Author: R. Alan Harrop, Ph.D.
Some of you may remember the controversy that occurred decades ago when the decision to place fluoride in municipal water systems occurred. The issue of fluoride in drinking water has been brought up again by the new Secretary of the Department of Health and Human Resources, Robert Kennedy, Jr. He has long been an advocate of ensuring that toxic chemicals should be eliminated, to whatever extent possible, from our food and drinking water. In fact, being placed in a position where he could influence this long-time major concern of his is part of the reason he may have decided to support President Trump’s campaign in 2024. Certainly, sounds like a reasonable concern and something we should care about.
Apparently, the primary concern about fluoride in drinking water is the suspicion that it may be causing the increase in childhood autism which has been reported over several years. Autism is a neurological developmental disorder that shows deficits in social communication and interaction with others, and restrictive, repetitive behavior and activities. Ability to relate to others is compromised. The symptoms of autism are usually observed in young children between two and three years of age. The symptoms may continue indefinitely. This can lead to difficult social adjustment and learning. Although autistic symptoms in children were reported in the 1920s and 1930s, the diagnosis of autism as a mental/behavioral disorder did not occur until 1980, when it was added to the Diagnostic and Statistical Manual of Mental Disorders (DSMIII) by the American Psychiatric Association. The incidence of diagnosed autism was reported to be 1 in 88 children in the year 2000 and has risen to 1 in 31 children by 2024, obviously, a large increase. It should also be noted that autism diagnoses are approximately four times higher in boys than girls. An interesting side note is that another childhood diagnosed condition, Attention Deficit Hyperactivity Disorder (ADHD), has also shown a significant increase from 6% of children in 1998 to over 10% in 2024.
Issue number one in the discussion of whether fluoride in drinking water is causing an increase in autism is the accuracy and reliability of diagnosing autism. Unlike most physical illnesses that are verifiable with reliable laboratory tests, the diagnosis of autism, like most mental illnesses, relies on considerable judgement on the part of the diagnostician either through direct observation or reported information by parents, teachers, and others. Consequently, reliability is less definitive. Also, importantly, one only finds something when you are looking for it. Whereas now a child’s behavior may be justification for a diagnosis of autism, years earlier, the child’s odd behavior might have been attributed to being a loner or introvert or “that’s just Johnny.” For example, years ago a child who was hyperactive and unruly may have just been considered undisciplined.
The second issue that must be addressed is whether any incidence of increased autism is directly caused by the fluoride levels. Fluoride is a naturally occurring element in nature and is frequently found in surface and well water. In fact, it is the 13th most abundant element and can be found in oceans, soil, and plants. The fact that two things increase together does not prove that the increase in one causes the increase in the other. This is the difference between correlation and causation; the latter being more difficult to prove but critical to actual science and must not be forgotten when dealing with this enquiry.
A third issue is the overwhelming evidence that fluoridation has dramatically reduced the occurrence of dental cavities, especially in children. The original study of 300,000 children, conducted in 1945 in Grand Rapids, Michigan showed a dramatic decrease of 60% of children’s dental cavities. In fact, the American Dental Association, which supports widespread water fluoridation, states that stopping water fluoridation would “ …take away the most effective, efficient, and equitable way for dental disease prevention.” Currently, about two thirds of the American population consumes fluoridated drinking water. On the other side, there has been a recent study that showed that fluoridated water may be negatively impacting children’s IQ, although that study used levels of fluoride twice the level allowed in drinking water. There is also concern about suspected thyroid and arthritis impacts. Assessing what levels may be safe certainly appears warranted.
The final issue, is one of control and freedom of choice, which are always important. Who gets to decide whether you consume fluoride in your water? In most places it is the state or local government. Secretary Kennedy appears to be of the opinion that fluoride should be treated like any medication to the extent that the individual ( or child’s parent) should make that decision. Not sure how that would be instituted, but it seems to make sense.
Secretary Kennedy, along with the Environmental Protection Agency head Lee Zeldin, announced that they would refer this matter to the Community Services Community Task Force, an independent panel composed of public health and prevention experts, to study this matter and develop recommendations. Sounds like a reasonable action to take. Let’s hope they do not throw out the baby with the proverbial bath water!