Story at-a-glance

• A collection of some of the strongest fluoride studies in history have recently been published, showing that fluoridation poses an unreasonable risk and hazard to all, but to the fetus and infants in particular
• After a four-year process, a landmark fluoridation trial was held in federal court, and fluoridation’s neurotoxic risk to vulnerable subpopulations was confirmed, along with the U.S. EPA’s failure to take action to protect citizens from these risks
• The judge has urged the parties to discuss the possibility of an amended TSCA petition and assessment by the EPA, or start a new petition and have the EPA conduct a proper review, after which the judge will present his final ruling
• While FAN is taking the lead in court, at the federal and state level, and helping campaigners at the local level to educate decision-makers and public health officials, we need your help to spread this educational campaign to every community, including yours
• New educational and advocacy tools are available so you can take action to end fluoridation in your community or state, to immediately protect the most vulnerable

Water fluoridation is one of the biggest public health failures of the 20th century. Despite solid scientific evidence of harm, politics and public relations have kept the practice alive.

Proponents, including the American Dental Association (ADA) and the Oral Health Division of the Centers for Disease Control (CDC), have spent millions of dollars on promotion and public relations to sell fluoridation using half-truths, convincing talking points, and diversions. 

But fluoridation is also one of the most widely rejected health interventions on Earth, with 95% of the world's population consuming water from systems that are not fluoridated. 

For the past decade, the trend has moved in the direction of communities ending the practice, not starting it. And now, due to an abundance of new research, a landmark lawsuit and the sustained advocacy and education efforts of the Fluoride Action Network and its supporters like you, the practice could be on the brink of extinction.

The Evidence of Harm Is Too Great To Be Ignored

All tissues are important, but the most important organ to protect during fetal and infant development is the brain. Damage occurring to this organ during these early stages of life is permanent and cannot be undone later in life. 

The evidence of neurotoxic harm from water fluoridation has been mounting at an unprecedented rate in recent years, and has quickly become the most urgent reason to end the practice as soon as possible. A cavity can easily be filled, but damage to a child's brain is permanent.

A large body of government-funded research now indicates that fluoride is neurotoxic and is associated with lowered IQ in children and a significant increase in ADHD diagnosis and related behaviors in children at doses experienced in fluoridated communities. Experts in the field have likened the size of the effect to that from lead.

This includes over 200 animal studies showing that prolonged exposure to varying levels of fluoride can damage the brain, 65 human studies linking moderately high fluoride exposures with reduced intelligence, three human studies linking fluoride exposure with impaired fetal brain development, and seven Mother-Offspring studies linking fluoride exposure during pregnancy to reduced IQ in offspring. 

Over the past year, we've also seen unprecedented new science from Canada and the USA showing fluoride harms the developing brain from exposures due primarily to artificial water fluoridation at the "optimal level." Several of these high-quality studies were funded by the U.S. National Institute of Environmental Health Sciences (formerly the National Institutes of Health).

Strongest Studies Published Over the Past Year

Seven studies published in 2019 and 2020 are among the strongest yet, and are obviously relevant to water fluoridation as they were conducted in communities with what the ADA considers the "optimal level" of fluoride in drinking water. These include:

1. Green 2019 — published in the Journal of the American Medical Association's journal on Pediatrics. It reported substantial IQ loss in Canadian children from prenatal exposure to fluoride from water fluoridation.
2. Riddell 2019 — published in Environment International. It found a shocking 284% increase in the prevalence of ADHD among children in fluoridated communities in Canada compared to nonfluoridated ones.
3. Till 2020 — published in Environment International. It reported that children who were bottle-fed in Canadian fluoridated communities lost up to 9 IQ points compared to those in nonfluoridated communities.
4. Uyghurturk 2020 — published in Environmental Health. It found that pregnant women in fluoridated communities in California had significantly higher levels of fluoride in their urine than those in nonfluoridated communities. The levels found in their urine were the same as those found to lower the IQ of the fetus in Green et al, 2019 and Bashash et al, 2017.
5. Malin 2019 — published in Environmental Health. It linked a doubling of symptoms indicative of sleep apnea in adolescents in the U.S. to levels of fluoride in the drinking water. The link between fluoride and sleep disturbances may be through fluoride's effect on the pineal gland.
6. Malin 2019 — published in Environment International. It reported that exposure to fluoridated water led to a reduction in kidney and liver function among adolescents in the U.S., and suggested those with poorer kidney or liver function may absorb more fluoride bodies. The CDC funded this study.

The claims made by proponents of fluoridation that there is only "one or two studies" finding harm, or that they are only from areas with naturally high fluoride levels, are no longer relevant. The scientific evidence can now be considered overwhelming and undeniable. In fact, the level of evidence that fluoride is neurotoxic now far exceeds the evidence that was in place when lead was banned from gasoline.

A recent review by Danish scientist, Harvard professor and neurotoxicity expert Philippe Grandjean, MD, DMSc, also concluded that:

"… there is little doubt that developmental neurotoxicity is a serious risk associated with elevated fluoride exposure, whether due to community water fluoridation, natural fluoride release from soil minerals, or tea consumption, especially when the exposure occurs during early development."

It should come as no surprise then, that a draft systematic review published in 2020 by the National Toxicology Program of human studies of fluoride's neurotoxicity concluded that fluoride was a "presumed" neurotoxin based on the large number, quality and consistency of brain studies. 

The review identified 149 human studies and 339 animal studies, but did not include the three most recent neurotoxicity-related studies from the York University group (Till 2019; Riddell 2019), or the study showing that women in the U.S. had levels of fluoride in urine high enough to cause damage to the brain of the fetus (Uyghurturk 2020).

While the draft NTP review is equivocal about effects at low exposures, these newest high-quality mother-child studies support a conclusion that artificially fluoridated water causes substantial IQ reductions. This fact was recently echoed in a letter published in Pediatric Research by the co-authors of the JAMA Pediatrics fluoride/IQ study, which said:

"Over the past 75 years, health authorities have declared that community water fluoridation-a practice that reaches over 400 million worldwide-is safe. Yet, studies conducted in North America examining the safety of fluoride exposure in pregnancy were nonexistent.

When a Canadian study reported that higher fluoride exposure in pregnant women was associated with lower IQ scores in young children, critics attacked the methodology of the study and discounted the significance of the results.

Health authorities continued to conclude that fluoride is unequivocally safe, despite four well-conducted studies over the last 3 years consistently linking fluoride exposure in pregnancy with adverse neurodevelopmental effects in offspring …

The tendency to ignore new evidence that does not conform to widespread beliefs impedes the response to early warnings about fluoride as a potential developmental neurotoxin. Evolving evidence should inspire scientists and health authorities to re-evaluate claims about the safety of fluoride, especially for the fetus and infant for whom there is no benefit."

FAN Leads the Fight Against Neurotoxins

Since 2000, the Fluoride Action Network (FAN) has been committed to reducing exposure to fluoride, and even with all of the science firmly on our side, we couldn't wait for legislators and public health officials to cast aside their entrenched dogma in favor of fluoridation and catch up on the science. Instead, we initiated the legal process to end the practice that today affects more than 200 million Americans.

A little-known provision of the Toxic Substances Control Act (TSCA) gave us our opportunity. It offers citizens a way to circumvent the corruption and force the U.S. Environmental Protection Agency (EPA) to prohibit or limit the use of toxic substances. 

Watchdog groups no longer have to convince the EPA of unreasonable risk; they can now have an objective judge decide based on an independent review of the evidence.

We are also laying the foundation for future TSCA challenges by citizens and environmental groups. For example, because of Judge Edward Chen's ruling to deny the EPA's motion to dismiss our case, TSCA law will now be interpreted to allow the EPA to be petitioned to regulate single uses of substances, rather all uses, which was the EPA's position. This change will make it easier for activists to force the EPA to review the risks of specific chemicals used commercially.

While it has been four years since this effort began in November of 2016 — when the Fluoride Action Network, together with a coalition of nonprofits and individual citizens, presented a petition to the EPA to end the deliberate addition of fluoridation chemicals to the public's drinking water — it has actually taken 20 years of effort by FAN to bring us to this point.

It took the development of our extensive website in the early days. It took the creation of our comprehensive health database (larger than any government had put together on fluoride's toxicity).

It took countless submissions to government agencies and the translation of many Chinese neurotoxicity studies and much more. And, after much delay due to government shut downs and Covid-19, our day in court finally arrived.

Trial of the Century

The trial began with an opening statement from the attorney for the plaintiffs, Michael Connett. He made the succinct but powerful case that fluoride presents a hazard (threat to the brain); that this hazard is a risk at the doses experienced in fluoridated communities; and that it is an unreasonable risk.

The EPA, represented by lawyers from the Department of Justice, argued that establishing fluoride as a neurotoxic hazard requires a systematic review, which they claimed FAN's experts didn't perform.

They also argued that the evidence showing harm from fluoride at the levels found in communities that practice fluoridation wasn't strong enough to yield action from the EPA. Both of these claims would be disproven by FAN's experts and attorney during the trial.

This was followed by three days of testimony from FAN's expert witnesses, all independent and leading scientists whose world-class expertise includes fluoride, neurotoxicity and risk assessments, and whose expertise the EPA has relied on in the past on other toxicants like lead and mercury. The witnesses included (click on links to see their declarations and resumes):

• Philippe Grandjean, MD, Ph.D.
• Howard Hu, MD, MPH, ScD
• Bruce Lanphear, M.D., MPH
• Kathleen Thiessen, Ph.D.

Their testimony was followed by the EPA's witnesses, two of which were experts-for-hire from the corporate consulting firm Exponent, and one was a risk assessment expert from the EPA.

It was revealed that the EPA paid Exponent approximately $350,000 for their testimony, which was focused primarily on claiming that there was insufficient evidence of harm — something they're known for doing in every trial, no matter who they're representing or how strong the science is.

One of their witnesses, Dr. Ellen Chang, has a long history of defending and producing systematic reviews for corporate polluters, including for DOW Chemical's Agent Orange, Monsanto's glyphosate, 3M's PFOAs, and pesticides from Syngenta and Croplife. She also worked for the American Chemistry Council, American Petroleum Institute, and the Manganese Interest Group.

Several paragraphs here couldn't possibly do the in-depth proceedings of the trial justice, or highlight all of the shocking and incredible statements that were made. I would urge you to read our detailed summaries for each of the trial days. 

I would also urge you to visit our TSCA trial overview page, where you can find the basic facts, a timeline of all actions and rulings, links to all of the submissions made by FAN, links to all of the media coverage, and links to the studies we relied upon to make our case. You can also visit our Twitter page, where we provided live tweet coverage of days 3 through 7.

The Judge's Reaction

After seven days of trial and closing statements from both parties, the judge held off on making a final ruling, but he did make it fairly obvious that he was convinced that FAN fluoride was a neurotoxin and likely posed an unreasonable risk. He said that the EPA had failed to properly assess that risk, and illegitimately turned down FAN's 2016 petition for TSCA action.

The judge urged the parties to spend the next few weeks discussing the possibility of an amended TSCA petition and assessment by the EPA, or start a new petition and have the EPA conduct a proper review, and leave his final ruling until that is complete. Both parties expressed doubt that such an arrangement would be fruitful, but ultimately agreed to move forward with it and update the court on their progress in the beginning of August. 

We Expect the EPA Could Continue to Delay

We don't expect the overzealous proponents of the fluoridation, including the EPA, CDC and ADA, to roll over without using every avenue possible to save their credibility by protecting fluoridation. They've already proven time and again, they have deep pockets and no shame.

Proponents don't seem to realize that continued promotion will cause an ever-increasing loss of the public's trust in the agencies that are meant to protect them. Continuing this practice in the absence of sound science — and investing millions of dollars in PR to cover up that fact — will further erode the public's trust in public health programs.

While FAN is taking the lead in court, at the federal and state level, and helping campaigners at the local level to educate decision-makers and public health officials, we need your help to spread this educational campaign to every community, including yours.

Right now, the only thing being protected is a failed policy and the reputation of those who refuse to accept that this program has been a massive failure both ethically and scientifically.

Before the trial the EPA had already intimated that they could appeal a ruling in our favor, and that even if we win the appeal the rulemaking process to end fluoridation's neurotoxic harm could take up to three years. This would mean tens of thousands more children permanently harmed by fluoridation.

This is why, regardless of the ultimate verdict, FAN will continue to need your support. We have forged this precedent-setting path together. Your support, contributions and sharing of our cause and legal case have played a critical role in making this happen, and we thank you. Whether we win or lose this trial, our important education efforts will have to continue.

Please consider investing in an end to fluoridation by making a tax-deductible donation to our work.

Also, please consider signing-up to receive FAN's email bulletins and following us on Facebook, Twitter, YouTube and Instagram. We will keep you informed about the latest fluoride research and news, plus give you opportunities help influence fluoride policy in your area and throughout the world.

New Tools and Resources to Educate Leaders About Neurotoxicity

While FAN is taking the lead in court at the federal and state level, and helping campaigners at the local level to educate decision-makers and public health officials, we need your help to spread this educational campaign to every community, including yours. To make the task easier, we have created a number of new educational materials.

First, is our handout on neurotoxicity. We have both a color version along with a black and white version for cheaper bulk printing, as well as a list of the references for this handout that you can combine to make a nice double-sided handout if you so choose. You can also check out our other handouts here.

Second, FAN's Research Director, Chris Neurath, filmed a Zoom webinar in which he presented detailed evidence that fluoride is a developmental neurotoxin.

He described the rapidly accumulating peer-reviewed science showing that fluoride lowers the IQ of children and increases their risk of neurobehavioral problems like ADHD. He put those studies into perspective in ways we can all understand.

This video a powerful tool for campaigners and parents looking to learn the science and to share it with decision-makers. Neurath's presentation is about 50 minutes and includes a 30-minute question and answer session that took place at the end. Click here to access the PowerPoint slides used in this presentation.

Help educate your state-level decision makers about the neurotoxic harm caused by water fluoridation. Use our simple automated email system to send Neurath's presentation to your state legislators and urge them to introduce a bill next session to end the practice throughout your state: Educate Your Legislators NOW.

FAN has also produced a new video series entitled, "Four Game-Changing Studies," explaining the science behind fluoridation's neurotoxicity in four short videos featuring Paul Connett, Ph.D. The shorter format makes the content easier to share on social media and easier for local authorities to digest incrementally.

• Game-Changing Study #1 — Bashash 2017
• Game-Changing Study #2 — Green 2019
• Game-Changing Study #3 — Riddell 2019
• Game-Changing Study #4 — Till 2020