Fluoride

Sometimes, just by chance, events line up. My last post was about the ivermectin controversy and the way science can be distorted, either unintentionally or with malice. Then, right after I posted the piece, Robert Kennedy Jr. rolled out his “Make America Healthy Again” initiative. That led me to other views RFK Jr. has expressed on other topics, particularly on the use of fluoride in water supplies to prevent tooth decay. Let’s take a closer look, with a little background information to supply some context.

In 1901, a young dentist named Fredrick McKay moved to Colorado Springs and set up shop. He immediately noticed that many of the people in Colorado Springs had badly stained teeth. The residents had their own theories about what caused this, including eating too much pork or drinking poor-quality milk. McKay reviewed the dental literature but could not find any references to this problem. He later collaborated with G.W. Black, a well-known dental researcher. The two of them looked at many possible causes for the discoloration of the children’s teeth but could not find one. After decades, they discovered two important pieces of information: the discoloration was occurring in areas that had high concentrations of fluoride in the water, and people who had the discoloration were resistant to developing dental caries, better known as cavities. The story is pretty interesting, but that’s not my focus here; if you want to read about it, here’s the link: https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation

In any case, this eventually led to most areas of the USA and other countries adding small amounts of fluoride to their water supplies. This has led to a 25% reduction in the number of dental caries in the population. It also led to conspiracy theories by groups such as the John Birch Society, which saw fluoridation as a wedge for the implementation of socialized medicine and a method of mind control of Americans by the forces of communism. I guess there is nothing new under the sun.

Enter RFK Jr.

So what are RFK Jr.’s claims regarding fluoride? Not all of these claims made it into the MAHA manifesto, but he has stated them in other places, including social media. Let’s examine them one at a time.

Fluoride is an industrial waste product

Let’s start with some definitions. A waste product is a material with no intended use or value and is typically discarded. Some examples of waste products would include:

• Sludge from sewage plants: This is what’s left over after wastewater is treated. It contains heavy metals, microplastics, and pathogens. It is disposed of in landfills or sometimes incinerated. 
• Mine tailings: The material left over from mining for gold, copper and other metals contains toxic heavy metals and acids and can contaminate water supplies
• Radioactive waste: Very dangerous to animal and plant life (that includes us) and has to be contained for between 500 years and more than a million years, depending on what kind of waste it is

A byproduct is different. It’s a substance that is created in the process of making something else. Whether you know it or not, you almost certainly use byproducts all the time. Here are some examples:

• Molasses: It’s a byproduct of sugar refining and is used as a food additive, livestock feed, and for fermentation. Ever drink porter or stout? Then you have been drinking a byproduct
• Wheat bran and germ: These are by-products produced when wheat is milled. Do you eat granola, whole wheat cereal, and your whole wheat avocado toast? Enjoy your by-products
• Sulfuric acid: This is a byproduct of metal refining and smelting. Its in your car battery 
• Glycerin: A byproduct of biodiesel fuel, used in cosmetics, food and medications

I could go on, but you get the picture. Fluoride is a byproduct? Who cares if that byproduct is useful and valuable? This is an example of a logical fallacy sometimes called “the generative fallacy.” The idea is that you dismiss an argument based on its source rather than on its merits. Here are some examples:

• “That policy must be bad; after all, it was proposed by a Democrat/Republican.” Party affiliation has nothing to do with the validity of a policy.
• “Democracy is a flawed system because it originated in ancient Greece, and they had slavery.” The origin of democracy doesn’t discredit the idea of democracy; its modern function should be the focus.
• “You can’t believe her statements about climate change; she’s just in high school.” The validity of the high school student’s statement is not a function of her age; facts should be judged on their merit.

So RFK Jr. is using a double whammy here; he mislabels a byproduct as a waste product and then tops it off with a logical fallacy. Let’s remember that he has a law degree from the University of Virginia School of Law and a Master of Laws from Pace University. A Master of Laws degree (M.L. or LL.M.) is a postgraduate degree someone can obtain after they finish law school. RFK’s L.L.M. was in environmental law. Let’s remember that a good deal of legal training involves critical thinking for the purposes of analyzing legal arguments and looking for flaws in reasoning. So he knows, or should know, a fallacious argument when he sees one or makes one. But if the floor is open to logical fallacies, how about this, from the BBC?

RFK Jr admits dumping bear carcass in New York’s Central Park

You can read the full story here: https://www.bbc.com/news/articles/c2j3353vvdvo. But how could a health policy from a man who thinks it’s a hoot to dump a rotting bear carcass in Central Park be any good? Sauce for the goose, as they say.

But lets focus on RFK Jr.’s beef with fluoride:

The Claims

Here’s a recent RFK Jr post to get us started:

@RobertKennedyJr

On January 20, the Trump White House will advise all U.S​. water systems to remove fluoride from public water. Fluoride is an industrial waste associated with arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid disease. President ​@realDonaldTrump and First Lady @MELANIATRUMP want to Make America Healthy Again.​ 

https://x.com/RobertKennedyJr/status/1852812012478398923

Let’s address these claims one by one:

Claim: Fluoride is a neurotoxin

This seems to be related to a number of studies that appear to suggest that fluoride is associated with lower IQs in children who are exposed to it. And there are some studies that point in this direction, but all is not what it seems. 

A 2012 study was published in Environmental Health Perspectives (Choi, A. L., Sun, G., Zhang, Y., & Grandjean, P. (2012). Developmental fluoride neurotoxicity: A systematic review and meta-analysis. Environmental Health Perspectives, 120(10), 1362–1368. https://doi.org/10.1289/ehp.1104912). The study looked at 27 studies, primarily from China. They found that children in areas with high fluoride exposure had lower IQ scores than those in low exposure areas. How low? These researchers found that high fluoride exposure was associated with IQs that were on average 6.75 lower than low-exposure peers. That is a significant drop in IQ and if accurate, it would raise serious concerns about fluoride.

Another more recent study on fluoride exposure was conducted by Taylor, K.W., et.al. (Taylor, K. W., [et al.]. (2025). Fluoride exposure and children’s IQ scores: A systematic review and meta-analysis. JAMA Pediatrics, 179(1), 1–10. https://doi.org/10.1001/jamapediatrics.2024) This has not actually been published yet, although it has been in the news; it is an anticipated paper that will probably be published in the future. Again, this study did not look at American children; they looked at data from children in China, India, Mexico, Canada, and Iran. This study found that for every 1mg/L increase in urinary fluoride concentration, IQ went down 1.6 points on average. 

So if I have kids, I should be concerned about fluoride in the water, right? Of course. But there are other factors to consider. One of these is the level of fluoride exposure. The two studies I cited all looked at areas where fluoride exposure was much higher than the standard level of fluoride added to US water systems. In the US, when fluoride is added to the water supply, it is at the recommended level of 0.7 mg/L; in the studies I cited, the exposure was generally at 1.5 mg/L with many of the reviewed studies having average levels of 2mg/L up to 4 mg/L. That’s a big difference. These studies also did not take into account confounding factors. These included:

• Socio-economic status and parental education level
• Iodine deficiencies, even those several of the areas studied (Iran and India), are known to have iodine deficiency problems
• Lead/arsenic exposure: These toxins are known to be common in areas with high levels of fluoride in their groundwater and are know to lower IQ
• Malnutrition
• Total fluoride exposure, including from toothpaste, foods such as tea and processed food
• Maternal health during pregnancy
• Exposure to pesticides and heavy metals

So these studies would have to be considered to be of lower quality, with very limited generalizability.

There’s more. One of these is that there are many substances, including medications, that are fine at the appropriate dose but bad news at higher levels that we use every day. Paracelsus (1493-1541) was a Swiss physician who is considered the father of modern toxicology. He introduced the idea that all substances can be poisonous, but the dose determines whether they are remedies or poisons. His maxim, “All things are poison, nothing is without poison; the dose alone makes a thing not poison” is still relevant today. Want some examples of this? 

• Fish oil: Omega-3 fatty acids are important for health, but at higher levels, they can cause blood thinning and vitamin A toxicity
• Broccoli and kale: Great in moderation, but can interfere with thyroid function if you over-do it
• Vitamin D: Great for your bones, but can cause kidney stones if you take too much
• Iron: Necessary for for oxygen transport in the blood, but damaging to organs at high levels
• Acetaminophen: Good for pain and fever, but will cause severe liver damage in overdose, and can kill you dead
• Water: Yes, water. Got to have it, but too much can make you drunker than alcohol and put you in a coma. Keep it up and your brainstem will herniate, causing heart attack and respiratory failure, brain damage and death

Then there are the potential downsides of not having fluoride in the water. There is no question that fluoride helps prevent cavities, with a 20-40% reduction in permanent teeth. That’s a good thing, and it’s not just a question of having lower dentist’s bills. Here are some of the problems associated with cavities in children:

• Persistent toothache, that interferes with eating sleeping and concentration
• Infection, leading to sepsis
• Problems in speech development
• Impaired nutrition
• School absence, a leading cause
• Poor school performance

So, if you were thinking that “even if there is a very small chance that fluoride might conceivably cause a drop in my child’s IQ, why not just eliminate it?” you have more to think about. These matters are complex and there is always a trade-off. I recall reading one of Malcolm Gladwell’s books and he discussed the positives and negatives of self-driving cars. He suggested that at some point, a self-driving car is going to malfunction and plow through a daycare center. When that happens, there will be a call to ban them, which would be understandable. But he pointed out that people drive through daycare centers now. What if it turns out that the level of daycare incidents overall is much lower with self-driving cars, even though they sometimes malfunction? I’m reminded of a quote by H.L. Mencken, who said, “For every complex problem, there is an answer that is clear, simple, and wrong.” And as with ivermectin, you can listen to the experts, or you can go along with the whole “a lot of people are saying” thing on social media.

Claim: Fluoride is associated with bone fractures

The basis of this claim was more difficult to track down, in part because RFK Jr is not big on citations. But fear not, gentle reader, I have taken it upon myself to do what RFK Jr didnt bother to do. So, is this claim supported by evidence, or is it just so much chin music?

I found this study on Cochrane Reports: Haguenauer D, Shea B, Tugwell P, Wells GA, Welch V. Fluoride for treating postmenopausal osteoporosis. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002825. DOI: 10.1002/14651858.CD002825

Here’s the deal. Osteoporosis is a big problem for the elderly, particularly women. It leads to fragile bones and if you are over 65, you are at risk for falling and breaking a hip and if that happens, the prognosis isn’t good. For this reason, doctors have been trying to find medications that can remineralize and strengthen bones. One of the remedies that has been tried is fluoride supplements. The authors of the study looked at the effects of fluoride supplements on bone fractures; this has been used for 30 years. They looked at 11 studies with a total of 1,429 women. Sure enough, the women who took fluoride had a bigger increase in bone density in their lower backs than those who didn’t. So far, so good. But after 4 years, the fluoride did not decrease the number of new spine fractures in these women. Also, these subjects had higher levels of other fractures (not in the back) at four years out. So, should you eschew fluoride so your kids won’t keep breaking bones? Probably not because:

• Optimally fluoridated water in the US would expose you to 1.4 mg per day
• To get to the level where bone fractures increased, you’d need to drink over 7 gallons of water per day, which is physically impossible

So a pattern is starting to emerge. If you have already decided that you don’t like a medication or supplement:

• Find a study or two that suggests that it might cause some kind of harm, then ignore all evidence to the contrary reputable public health groups because, as we all know, that evidence is fake news promulgated by Bill Gates, George Soros, Big Pharma and the Deep State 
• Tie yourself in knots to avoid dealing with high quality research that refutes your claim or attack the messenger
• Ignore the idea that dose defines the poison
• Deny any positive effects of the drug or substance

I did say at the outset of this post that I would take on these claims one by one; I don’t know about you, but I think we all get the idea. Let’s cut to the chase and just deal with them with this convenient table:

Claim	Scientific Support
Fluoride is an industrial waste product	Untrue, and not relevant to risk
Fluoride is a neurotoxin	Partially supported, but only at doses far higher than what is in the US water supply
Causes arthritis, fractures, cancer, and thyroid disease	Largely unsupported and recommended levels
CDC and other health injuries misled the public	No strong evidence of intentional deception
No safe level fluoride	Not supported; safe levels are well studied
Water fluoridation should end	Only if you want your kids to have lots of cavities

So how best to present health misinformation to the American people if you are so inclined? Actually, it’s not that difficult when you put your mind to it. Let me give it a shot. Most people know, or should know, that too much salt is bad for you. On the other hand, you have to have some; it’s necessary for life. If you don’t get enough, you can develop headaches, muscle cramps, and confusion. If it drops even lower, your brain can swell, you can go into shock, and you can even die. That’s why animals such as moose will walk 10 miles out of their way to find a salt lick. But let’s pretend I have a blog (which I do, come to think of it) and have a thing about salt. Here’s what I’d say:

Salt: The Silent Killer They’re Sneaking Into Your Food

You probably sprinkle it on your fries and into your clam chowder. But what if I told you that salt is a toxic substance pushed on us by shadowy government agencies and powerful food conglomerates? Hold onto your hats; it’s much worse than you ever imagined!

Poisoning the Masses One Bag of Fries at a Time

Salt is in everything because it’s an inexpensive way for Big Food to get you addicted. They know that salt is linked to kidney failure, seizures, brain swelling, and even death, but they keep pumping it into your children’s food. So-called “experts” say it’s fine in “recommended” doses. But who pays these experts? Follow the money!

 Salt: The Real Reason American Health Is the Worst in the Developed World

Open your eyes and look around you; kidney disease is skyrocketing, neurological disease is everywhere and it seems like every other kid has autistic spectrum disorder. But they keep pumping salt into our food. I’ve been working in mental health for 40 years, and every heroin addict I ever met started with salt. People are dying everywhere from salt but you never hear about it on the news.

 The Deep State-Big Food Cover-Up

Why don’t you ever hear about this? Salt is big business. The food industry, medical establishment, and FDA are all in on it. They want you addicted, sick, and dependent on their high blood pressure medications. The less you know, the better they like it. Wake up and take back your health!

Reclaim Your Health

Don’t be caught up in their game. Kill your saltshaker. Ignore the so-called “experts.” The truth is out there, but you won’t find it on the nutritional label!

[Disclaimer: The statements above are intended to be satirical; consult your doctor if you have questions about salt in your diet. I’m not a physician or nutritionist; I’m just a psychologist who writes a blog to amuse myself.]

But here’s the bottom line as far as I’m concerned. Don’t believe every inflammatory statement you read on social media or your X feed. If it is important, ask to see the evidence, talk to your doctor, and do a little research on a number of platforms, not just the ones (right or left) that happen to share your worldview. Doctors have a saying about this: “You find what you look for, and you look for what you know.” My best advice is to learn a little bit about science and do your best to be an informed consumer of information. Also, maybe don’t accept information about medicine and health from a lawyer who dumps bear carcasses in Central Park.