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1391113 
Journal Article 
Addressing Toxicological Challenges To Community Water Fluoridation In Washington State 
Dodge, D; Pleus, RC; Peterson, MK 
2005 
1 
Toxicological Sciences
ISSN: 1096-6080
EISSN: 1096-0929 
TOX/5000382 
84 
1-S 
eng 
Fluoride is added to thousands of public water systems in the US as a public health measure. Its primary beneficial effect is the reduction of dental caries, a health problem for nearly 80% of the world?s population. The percentage of the population receiving fluoridated water in Washington State is lower than the national average; by several measures, children in Washington State lag behind other states in oral health. In order to improve the oral health of the state, the Washington Dental Service Foundation (WDSF) provides partial funding for and actively promotes water fluoridation in state communities. Despite endorsement by nearly every major public health, dental, and medical association in the nation and world, there is strong and vocal opposition to fluoridation that has made local government and the public wary of passing fluoridation measures. Recently we have assisted WDSF in addressing claims of toxicity put forth by opponents of fluoridation in several Washington communities where fluoridation measures are currently in debate. Allegations include the following: 1) health effects from fluoride itself, including skeletal fluorosis, bone fractures, cancer, and effects on the central nervous system; 2) health effects due to contaminants (e.g., arsenic, mercury) in the concentrated fluoride additive; and 3) health effects due to the leaching of chemicals (e.g., lead, aluminum) from water systems. Many of these allegations fail to recognize dose-response principles. For instance, fluoride is known to cause adverse effects at sufficient doses, but not at concentrations found in optimally treated drinking water. Risks from chemical contaminants are purported as significant simply due to their detection in concentrated solution, despite being present at levels far below toxicity and regulatory thresholds upon dilution. Still other allegations are based on poorly designed studies. We describe our experiences defending the safety of fluoride in Washington communities in the face of opposition challenges.