, the authors analyzed 532 juices and juice drinks for fluoride. Fluoride ion concentrations ranged from 0.02 to 2.80 parts per million, in part because of variations in fluoride concentrations of water used in production. They say that children’s ingestion of fluoride from juices and juice-flavored drinks can be substantial and a factor in the development of fluorosis (11).

Fluorosis is a permanent disfigurement. But it is more than just a cosmetic problem that the fluoridistas would have us believe, fluorosis is a visible sign of damage to bones throughout the body (12).

Poor children are more at risk
The fluoride intake, diet, and health status of children in two dental fluorosis-afflicted areas in the Province of Jiangxi, China were studied in an attempt to correlate nutritional status with dental fluorosis(13). The relationship between mild consumption and the incidence of dental fluorosis among children was stressed in this study. Average body weight of the children approximated that of the national standard. Protein intake was above the national standard of 0.75 g/kg body weight/day, But the protein was derived mainly from plant sources. Calcium intake was found to be insufficient. Based on the diet and fluoride intake of the studied groups, the areas with a better nutritional status were found to have a lower incidence of dental fluorosis. The incidence among milk-consuming children was lower than that of non-milk consuming children.

What this study demonstrates is that the very children whom dentistry claims will benefit from ingesting fluoride — poor children — are the ones who are most affected by fluoride’s toxic effects because of inadequate nutrition.

This is true wherever dental fluorosis is seen.

Dr L C Simko of the Duquesne University School of Nursing, Pittsburgh, PA, USA, pointing out the worrying increase in fluorosis, says that “health care professionals need to understand the history of water fluoridation, examine the benefits and complications of fluoride, and, if need be, take an informed political stance on an issue that is affecting large numbers among our pediatric population.”(14)

That dental fluorosis occurs is undisputed — and its occurence, therefore, is foreseeable. To see the legal implications for recommending any fluoride product under these circumstances, see – Dental Fluorosis: Smile please – But Don’t Say Cheese!


  1. Black GV, McKay F. Mottled teeth: an Endemic developmental imperfection of the enamel heretofore unknown in the literature of dentistry. Dental Cosmos 1916; 58 (2): 129-156.
  2. Churchill HV. The occurrence of fluorides in some waters of the United States. J Am Water Works Assn. 1931; 23: 1399-1403.
  3. Smith MC, et al. The cause of mottled enamel, a defect of human teeth. Technical Bulletin No. 32, University of Arizona College of Agriculture, 10 June 1931.
  4. Velu H. Dental dystrophy in mammals of the phosphate zone and chronic fluorosis. C R Seances Soc Biol Ses Fil. 1931; 108: 750-2.
  5. Anderson BG. An endemic center of mottled enamel in China. J Dent Res. 1932; 12: 591-3.
  6. Chaneles J. A dental problem of interest in Argentina: The etiology of ‘mottled teeth’. Rev Odontol (Buenos Aires). 1932; 20: 64-73.
  7. Ainsworth NJ. Mottled teeth. Br Dent J . 1933; 55: 233-250.
  8. Ricci E. The phenomenon of mottled teeth in Italy. Ann Clin Odontol. 1933; 12: 1029-43.
  9. Nakano R. A statistical observation of endemic effects on teeth. Rinsho Shika. 1933 2: 102.
  10. Leverett D. Fluorides in the changing prevalence of decay rates. Science. 1982; 217: 26-30.
  11. Kiritsy MC, Levy SM, Warren JJ, Guha-Chowdhury N, Heilman JR, Marshall T. Assessing fluoride concentrations of juices and juice-flavored drinks. J Am Dent Assoc 1996; 127: 895-902
  12. Singh A, Jolly SS. Chronic toxic effects on the skeletal system. In: Fluorides and Human Health. WHO, Geneva, 1970: 238-49.
  13. Chen YC, Lin MQ, Xia YD, Gan WM, Min D, Chen C, Nutrition survey in dental fluorosis-afflicted areas. Fluoride 1997; 30:2, 77-80
  14. Simko LC. Water fluoridation: time to reexamine the issue. Pediatr Nurs 1997; 23: 155-9.
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