Hey everyone. So as you probably know, I do enjoy debunking some pseudoscience from time to time,
and today I want to do something a little bit different from my usual target-specific debunks.
I’d like to address a wide variety of misinformation, scams, and snake oil all
pertaining to a singular common theme, water. Water is a popular vehicle for purveyors of
pseudoscience, because when it comes to their target audience, familiarity is key, and we all
know what water is. We drink water every day. By mass, most of the human body is water. It is the
life essence. Like every other organism on Earth, we need it to survive, just as we have for all
of human history. Water is therefore steeped in mythology and folklore, with ancient gods
of the sea and rain, making it an easy concept to exploit in order to tap into a romantic narrative.
So what do we get? Supercharged water! Alkaline water! Oxygenated water! Chlorophyll water!
Detox water! So many super-special waters that you can buy for a pretty penny instead of that awful,
awful practically free tap water we all have access to. Speaking of tap water, the fuss is not
just about selling products. Water fluoridation has been the source of much conspiratorial thought
over the decades. Then there are the fanciful claims regarding so-called structured water,
or that speaking or singing to water with particular intent can change its properties,
and all manner of other nonsense. It’s an Olympic-sized swimming pool of pseudoscience.
Now there’s a lot to cover here, but let’s get through as much as we can,
from the fallacious claims to the bogus products,
and elucidate the reasoning behind them so that we can all stay above the waves.
First up let’s tackle the one that the most people are probably familiar with, water
fluoridation. Most tap water contains fluoride, which is a word that refers to negatively
charged fluorine anions. When a fluorine atom gains an electron, it becomes a fluoride ion.
The reason fluoride is added to tap water is that health professionals all over the world
recommend fluoride for preventing tooth decay as well as bone decay. It joins calcium and phosphate
to form a mineral called fluoroapatite, which is incorporated into tooth enamel and is highly
resistant to deterioration. But fluoride has been the subject of conspiracy theories for decades.
For some, their anti-fluoride beliefs go so far that they avoid all forms of fluoride.
This means no fluoride toothpaste, no fluoride treatments from a dentist, and no fluoride
mouth rinse. But such people are pretty rare. 95% of toothpaste sales in the United States
are for fluoride toothpastes that have the American Dental Association’s seal of approval.
Most conspiracy theories and misinformation about fluoride are directed at water fluoridation, the
form of fluoride-based cavity prevention that gets the most people whipped up into a frenzy of false
claims. Let’s address these claims now, in as thorough a manner as possible. Fluoridated water
is actually the first method by which we used fluoride for cavity prevention. All other forms
of fluoride for oral health are based on original research with fluoride of a natural origin in
water from the early 1900s to the 1940s, which led, in turn, to the proposal for a new public
health practice, the fluoridation of drinking water. Dental public health scientists like Dr.
Henry Trendley Dean and Dr. Phillip Jay proposed adding a small amount of fluoride to drinking
water in order to achieve the same reduction in cavities that those researchers observed
for children living in communities where fluoride levels were naturally about one part per million.
In 1945, Grand Rapids, Michigan was the first city ever to add fluoride to their drinking water,
for a trial of this new public health practice. Right from the very beginning,
before they even added any fluoride to their water, there was anti-fluoride opposition,
some of which was based on fantastical claims from residents with very active imaginations.
Starting around January 8th, 1945, multiple calls to the Director of the Grand Rapids Waterworks
complained that because his department had added fluoride to the city’s water, their “teeth were
falling out,” their “enamel was peeling off,” and their “gums were sore.” Ironically, the Waterworks
had not yet begun adding any fluoride. The local newspaper had originally reported fluoridation
would start in Grand Rapids in early January, but the start date for the fluoridation trial
was actually January 25th, a full two weeks after these residents reported their imaginary ailments.
But most residents of the city took pride in being part of a cutting-edge pilot of a public health
measure that local dentists had good reason to believe would make a difference with the rampant
tooth decay kids in the 1940s were plagued with. By 1950, evidence from the 1930s research and the
dramatic reduction of tooth decay among school children in Grand Rapids, as well as other trial
cities in New York, Illinois, and Canada, was so clear that the U.S. Public Health Service, the
American Dental Association, and other scientific bodies endorsed water fluoridation. Cities across
the country started adopting the practice. But as fluoridation grew in popularity,
so did the conspiracy theories. Members of the John Birch Society popularized the notion that
fluoridation was a communist plot, and their crackpot opposition to fluoridation culminated
in the famous satirization of this anticommunist paranoia in the 1964 Stanley Kubrick film,
Dr. Strangelove. In the film, General Jack D. Ripper goes rogue and launches a nuclear attack
on Russia because he believes the Reds have infiltrated American drinking water supplies
and inserted fluoride in order to “sap and impurify all of our precious bodily fluids.”
Indeed, outlandish claims about fluoride have been around for a long time,
and the whole evil government plot is just one of them. The notion that fluoridation
is a plot to poison us has continued to thread its way through the far right over the decades,
with conspiracy theorist Alex Jones being the most famous modern promoter of the idea
that the government is purposefully trying to harm us with fluoride in water. Conveniently,
he also sells water filters off of this grift. But beyond wild conspiracy theories, there are
many other false claims that are made about water fluoridation, so let’s address the main ones.
First let’s focus on how fluoridated water works, and popular notions people develop about it
from their perceptions of fluoride toothpaste. These claims are false,
but they have some logic to them. These are misunderstandings that reasonable people have
about fluoridated water, which anti-fluoride activists exploit to sell fear-mongering books,
expensive water filtration systems, and natural health products with no basis in science.
First there is the idea that fluoride toothpaste made water fluoridation obsolete.
It is a reasonable thing to wonder if you haven’t looked into it. Does fluoride in our drinking
water serve any purpose if we are brushing with fluoride toothpaste? The answer is yes. First,
fluoridated water is a baseline source of fluoride that is quite helpful for times in our lives we
are not consistently brushing. Not all people can or do brush, and even the most health-conscious
and oral hygiene-focused people have off days, or get illnesses that make basic oral hygiene tasks
difficult. But fluoridated water is not just a baseline during days we don’t manage to brush.
Even for those of us who are consistent with brushing the recommended twice a day for two
full minutes, fluoridated water provides a base of cavity protection that is better-matched
with the pattern and timing of the sugar-acid challenges of normal eating habits. We consume
various food and drink throughout the day. Oral bacteria consume these carbohydrates and produce
organic acids. These acids demineralize our enamel each time we eat, and throughout the
day. But we also drink water throughout the day. If we are drinking fluoridated water,
and maybe even making some of our food and drink with fluoridated water, then our teeth are getting
fluoride that remineralizes enamel at roughly the same frequency as our eating demineralizes enamel,
and with fluoroapatite instead of hydroxyapatite, replacing hydroxyl groups with fluoride ions in
the apatite crystal, and making the enamel less soluble, even under acidic conditions.
Fluoridated water keeps a trace amount of fluoride in our saliva available to remineralize enamel all
day long, rather than just during the two times a day we ideally brush.
The CDC’s Oral Health Division says: “Fluoride helps to rebuild and strengthen the tooth’s
surface, or enamel. Water fluoridation prevents tooth decay by providing frequent and consistent
contact with low levels of fluoride.” So the next time you see a claim that
fluoridated water isn’t necessary because we have fluoride toothpaste, especially in the middle of
an anti-fluoride rant full of conspiracy theories about aluminum or Nazi Germany, you’ll know it’s
false. Questioning whether fluoride in water is important when we have other forms of fluoride
is a reasonable question, but it is kind of like asking whether seat belts are necessary
because we have air bags in our vehicles. The two measures provide different kinds of protection.
A closely related claim that anti-fluoride activists make, which is a deliberate
manipulation and misrepresentation of the truth, is that the CDC admits that fluoride’s benefits
are “topical,” and not “systemic,” so it does no good to swallow it.
This is a complicated fabrication in which bad actors are lying about technical,
detailed research history. Specifically, they are lying about the history of our scientific
understanding about how fluoridated water works, and our current understanding as well.
From the 1940s to the 1990s, fluoridated water’s main benefits were thought to be for kids,
and from the systemic mechanism. The systemic mechanism refers to when fluoride is ingested and
subsequently incorporated into kids’ teeth before they erupt, while they are still forming under the
gumline. In the 1990s, laboratory research and oral health epidemiologists started showing much
more clearly that the topical mechanism was very important to the way fluoridated water
prevents cavities as well, and that fluoridated water works for all of us, not just for kids.
The topical mechanism is the one we described already, in which fluoride from the toothpaste
you just brushed with or the water you just drank goes into your saliva, and from there,
that fluoride remineralizes tooth enamel after a sugar-acid challenge that causes demineralization.
The benefits that fluoridated water provides people of all ages via the topical mechanism
were clarified and quantified in much greater detail in the late 1980s and 1990s, especially
with the more powerful research capabilities that were developing in the dental sciences.
In 2000, the CDC Oral Health Program, the ADA, and the dental research community at large
did take in all this research in order to formally update their consensus understanding that the
topical mechanism represented the lion’s share of the cavity prevention from fluoridated water
throughout our lives. But the CDC and ADA did not reject the importance of the systemic mechanism.
And research in the 20 years since has continued to show the benefits of the systemic mechanism
towards teeth forming under the gumline for children. Studies indicate that systemic
fluoride especially protects the pits and fissures of kids’ permanent teeth. Furthermore,
having fluoride in the water that we are drinking and therefore swallowing provides those topical
benefits CDC and ADA identify as well. So when you see an anti-fluoride rant claiming that CDC
admitted fluoridated water benefits are topical, not systemic, and there is no need to swallow it,
it is a lie that anti-fluoride leaders tell for all manner of deceptive purposes.
Another common false claim is that fluoridated water is unsafe because the back of fluoride
toothpaste says “do not swallow” and the FDA warning says to call Poison Control if more
than used for brushing is accidentally swallowed. This is another claim that has some logic to it.
Why do the experts tell us not to swallow fluoride toothpaste and call Poison Control if a lot is
swallowed, but also to drink fluoridated water? This is very easy to answer. First, toothpaste
has far more fluoride in it than fluoridated water does. The concentration of fluoride in
your average tube of Crest or Colgate or other brand of fluoride toothpaste, is 1100 parts per
million by weight, which is 1500 milligrams of fluoride per liter. The concentration of
fluoride in fluoridated water is around 0.7 parts per million, or less than 1 milligram per liter.
So there is about 2000 times more fluoride in a liter of toothpaste than in a liter of fluoridated
water, just to give you an idea of how incredibly dilute the fluoride in tap water really is.
Fluoride, like literally any substance, even water itself, is harmful if you have too much of it.
Both fluoride and water can kill you if you consume enough of it in a short period of time.
As we have discussed in several other debunks already, the dose makes the poison,
so any talk of toxicity without referencing concentrations or amounts is clear deception
attempting to capitalize on chemophobia. The list of totally natural and commonly ingested
substances that would become harmful if consumed in highly concentrated amounts
is unimaginably long, so those who refer to fluoride as “extremely toxic” simply have no
real understanding of toxicity as a concept. The amount of fluoride in over-the-counter
toothpaste is also regulated to be well below an amount that can cause death, but there is
enough fluoride in a tube of toothpaste to result in the need for medical attention if someone,
especially a toddler, really eats a lot of it, not to mention other ingredients that can also
be harmful in large doses. It is extremely rare, but there have been a few cases over the years of
toddlers eating most of a tube, and then needing treatment for low calcium in the blood as well as
monitoring of a temporary irregular heartbeat. In the vast majority of calls to Poison Control
Centers, however, a kid has only eaten enough in one sitting to cause an upset stomach or nausea,
or kids have eaten an amount that doesn’t cause any immediate symptoms, but if they keep having
that amount every day for months, they may get something called fluorosis, a cosmetic
condition affecting the teeth. In most cases, fluorosis is limited to lacy white markings,
but in more moderate and severe cases, it might include some brown spots and pitting of the teeth.
So because toothpaste tastes good, especially to kids, it needs to be kept out of the reach
of toddlers and preschoolers who don’t know that they are going to get sick to their stomach or
develop white spots on their teeth if they eat a lot of it. Fluoridated water may contribute
to a few white lacy spots on teeth as well, but at less than a milligram of fluoride per liter,
fluoridated water has far too little fluoride in it to cause any nausea or sickness.
The FDA warning to call Poison Control if too much toothpaste is ingested
is for the amount of fluoride in toothpaste, not the amount in fluoridated water. So beyond the
bizarre hypocrisy people exhibit in referencing the FDA label about toxicity as ultimate authority
but rejecting FDA support for fluoridated water, it’s just not a legitimate concern.
Finally, those who push anti-fluoride sentiment that wish to appear the most scientific will make
the claim that it is a neurotoxin. Again, this is a situation where the truth is being stretched by
questionable actors beyond what the evidence shows. There is an active and legitimate line
of research on associations between fluoride and measures of IQ. But the evidence in those studies
is shaky at best, and can’t be credibly used to support abandoning the fundamental role of
fluoride in oral health. One of the early studies in the last decade that kicked off a lot of the
hype about this was a metaanalysis of a bunch of studies in China and Iran. But the studies in the
metaanalysis turned out to be of poor quality and didn’t control for confounders like lead,
arsenic, and naturally high levels of fluoride in groundwater. Some of the studies weren’t even
looking at fluoride in water, they were looking at whether indoor coal burning in rural China
is associated with IQ measurements for children in homes where coal is used for cooking meals
with no ventilation, wherein fluoride is just one component that is released during this process,
among many known harmful substances. The IQ measurements were also questionable themselves,
so these studies are not applicable to fluoridation in developed countries.
There have been other studies since then which indicate the possibility of an association
between fluoride and neurotoxic effects, some from existing data in Mexico, and some from Canada.
But again, these studies had serious limitations, while the ethics, bias, and judgement of some
of the researchers involved have come into question. One of the well-known authors in Canada,
Christine Till, accepted an invitation to speak at a conference by a well-known quack organization,
the International Academy of Oral Medicine and Toxicology, which is opposed to scientific
consensus on a variety of health topics. Furthermore, upon learning that her fellow
headliners would include disgraced anti-vaxxer Andrew Wakefield, whose fraudulence we covered in
another debunk, and the COVID conspiracy theorist Judy Mikovits, who is responsible for the debacle
that is the Plandemic video, Till went forward with the gig anyway. Any serious researcher
would not associate themselves with such dubious company. In the meantime, researchers like
Broadbent and colleagues, who do not take such dodgy speaking gigs but rather focus on doing
valid science in New Zealand, where fluoridation has been supported by all health agencies for
decades, have published studies that find no relationship between fluoridated water and IQ.
So we can say that there is an active line of research raising questions about high
levels of fluoride and IQ, but it is riddled with anti-fluoride hype, as well as questionable ethics
and research methods, as propagandists attempt to generate a scientific basis for their agenda.
So those are a few of the common false claims made about fluoride,
though there certainly are a lot more. The idea that water fluoridation is an
evil scheme to poison and control people has been a conspiracy theory for decades.
And there are a few good resources online for more debunks of fluoride misinformation that are worth
checking out. The American Fluoridation Society, at americanfluoridationsociety.org, is run by a
group of dentists who do a lot of good takedowns. Finally, Fluoride Exposed, at fluorideexposed.org,
is a cheeky name for a site run by a public health educator and a water quality scientist,
and it is actually science-based. Fluoride Exposed brings more exposure to accurate fluoride science.
Check the links in the description section for more information.
And with that we’ve covered one major area of misinformation regarding water. But don’t worry,
we’re just getting warmed up. In Part 2 we’re gonna tackle some of the newer fads in the
way of all the special waters that have become popular in recent years. I’ll see you over there.