A Bibliography of Scientific Literature on Fluoride

Contents

I. FLUORIDE & THE BRAIN

II. FLUORIDE & OXIDATIVE STRESS

III. FLUORIDE & G-PROTEINS

IV. FLUORIDE & BONE

V. FLUORIDE & CANCER

VI. FLUORIDE & THE THYROID

VII. FLUORIDE & the KIDNEYS

VIII. FLUORIDE & GASTOINTESTINAL DISORDERS

IX. FLUORIDE & REPRODUCTIVE SYSTEM

X. FLUORIDE & BIRTH DEFECTS

XI. FLUORIDE & THE IMMUNE SYSTEM

XII. ALLERGY/HYPERSENSITIVITY TO FLUORIDE

XIII. FLUORIDE & CARIES (Tooth Decay)

XIV. DENTAL FLUOROSIS

XV. FLUORIDE: NOT an ESSENTIAL NUTRIENT

XVI. SOURCES OF FLUORIDE EXPOSURE

XVII. NUTRITONAL DEFICIENCIES EXACERBATE FLUORIDE'S TOXICITY

XVIII. ACUTE TOXICITY of FLUORIDE

XIX. SYSTEMIC FLUORIDE NEVER APPROVED BY FDA

XX. ALTERNATIVES TO FLUORIDE

XXI. REVIEWS of the SCIENTIFIC LITERATURE

I. FLUORIDE & THE BRAIN (back to top)

Fluoride & Learning/Behavior:

Bhatnagar M, et al. (2002). Neurotoxicity of fluoride: neurodegeneration in hippocampus of female mice. Indian Journal of Experimental Biology 40: 546-54. (See abstract)

Calderon J, et al. (2000). Influence of fluoride exposure on reaction time and visuospatial organization in children. Epidemiology 11(4): S153. (See abstract)

Calvert GM, et al. (1998). Health effects associated with sulfuryl fluoride and methyl bromide exposure among structural fumigation workers. American Journal of Public Health 88(12):1774-80. (See abstract)

Ekambaram P, Paul V. (2001). Calcium preventing locomotor behavioral and dental toxicities of fluoride by decreasing serum fluoride level in rats. Environmental Toxicology and Pharmacology 9(4):141-146. (See abstract)

Li XS. (1995). Effect of fluoride exposure on intelligence in children. Fluoride 28(4):189-192. (See abstract)

Li Y, et al. (1994). [Effect of excessive fluoride intake on mental work capacity of children and a preliminary study of its mechanism] Hua Hsi I Ko Ta Hsueh Hsueh Pao. 25(2):188-91. (See abstract)

Lin Fa-Fu; et al (1991). The relationship of a low-iodine and high-fluoride environment to subclinical cretinism in Xinjiang. Iodine Deficiency Disorder Newsletter Vol. 7. No. 3. (See study)

Lu Y, et al (2000). Effect of high-fluoride water on intelligence of children. Fluoride 33:74-78. (See abstract | See study )

Morgan L, et al (1998). Investigation of the possible associations between fluorosis, fluoride exposure, and childhood behavior problems. Pediatric Dentistry 20: 244-252. (See abstract)

Mullenix P, et al. (1995).Neurotoxicity of sodium fluoride in rats. Neurotoxicology and Teratology 17:169-177. (See abstract | See editorial discussing this study)

National Research Council. (2006). Neurotoxicity and Neurobehavioral Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Paul V, et al. (1998). Effects of sodium fluoride on locomotor behavior and a few biochemical parameters in rats. Environmental Toxicology and Pharmacology 6: 187–191. (See abstract)

Qin LS, Cui SY. (1990). The influence of drinking water fluoride on pupils IQ, as measured by Rui Wen's standards. Chinese Journal of the Control of Endemic Diseases 5:203-204.

Schettler T, et al. (2000). Known and suspected developmental neurotoxicants. pp. 90-92. In: In Harms Way - Toxic Threats to Child Development. Greater Boston Physicians for Social Responsibility: Cambridge, MA. (See excerpt)

Spittle B. (2000). Fluoride and intelligence (Editorial). Fluoride 33: 49-52. (See editorial)

Sun ZR, et al. (2000). Effects of high fluoride drinking water on the cerebral functions of mice. Chinese Journal of Epidemiology 19: 262-263. (See abstract)

Wang G, et al. (1996). Research on intelligence quotient of 4-7 year-old children in a district with a high level of fluoride. Endemic Diseases Bulletin 11:60-62.

Wang S, et al. (2005). Investigation and evaluation on intelligence and growth of children in endemic fluorosis and arsenism areas. Chinese Journal of Endemiology 24:179-182.

Xiang Q, et al. (2003). Effect of fluoride in drinking water on children's intelligence. Fluoride 36: 84-94. (See abstract)

Yang Y, et al. (1994). [Effects of high iodine and high fluorine on children's intelligence and the metabolism of iodine and fluorine]. Zhonghua Liu Xing Bing Xue Za Zhi.15(5):296-8. (See abstract)

Zhang C, et al. (1999). [Effect of fluoride-arsenic exposure on the neurobehavioral development of rats offspring] Wei Sheng Yan Jiu. 28(6):337-8. (See abstract)

Zhang Z, et al. (2001). [Effects of selenium on the damage of learning-memory ability of mice induced by fluoride]. Wei Sheng Yan Jiu. 30(3):144-6. (See abstract)

Zhang Z, et al. (1999). [Effect of fluoride exposure on synaptic structure of brain areas related to learning-memory in mice] [Article in Chinese]. Wei Sheng Yan Jiu 28(4):210-2. (See abstract)

Zhao LB, et al (1996). Effect of high-fluoride water supply on children's intelligence. Fluoride 29: 190-192. (See abstract)

Fluoride-Induced Damage to Brain (back to top)

Bhatnagar M, et al. (2002). Neurotoxicity of fluoride: neurodegeneration in hippocampus of female mice. Indian Journal of Experimental Biology 40: 546-54. (See abstract)

Bhatnagar M, et al. (2006). Biochemical changes in brain and other tissues of young adult female mice from fluoride in their drinking water. Fluoride 39:280-284. (See study)

Chen J, et al. (2003). Selective decreases of nicotinic acetylcholine receptors in PC12 cells exposed to fluoride. Toxicology 183(1-3):235-42. (See abstract)

Chen J, et al. (2002). Studies on DNA damage and apoptosis in rat brain induced by fluoride. Zhonghua Yu Fang Yi Xue Za Zhi. 36(4):222-224. (See abstract)

Chen J, et al. (2002). Selective decreases of nicotinic acetylcholine receptors in PC12 cells exposed to fluoride. Toxicology 183(1-3):235-42. (See abstract)

Chinoy NJ, et al. (2004). Biochemical effects of sodium fluoride and arsenic trioxide toxicity and their reversal in the brain of mice. Fluoride 37: 80-87. (See abstract)

Du L. (1992). [The effect of fluorine on the developing human brain]. Chung-hua Ping Li Hsueh Tsa Chih. 21(4):218-20. (See abstract)

Eisenbrandt DL, Nitschke KD. (1989). Inhalation toxicity of sulfuryl fluoride in rats and rabbits. Fundamentals of Applied Toxicology 1989 Apr;12(3):540-57. (See abstract)

Ge Y, et al. (2005). Effects of high fluoride and low iodine on brain histopathology in offspring rats. Fluoride 38: 127-132.

Ge Y, et al. (2006). Apoptosis in brain cells of offspring rats exposed to high fluoride and low iodine. Fluoride 39:173-178. (See study)

Guan ZZ, et al (1998). Influence of chronic fluorosis on membrane lipids in rat brain. Neurotoxicology and Teratology 20: 537-542. (See abstract)

Janiszewska G, et al. (1984). Effect of certain agents on subcellular cAMP level in different areas of rat brain. Acta Physiologica Polonica 35(3):199-206. (See abstract)

Kay AR, et al. (1986). Intracellular fluoride alters the kinetic properties of calcium currents facilitating the investigation of synaptic events in hippocampal neurons. Journal of Neuroscience 6(10):2915-20. (See abstract)

Lakshmi Vani M, Pratap Reddy K. (2000). Effects of fluoride accumulation on some enzymes of brain and gastrocnemius muscle of mice. Fluoride 33: 17-26. (See abstract)

Liu WX. (1989). [Experimental study of behavior and cerebral morphology of rat pups generated by fluorotic female rat] Zhonghua Bing Li Xue Za Zhi. 18(4):290-2. (See abstract)

Long YG, et al. (2002). Chronic fluoride toxicity decreases the number of nicotinic acetylcholine receptors in rat brain. Neurotoxicology and Teratology 24(6):751-7. (See abstract)

Lu XH, et al. (2000). Study of the mechanism of neurone apoptosis in rats from the chronic fluorosis. Chinese Journal of Epidemiology 19: 96-98. (See abstract)

National Research Council. (2006). Neurotoxicity and Neurobehavioral Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Sarri E, Claro E. (1999). Fluoride-induced depletion of polyphosphoinositides in rat brain cortical slices: a rationale for the inhibitory effects on phospholipase C. International Journal of Developmental Neuroscience 17(4):357-67. (See abstract)

Shah SD, Chinoy NJ. (2004). Adverse effects of fluoride and/or arsenic on the cerebral hemisphere of mice and recovery by some antidotes. Fluoride 37: 162-171. (See abstract)

Shan KR, et al. (2004). Decreased nicotinic receptors in PC12 cells and rat brains influenced by fluoride toxicity-a mechanism relating to a damage at the level in post-transcription of the receptor genes. Toxicology 200: 169-77. (See abstract)

Shao Q, et al. (2000). [Influence of free radical inducer on the level of oxidative stress in brain of rats with fluorosis]. Zhonghua Yu Fang Yi Xue Za Zhi 34(6):330-2. (See abstract)

Shashi A. (2003). Histopathological investigation of fluoride-induced neurotoxicity in rabbits. Fluoride 36: 95-105. (See abstract)

Shashi A, et al. (1994). Effect of long-term administration of fluoride on levels of protein, free amino acids and RNA in rabbit brain. Fluoride 27: 155-159. (See abstract)

Shashi A. (1992). Studies on alterations in brain lipid metabolism following experimental fluorosis. Fluoride 25(2):77-84. (See abstract)

Shen X, Zhang Z, Xu X. (2004). [Influence of combined iodine and fluoride on phospholipid and fatty acid composition in brain cells of rats] Wei Sheng Yan Jiu. 33:158-61. (See abstract)

Shivarajashankara YM , et al. (2002). Histological changes in the brain of young fluoride-intoxicated rats. Fluoride 35(1): 12-21. (See study)

Shivarajashankara YM , et al. (2002). Brain lipid peroxidation and antioxidant systems of young rats in chronic fluoride intoxication. Fluoride 35: 197-203. (See abstract)

Trabelsi M, et al. (2001). Effect of fluoride on thyroid function and cerebellar development in mice. Fluoride 34: 165-173. (See study)

Varner JA, et al. (1998). Chronic administration of aluminum-fluoride and sodium-fluoride to rats in drinking water: alterations in neuronal and cerebrovascular integrity. Brain Research 784: 284-298. (See abstract | See condensed version of study | See media report)

Wang J, et al. (2004). Effects of high fluoride and low iodine on oxidative stress and antioxidant defense of the brain in offspring rats. Fluoride 37: 264-270. (See abstract)

Wang Y, et al. (1997). [Changes of coenzyme Q content in brain tissues of rats with fluorosis]. Zhonghua Yu Fang Yi Xue Za Zhi. 31: 330-3. (See abstract)

Zhai JX, et al. (2003). [Studies on fluoride concentration and cholinesterase activity in rat hippocampus] Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 21(2):102-4. (See abstract)

Zhao XL, Wu JH. (1998). Actions of sodium fluoride on acetylcholinesterase activities in rats. Biomedical and Environmental Sciences 11(1):1-6. (See abstract)

Zhao XL, Gao WH, Zhao ZL. (1994). [Effects of sodium fluoride on the activity of Ca2+Mg(2+)-ATPase in synaptic membrane in rat brain] Zhonghua Yu Fang Yi Xue Za Zhi.28(5):264-6. (See abstract)

Silicofluoride/lead uptake (back to top)

Macek M, et al. (2006). Blood lead concentrations in children and method of water fluoridation in the United States, 1988-1994. Environmental Health Persepctives 114:130-134. (See abstract)

Macek M, et al. (2003). Water fluoridation and blood lead levels in US children. Journal of Public Health Dentistry 63(Suppl 1): S36. (See abstract)

Masters R, et al. (2000). Association of silicofluoride treated water with elevated blood lead. Neurotoxicology 21(6): 1091-1099. (See abstract)

Masters RD, Coplan M. (1999). Water treatment with Silicofluorides and Lead Toxicity. International Journal of Environmental Studies 56: 435-449. (See abstract)

Seavey J. (2005). Water fluoridation and crime in America. Fluoride 38: 11-22.

For commentary, see:

Coplan MJ, Masters RD. (2001). Silicofluorides and fluoridation. Fluoride 34(3): 161-220. (See paper)

"Dartmouth researcher warns of chemicals added to drinking water." (March 15, 2001). Dartmouth College News. (See news release)

Fluoride & the Pineal Gland (back to top)

Luke J. (1997). The Effect of Fluoride on the Physiology of the Pineal Gland. Ph.D. Thesis. University of Surrey, Guildford. (See abstract | See study)

Luke J. (2001). Fluoride deposition in the aged human pineal gland. Caries Research 35:125-128. (See abstract)

Synergistic effects of Fluoride/Aluminum (back to top)

Allain P, et al. (1996). Enhancement of aluminum digestive absorption by fluoride in rats. Research Communications in Molecular Pathology and Pharmacology 91(2):225-31. (See abstract)

Chase M. (1992). Rat studies link brain cell damage with aluminum and fluoride in water. Wall Street Journal October 28: B6. (See article)

Strunecka A, Patocka J. (1999). Pharmacological and toxicological effects of aluminofluoride complexes. Fluoride 32: 230-242. (See paper)

Strunecka A, Patocka J. (2002). Aluminofluoride complexes in the etiology of Alzheimer's disease. Structure and bonding 104: 239-280.

van der Voet GB, et al. (1999). Fluoride enhances the effect of aluminium chloride on interconnections between aggregates of hippocampal neurons. Archives of Physiology and Biochemistry 107(1):15-21. (See abstract)

Varner JA, et al. (1998). Chronic administration of aluminum-fluoride and sodium-fluoride to rats in drinking water: alterations in neuronal and cerebrovascular integrity. Brain Research 784: 284-298. (See abstract | See condensed version of study | See media report)

Varner JA, et al. (1997). Toxin-induced blood vessel inclusions caused by the chronic administration of aluminum and sodium fluoride and their implications for dementia. Annals of the New York Academy of Science 825: 152-166. (See condensed version of study)

Other (back to top)

National Research Council. (1971). Effects of Fluoride on Human Health: Nervous System. In: Fluorides. Committee on Biological Effects of Atmospheric Pollutants. National Academy of Sciences. Washington, D.C. Chapter 9. (See excerpt)

Popov LI, et al. (1974). Aspects of nervous system affections in occupational fluorosis. Gig. Tr. Prof. Zabol. 5: 25-27.

II. FLUORIDE & OXIDATIVE STRESS (back to top)

Akdogan M, et al. (2004). Effects of fluoride on lipid peroxidation in rabbits. Fluoride 37: 185-189.

Chlubek D. (2003). Fluoride and oxidative stress. Fluoride 36: 217-228.

Ghosh D, et al. (2002). Testicular toxicity in sodium fluoride treated rats: association with oxidative stress. Reproductive Toxicolology 16(4):385.(See abstract)

Guan ZZ, et al. (2000). Changed cellular membrane lipid composition and lipid peroxidation of kidney in rats with chronic fluorosis. Archives of Toxicology 74: 602-8. (See abstract)

Guan ZZ, et al (1998). Influence of chronic fluorosis on membrane lipids in rat brain. Neurotoxicology and Teratology 20: 537-542. (See abstract)

Guan ZZ, et al. (1989). An experimental study of blood biochemical diagnostic indices for chronic fluorosis. Fluoride 22: 112-128.

Guven A, et al. (2005). Effect of fluoride intoxication on lipid peroxidation and reduced glutathione in Tuj sheep. Fluoride 38: 133-138.

Inkielewicz I, Krechniak J. (2004). Fluoride effects on glutathione peroxidase and lipid peroxidation in rats. Fluoride 37: 7-12. (See abstract)

Reddy GB, et al. (2003). Antioxidant defense system and lipid peroxidation in patients with skeletal fluorosis and in fluoride-intoxicated rabbits. Toxicological Sciences 72: 363-8. (See abstract)

Rzeuski R, Chlubek D, Machoy Z. (1998). Interactions between fluoride and biological free radical reactions. Fluoride 31: 43-45. (See paper)

Shan KR, et al. (2004). Decreased nicotinic receptors in PC12 cells and rat brains influenced by fluoride toxicity-a mechanism relating to a damage at the level in post-transcription of the receptor genes. Toxicology 200: 169-77. (See abstract)

Shanthakumari D, et al. (2004). Effect of fluoride intoxication on lipidperoxidation and antioxidant status in experimental rats. Toxicology 204: 219-28. (See abstract)

Shao Q, et al. (2000). [Influence of free radical inducer on the level of oxidative stress in brain of rats with fluorosis]. Zhonghua Yu Fang Yi Xue Za Zhi 34(6):330-2. (See abstract)

Shen X, Zhang Z, Xu X. (2004). [Influence of combined iodine and fluoride on phospholipid and fatty acid composition in brain cells of rats]. Wei Sheng Yan Jiu. 33(2):158-61.(See abstract)

Shivashankara AR, et al. (2002). Lipid peroxidation and antioxidant defense systems in liver of rats in chronic fluoride toxicity. Bulletin of Environmetnal Contamination and Toxicology 68: 612-6.

Shivarajashankara YM, et al. (2003). Lipid peroxidation and antioxidant systems in the blood of young rats subjected to chronic fluoride toxicity. Indian Journal of Experimental Biology 41: 857-60. (See abstract)

Shivarajashankara YM , et al. (2002). Brain lipid peroxidation and antioxidant systems of young rats in chronic fluoride intoxication. Fluoride 35: 197-203. (See abstract)

Shivashankara YM, et al. (2001). Oxidative stress in children with endemic skeletal fluorosis. Fluoride 34: 103-107. (See study)

Shivashankara YM, et al. (2001). Effect of fluoride intoxication on lipid peroxidation and antioxidant systems in rats. Fluoride 34: 108-113. (See study)

Susheela AK, Bhatnagar M. (2002). Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants. Molecular and Cellular Biochemistry 234-235(1-2):335-40. (See abstract | See study)

Wang AG, et al. (2004). Effects of fluoride on lipid peroxidation, DNA damage and apoptosis in human embryo hepatocytes. Biomedical and Environmental Sciences 17: 217-22. (See abstract)

Wang YN, et al. (2000). Effect of long term fluoride exposure on lipid composition in rat liver. Toxicology 146: 161-9. (See abstract)

Wang Y, et al. (1997). [Changes of coenzyme Q content in brain tissues of rats with fluorosis]. Zhonghua Yu Fang Yi Xue Za Zhi. 31: 330-3. (See abstract)

Zhan X, et al. (2005). Effects of fluorosis on lipid peroxidation and antioxidant systems in young pigs. Fluoride 38: 157-161.

III. FLUORIDE & G-PROTEINS (back to top)

Ahmadian MR, et al. (1997). Aluminum fluoride associates with the small guanine nucleotide binding proteins. FEBS Letters 408(3):315-8. (See abstract)

Bigay J, et al. (1987). Fluoride complexes of aluminium or beryllium act on G-proteins as reversibly bound analogues of the gamma phosphate of GTP. European Molecular Biology Organization Journal 6:2907-2913. (See abstract)

Bigay J, et al. (1985). Fluoroaluminates activate transducin-GDP by mimicking the gamma-phosphate of GTP in its binding site. FEBS Letters 191:181-185. (See abstract)

Chabre M. (1990). Aluminofluoride and beryllofluoride complexes: a new phosphate analogs in enzymology. Trends in Biochemical Sciences 15: 6-10. (See abstract)

Gilman AG (1987). G proteins: transducers of receptor-generated signals. Annual Review of Biochemistry 56: 615-649.

Li L. (2003). The biochemistry and physiology of metallic fluoride: action, mechanism, and implications. Critical Reviews of Oral Biology and Medicine 14(2):100-14. (See abstract)

Loweth AC, et al. (1996). Heterotrimeric G-proteins are implicated in the regulation of apoptosis in pancreatic beta-cells. Experimental Cell Research 229(1):69-76. (See abstract)

Matsuo S, et al. (1998). Mechanism of toxic action of fluoride in dental fluorosis: whether trimeric G proteins participate in the disturbance of intracellular transport of secretory ameloblast exposed to fluoride. Archives of Toxicology 72(12):798-806. (See abstract)

Sternweis PC, Gilman AG. (1982). Aluminum: a requirement for activation of the regulatory component of adenylate cyclase by fluoride. Proceedings of the National Academy of Sciences of the United States of America 79: 4888-91. (See abstract)

Strunecka A, Patocka J. (2002). Aluminofluoride complexes in the etiology of Alzheimer's disease. Structure and bonding 104: 239-280.

Strunecka A, Patocka J. (1999). Pharmacological and toxicological effects of aluminofluoride complexes. Fluoride 32: 230-242. (See paper)

Susa M. (1999). Heterotrimeric G proteins as fluoride targets in bone (review). International Journal of Molecular Medicine 3(2):115-26. (See abstract)

Wittinghofer A. (1997). Signaling mechanistics: aluminum fluoride for molecule of the year. Current Biology 7: R682-5. (See abstract)

IV. FLUORIDE & BONE (back to top)

Endemic fluorosis (back to top)

Azar HA, et al. (1961). Skeletal fluorosis due to chronic fluoride intoxication. Annals of Internal Medicine 55:193-200.

Barot VV. (1998). Occurrence of endemic fluorosis in human population of North Gujarat, India: human health risk. Bulletin of Environmental Contamination and Toxicology 61: 303-10.

Bo Z, et al. (2003). Distribution and risk assessment of fluoride in drinking water in the west plain region of Jilin province, China. Environmental Geochemistry and Health 25(4): 421-31. (See abstract)

Boyle DR, Chagnon M. (1995). An incidence of skeletal fluorosis associated with groundwaters of the maritime carboniferous basin, Gaspe region, Quebec, Canada. Environmental Geochemistry and Health 17: 5-12.

Bruns BR, Tytle T. (1988). Skeletal fluorosis: a report of two cases. Orthopedics 11: 1083-1087. (See abstract)

Cao J, et al. (2003). Brick tea fluoride as a main source of adult fluorosis. Food and Chemical Toxicology 41(4):535-42. (See abstract)

Choubisa SL, et al. (2001). Endemic fluorosis in Rajasthan. Indian Journal of Environmental Health 43:177-89. (See abstract)

Christie DP. (1980). The spectrum of radiographic bone changes in children with fluorosis. Radiology 136(1):85-90. (See abstract)

Cook HA. (1971). Fluoride studies in a patient with arthritis. The Lancet 1: 817. (See study)

Dhuna AK, et al. (1992). Skeletal fluorosis. An unusual cause of progressive radiculomyelopathy. Spine 17:842-4.

Faccini JM, Teotia SPS. (1974). Histopathological assessment of endemic skeletal fluorosis. Calcified Tissue Research 16: 45-57.

Felsenfeld AJ, Roberts MA. (1991). A report of fluorosis in the United States secondary to drinking well water. Journal of the American Medical Association 265:486-8. (See abstract)

Fisher JR, et al. (1981). Skeletal fluorosis from eating soil. Arizona Medicine 38: 833-5. (See abstract)

Fisher RL, et al. (1989). Endemic fluorosis with spinal cord compression. A case report and review. Archives of Internal Medicine 149: 697-700. (See abstract)

Gilbaugh JH, Thompson GJ. (1966). Fluoride osteosclerosis simulating carcinoma of the prostate with widespread bony metastasis: a case report. Journal of Urology 96: 944-946.

Goldman SM, et al. (1971). Radiculomyelopathy in a southwestern indian due to skeletal fluorosis. Arizona Medicine 28: 675-677.

Gupta RK, et al. (1996). Compressive myelopathy in fluorosis. Neuroradiology 38: 338-342. (See abstract)

Haimanot RT. (1990). Neurological complications of endemic skeletal fluorosis, with special emphasis on radiculo-myelopathy. Paraplegia 28:244-51. (See abstract)

Hileman B. (1988). Fluoridation of water. Questions about health risks and benefits remain after more than 40 years. Chemical and Engineering News August 1. 26-42. (See excerpt)

Johnson W, et al. (1979). Fluoridation and bone disease in renal patients. In: E Johansen, DR Taves, TO Olsen, Eds. Continuing Evaluation of the Use of Fluorides. AAAS Selected Symposium. Westview Press, Boulder, Colorado. pp. 275-293. (See extended excerpt)

Jolly SS, et al. (1973). Endemic fluorosis in Punjab: 1. skeletal aspect. Fluoride 6: 4-18.

Jolly SS. (1970). Hydric fluorosis in Punjab. In: TL Vischer, ed. (1970). Fluoride in Medicine. Hans Huber, Bern. pp. 106-121.

Jolly SS. (1968). An epidemiological, clinical and biochemical study of endemic, dental and skeletal fluorosis in Punjab. Fluoride 1(2): 65-75.

Juncos LI, Donadio JV Jr. (1972). Renal failure and fluorosis. Journal of the American Medical Association 222(7):783-5. (See abstract)

Kilborn LG, et al. (1950). Fluorosis with report of an advanced case. Canadian Medical Association Journal 62: 135-141.

Krishnamachari KA. (1986). Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease. Progress in Food and Nutrition Sciences 10(3-4):279-314. (See abstract)

Krishnamachari KA, Krishnaswamy K. (1973). Genu valgum and osteoporosis in an area of endemic fluorosis. The Lancet. 2(7834): 877-879. (See abstract)

Kumar SP, Harper RA. (1963). Fluorosis in Aden. British Journal of Radiology 36: 497-502.

Lantz O, et al. (1987). Fluoride-induced chronic renal failure. American Journal of Kidney Disorders 10:136-9. (See abstract)

Latham MC, Grech P. (1967). The effects of excessive fluoride intake. American Journal of Public Health 57: 651-660.

Leone NC, Stevenson CA, Hilbish TF, Sosman MC. (1955). A roentgenologic study of a human population exposed to high-fluoride domestic water: a ten year study. American Journal of Roentgenology, Radium Therapy and Nuclear Medicine 74: 874-885.

Lian ZC, Wu EH. (1986). Osteoporosis--an early radiographic sign of endemic fluorosis. Skeletal Radiology 15(5):350-3. (See abstract)

Linsman JF, McMurray CA. (1943). Fluoride osteosclerosis from drinking water. Radiology 40: 474-484.

Littleton J. (1999). Paleopathology of skeletal fluorosis. American Journal of Physical Anthropology 109(4):465-83. (See abstract)

Lyth O. (1946). Endemic fluorosis in Kweichow, China. The Lancet 1: 233-235.

Misra UK, et al. (1988). Endemic fluorosis presenting as cervical cord compression. Archives of Environmental Health 43:18-21. (See abstract)

Mithal A, et al. (1993). Radiological spectrum of endemic fluorosis: relationship with calcium intake. Skeletal Radiology 22(4):257-61. (See abstract)

Morris JW. (1965). Skeletal fluorosis among indians of the American Southwest. American Journal of Roentgenology, Radium Therapy & Nuclear Medicine 94: 608-615.

Muthukumar N. (2005). Ossification of the ligamentum flavum as a result of fluorosis causing myelopathy: report of two cases. Neurosurgery 56: 622. (See abstract)

Pandit CG, et al. (1940). Endemic fluorosis in South India. Indian Journal of Medical Research 28: 533-558.

Pinet A, Pinet F. (1968). Endemic fluorosis in the Sahara. Fluoride 1(2): 85-93.

Sauerbrunn BJ, et al. (1965). Chronic fluoride intoxication with fluorotic radiculomyelopathy. Annals of Internal Medicine 63: 1074-1078.

Savas S, et al. (2001). Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis. Rheumatology International 21(1):30-5. (See abstract )

Shortt HE, et al. (1937). Endemic fluorosis in the Madras presidency. Indian Journal of Medical Research 25: 553-568.

Siddiqui AH. (1970). Neurological complications of skeletal fluorosis with special reference to lesions in the cervical region. Fluoride 3: 91-96.

Siddiqui AH. (1955). Fluorosis in Nalgonda district, Hyderabad-Deccan. British Medical Journal ii (Dec 10): 1408-1413.

Singh A, Jolly SS. (1970). Chronic toxic effects on the skeletal system. In: Fluorides and Human Health. World Health Organization.

Singh A, et al. (1963). Endemic fluorosis. Epidemiological, clinical and biochemical study of chronic fluoride intoxication in Punjab. Medicine. 42: 229-246.

Singh A, et al. (1961). Skeletal fluorosis and its neurological complications. Lancet 1: 197-200.

Soriano, M. (1968). Periostitis deformans due to wine fluorosis. Fluoride 1: 56-64.

Stevenson CA, Watson R. (1957). Fluoride osteosclerosis. American Journal of Roentgenology, Radium Therapy and Nuclear Medicine 78: 13-18.

Susheela AK, Bhatnagar M. (2002). Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants. Molecular and Cellular Biochemistry 234-235(1-2):335-40. (See abstract)

Susheela AK, et al. (1993). Prevalence of endemic fluorosis with gastro-intestinal manifestations in people living in some North-Indian villages. Fluoride 26(2): 97-104. (See abstract)

Teotia M, Teotia SP, Singh KP. (1998). Endemic chronic fluoride toxicity and dietary calcium deficiency interaction syndromes of metabolic bone disease and deformities in India: year 2000. Indian Journal of Pediatrics 65:371-81. (See abstract)

Teotia SPS, et al. (1976). Symposium on the non-skeletal phase of chronic fluorosis: the joints. Fluoride 9(1): 19-24. (See paper)

Teotia M, Teotia SPS. (1973). Further observations on endemic fluoride-induced osteopathies in children. Fluoride 6: 143-151.

UNICEF Water, Environment & Sanitation. (1999). Fluoride in water: An overview. Waterfront December. (See report)

Xu RQ, et al. (1997). Relations between environment and endemic fluorosis in Hohot region, Inner Mongolia. Fluoride 30: 26-28

Waldbott GL. (1956). Incipient fluorine intoxication from drinking water. Acta Medica Scandinavica 156: 157-168. (See summary)

Wang W, et al. (2004). Ossification of the transverse atlantal ligament associated with fluorosis: a report of two cases and review of the literature. Spine 29 :E75-8. (See abstract)

Wang Y, et al. (1994). Endemic fluorosis of the skeleton: radiographic features in 127 patients. American Journal of Roentgenology 162(1):93-8. (See abstract).

Webb-Peploe MM, Bradley WG. (1966). Endemic fluorosis with neurological complications in a Hampshire man. Journal of Neurology, Neurosurgery and Psychiatry 29:577-583.

Whyte MP, et al. (2005). Skeletal fluorosis and instant tea. American Journal of Medicine 118:78-82. (See press release)

Yang L, et al. (2003). Developing environmental health indicators as policy tools for endemic fluorosis management in the People's Republic of China. Environmental Geochemistry and Health 25(3):281-95. (See abstract)

Zhavoronkov AA. (1977). [Non-skeletal forms of fluorosis]. Arkh Patol. 39(3):83-91. (See abstract)

See also:

Fluoride Action Network. (2004). Fluorosis in India: Recent Reports. http://www.fluoridealert.org/fluorosis-india.htm

Occupational Fluorosis (back to top)

Boillat MA, et al. (1980). Radiological criteria of industrial fluorosis. Skeletal Radiology 5: 161-165.

Carnow BW, Conibear SA. (1981). Industrial fluorosis. Fluoride 14(4): 172-181. (See study)

Czerwinski E, et al. (1988). Bone and joint pathology in fluoride-exposed workers. Archives of Environmental Health 43(5):340-3. (See abstract)

Czerwinski E, Lankosz W. (1978). Skeletal changes in industrial and endemic fluorosis. Fluoride 11(1):29-32. (See study).

Czerwinski E, Lankosz W. (1977). Fluoride-induced changes in 60 retired aluminum workers. Fluoride 10(3): 125-136. (See study)

Derryberry OM, et al. (1963). Fluoride exposure and worker health. Archives of Environmental Health 6: 503-514.

Franke J, et al. (1975). Industrial fluorosis. Fluoride 8(2): 61-83.

Grandjean P. (1982). Occupational fluorosis through 50 years: clinical and epidemiological experiences. American Journal of Industrial Medicine 3(2):227-36. (See abstract)

Hodge HC, Smith FA. (1979). Occupational fluoride exposure. Journal of Occupational Medicine 19: 12-39.

Kaltreider NL, et al. (1972). Health survey of aluminum workers with special reference to fluoride exposure. Journal of Occupational Medicine 14(7): 531-541.

Moller PF, Gudjonsson SV. (1932). Massive fluorosis of bones and ligaments. Acta Radiology 13:269-294.

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.

Runge H, Franke J. (1989). Radiological modifications of the skeletal system among aluminum smelter workers: A 15 year retrospective study. Fluoride 22: 157-164. (See study)

Tartatovskaya LY, et al. (1995). Clinico-hygiene assessment of the combined effect on the body of vibration and fluorine. Noise and Vibration Bulletin 263-264.

Waldbott GL, Cecilioni VA. (1969). Neighborhood fluorosis. Fluoride 2: 206-213. (See study)

Zhiliang Y, et al. (1987). Industrial fluoride pollution in the metallurgical industry in China. Fluoride 20(3): 118-125. (See study)

Livestock Fluorosis (back to top)

Griffith-Jones W. (1977). Fluorosis in dairy cattle. The Veterinary Record 100: 84-89. (See abstract)

Huffman WT. (1949). Effects on livestock of air contamination caused by fluoride fumes. pp. 59-63. In: Air Pollution. Proceedings of the United States Technical Conference on Air Pollution. McGraw-Hill Book Co, New York.

Krook L, Maylin GA. (1979). Industrial fluoride pollution. Chronic fluoride poisoning in Cornwall Island cattle. Cornell Veterinarian 69(Suppl 8): 1-70. (See abstract)

Lillie RJ. (1970). Air Pollutants Affecting the Performance of Domestic Animals: A Literature Review. U.S. Dept. of Agriculture. Agricultural Handbook No. 380. Washington D.C.

National Academy of Sciences. (1960). The fluorosis problem in livestock production. Committee on Animal Nutrition, Agricultural Board. Washington DC.

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.

Schmidt HJ, Rand WE. (1952). A critical study of the literature on fluoride toxicology with respect to cattle damage. American Journal of Veterinary Research 13: 39-48.

Shupe JL, Olson AE. (1971). Clinical aspects of fluorosis in horses. Journal of the American Veterinary Association 158: 167-174. (See study)

Shupe JL, et al. (1963). The effect of fluorine on dairy cattle II. Clinical and pathologic effects. American Journal of Veterinary Research 24: 964-979.

Suttie JW. (1977). Effects of fluoride on livestock. Journal of Occupational Medicine 19: 40-48.

Fluoride & Bone Strength: Animal Studies (back to top)

Bohatyrewicz A. (1999). Effects of fluoride on mechanical properties of femoral bone in growing rats. Fluoride 32: 47-54. (See abstract)

Burnell TW, et al. (1986). Effect of dietary fluorine on growth, blood and bone characteristics of growing-finishing pigs. Journal of Animal Science 63: 2053-67. (See abstract)

Carter DR, Beaupre GS. (1990). Effects of fluoride treatment on bone strength. Journal of Bone and Mineral Research 5 Suppl 1:S177-84. (See abstract)

Gedalia I, et al. (1964). Effects of estrogen on bone composition in rats at low and high fluoride intake. Endocrinology 75: 201-205. (See abstract)

Giavaresi G, et al. (1999). The mechanical properties of fluoride-treated bone in the ovariectomized rat. Calcified Tissue International 65: 237-41. (See abstract)

Lafage MH, et al. (1995). Comparison of alendronate and sodium fluoride effects on cancellous and cortical bone in minipigs. A one-year study. Journal of Clinical Investigation 95: 2127-33. (See abstract)

Mosekilde L, et al. (1987). Compressive strength, ash weight, and volume of vertebral trabecular bone in experimental fluorosis in pigs. Calcified Tissue International 40: 318-22. (See abstract)

Riggins RS, et al. (1976). The effect of fluoride supplementation on the strength of osteopenic bone. Clinical Orthopaedics (114):352-7. (See abstract)

Riggins RS, et al. (1974). The Effects of Sodium Fluoride on Bone Breaking Strength. Calcified Tissue Research 14: 283-289. (See abstract)

Silva MJ, Ulrich SR. (2000). In vitro sodium fluoride exposure decreases torsional and bending strength and increases ductility of mouse femora. Journal of Biomechanics 33(2):231-4. (See abstract)

Sogaard CH, et al. (1995). Effects of fluoride on rat vertebral body biomechanical competence and bone mass. Bone 16(1): 163-9. (See abstract)

Turner CH, et al. (2001). Combined effects of diets with reduced calcium and phosphate and increased fluoride intake on vertebral bone strength and histology in rats. Calcified Tissue International 69(1):51-7. (See abstract)

Turner CH, et al. (1997). Fluoride treatment increased serum IGF-1, bone turnover, and bone mass, but not bone strength, in rabbits. Calcified Tissue International 61(1):77-83. (See abstract)

Turner CH, et al. (1996). High fluoride intakes cause osteomalacia and diminished bone strength in rats with renal deficiency. Bone 19(6):595-601.(See abstract)

Turner CH, et al. (1996). Reductions in bone strength after fluoride treatment are not reflected in tissue-level acoustic measurements. Bone 19(6):603-7. (See abstract)

Turner CH, et al. (1995). Fluoride reduces bone strength in older rats. Journal of Dental Research 74(8):1475-81. (See abstract)

Turner CH, Dunipace AJ. (1993). On fluoride and bone strength (letter). Calcified Tissue International 53: 289-290.

Turner CH, et al. (1992). The effects of fluoridated water on bone strength. Journal of Orthopaedic Research 10(4):581-7. (See abstract)

Walsh WR, Guzelsu N. (1993). The role of ions and mineral-organic interfacial bonding on the compressive properties of cortical bone. Bio-Medical Materials and Engineering 3: 75-84. (See abstract)

Wolinsky I, et al. (1972). Effects of fluoride on metabolism and mechanical properties of rat bone. American Journal of Physiology 223(1): 46-50. (See abstract)

Fluoride & Bone Fracture: Human Clinical Trials (back to top)

Bayley TA, et al. (1990). Fluoride-induced fractures: relation to osteogenic effect. Journal of Bone and Mineral Research 5(Suppl 1):S217-22. (See abstract)

Dambacher MA, et al. (1986). Long-term fluoride therapy of postmenopausal osteoporosis. Bone 7: 199-205. (See abstract

Gerster JC, et al. (1983). Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed) 287(6394):723-5. (See abstract)

Gutteridge DH, et al. (2002). A randomized trial of sodium fluoride (60 mg) +/- estrogen in postmenopausal osteoporotic vertebral fractures: increased vertebral fractures and peripheral bone loss with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral fractures. Osteoporosis International 13(2):158-70. (See abstract)

Gutteridge DH, et al. (1990). Spontaneous hip fractures in fluoride-treated patients: potential causative factors. Journal of Bone and Mineral Research 5 Suppl 1:S205-15. (See abstract)

Haguenauer D, et al. (2000). Fluoride for the treatment of postmenopausal osteoporotic fractures: a meta-analysis. Osteoporosis International 11(9):727-38. (See abstract)

Hedlund LR, Gallagher JC. (1989). Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride. Journal of Bone and Mineral Research 4:223-5. (See abstract)

Inkovaara J, et al. (1975). Prophylactic fluoride treatment and aged bones. British Medical Journal 3(5975):73-4. (See abstract)

Kleerekoper M, et al. (1991). A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. Osteoporosis International 1(3):155-61. (See abstract)

Meunier PJ, et al. (1998). Fluoride salts are no better at preventing new vertebral fractures than calcium-vitamin D in postmenopausal osteoporosis: the FAVOStudy. Osteoporosis International 8: 4-12. (See abstract)

National Research Council. (2006). Musculoskeletal Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

O'Duffy JD, et al. (1986). Mechanism of acute lower extremity pain syndrome in fluoride-treated osteoporotic patients. American Journal of Medicine 80: 561-6. (See abstract)

Orcel P, et al. (1990). Stress fractures of the lower limbs in osteoporotic patients treated with fluoride. Journal of Bone and Mineral Research 5(Suppl 1): S191-4. (See abstract)

Orcel P, et al. (1987). [Spontaneous fissures and fractures of the legs in patients with osteoporosis treated with sodium fluoride]. Presse Med. 16: 571-5. (See abstract)

Pak CY, et al. (1996). Comparison of nonrandomized trials with slow-release sodium fluoride with a randomized placebo-controlled trial in postmenopausal osteoporosis. Journal of Bone and Mineral Research 11(2):160-8. (See abstract)

Pak CY, et al. (1995). Treatment of postmenopausal osteoporosis with slow-release sodium fluoride. Final report of a randomized controlled trial. Annals of Internal Medicine 123: 401-8. (See abstract)

Riggs BL, et al. (1990). Effect of Fluoride treatment on the Fracture Rates in Postmenopausal Women with Osteoporosis. New England Journal of Medicine 322:802-809. (See abstract)

Rubin CD, et al. (2001). Sustained-release sodium fluoride in the treatment of the elderly with established osteoporosis. Archives of Internal Medicine 161(19):2325-33. (See abstract)

Schnitzler CM, et al. (1990). Bone fragility of the peripheral skeleton during fluoride therapy for osteoporosis. Clinical Orthopaedics (261):268-75. (See abstract)

Schnitzler CM, Solomon L. (1985). Trabecular stress fractures during fluoride therapy for osteoporosis. Skeletal Radioliology 14(4):276-9. (See abstract)

Fluoride & Bone Fracture: Epidemiological Studies (back to top)

Studies reporting association between fluoridated water (< 1.2 ppm fluoride) & hip fracture. (back to top)

a) Cooper C, et al. (1990). Water fluoride concentration and fracture of the proximal femur. Journal of Epidemiology and Community Health 44: 17-19.

b) Cooper C, et al. (1991). Water fluoridation and hip fracture. Letter. Journal of the American Medical Association 266: 513-514. (A reanalysis of data presented in 1990 paper). (See letter)

Danielson C, et al. (1992). Hip fractures and fluoridation in Utah's elderly population. Journal of the American Medical Association 268(6): 746-748. (See abstract)

Hegmann KT, et al. (2000). The effects of fluoridation on degenerative joint disease (DJD) and hip Fractures. Abstract # 71 of the 33rd annual meeting of the Society for Epidemiological Research. American Journal of Epidemiology S18. (See abstract).

Jacobsen SJ, et al. (1992). The association between water fluoridation and hip fracture among white women and men aged 65 years and older; a national ecologic study. Annals of Epidemiology 2: 617-626. (See abstract)

Jacobsen SJ, et al. (1990). Regional variation in the incidence of hip fracture: US white women aged 65 years and olders. Journal of the American Medical Association 264(4): 500-2. (See excerpt)

a) Jacqmin-Gadda H, et al. (1995). Fluorine concentration in drinking water and fractures in the elderly. Journal of the American Medical Association 273: 775-776 (letter). (See letter)

b) Jacqmin-Gadda H, et al. (1998). Risk factors for fractures in the elderly. Epidemiology 9(4): 417-423. (An elaboration of the 1995 study referred to in the JAMA letter). (See abstract)

Keller C. (1991) Fluorides in drinking water. Unpublished results. Discussed in: Gordon SL, Corbin SB. (1992). Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health. Osteoporosis International 2: 109-117. (See excerpt)

Kurttio PN, et al. (1999). Exposure to natural fluoride in well water and hip fracture: A cohort analysis in Finland. American Journal of Epidemiology 150(8): 817-824. (See abstract)

May DS, Wilson MG. (1992). Hip fractures in relation to water fluoridation: an ecologic analysis. Unpublished results. Discussed in: Gordon SL, Corbin SB. (1992). Summary of Workshop on Drinking Water Fluoride Influence on Hip Fracture on Bone Health. Osteoporosis International 2: 109-117. (See excerpt)

Suarez-Almazor M, et al. (1993). The fluoridation of drinking water and hip fracture hospitalization rates in two Canadian communities. American Journal of Public Health 83: 689-693. (See abstract)

The authors of this study conclude there is no association between fluoridation and hip fracture. However, their own data reveals a significant increase in hip fracture for men living in the fluoridated area. According to the study, "although a statistically significant increase in the risk of hip fracture was observed among Edmonton men, this increase was relatively small (RR=1.12)."

b) Studies investigating association between water-fluoride levels higher than fluoridated water (2 to 5 ppm) & bone/hip fracture. (back to top)

Alarcon-Herrera MT, et al. (2001). Well Water Fluoride, Dental fluorosis, Bone Fractures in the Guadiana Valley of Mexico. Fluoride 34(2): 139-149. (See study)

Li Y, et al. (2001). Effect of long-term exposure to fluoride in drinking water on risks of bone fractures. Journal of Bone and Mineral Research 16(5):932-9. (See abstract)

Sowers MR, et al. (1986). The relationship of bone mass and fracture history to fluoride and calcium intake: a study of three communities. American Journal of Clinical Nutrition 44:889-98. (See abstract)

Sowers M, et al. (1991). A prospective study of bone mineral content and fracture in communities with differential fluoride exposure. American Journal of Epidemiology 133: 649-660. (See abstract)

Sowers M, et al.(2005) Elevated serum fluoride concentrations in women are not related to fractures and bone mineral density. Journal of Nutrition 135:2247-52. (See abstract)

c) Studies reporting no association, or a negative association, between fluoridated water & hip fracture. (back to top)

(Note that in 3 of these 9 studies, an association was found between fluoride and some form of fracture - i.e. distal forearm. See notes and quotes below.)

Arnala I, et al. (1986). Hip fracture incidence not affected by fluoridation. Osteofluorosis studied in Finland. Acta Orthopaedica Scandinavica 57: 344-348. (See abstract)

Cauley J. et al. (1995). Effects of fluoridated drinking water on bone mass and fractures: the study of osteoporotic fractures. Journal of Bone and Mineral Research 10(7): 1076-86. (See abstract)

Feskanich D, et al. (1998). Use of toenail fluoride levels as an indicator for the risk of hip and forearm fractures in women. Epidemiology 9(4): 412-6. (See abstract)

While this study didn't find an association between water fluoride and hip fracture, it did find an association - albeit non-significant 1.6 (0.8-3.1) - between fluoride exposure and elevated rates of forearm fracture.

Hillier S, et al. (2000). Fluoride in drinking water and risk of hip fracture in the UK: a case control study. The Lancet 335: 265-2690. (See abstract)

Jacobsen SJ, et al. (1993). Hip fracture incidence before and after the fluoridation of the public water supply, Rochester, Minnesota. American Journal of Public Health 83: 743-745. (See abstract)

Karagas MR, et al. (1996). Patterns of fracture among the United States elderly: Geographic and fluoride effects. Annals of Epidemiology 6 (3): 209-216. (See abstract | See critique of study)

As with Feskanich (1998) this study didn't find an association between fluoridation & hip fracture, but it did find an association between fluoridation and distal forearm fracture, as well as proximal humerus fracture. "Independent of geographic effects, men in fluoridated areas had modestly higher rates of fractures of the distal forearm and proximal humerus than did men in nonfluoridated areas."

Lehmann R, et al. (1998). Drinking water fluoridation: Bone mineral density and hip fracture incidence. Bone 22: 273-278. (See abstract)

Madans J, et al. (1983). The relationship between hip fracture and water fluoridation: an analysis of national data. American Journal of Public Health 73: 296-298. (See abstract)

Phipps KR, et al. (2000). Community water fluoridation, bone mineral density and fractures: prospective study of effects in older women. British Medical Journal 321: 860-4. (See abstract | See Study | See BMJ letter responding to study| See critique of study )

This study reported a decreased incidence of hip fracture in fluoridated areas. However, as with Feskanich (1998) and Karagas (1996), the study also found an association between fluoridation and other types of fracture - in this case, wrist fracture. "There was a non-significant trend toward an increased risk of wrist fracture."

See also:

Bernstein DS, et al. (1966). Prevalence of osteoporosis in high- and low-fluoride areas in North Dakota. Journal of the American Medical Association 198: 499-504. (See abstract & critique)

Lee JR. (1993). Fluoridation & hip fracture. Fluoride 26(4): 274-277. (See paper)

National Research Council. (2006). Musculoskeletal Effects. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Fluoride & Bone Quality: Animal Studies (back to top)

Belanger LF, et al. (1958). Rachitomimetic effects of fluoride feeding on the skeletal tissues of growing pigs. American Journal of Pathology 34: 25-36.

Burkhart JM, Jowsey J. (1968). Effect of variations in calcium intake on the skeleton of fluoride-fed kittens. Journal of Laboratory and Clinical Medicine 72: 943-50.

Chachra D, et al. (1999). The effect of fluoride treatment on bone mineral in rabbits. Calcified Tissue International 64: 345-51. (See abstract)

Comar CL, et al. (1953). Effects of fluorine on calcium metabolism and bone growth in pigs. American Journal of Anatomy 92: 361-362.

Kragstrup J, et al. (1984). Experimental osteo-fluorosis in the domestic pig: a histomorphometric study of vertebral trabecular bone. Journal of Dental Research 63: 885-889.

Fratzl P, et al. (1996). Effects of sodium fluoride and alendronate on the bone mineral in minipigs: a small-angle X-ray scattering and backscattered electron imaging study. Journal of Bone and Mineral Research 11(2):248-53. (See abstract)

Golub L, et al. (1968). The effect of sodium fluoride on the rates of synthesis and degradation of bone collagen in tissue culture. Proceedings of the Society for Experimental Biology and Medicine 129: 973-977.

Guggenheim K, et al. (1976). The effect of fluoride on bone of rats fed diets deficient in calcium or phosphorus. Calcified Tissue Research 22: 9-17.

Henrikson PA, et al. (1970). Fluoride and nutritional osteoporosis. Fluoride 3: 204-207.

Ittel TH, et al. (1992). Effect of fluoride on aluminum-induced bone disease in rats with renal failure. Kidney International 41: 1340-1348. (See abstract)

Jiang Y, et al. (1996). Effects of low-dose long-term sodium fluoride preventive treatment on rat bone mass and biomechanical properties. Calcified Tissue International 58: 30-9. (See abstract)

Kierdorf U, et al. (1997). Fluoride content and mineralization of red deer (Cervus elaphus) antlers and pedicles from fluoride polluted and uncontaminated regions. Archives of Environmental Contamination and Toxicology 32: 222-227. (See abstract)

Mosekilde L, et al. (1987). Compressive strength, ash weight, and volume of vertebral trabecular bone in experimental fluorosis in pigs. Calcified Tissue International 40: 318-22. (See abstract)

Ream JL, et al. (1983). Fluoride ingestion during multiple pregnancies and lactations: microscopic observations on bone of the rat. Virchows Archiv B 44: 35-44. (See abstract)

Ream LJ. (1981). The effects of short-term fluoride ingestion on bone formation and resorption in the rat femur. Cell and Tissue Research 221: 421-430. (See abstract)

Robin JC, et al. (1980). Studies on osteoporosis III. Effect of estrogens and fluoride. Journal of Medicine 11: 1-14. (See abstract)

Rockert H. (1963). X-ray absorption and x-ray fluorescence micro-analysis of mineralized tissue of rats which have ingested fluoridated water. Acta Pathologica et Microbiologica Scandinavica 59: 32-38.

Sharma YD. (1982). Effect on sodium fluoride on collagen cross-link precursors. Toxicology Letters 10: 97-100. (See abstract)

Snow GR, Anderson C. (1986). Short-term chronic fluoride administration and trabecular bone remodeling in beagles: a pilot study. Calcified Tissue International 38(4):217-21. (See abstract)

Susheela AK, Jha M. (1983). Cellular and histological characteristics of osteoid formed in experimental fluoride poisoning. Toxicology Letters 16: 35-40.

Turner CH, et al. (1996). Reductions in bone strength after fluoride treatment are not reflected in tissue-level acoustic measurements. Bone 19(6):603-7. (See abstract)

Turner RT, et al. (1989). The effects of fluoride on bone and implant histomorphometry in growing rats. Journal of Bone and Mineral Research 4(4):477-84. (See abstract)

Uslu B. (1983). Effect of fluoride on collagen synthesis in the rat. Research and Experimental Medicine 182(1):7-12. (See abstract)

Walsh WR, Guzelsu N. (1993). The role of ions and mineral-organic interfacial bonding on the compressive properties of cortical bone. Bio-Medical Materials and Engineering 3: 75-84. (See abstract)

Walsh WR, Guzelsu N. (1991). Fluoride ion effect on interfacial bonding and mechanical properties of bone. Journal of Biomechanics 24: 237.

Zhang X, Qiu MC, Liu WB. (1994). [Effects of pollution with fluoride on bone dynamics of periosteum in iliac of domestic pigs]. Zhonghua Yu Fang Yi Xue Za Zhi 28(6):360-2. (See abstract)

See also:

Krook L, Minor RR. (1998). Fluoride and alkaline phosphatase. Fluoride 31: 177-82.

Fluoride & Bone Quality: Human Clinical Trials (back to top)

Balena R, et al. (1998). Effects of different regimens of sodium fluoride treatment for osteoporosis on the structure, remodeling and mineralization of bone. Osteoporosis International 8(5):428-35. (See abstract)

Baylink DJ, Bernstein DS. (1967). The effects of fluoride therapy on metabolic bone disease. Clinical Orthopaedics and Related Research 55: 51-85.

Boivin G, et al. (1993). Relationship between bone fluoride content and histological evidence of calcification defects in osteoporotic women treated long term with sodium fluoride. Osteoporosis International 3(4):204-8. (See abstract)

Cass RM, et al. (1966). New bone formation in osteoporosis following treatment with sodium fluoride. Archives of Internal Medicine 118: 111-116.

Compston JE, et al. (1980). Osteomalacia developing during treatment of osteoporosis with sodium fluoride and vitamin D. British Medical Journal 281: 910-1.

Fratzl P, et al. (1994). Abnormal bone mineralization after fluoride treatment in osteoporosis: a small-angle x-ray-scattering study. Journal of Bone and Mineral Research 9(10):1541-9. (See abstract)

Inkovaara JA. (1991). Is fluoride treatment justified today? Calcified Tissue International 49 Suppl:S68-9. (See abstract)

Jowsey J, et al. (1972). Effect of combined therapy with sodium fluoride, vitamin D and calcium in osteoporosis. American Journal of Medicine 53(1):43-9.

Jowsey J, et al. (1968). Some results of the effect of fluoride on bone tissue in osteoporosis. Journal of Clinical Endocrinology 28: 869-874.

Kragstrup J, et al. (1989). Effects of sodium fluoride, vitamin D, and calcium on cortical bone remodeling in osteoporotic patients. Calcified Tissue International 45: 337-41. (See abstract)

Lindsay R. (1990). Fluoride and Bone - Quantity Versus Quality. Editorial. New England Journal of Medicine 322: 845-846. (See editorial)

Lundy MW, et al. (1995). Histomorphometric analysis of iliac crest bone biopsies in placebo-treated versus fluoride-treated subjects. Osteoporosis International 5: 115-29. (See abstract)

Patel S, et al. (1996). Fluoride pharmacokinetics and changes in lumbar spine and hip bone mineral density. Bone 19(6):651-5. (See abstract)

Riggs BL. (1983). Treatment of osteoporosis with sodium fluoride: An appraisal. Bone and Mineral Research 2: 366-393.

Schnitzler CM, et al. (1990). Iliac bone biopsies at the time of periarticular stress fractures during fluoride therapy: comparison with pretreatment biopsies. Journal of Bone and Mineral Research 5(2):141-52. (See abstract)

Sogaard CH, et al. (1994). Marked decrease in trabecular bone quality after five years of sodium fluoride therapy--assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients. Bone 15(4): 393-99. (See abstract)

Vigorita VJ, Suda MK. (1983). The microscopic morphology of fluoride-induced bone. Clinical Orthopaedics 177:274-82. (See abstract)

Zerwekh JE, et al. (1994). Effect of slow-release sodium fluoride on cancellous bone histology and connectivity in osteoporosis. Bone 15: 691-9. (See abstract)

See also:

Krook L, Minor RR. (1998). Fluoride and alkaline phosphatase. Fluoride 31: 177-82.

Fluoride Concentrations in Human Bone (back to top)

Alhava EM, et al. (1980). The Effect of Drinking Water Fluoridation on the Fluoride Content, Strength and Mineral Density of Human Bone. Acta Orthopaedica Scandinavica 51: 413-420.

Bohatyrewicz A. (2001). Bone fluoride in proximal femur fractures. Fluoride 34: 227-235.

Arnala I, et al. (1985). Effects of fluoride on bone in Finland. Histomorphometry of cadaver bone from low and high fluoride areas. Acta Orthopaedica Scandinavica 56(2):161-6.

Boivin G, et al. (1988). Fluoride content in human iliac bone: results in controls, patients with fluorosis, and osteoporotic patients treated with fluoride. Journal of Bone and Mineral Research 3(5):497-502.

Call RA, et al. (1965). Histological and chemical studies in man on effects of fluoride. Public Health Reports 80: 529-538.

Charen J, et al. (1979). Bone fluoride concentrations associated with fluoridated drinking water. Calcified Tissue International 27(2):95-9.

Cohen-Solal ME, et al. (2002). Fluoride and strontium accumulation in bone does not correlate with osteoid tissue in dialysis patients. Nephrology Dialysis Transplantation 17: 449–454.

Eble DM, et al. (1992). Fluoride concentrations in human and rat bone. Journal of Public Health Dentistry 52: 288-291.

Glock GE, et al. (1941). The retention and elimination of fluoride in bones. Biochemical Journal 35: 1235-1239.

Hefti A, Marthaler TM. (1981). Bone fluoride concentrations after 16 years of drinking water fluoridation. Caries Research 15(1):85-9.

Jackson D, Weidman SM. (1958). Fluorine in human bone related to age and the water supply of different regions. Journal of Pathological Bacteriology 76: 451-459.

Kuo HC, Stamm JW. (1974). Fluoride levels in human rib bone: a preliminary study. Canadian Journal of Public Health 65(5):359-61.

National Research Council. (2006). Pharmacokinetics of Fluoride. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Ng AHM, et al. (2004). Association between fluoride, magnesium, aluminum and bone quality in renal osteodystrophy. Bone 34: 216-224.

Parkins FM, et al. (1974). Relationships of human plasma fluoride and bone fluoride to age. Calcified Tissue Research 16: 335-338.

Richards A, et al. (1994). Normal age-related changes in fluoride content of vertebral trabecular bone - Relation to bone quality. Bone 15: 21-26.

Smith FA, et al. (1953). Age increase and fluoride content in human bone. (abstract). Federation Proceedings 12: 368.

Stein ID, Granik G. (1980). Human vertebral bone: Relation of strength, porosity, and mineralization to fluoride content. Calcified Tissue International 32: 189-194.

Sogaard CH, et al. (1994). Marked decrease in trabecular bone quality after five years of sodium fluoride therapy--assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients. Bone 15(4): 393-99.

Wix P, Mohamedally SM. (1980). The significance of age-dependent fluoride accumulation in bone in relation to daily intake of fluoride. Fluoride 13: 100-104.

Zipkin L, et al. (1958). Fluoride deposition in human bones after prolonged ingestion of fluoride in drinking water. US Public Health Reports 73:732-740.

Factors which Increase Accumulation of Fluoride in Bone: Kidney Disease (back to top)

Adams PH, Jowsey J. (1965). Sodium Fluoride in the Treatment of Osteoporosis and Other Bone Diseases. Annals of Internal Medicine 63(6): 1151-1155. (See excerpt)

Arnala I, et al. (1985). Effects of fluoride on bone in Finland. Histomorphometry of cadaver bone from low and high fluoride areas. Acta Orthopaedica Scandinavica 56(2):161-6.

Call RA, et al. (1965). Histological and chemical studies in man on effects of fluoride. Public Health Reports 80: 529-538.

Gerster JC, et al. (1983). Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed) 287(6394):723-5. (See abstract)

Hefti A, Marthaler TM. (1981). Bone fluoride concentrations after 16 years of drinking water fluoridation. Caries Research 15(1):85-9.

Johnson W, et al. (1979). Fluoridation and bone disease in renal patients. In: E Johansen, DR Taves, TO Olsen, Eds. Continuing Evaluation of the Use of Fluorides. AAAS Selected Symposium. Westview Press, Boulder, Colorado. pp. 275-293. (See extended excerpt)

Juncos LI, Donadio JV Jr. (1972). Renal failure and fluorosis. Journal of the American Medical Association 222(7):783-5. (See abstract)

Kono K, et al. (1984). Urinary fluoride excretion in fluoride exposed workers with diminished renal function. Industrial Health 22(1):33-40. (See abstract)

Linsman JF, McMurray CA. (1943). Fluoride osteosclerosis from drinking water. Radiology 40: 474- 484.

Ng AHM, et al. (2004). Association between fluoride, magnesium, aluminum and bone quality in renal osteodystrophy. Bone 34: 216-224. (See abstract)

Noel C, et al. (1985). [Risk of bone disease as a result of fluoride intake in chronic renal insufficiency]. (Article in French). Nephrologie 1985;6(4):181-5. (See abstract)

Spak CJ, et al. (1985). Renal clearance of fluoride in children and adolescents. Pediatrics 75(3):575-9. (See abstract)

Turner CH, et al. (1996). High fluoride intakes cause osteomalacia and diminished bone strength in rats with renal deficiency. Bone 19(6):595-601.(See abstract)

Welsch M, et al. (1990). [Iatrogenic fluorosis. 2 cases]. Therapie 45(5):419-22. (See abstract)

Factors which Increase Accumulation of Fluoride in Bone: Nutritional Deficiencies (back to top)

Beary DF. (1969). The effects of fluoride and low calcium on the physical properties of the rat femur. The Anatomical Record 164: 305-316.

Jowsey J, et al. (1972). Effect of combined therapy with sodium fluoride, vitamin D and calcium in osteoporosis. American Journal of Medicine 53(1):43-9.

Li G, Ren L. (1997). [Effects of excess fluoride on bone turnover under conditions of diet with different calcium contents] [Article in Chinese] Zhonghua Bing Li Xue Za Zhi 26(5):277-80. (See abstract)

Likimani S, et al. (1992). The effects of protein deficiency and fluoride on bone mineral content of rat tibia. Calcified Tissue International 50(2):157-64. (See abstract)

Marier JR, et al. (1963). Accumulation of skeletal fluoride and its implications. Archives of Environmental Health 6: 664-671.

Riggins RS, et al. (1976). The effect of fluoride supplementation on the strength of osteopenic bone. Clinical Orthopaedics (114):352-7.

Riggins RS, et al. (1974). The effects of sodium fluoride on bone breaking strength. Calcified Tissue Research 14: 283-289.

Teotia M, Teotia SP, Singh KP. (1998). Endemic chronic fluoride toxicity and dietary calcium deficiency interaction syndromes of metabolic bone disease and deformities in India: year 2000. Indian Journal of Pediatrics 65(3):371-81. (See abstract)

V. FLUORIDE & CANCER (back to top)

US National Toxicology Program's Bioassay (back to top)

Bucher JR, et al. (1991). Results and conclusions of the National Toxicology Program's rodent carcinogenicity studies with sodium fluoride. International Journal of Cancer 48(5):733-7. (See abstract)

National Toxicology Program [NTP] (1990). Toxicology and Carcinogenesis Studies of Sodium Fluoride in F344/N Rats and B6C3f1 Mice. Technical report Series No. 393. NIH Publ. No 91-2848. National Institute of Environmental Health Sciences, Research Triangle Park, N.C. (See executive summary | See study | See news articles)

For commentary on NTP Study, see:

Calabrese E. (1991). Evaluation of the National Toxicology Program (NTP) Cancer Bioassay on Sodium Fluoride. Commissioned by the East Bay Municipal Utility District. Oakland, California. (See paper)

Connett P. (2000). Fluoride: A Statement of Concern. Waste Not #459. Canton NY. (See excerpt)

Hirzy JW. (2000). Video-taped interview with Dr. J. William Hirzy, Senior Vice President, EPA Headquarters Union. July 3. (Read interview)

Lee JR. (1993). Fluoridation and Bone Cancer. Fluoride 26(2):79-82. (See paper).

Liteplo RG, et al. (1994). Inorganic fluoride: Evaluation of risks to health from environmental exposure in Canada. Journal of Environmental Science and Health. Part C, Environmental Carcinogenesis & Ecotoxicology Reviews 12: 327-344.

Marcus W. (1990). Memorandum from Dr. William Marcus,to Alan B. Hais, Acting Director Criteria & Standards Division ODW, US EPA. May 1, 1990. (See memo)

National Research Council. (2006). Genotoxicity and Carcinogenicity. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

World Health Organization. (2002). Environmental Health Criteria 227: FLUORIDES. World Health Organization, Geneva. (See excerpt)

Proctor & Gamble's Bioassay (back to top)

Food & Drug Administration (FDA). (1990). Dose determination and carcinogenicity studies of sodium fluoride in Crl:CD-1 Mice and Crl:CD (Sprague Dawley)BR Rats. In: Department of Health & Human Services. (U.S. DHHS) (1991). Review of Fluoride: Benefits and Risks. US Public Health Service. pp. D1-D7.

Maurer JK, et al. (1993). Confounded carcinogenicity study of sodium fluoride in CD-1 mice. Regulatory Toxicology and Pharmacology 18:154-68. (See abstract)

Maurer JK, Cheng MC, Boysen BG, Anderson RL. (1990). Two-year carcinogenicity study of sodium fluoride in rats. Journal of the National Cancer Institute 82:1118-26. (See abstract)

Recent Epidemiological Studies on Fluoridation/Cancer (back to top)

Bassin EB, Wypij D, Davis RB, Mittleman MA. (2006). Age-specific Fluoride Exposure in Drinking Water and Osteosarcoma (United States). Cancer Causes and Control 17: 421-8. (See abstract)

Bassin EB. (2001). Association Between Fluoride in Drinking Water During Growth and Development and the Incidence of Ostosarcoma for Children and Adolescents. Doctoral Thesis, Harvard School of Dental Medicine. (See excerpt of study)

Cohn PD. (1992). A Brief Report On The Association Of Drinking Water Fluoridation And The Incidence of Osteosarcoma Among Young Males. New Jersey Department of Health Environ. Health Service: 1- 17. (See Executive Summary | See Study)

Douglass CW, Joshipura K. (2006). Caution needed in fluoride and osteosarcoma study. Cancer Causes and Control 17:481-2.

Freni S.C., Gaylor, D.W. (1992). International trends in the incidence of bone cancer are not related to drinking water fluoridation. Cancer 70: 611-8. (See abstract)

Gelberg K.H., Fitzgerald E.F., Hwang S., Dubrow R. (1995). Fluoride exposure and childhood osteosarcoma: a case-control study. American Journal of Public Health 85:1678-83. (See abstract)

Hoover RN, et al. (1991). Time trends for bone and joint cancers and osteosarcomas in the Surveillance, Epidemiology and End Results (SEER) Program. National Cancer Institute. In: Review of Fluoride: Benefits and Risks. US Public Health Service. pp F1 -F7. (See study)

Mahoney M.C., Nasca P.C., Burnett W.S., Meius J.M. (1991). Bone cancer incidence rates in New York State: time trends and fluoridated drinking water. American Journal of Public Health 81: 475-9. (See abstract)

Moss M.E., Kanarek M.S., Anderson H.A., Hanrahan L.P., Remington P.L. (1995). Osteosarcoma, seasonality, and environmental factors in Wisconsin, 1979-1989. Archives of Environmental Health 50:235-41. (See abstract)

Takahashi K., Akiniwa K., Narita K. (2001). Regression analysis of cancer incidence rates and water fluoride in the U.S.A. based on IACR/IARC (WHO) data (1978-1992). International Agency for Research on Cancer. Journal of Epidemiology 11:170-9. (See abstract)

Tohyama E. (1996). Relationship between fluoride concentration in drinking water and mortality rate from uterine cancer in Okinawa prefecture, Japan. Journal of Epidemiology 6(4):184-191. (See abstract)

Yang CY, et al. (2000). Fluoride in drinking water and cancer mortality in Taiwan. Environmental Research 82:189-93. (See abstract)

Yiamouyiannis JA. (1993). Fluoridation and cancer: The biology and epidemiology of bone and oral cancer related to fluoridation. Fluoride 26: 83-96.

Occupational Fluoride/Cancer (back to top)

Studies where fluoride is primary contaminant in workplace, with no PAH exposure.

Grandjean P, Olsen J. (2004). Extended follow-up of cancer incidence in fluoride-exposed workers. Journal of the National Cancer Institute 96: 802-803. (See commentary on study)

Grandjean P, et al. (1992). Cancer incidence and mortality in workers exposed to fluoride. Journal of the National Cancer Institute 84(24):1903-9. (See abstract)

Grandjean P, et al. (1985). Mortality and cancer morbidity after occupational fluoride exposure. American Journal of Epidemiology 121: 57-64. (See abstract)

Studies where fluoride is accompanied with other contaminants, particularly PAH - the presumed causative agent.

Andersen, et al. (1982). Risk of cancer in the Norwegian aluminum industry. International Journal of Cancer 29: 295-298. (See abstract)

Armstrong B, et al. (1994). Lung cancer mortality and polynuclear aromatic hydrocarbons: A case-cohort study of aluminum production workers in Arvida, Quebec, Canada. American Journal of Epidemiology 139: 250-262. (See abstract)

Gibbs GW, Horowitz I. (1979). Lung cancer mortality in aluminum reduction plant workers. Journal of Occupational Medicine 21: 347-353. (See abstract)

Milham S. (1979). Mortality in aluminum reduction plant workers. Journal of Occupational Medicine 21: 475-480. (See abstract)

Moulin JJ, et al. (2000). A mortality study among potroom workers in a French aluminum reduction plant. International Archives of Occupational and Environmental Health 73: 323-330. (See abstract)

Romundstad P, et al. (2000). Cancer incidence among workers in six Norwegian aluminum plants. Scandinavian Journal of Worker and Environmental Health 26: 461-469. (See abstract)

Ronneberg A, Andersen A. (1995). Mortality and cancer morbidity in workers from an aluminum smelter with prebaked carbon anodes - part II: cancer morbity. Occupational and Environmental Medicine 52: 250-254. (See abstract)

Spinelli JJ, et al. (1991). Mortality and cancer incidence in aluminum reduction plant workers. Journal of Occupational Medicine 33: 1150-1155. (See abstract)

Fluoride & Mutagenicity (back to top)

Aardema MJ, et al (1989). Sodium fluoride-induced chromosome aberrations in different stages of the cell cycle: a proposed mechanism. Mutation Research 223:191-203. (See abstract)

Albanese R. (1987). Sodium fluoride and chromosome damage (in vitro human lymphocyte and in vivo micronucleus assays). Mutagenesis 2(6):497-9. (See abstract)

Bale SS, Mathew MT. (1987). Analysis of chromosomal abnormalities at anaphase-telophase induced by sodium fluoride in vitro. Cytologia 52: 889-893. (See abstract)

Caspary WJ, et al (1987). Mutagenic activity of fluorides in mouse lymphoma cells. Mutation Research 187(3):165-80. (See abstract)

Chen J, et al. (2002). Studies on DNA damage and apoptosis in rat brain induced by fluoride. Zhonghua Yu Fang Yi Xue Za Zhi. 36(4):222-224. (See abstract)

Chen J, et al. (2000). [Effects of selenium and zinc on the DNA damage caused by fluoride in pallium neural cells of rats]. Wei Sheng Yan Jiu. 29(4):216-7. (See abstract)

Cole J, et al. (1986). The mutagenicity of sodium fluoride to L5178Y [wild-type and TK+/- (3.7.2c)] mouse lymphoma cells. Mutagenesis 1(2):157-67. (See abstract)

Crespi CL, et al. (1990). Sodium fluoride is a less efficient human cell mutagen at low concentrations. Environmental Molecular Mutagenesis 15(2):71-7. (See abstract)

Department of Health and Human Services (1991). Review of fluoride benefits and risks. Appendix H. H1-H6.

Edwards SL, et al. (1984). The crystal structure of fluoride-inhibited cytochrome c peroxidase. Journal of Biological Chemistry 259: 12984-12988. (See article discussing study)

Emsley J, et al. (1982). The uracil fluoride interaction: ab intro calculation including solvation. Journal of the Chemical Society Chemical Communications 476-478.

Emsley J, et al (1981). An unexpectedly strong hydrogen bond: Ab initio calculations and spectroscopic studies of amide-fluoride systems. Journal of the American Chemical Society 103: 24-28.

Gadhia PK, Joseph S. (1997). Sodium fluoride induced chromosome aberrations and sister chromatid exchange in cultured human lymphocytes. Fluoride 30(3):153-6.

Gerdes RA, et al. (1971). The effects of atmospheric hydrogen fluoride upon Drosophila melanogaster. II. Fecundity, hatchability and fertility. Atmospheric Environment 5:117-122. (See abstract)

Gritsan, NP. (1993). Cytogenetic effects of gaseous fluorides on grain crops. Fluoride 26(1): 23-32. (See paper)

Hayashi N, Tsutsui T. (1993). Cell cycle dependence of cytotoxicity and clastogenicity induced by treatment of synchronized human diploid fibroblasts with sodium fluoride. Mutation Research 290: 293-302. (See abstract)

Jachimczak D, Skotarczak B. (1978). The effect of fluorine and lead ions on the chromosomes of human leucocytes in vitro. Genetica Polonica 19(3): 353-7.

Jagiello G, Lin JS. (1974). Sodium fluoride as potential mutagen in mammalian eggs. Archives of Environmental Health 29:230-5. (See abstract)

Joseph S, Gadhia PK. (2000). Sister chromatid exchange frequency and chromosome aberrations in residents of fluoride endemic regions of South Gujarat. Fluoride 33: 154-158. (See abstract | See study)

Khalil AM. (1995). Chromosome aberrations in cultured rat bone marrow cells treated with inorganic fluorides. Mutation Research 343(1):67-74. (See abstract)

Kishi K, Ishida T. (1993). Clastogenic activity of sodium fluoride in great ape cells. Mutation Research 301(3):183-8. (See abstract)

Kishi K, Tonomura A. (1984). Cytogenetic effects of sodium fluoride.Mutation Research 130: 367. (See abstract)

Kleinsasser NH, et al. (2001). [Cytotoxicity and genotoxicity of fluorides in human mucosa and lymphocytes]. Laryngorhinootologie 80(4):187-90. (See abstract)

Lasne C, et al. (1988). Transforming activities of sodium fluoride in cultured Syrian hamster embryo and BALB/3T3 cells. Cell Biology and Toxicology 4(3):311-24. (See abstract)

Lazutka JR, et al. (1999). Chromosomal aberrations and sister-chromatid exchanges in Lithuanian populations: effects of occupational and environmental exposures. Mutation Research 445: 225-229. (See abstract)

Li YM, et al. (1988). Genotoxic effects of fluoride: a controversial issue. Mutation Research 195(2):127-36. (See abstract)

Meng Z, Zhang B. (1997). Chromosomal aberrations and micronuclei in lymphocytes of workers at a phosphate fertilizer factory. Mutation Research 393: 283-288. (See paper)

Meng Z, et al. (1995). Sister-chromatid exchanges in lymphocytes of workers at a phosphate fertilizer factory. Mutation Research 334(2):243-6. (See abstract)

Mihashi M, Tsutsui T. (1996). Clastogenic activity of sodium fluoride to rat vertebral body-derived cells in culture. Mutation Research 368(1):7-13 (See abstract)

Mohamed AH, Chandler ME. (1982). Cytological effects of sodium fluoride on mice. Fluoride 15(3): 110-18. (See abstract)

Mohamed AH. (1977). Cytogenetic effects of hydrogen fluoride gas on maize. Fluoride 10(4): 157-164. (See abstract)

Mohamed AH. (1970). Chromosomal changes in maize induced by hydrogen fluoride gas. Canadian Journal of Genetics and Cytology 12: 614-620. (See abstract)

Mohamed AH. (1969). Cytogenetic effects of hydrogen fluoride on plants. Fluoride 2(2): 76-84. (See abstract)

Mukerjee RN, Sobels FH. (1968). The effect of sodium fluoride and idoacetamide on mutation induction by X-irradiation in mature spermatozoa of drosophila. Mutation Research 6: 217- 25. (See abstract)

National Research Council. (1993). Genotoxicity of Fluoride. In: Health effects of ingested fluoride. Report of the Subcommittee on Health Effects of Ingested Fluoride. National Academy Press, Washington, DC. (See chapter)

National Toxicology Program [NTP] (1990). Toxicology and Carcinogenesis Studies of Sodium Fluoride in F344/N Rats and B6C3f1 Mice. Technical report Series No. 393. NIH Publ. No 91-2848. National Institute of Environmental Health Sciences, Research Triangle Park, N.C.

Pati PC, Bhunya SP. (1987). Genotoxic effect of an environmental pollutant, sodium fluoride, in mammalian in vivo test system. Caryologia 40:79-87. (See abstract)

Ramesh N, et al. (2001). Low levels of p53 mutations in Indian patients with osteosarcoma and the correlation with fluoride levels in bone. Journal of Environmental Pathology, Toxicology, and Oncology 20(3):237-43.(See abstract)

Rao MV, Tiwari H. (2006). Amelioration by melatonin of chromosomal anomalies induced by arsenic and/or fluoride in human blood lymphocyte cultures. Fluoride 39:255-260. (See study)

Ribeiro DA, et al. (2006). Lack of DNA damage induced by fluoride on mouse lymphoma and human fibroblast cells by single cell gel (comet) assay. Brazilian Dental Journal 17:91-4. (See abstract)

Rivedal E, et al. (2000). Morphological transformation and effect on gap junction intercellular communication in Syrian hamster embryo cells as screening tests for carcinogens devoid of mutagenic activity. Toxicology In Vitro 14(2):185-92. (See abstract)

Scott D, Roberts SA. (1987). Extrapolation from in vitro tests to human risk: experience with sodium fluoride clastogenicity. Mutation Research 189(1):47-58. (See abstract)

Sheth FJ, et al. (1994). Sister chromatid exchanges: A study in fluorotic individuals of North Gujurat. Fluoride 27: 215-219. (See abstract)

Smith GE. (1988). Is fluoride a mutagen? Science of the Total Environment 68:79-96. (See abstract)

Suzuki N, Tsutsui T. (1989). [Dependence of lethality and incidence of chromosome aberrations induced by treatment of synchronized human diploid fibroblasts with sodium fluoride on different periods of the cell cycle]. [Article in Japanese] Shigaku. 77(2):436-47. (See abstract)

Taylor A, Taylor NC. (1965). Effect of sodium fluoride on tumor growth. Proceedings of the Society for Experimental Biology and Medicine 119:252-255. (See study)

Tazhibaev ShS, et al. (1987). [Modifying effect of nutrition on the mutagenic activity of phosphorus and fluorine compounds]. Vopr Pitan. Jul-Aug;(4):63-6. (See abstract)

Tsutsui T, Suzuki N, Ohmori M. (1984) Sodium fluoride-induced morphological and neoplastic transformation, chromosome aberrations, sister chromatid exchanges, and unscheduled DNA synthesis in cultured syrian hamster embryo cells. Cancer Research 44(3):938-41. (See abstract)

Tsutsui T, Suzuki N, Ohmori M, Maizumi H. (1984). Cytotoxicity, chromosome aberrations and unscheduled DNA synthesis in cultured human diploid fibroblasts induced by sodium fluoride. Mutation Research 139(4):193-8. (See abstract)

Tsutsui T, Ide K, Maizumi H. (1984). Induction of unscheduled DNA synthesis in cultured human oral keratinocytes by sodium fluoride. Mutation Research 140(1):43-8. (See abstract)

Voroshilin SI, et al. (1975). Mutagenic effect of hydrogen fluoride on animals. Tsitol Genet. 9(1): 42-44. (See abstract)

Wang AG, et al. (2004). Effects of fluoride on lipid peroxidation, DNA damage and apoptosis in human embryo hepatocytes. Biomedical and Environmental Sciences 17: 217-22. (See abstract)

Wu DQ, Wu Y. (1995). Micronucleus and Sister Chromatid Exchange Frequency in Endemic Fluorosis. Fluoride 28(3): 125-127. (See study)

Zeiger E, et al. (1993). Genetic toxicity of fluoride.Environmental Molecular Mutagenesis 21(4):309-18. (See abstract)

Zeiger E, et al. (1994). Cytogenetic studies of sodium fluoride in mice. Mutagenesis 9(5):467-71.(See abstract)

Zhang Y, et al. (2006). DNA damage induced by fluoride in rat osteoblasts. Fluoride 39:191-194. (See study)

VI. FLUORIDE & THE THYROID (back to top)

For additional references on fluoride/thyroid, click here

Fluoride treatment for Hyperthyroidism (back to top)

Galletti P, Joyet G. (1958). Effect of Fluorine on Thyroidal Iodine Metabolism in Hyperthyroidism. Journal of Clinical Endocrinology 18:1102-1110 (See study)

Goldemberg L. (1930). Compt Rend Soc Biol (Paris) 104:1031.

Goldemberg L. (1926). [Action physiologique des fluorures] Compt Rend Soc Physiol (Paris. 95:1169.

May W. (1935). [Antagonismus zwischen Jod und Fluor im Organismus] Klin Wochenschr 14:790-792.

May W. (1937). [Behandlung the Hyperthyreosen einschliesslich des schweren genuinen Morbus Basedow mit Fluor] Klin Wochenschr 16:562-564.

Schuld A. (1999). Fluoride-Iodine Antagonism: Some History. Parents of Fluoride Poisoned Children. (See paper)

Stecher P, et al. (1960). The Merck Index of Chemicals and Drugs. Merck & Co., Inc, Rathway NJ.

Fluoride & Goiter (back to top)

Burgi H, et al. (1984). Fluorine and thyroid gland function: a review of the literature. Klin Wochenschr 15;62(12):564-9. (See abstract)

Day TK, Powell-Jackson PR. (1972). Fluoride, Water Hardness, and Endemic Goitre. Lancet 1:1135-1138. (See study )

Desai VK, et al. (1993). Epidemiological study of goitre in endemic fluorosis district of Gujarat. Fluoride 26:187-90. (See excerpt)

Jooste PL. (1999). Endemic goitre in the absence of iodine deficiency in schoolchildren of the Northern Cape Province of South Africa. European Journal of Clinical Nutrition 53(1):8-12. (See abstract)

Latham MC, Grech P. (1967). The effects of excessive fluoride intake. American Journal of Public Health 57: 651-660.

McKay FS. (1918). Progress of the year in the investigation of mottled enamel with special reference to its association with artesian water. Journal of the National Dental Association 5:721-750.

Obel AO. (1982). Goitre and fluorosis in Kenya. East African Medical Journal 59:363-365. (See paper)

Siddiqui AH. (1969). Incidence of simple goiter in areas of endemic fluorosis in Nalgonda District, Andra Pradesh, India. Fluoride 2:200-205.

Steyn DG, et al. (1955). Endemic Goitre in the Union of South Africa and Some Neighbouring Territories. Union of South Africa. Department of Nutrition. (See excerpts)

Wespi HJ. (1954). Besteht ein Antagonismus zwischen Fluor und Jod? Praxis 43: 616-623.

Wilson D. (1941). Fluorine in the aetiology of endemic goitre. The Lancet Feb 15: 212-213. (See study)

Zhao W, et al. (1998). Long-term effects of various iodine and fluorine doses on the thyroid and fluorosis in mice. Endocrine Regulations 32(2):63-70.(See abstract | See study)

Fluoride/Iodine Interactions(back to top)

Gas'kov A, Savchenkov MF, Iushkov NN. (2005). [The specific features of the development of iodine deficiencies in children living under environmental pollution with fluorine compounds] Gig Sanit. Nov-Dec;(6):53-5. (See abstract)

Ge Y, et al. (2005). Effects of high fluoride and low iodine on brain histopathology in offspring rats. Fluoride 38: 127-132.

Guan ZZ, et al. (1988). Synergistic action of iodine-deficiency and fluorine-intoxication on rat thyroid. Chinese Medical Journal 101(9):679-84.

Lin Fa-Fu, et al (1991). The relationship of a low-iodine and high-fluoride environment to subclinical cretinism in Xinjiang. Iodine Deficiency Disorder Newsletter Vol. 7. No. 3.(See study)

Minder W, Gordonoff T. (1956). An antagonism between iodine and fluorine. Arch Intern Pharma Codyn 107: 374-381.

National Research Council. (2006). Effects on the Endocrine System. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Shen X, Zhang Z, Xu X. (2004). [Influence of combined iodine and fluoride on phospholipid and fatty acid composition in brain cells of rats]. Wei Sheng Yan Jiu. 33(2):158-61.(See abstract)

Sidora VD, et al. (1983). [Indices of the pituitary-thyroid system in residents of cities with various fluorine concentrations in drinking water]. Probl Endokrinol (Mosk) 29(4):32-5. (See abstract)

Steyn DG, et al. (1955). Endemic Goitre in the Union of South Africa and Some Neighbouring Territories. Union of South Africa. Department of Nutrition. (See excerpts)

Stolc V, Podoba J. (1960). Effect of fluoride on the biogenesis of thyroid hormones. Nature 188:855-856.

Wilson RH, DeEds F. (1940). The synergistic action of thyroid on fluoride toxicity. Endocrinology 26:851.

Yang Y, et al. (1994). [Effects of high iodine and high fluorine on children's intelligence and the metabolism of iodine and fluorine]. Zhonghua Liu Xing Bing Xue Za Zhi.15(5):296-8. (See abstract)

Wang J, et al. (2004). Effects of high fluoride and low iodine on oxidative stress and antioxidant defense of the brain in offspring rats. Fluoride 37: 264-270. (See abstract)

Zhao W, et al. (1998). Long-term Effects of Various Iodine and Fluorine Doses on the Thyroid and Fluorosis in Mice. Endocrine Regulations 32(2):63-70. (See abstract | See study)

For more references, see:

Schuld A. (2006). History of the fluoride/iodine antagonism. Parents of Fluoride Poisoned Children. (See paper)

Other (back to top)

Bachinskii PP, et al. (1985) Action of the body fluorine of healthy persons and thyroidopathy patients on the function of hypophyseal-thyroid the system. Probl Endokrinol (Mosk) 31(6):25-9. (See abstract | See study)

Balabolkin MI, et al. (1995). [The interrelationship of the thyroid and immune statuses of workers with long-term fluorine exposure] [Article in Russian] Ter Arkh. 67(1):41-2. (See abstract)

Bobek S, et al. (1976). Effect of long-term fluoride administration on thyroid hormones level blood in rats. Endocrinologia Experimentalis 10(4):289-95.(See abstract)

Bylgyly A, et al. (2004). The effects of fluoride on thyroid hormones in rabbits. Indian Veterinary Journal 81:986-988.

Kendall-Taylor P. (1972). Comparison of the effects of various agents on thyroidal adenyl cyclase activity with their effects on thyroid hormone release. Journal of Endocrinology 54(1):137-45. (See abstract)

Hara K. (1980). [Studies on fluorosis, especially effects of fluoride on thyroid metabolism]. Koku Eisei Gakkai Zasshi. 30(1):42-57.

Hillman D, et al. (1979). Hypothyroidism and anemia related to fluoride in dairy cattle. Journal of Dairy Science 62(3):416-23. (See abstract)

Liu G, et al. (2002). Effects of fluoride on metabolism of thyroid hormone in chicks. Chinese Journal of Veterinary Science 22: 61-62.

Liu G, et al. (2002). Effects of fluoride on ultrastructure of thyroid mitochondria in chicks. Chinese Journal of Veterinary Science 22:512-514.

Liu G, et al. (2002). Effect of sodium fluoride upon activity of peroxidase in the thyroid gland of chickens. Chinese Journal of Veterinary Science and Technology 32:32-33.

Liu G, et al. (2003). Effects of adding selenium to diets on the function of thyroid of fluorositic chicks. Journal of Shanghai Jiaotong University - Agricultural Science 21: 177-180.

Mikhailets ND, et al. (1996). Thyroid function during prolonged exposure to fluorides. Probl Endokrinol 42: 6-9. (See abstract)

National Research Council. (2006). Effects on the Endocrine System. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See chapter)

Okayasu I, et al. (1985). Hyperplastic nodules of thyroid parafollicular cells (C cells) in rats induced by prolonged low dose ingestion of NaF. Fluoride 18:111-117. (See abstract)

Schuld A. (2005). Is dental fluorosis caused by thyroid hormone disturbances? Fluoride 38: 91-94.

Shashi A. (1988). Biochemical effects of fluoride on thyroid gland during experimental fluorosis. Fluoride 21: 127-130. (See abstract)

Susheela AK, et al. (2005). Excess fluoride ingestion and thyroid hormone derangements in children living in Delhi, India. Fluoride 38: 98-108.

Tokar VI, et al. (1989). [Chronic effects of fluorides on the pituitary-thyroid system in industrial workers]. Gig Tr Prof Zabol (9):19-22. (See abstract)

Trabelsi M, et al. (2001). Effect of fluoride on thyroid function and cerebellar development in mice. Fluoride 34: 165-173. (See study)

Yu YN. (1985). [Effects of chronic fluorosis on the thyroid gland]. Zhonghua Yi Xue Za Zhi. 65(12):747-9.

VII. FLUORIDE & the KIDNEYS (back to top)

Kidney damage in skeletal fluorosis (back to top)

Altintas A, et al. (2000). Serum proteins electrophoresis and kidney function in sheep with natural and industrial fluorosis. Ankara Universitesi Veteriner Fakultesi Dergisi 47:105-114.

Ando M, et al. (2001). Health effects of fluoride pollution caused by coal burning. Science of the Total Environment 271(1-3):107-16. (See abstract)

Derryberry OM, et al. (1963). Fluoride exposure and worker health. Archives of Environmental Health 6: 503-511.

Jolly SS, et al. (1980). Kidney changes and kidney stones in endemic fluorosis. Fluoride 13: 10-16.

Kumar SP, Harper RA. (1963). Fluorosis in Aden. British Journal of Radiology 36: 497-502.

Lantz O, et al. (1987). Fluoride-induced chronic renal failure. American Journal of Kidney Disorders 10:136-9.

Reggabi M, et al. (1984). Renal function in residents of an endemic fluorosis area in southern Algeria. Fluoride 17: 35-41.

Shortt HE, et al. (1937). Endemic fluorosis in the Madras presidency. Indian Journal of Medical Research 25: 553-568.

Siddiqui AH. (1955). Fluorosis in Nalgonda district, Hyderabad-Deccan. British Medical Journal ii (Dec 10): 1408-1413.

Singh A, et al. (1963). Endemic fluorosis. Epidemiological, clinical and biochemical study of chronic fluoride intoxication in Punjab. Medicine 42: 229-246.

Singla VP, et al. (1976). The kidneys. Fluoride 9: 33-35.

Xiong X, et al. (2006). Dose-effect relationship between drinking water fluoride levels and damage to liver and kidney functions in children. Environmental Research Jul 8; [Epub ahead of print]. (See abstract)

Fluoride-Induced Nephrotoxicity: (back to top)

Atkinson F, Hard GC. (1966). Chronic fluorosis in the guinea-pig. Nature July 23. 429-430.

Banu Priya C, et al. (1997). Toxicity of fluoride to diabetic rats. Fluoride 30: 51-58. (See abstract | See study)

Bhatnagar M, Susheela AK. (1998). Chronic fluoride toxicity: an ultrastructural study of the glomerulus of the rabbit kidney. Environmetnal Sciences 6: 43–54.

Birkner E, et al. (2006). Influence of sodium fluoride and caffeine on the kidney function and free-radical processes in that organ in adult rats. Biological Trace Element Research 109:35-48. (See abstract)

Bond AM, Murray MM. (1952). Kidney function and structure in chronic fluorosis. British Journal of Experimental Pathology 33: 168-176.

Borke JL, Whitford GM. (1999). Chronic fluoride ingestion decreases 45Ca uptake by rat kidney membranes. Journal of Nutrition 129(6):1209-13. (See abstract | See study)

Bouaziz H, et al. (2005). Toxic effects of fluoride by maternal ingestion on kidney function of adult mice and their suckling pups. Fluoride 38: 23-31.

Cittanova ML, et al. (2002). Fluoride ion toxicity in rabbit kidney thick ascending limb cells. European Journal of Anaesthesiology 19(5):341-9. (See abstract)

Cittanova ML, et al. (1996). Fluoride ion toxicity in human kidney collecting duct cells. Anesthesiology 84(2):428-35. (See abstract)

Daston GP, et al. (1985). Toxicity of sodium fluoride to the postnatally developing rat kidney. Environmental Research 37(2):461-74. (See abstract)

Dote T, et al. (2000). Toxicokinetics of intravenous fluoride in rats with renal damage caused by high-dose fluoride exposure. International Archives of Occupational and Environmental Health 73 Suppl:S90-2. (See abstract)

Eisenbrandt DL, Nitschke KD. (1989). Inhalation toxicity of sulfuryl fluoride in rats and rabbits. Fundamentals of Applied Toxicology 1989 Apr;12(3):540-57. (See abstract)

Greenberg SR. (1986). Response of the renal supporting tissues to chronic fluoride exposure as revealed by a special technique. Urologia Internationalis 41(2):91-4. (See abstract)

Guan ZZ, et al. (2000). Changed cellular membrane lipid composition and lipid peroxidation of kidney in rats with chronic fluorosis. Archives of Toxicology 74(10):602-8. (See abstract)

Hamuro Y. (1972). Relationship between prevention of renal calcification by fluoride and fluoride-induced diuresis and reduction of urinary phosphorus excretion in magnesium-deficient KK mice. Journal of Nutrition 102: 893-900.

Jankauskas J. (1974). Effects of fluoride on the kidney: A review. Fluoride 7: 93-105. (See abstract)

Kapoor V, et al. (1993). Effect of dietary fluorine on histopathological changes in calves. Fluoride 26: 105-100.

Karaoz E, et al. (2004). Effect of chronic fluorosis on lipid peroxidation and histology of kidney tissues in first- and second-generation rats. Biological Trace Element Research 102:199-208. (See abstract)

Kessabi M, et al. (1985). Experimental acute sodium fluoride poisoning in sheep: Renal, hepatic, and metabolic effects. Fundamentals of Applied Toxicology 7(2): 93-105. (See abstract)

Kessabi M, et al. (1981). Comparison of sodium and stannous fluoride nephrotoxicity. Toxicology Letters 7(6):463-7. (See abstract)

Kour K, Singh J. (1980). Histological findings in kidneys of mice following sodium fluoride administration. Fluoride 13: 163-167. (See abstract)

Lantz O, et al. (1987). Fluoride-induced chronic renal failure. American Journal of Kidney Disorders 10(2):136-9. (See abstract)

Lindemann G, et al. (1959). Recovery of the rat kidney in fluorosis. Archives of Pathology 67: 30-33.

Liu JL, et al. (2005). [The dose-effect relationship of water fluoride levels and renal damage in children] Wei Sheng Yan Jiu. 34:287-8. (See abstract)

Manocha SL, et al. (1975). Cytochemical response of kidney, liver and nervous system to fluoride ions in drinking water. Histochemical Journal 7: 343-355. (See abstract)

Mazze RI, et al. (1977). Inorganic fluoride nephrotoxicity: prolonged enflurane and halothane anesthesia in volunteers. Anesthesiology 46(4):265-71. (See abstract | See excerpt)

Murao H, et al. (2000). Sodium fluoride increases intracellular calcium in rat renal epithelial cell line NRK-52E. Biological and Pharmaceutical Bulletin 23(5):581-4. (See abstract)

National Research Council. (1993). Effects of ingested fluoride on renal, gastrointestinal, and immue systems. In: Health Effects of Ingested Fluoride. Report of the Subcommittee on Health Effects of Ingested Fluoride. National Academy Press, Washington, DC. (See chapter)

Partanen S. (2002). Inhibition of human renal acid phosphatases by nephrotoxic micromolar concentrations of fluoride. Experimental and Toxicologic Pathology 54(3):231-7. (See abstract)

Pindborg JJ. (1957). The effect of 0.05 per cent dietary sodium fluoride on the rat kidney. Acta pharmacolgica et toxicologica 13: 36-45.

Poulson H, Ericcson Y. (1965). Chronic toxicity of dietary sodium monofluorophosphate in growing rats, with special reference to kidney changes. Acta pathologica et microbiologica Scandinavica 65: 493-504.

Ramseyer WF, et al. (1957). Effect of sodium fluoride administration on body changes in old rats. Journal of Gerontology 12: 14-19. (See excerpt)

Roman RJ, et al. (1977). Renal tubular site of action of fluoride in Fischer-344 rats. Anesthesiology 46: 260-264. (See abstract)

Shashi A, et al. (2002). Toxic effects of fluoride on rabbit kidney. Fluoride 35(1): 38-50. (See study)

Singer I, and Forrest JN. (1976). Drug-induced states of nephrogenic Diabetes Insipidus. Kidney International 10:82-95.

Singh M, Kanwar KS. (1981). Effect of fluoride on tissue enzyme activities in rat: Biochemical and histochemical studies. Fluoride 14: 132-141. (See abstract)

Suketa Y, Mikami E. (1977). Changes in urinary ion excretion and related renal enzyme activities in fluoride-treated rats. Toxicology and Applied Pharmacology 40: 551-9.

Sullivan WD. (1969). The in vitro and in vivo effects of fluoride on succinic dehydrogenase activity. Fluoride 2:168-175.

Taylor JM, et al. (1961). Toxic effects of fluoride on the rat kidney. II. Chronic effects. Toxicology and Applied Pharmacology 3:290-314.

Thongboonkerd V, et al. (2002). Fluoride exposure attenuates expression of Streptococcus pyogenes virulence factors. Journal of Biological Chemistry 277(19):16599-605. (See abstract)

Tormanen CD. (2003). Substrate inhibition of rat liver and kidney arginase with fluoride. Journal of Inorganic Biochemistry 93(3-4):243-6. (See abstract)

Usuda K, et al. (1999). Usefulness of the assessment of urinary enzyme leakage in monitoring acute fluoride nephrotoxicity. Archives of Toxicology 73(6):346-51. (See abstract)

Usuda K, et al. (1998). Urinary biomarkers monitoring for experimental fluoride nephrotoxicity. Archives of Toxicology 72(2):104-9. (See abstract)

Varner JA, et al. (1998). Chronic administration of aluminum-fluoride and sodium-fluoride to rats in drinking water: Alterations in neuronal and cerebrovascular integrity. Brain Research 784: 284-298. (See abstract)

Waldbott GL, et al. (1978). Fluoridation: The Great Dilemma. Coronado Press, Inc., Lawrence, Kansas. (See excerpt)

Wallin JD, Kaplan RA. (1977). Effect of sodium fluoride on concentrating and diluting ability in the rat. American Journal of Physiology 232: F335-40. (See abstract)

Whitford GM, Stringer GI. (1978). Duration of the fluoride-induced urinary concentrating defect in rats. Proceedings of the Society for Experimental Biology and Medicine 157(1):44-9. (See abstract)

Whitford GM, Taves DR. (1971). Fluoride-induced diuresis: Plasma concentrations in the rat. Proceedings of the Society for Experimental Biology and Medicine 137:458-460.

Xu H, et al. (2006). Effect of sodium fluoride on the expression of bcl-2 family and osteopontin in rat renal tubular cells. Biological Trace Element Research 109:55-60. (See abstract)

Xue C, et al. (2000). [Study on antagonistic effects of selenium and zinc on the renal impairments induced by fluoride in rats] Wei Sheng Yan Jiu 29(1):21-3. (See abstract)

Fluoride-Induced Nephrotoxicity in Anaesthesia: (back to top)

Abdel-Latif, MM, et al. (2003). Serum fluoride ion and renal function after prolonged sevoflurane or isoflurane anaesthesia. Egyptian Journal of Anaesthesia 19: 79-83. (See abstract | See study)

Arthaud LE, Loomis TA. (1975). The relationship of the total dose and duration of methoxyflurane anesthesia to renal toxicity in Fischer 344 rats. Toxicology of Applied Pharmacology 33: 176.

Cousins MJ, et al. (1983). Anaesthesia and the kidney. Anesthesiology and Intensive Care 11(4):292-320. (See abstract)

Goldberg ME, et al. (1996). Sevoflurane versus isoflurane for maintenance of anesthesia: are serum inorganic fluoride ion concentrations of concern? Anesthesia and Analgesia 82(6):1268-72. (See abstract)

Gottlieb LS, Trey C. (1974). The effects of fluorinated anesthetics on the liver and kidneys. Annual Review of Medicine 25: 411-429. (See excerpt)

Mazze RI. (1984). Fluorinated anesthetic nephrotoxicity: An update. Canadian Anaesthetic Society Journal 31:S16-S22. (See abstract)

Mazze RI, et al. (1977). Inorganic fluoride nephrotoxicity: prolonged enflurane and halothane anesthesia in volunteers. Anesthesiology 46(4):265-71. (See abstract | See excerpt)

Mazze RI. (1976). Methoxyflurane nephropathy. Environmental Health Perspectives 15:111-9.(See abstract)

Nuscheler M, et al. (1996). [Fluoride-induced nephrotoxicity: fact or fiction?]. Anaesthesist 45 Suppl 1:S32-40. (See abstract)

Reichle FM, Conzen PF. (2003). Halogenated inhalational anaesthetics. Best practice & research. Clinical anaesthesiology 17(1):29-46. (See abstract)

Taves DR, et al. (1972). Role of metabolism in the nephrotoxicity of methoxyflurane. Toxicicology of Applied Pharmacology 23:795-796.

Kidney ailments heighten susceptibility to fluoride toxicity (back to top)

Arnala I, et al. (1985). Effects of fluoride on bone in Finland. Histomorphometry of cadaver bone from low and high fluoride areas. Acta Orthopaedica Scandinavica 56(2):161-6.

Banu Priya C, et al. (1997). Toxicity of fluoride to diabetic rats. Fluoride 30: 51-58. (See abstract | See study)

Bober J, et al. (2006). Fluoride aggravation of oxidative stress in patients with chronic renal failure. Fluoride 39:302-309. (See study)

Call RA, et al. (1965). Histological and chemical studies in man on effects of fluoride. Public Health Reports 80: 529-538.

Fisher JR, et al. (1981). Skeletal fluorosis from eating soil. Arizona Medicine 38: 833-5.

Gerster JC, et al. (1983). Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed). 287(6394):723-5. (See abstract)

Hefti A, Marthaler TM. (1981). Bone fluoride concentrations after 16 years of drinking water fluoridation. Caries Research 15(1):85-9.

Johnson W, et al. (1979). Fluoridation and bone disease in renal patients. In: E Johansen, DR Taves, TO Olsen, Eds. Continuing Evaluation of the Use of Fluorides. AAAS Selected Symposium. Westview Press, Boulder, Colorado. pp. 275-293. (See extended excerpt)

Juncos LI, Donadio JV Jr. (1972). Renal failure and fluorosis. Journal of the American Medical Association 222(7):783-5. (See abstract)

Kono K, et al. (1984). Urinary fluoride excretion in fluoride exposed workers with diminished renal function. Industrial Health 22(1):33-40. (See abstract)

Linsman JF, McMurray CA. (1943). Fluoride osteosclerosis from drinking water. Radiology 40: 474- 484.

Marier JR. (1977). Some current aspects of environmental fluoride. Science of the Total Environment 8:253-265. (See abstract)

Noel C, et al. (1985). [Risk of bone disease as a result of fluoride intake in chronic renal insufficiency]. (Article in French). Nephrologie 1985;6(4):181-5. (See abstract)

Schmidt CW, et al. (1985). [Massive skeletal fluorosis in compromised kidney function]. (Article in German). Z Urol Nephrol. 78(3):173-6. (See abstract)

Spak CJ, et al. (1985). Renal clearance of fluoride in children and adolescents. Pediatrics 75(3):575-9. (See abstract)

Spencer H, et al. (1980). Fluoride metabolism in patients with chronic renal failure. Archives of Internal Medicine 140: 1331-1335.

Turner CH, et al. (1996). High fluoride intakes cause osteomalacia and diminished bone strength in rats with renal deficiency. Bone 19(6):595-601.(See abstract)

Welsch M, et al. (1990). [Iatrogenic fluorosis. 2 cases]. Therapie 45(5):419-22. (See abstract)

Fluoride/Kidney Stones - Association (back to top)

Anasuya A. (1982). Role of fluoride in formation of calculi: studies on rats. Journal of Nutrition 112(9):1787-95. (See abstract)

Anasuya A, Rao BS. (1983). Effect of fluoride, silicon and magnesium on the mineralizing capacity of an inorganic medium and stone formers urine tested by a modified in-vitro method. Biochemistry and Medicine 30:146. (See abstract)

Jolly SS, et al. (1980). Kidney changes and kidney stones in endemic fluorosis. Fluoride 13(1): 10-16. (See abstract)

Rathee N, Garg P, Pundir C.S. (2004). Correlative study of fluoride content in urine, serum and urinary calculi. Indian Journal of Clinical Biochemistry 19: 100-102.

Singh PP, Barjatiya MK, Dhing S, Bhatnagar R, et al. (2001). Evidence suggesting that high intake of fluoride provokes nephrolithiasis in tribal populations. Urological Research 29(4): 238-44. (See abstract | See excerpt)

Fluoride/Kidney Stones - No association (back to top)

Hering F, et al. (1985). Fluoridation of drinking water: effects on kidney stone formation. Urological Research 13(4):175-8. (See abstract)

Li LC, et al. (1992). Inhibitory effect of fluoride on renal stone formation in rats. Urologia Internationalis 48(3):336-41. (See abstract)

Teotia M, et al. (1991). Fluoride metabolism and fluoride content of stones from children with endemic vesical stones. British Journal of Urology 68(4):425-9. (See abstract)

VIII. FLUORIDE & GASTOINTESTINAL DISORDERS (back to top)

Das TK, et al. (1994). Toxic effects of chronic fluoride ingestion on the upper gastrointestinal tract. Journal of Clinical Gastroenterology 18(3):194-9. (See abstract)

Dasarathy S, et al. (1996). Gastroduodenal manifestations in patients with skeletal fluorosis. Journal of Gastroenterology 31(3):333-7. (See abstract)

Fujii A, Tamura T. (1989). Deleterious effect of sodium fluoride on gastrointestinal tract. General Pharmacology 20(5):705-10. (See abstract)

Gupta IP, et al. (1992). Fluoride as a possible aetiological factor in non-ulcer dyspepsia. Journal of Gastroenterology and Hepatology 7(4):355-9. (See abstract)

Muller P, et al. (1992). Sodium fluoride-induced gastric mucosal lesions: comparison with sodium monofluorophosphate. Z Gastroenterol. 30(4):252-4. (See abstract)

National Research Council. (1993). Effects of ingested fluoride on renal, gastrointestinal, and immue systems. In: Health Effects of Ingested Fluoride. Report of the Subcommittee on Health Effects of Ingested Fluoride. National Academy Press, Washington, DC. (See chapter)

Pashley DH, et al. (1984). The effects of fluoride on the gastric mucosa of the rat. Journal of Oral Pathology 13(5):535-45. (See abstract)

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.

Shashi A. (2002). Histopathological effects of sodium fluoride on the duodenum of rabbit. Fluoride 35(1): 28-37. (See study)

Shayiq RM, et al. (1984). Alteration in gastric secretion of rats administered NaF. Fluoride 17: 178-182. (See abstract)

Sondhi H, et al. (1995). Intestinal effects of sodium fluoride in Swiss Albino mice. Fluoride 28: 21-24. (See abstract)

Spak CJ, et al. (1990). Studies of human gastric mucosa after application of 0.42% fluoride gel. Journal of Dental Research 69(2):426-9. (See abstract)

Spak CJ, et al. (1989). Tissue response of gastric mucosa after ingestion of fluoride. British Medical Journal 298(6689):1686-7. (See study)

Susheela AK, et al. (1993). Prevalence of endemic fluorosis with gastro-intestinal manifestations in people living in some North-Indian villages. Fluoride 26(2): 97-104. (See abstract)

Susheela AK, et al. (1992). Fluoride ingestion and its correlation with gastrointestinal discomfort. Fluoride 25(1): 5-22. (See abstract)

Susheela AK, Das TK. (1988). Chronic fluoride toxicity: a scanning electron microscopic study of duodenal mucosa. Journal of Toxicology and Clinical Toxicology 26(7):467-76. (See abstract)

Waldbott GW. (1977). Gastric ulcer and fluoride. Fluoride 10: 140-151. (See abstract)

Whitford GM, et al. (1997). Effects of fluoride on structure and function of canine gastric mucosa. Digestive Diseases and Sciences 42(10):2146-55. (See abstract)

IX. FLUORIDE & REPRODUCTIVE SYSTEM (back to top)

Animals: (back to top)

Araibi AA, et al. (1989). Effect of high fluoride on the reproductive performance of the male rat. Journal of Biological Science Research 20: 19-30.

Bano R, Sahdey S, Lall SB. (1996). Biochemical changes in the testes of Swiss albino mice exposed to chronic ingestion of sodium fluoride. Indian Journal of Environment and Toxicology 6:19-21.

Chinoy NJ, et al. (2005). Fluoride + aluminum induced toxicity in mice testis witih giant cells and its reversal by vitamin C. Fluoride 38: 109-114.

Chinoy NJ, et al. (2005). Fluoride and aluminum induced toxicity in mice epididymis and its mitigation by vitamin C. Fluoride 38: 115-121.

Chinoy NJ, Patel TN. (2001). Efects of sodium fluoride and aluminium chloride on ovary and uterus of mice and their reversal by some antidotes. Fluoride 34: 9-20. (See study)

Chinoy NJ, Sharma A. (2000). Reversal of fluoride-induced alteration in cauda epididymal spermatozoa and fertility impairment in male mice. Environmental Sciences 7: 29-38. (See abstract)

Chinoy NJ, Mehta D. (1999). Effects of protein supplementation and deficiency on fluoride-induced toxicity in reproductive organs of male mice. Fluoride 32: 204-214. (See abstract)

Chinoy NJ, Sharma A. (1998). Amelioration of fluoride toxicity by vitamin E and D in reproductive functions of male mice. Fluoride 31: 203-216. (See abstract)

Chinoy NJ, et al. (1997). Fluoride toxicity in the testis and cauda epididymis of guinea pig and reversal by ascorbate. Medical Science Research 25: 97-100. (See abstract)

Chinoy NJ, et al. (1997). Fluoride toxicity on rat testis and cauda epididymal tissue components and its reversal. Fluoride 30: 41-50. (See abstract)

Chinoy NF, et al. (1995). Amelioration of fluoride toxicity in some accessory reproductive glands and spermatozoa of rat. Fluoride 28: 75-86. (See abstract)

Chinoy NJ, Narayana MV. (1994). In vitro fluoride toxicity in human spermatozoa. Reproductive Toxicology 8: 155-9. (See abstract)

Chinoy NF, et al. (1994). Beneficial effects of ascorbic acid and calcium on reproductive functions of sodium fluoride-treated prepubertal male rats. Fluoride 27: 67-75. (See abstract)

Chinoy NJ, et al. (1992). Effects of fluoride ingestion on the physiology of reproductive organs of male rats. Journal of Environmental Biology 13: 55-61. (See abstract)

Chinoy NJ , Sequeira E. (1992). Reversible fluoride induced fertility impairment in male mice. Fluoride 25 71-76. (See abstract)

Chinoy NJ, et al. (1991). Microdose vasal injection of sodium fluoride in the rat. Reproductive Toxicolology 5(6):505-12. (See abstract)

Chinoy NJ , Sequeira E. (1989). Effects of fluoride on the histoarchitecture of reproductive organs of the male mouse. Reproductive Toxicolology 3(4):261-7. (See abstract)

Chinoy NJ, Sequeira E. (1989). Fluoride induced biochemical changes in reproductive organs of male mice. Fluoride 22: 78-85. (See abstract)

Chubb C. (1985). Reproductive toxicity of fluoride. Journal of Andrology 6: 59. (See abstract)

Collins TF, et al. (2001). Multigenerational evaluation of sodium fluoride in rats. Food and Chemical Toxicology 39(6):601-13. (See abstract)

Collins TF, et al. (2001). Developmental toxicity of sodium fluoride measured during multiple generations. Food and Chemical Toxicology 39: 867-76. (See abstract)

Collins TF, et al. (1995). Developmental toxicity of sodium fluoride in rats. Food and Chemical Toxicology 33(11):951-60. (See abstract)

Das Sarkar S, et al. (2006). Management of fluoride induced testicular disorders by calcium and Vitamin-E co-administration in the albino rat. Reproductive Toxicology 2006 Jun 10; [Epub ahead of print]. (See abstract)

Dunipace AJ, et al. (1989). Genotoxic evaluation of chronic fluoride exposure: micronucleus and sperm morphology studies. Journal of Dental Research 68: 1525-8. (See abstract)

Eckerlin RH, et al. (1988). Ameliorative effects of reduced food-borne fluoride on reproduction in silver foxes. Cornell Veterinarian 78(4):385-91. (See abstract)

Elbetieha A, et al. (2000). Fertility effects of sodium fluoride in male mice. Fluoride 33: 128-134. (See abstract | See study)

Ghosh D, et al. (2002). Testicular toxicity in sodium fluoride treated rats: association with oxidative stress. Reproductive Toxicolology 16(4):385.(See abstract)

Guna Sherlin DM, Verma RJ. (2001). Vitamin D ameliorates fluoride-induced embryotoxicity in pregnant rats. Neurotoxicology and Teratology 23(2):197-201. (See abstract)

Hiyasat AS. (2000). Reproductive Toxic effects of ingestion of sodium fluoride in female rats. Fluoride 33(2): 79-84. (See study)

Hoffman DJ, et al. (1985). Effects of fluoride on screech owl reproduction: teratological evaluation, growth, and blood chemistry in hatchlings. Toxicology Letters 26(1):19-24. (See abstract)

Jiang CX, et al. (2005). [Relationship between spermatogenic cell apoptosis and serum estradiol level in rats exposed to fluoride]. Wei Sheng Yan Jiu. 34:32-4. (See abstract)

Kour K, Singh J. (1980). Histological finding of mice testes following fluoride ingestion. Fluoride 13: 160-162. (See abstract)

Krasowska A, et al. (2004). Zinc protection from fluoride-induced testicular injury in the bank vole (Clethrionomys glareolus). Toxicology Letters 147: 229-235. (See abstract)

Krasowska A, Wlostowski T. (1992). The effect of high fluoride intake on tissue trace elements and histology of testicular tubules in the rat. Comparative Biochemistry and Physiology: Part C 103(1):31-4. (See abstract)

Kumar A, Susheela AK. (1994). Ultrastructural studies of spermiogenesis in rabbit exposed to chronic fluoride toxicity. International Journal of Fertility and Menopausal Studies 39(3):164-71. (See abstract)

Li Y, et al. (1987). Effects of fluoride on the mouse sperm morphology test. Journal of Dental Research 66(9):1509-11. (See abstract)

Messer HH, et al. (1973). Influence of fluoride intake on reproduction in mice. Journal of Nutrition 103: 1319-26. (See abstract)

Narayana MV, et al. (1994). Reversible effects of sodium fluoride ingestion on spermatozoa of the rat. International Journal of Fertility and Menopausal Studies 39(6):337-46. (See abstract)

Narayana MV, Chinoy NJ. (1994). Effect of fluoride on rat testicular steroidogenesis. Fluoride 27: 7-12. (See abstract)

National Research Council. (1993). Reproductive effects of fluoride. In: Health Effects of Ingested Fluoride. Report of the Subcommittee on Health Effects of Ingested Fluoride. National Academy Press Washington, DC . (See chapter)

Pati PC, Bhunya SP. (1987). Genotoxic effect of an environmental pollutant, sodium fluoride, in mammalian in vivo test system. Caryologia 40:79-87. (See abstract)

Pattee OH, et al. (1988). Effects of dietary fluoride on reproduction in Eastern Screech-Owls. Archives of Environmental Contamination and Toxicology 17: 213-218. (See abstract)

Pinto R, et al. (1998). NaF may disturb male fertility in rodents. Toxicology Letters 95(Suppl 1): 214. (See abstract)

Pushpalatha T, et al. (2005). Exposure to high fluoride concentration in drinking water will affect spermatogenesis and steroidogenesis in male albino rats. Biometals 18:207-12. (See abstract)

Sahdey S, Bano R, Lall SB. (1996). Effects of sodium fluoride on testicular enzymes in the sexually mature Swiss albino mice. Indian Journal of Environment and Toxicology 6:1-4.

Shashi A. (1992). Biochemical effects of fluoride on lipid metabolism in the reproductive organs of male rabbits. Fluoride 25: 149-154.

Shashi A. (1990). Histopathological changes in rabbit ovary during experimental fluorosis. Indian Journal of Pathology and Microbiology 33(2):113-7. (See abstract)

Shashi A. (1990). Histopathological changes in rabbit testes during experimental fluorosis. Folia Morphol (Praha) 38(1):63-5. (See abstract)

Sprando RL, et al. (1998). Testing the potential of sodium fluoride to affect spermatogenesis: a morphometric study. Food and Chemical Toxicology 36: 1117-24. (See abstract)

Sprando RL, et al. (1997). Testing the potential of sodium fluoride to affect spermatogenesis in the rat. Food and Chemical Toxicology 35(9):881-90. (See abstract)

Sprando RL, et al. (1996). Effect of intratesticular injection of sodium fluoride on spermatogenesis. Food and Chemical Toxicology 34: 377-84. (See abstract)

Susheela AK, Kumar A. (1991). A study of the effect of high concentrations of fluoride on the reproductive organs of male rabbits, using light and scanning electron microscopy. Journal of Reproductive Fertility 92(2):353-60. (See abstract)

van Rensburg SWJ, de Vos WH. (1966). The influence of excess fluorine intake in the drinking water on reproductive efficiency in bovines. The Onderstepoort Journal of Veterinary Research 33: 185-194. (See summary)

Yang KD, et al. (2002). [Study on antagonistic effects of selenite on fluoride-induced impairments of testis and epididymis in rats]. Chung-Kuo Kung Kung Wei Sheng 18: 427-9. (See abstract)

Zakrzewska H, et al. (2002). In vitro influence of sodium fluoride on ram semen quality and enzyme activities. Fluoride 35: 153-160. (See abstract | See study)

Zhao ZL, et al. (1995). The influence of fluoride on the content of testosterone and cholesterol in rat. Fluoride 28: 128-130. (See abstract)

Zhu XZ, et al. (2000). [The primary study of antagonism of selenium on fluoride-induced reproductive toxicity of male rat]Chung-Kuo Kung Kung Wei Sheng 16: 697-8. (See abstract)

Humans: (back to top)

Barot VV. (1998). Occurrence of endemic fluorosis in human population of North Gujurat, India: human health risk. Bulletin of Environmental Contamination and Toxicology 61: 303-310.

Chinoy, NJ, Narayana MV. (1994). In vitro fluoride toxicity in human spermatozoa. Reproductive Toxicology 8(2):155-9. (See abstract)

Freni SC. (1994). Exposure to high fluoride concentrations in drinking water is associated with decreased birth rates. Journal of Toxicology and Environmental Health 42:109-121. (See abstract)

Kuznetsova LS. (1969). The effects of the various operations in the manufacture of superphosphate on the sex organs of female workers. Gig Tr i Prof Zabol. 13: 21-25. (See discussion of study)

Neelam, K, et al. (1987). Incidence of prevalence of infertility among married male members of endemic fluorosis district of Andhra Pradesh. In: Abstract Proc Conf Int Soc for Fluoride Res. Nyon, Switzerland.

Ortiz-Perez D, et al. (2003). Fluoride-induced disruption of reproductive hormones in men. Environmental Research 93(1):20-30. (See abstract)

Susheela AK, Jethanandani P. (1996). Circulating testosterone levels in skeletal fluorosis patients. Journal of Toxicology and Clinical Toxicology 34(2):183-9. (See abstract)

Tokar VI, Savchenko ON. (1977). Effect of inorganic fluorine compounds on the functional state of the pituitary-testis system. Probl Endokrinol (Mosk). 23(4):104-7. (See abstract)

X. FLUORIDE and BIRTH DEFECTS (back to top)

Burgstahler AW. (1975). Editorial Review: Fluoride and Down's Syndrome (Mongolism). Fluoride 8: 1-11, 120.

Erickson JD, et al. (1976). Water Fluoridation and Congenital Malformations: No Association. Journal of the American Dental Association 93 (5): 981-984. (See abstract)

Goh EH, Neff AW. (2003). Effects of fluoride on Xenopus embryo development. Food and Chemical Toxicology 41(11): 1501-8. (See abstract)

Minta M, Wlodarczyk B. (2003). Effect of some environmental contaminants on differentiation in micromass culture of rat embryo limb bud cells. Reproductive Toxicology 17: 500. (See abstract)

Needleman HL, et al. (1974). Fluoridation and the Occurrence of Down's Syndrome. New England Journal of Medicine 291: 821-823.

Rapaport I. (1963). Oligophrenie mongolienne et caries dentaires. Rev. Stomatol. 64: 207-218. (See paper)

Rapaport I. (1961). A propos du mongolisme infantile. Une deviation du metabolisme de tryptophane provoquee par le fluor chez la drosophile. Bull. Acad. Natl. Med. (Paris). 145: 450-453. (See discussion of Rapaport's research)

Rapaport I. (1960). Oligophrenie mongolienne et ectodermoses congenitales. Ann. Dermatol. Syphiligr. 87: 263-278.

Rapaport I. (1959). Nouvelles recherches sur le mongolisme. A propos du role pathogenique du fluor. Bull. Acad. Nat. Med. (Paris). 143: 367-370. (See translation of paper)

Rapaport I. (1957). Contribution a l'etude etiologique du mongolisme. Role des inhibiteurs enzymatiques. Encephale. 46: 468-481. (See paper)

Takahashi K. (1998). Fluoride-linked down syndrome births and their estimated occurrence due to water fluoridation. Fluoride 31(2):61-73. (See paper)

Verma RJ, Sherlin DM. (2001). Vitamin C ameliorates fluoride-induced embryotoxicity in pregnant rats. Human & Experimental Toxicology 20(12):619-23. (See abstract)

Waldbott GL, Burgstahler AW, and McKinney HL. (1978). Fluoridation: The Great Dilemma. Coronado Press, Inc., Lawrence, Kansas. p. 212-219. (See excerpt)

Whiting P. (2001). Association of Down's syndrome and water fluoride level: a systematic review of the evidence. BioMed Central Public Health 1:6.(See study)

See also Fluoride & Mutagenicity

XI. FLUORIDE & THE IMMUNE SYSTEM (back to top)

Das (Sarkar) S, Maiti R, Ghosh D. (2006). Fluoride induced immunotoxicity in adult male albino rat: a correlative approach to oxidative stress. Journal of Immunotoxicology 3:1–7.

Gabler WL, Leong PA. (1979). Fluoride inhibition of polymorphonuclear leukocytes. Journal of Dental Research 58(9):1933-9. (See abstract)

Gibson S. (1992). Effects of fluoride on immune system function. Complementary Medical Research 6: 111-113. (See excerpts | See study)

Greenberg SR. (1982). Leukocyte response in young mice chronically exposed to fluoride. Fluoride 15: 119-123. (See abstact)

Jain SK, Susheela AK. (1987). Effect of sodium fluoride on antibody formation in rabbits. Environmental Research 44: 117-125. (See abstract)

Loftenius A, et al. (1999). Fluoride augments the mitogenic and antigenic response of human blood lymphocytes in vitro. Caries Research 33:148-55. (See abstract)

Susheela AK, Jain SK. (1983). Fluoride-induced haematological changes in rabbits. Bulletin of Environmental Contamination and Toxicology 30: 388-93. (See abstract)

Sutton P. (1991). Is the ingestion of fluoride an immunosuppressive practice? Medical Hypotheses 35: 1-3. (See paper)

Sutton P. (1987). Does fluoride ingestion affect developing immune system cells? Medical Hypotheses 23: 335-336. (See paper)

Wilkinson PC. (1983). Effects of fluoride on locomotion of human blood leucocytes in vitro. Archives of Oral Biology 28: 415-8. (See abstract)

XII. ALLERGY/HYPERSENSITIVITY TO FLUORIDE (back to top)

de Vos G, et al. (2004). Effects of fluoride and mercury on human cytokine response in vitro. Journal of Allergy and Clinical Immunology 113(Suppl 1): S66. (See abstract)

Goldman D. (2001). Tacrolimus ointment for the treatment of steroid-induced rosacea: a preliminary report. Journal of the American Academy of Dermatology 44: 995-8. (See abstract)

Grimbergen GW. (1974). A Double Blind Test for Determination of Intolerance to Fluoridated Water (Preliminary Report). Fluoride 7:146-152.

Feltman R, Kosel G. (1961). Prenatal and postnatal ingestion of fluorides - Fourteen years of investigation - Final report. Journal of Dental Medicine 16: 190-99. (See excerpts)

Feltman R. (1956). Prenatal and postnatal ingestion of fluoride salts: A progress report. Dental Digest 62: 353-357. (See excerpt)

Lewis A, Wilson CW. (1985). Fluoride hypersensitivity in Mains tap water demonstrated by skin potential changes in guinea-pigs. Medical Hypotheses 16: 397-402. (See abstract)

Prival MJ. (1972). Fluorides and human health. Center for Science in the Public Interest, Washington D.C. pp. 23-25. (See excerpt)

Shea JJ, et al. (1967). Allergy to fluoride. Annals of Allergy 25:388-91. (See study)

Spittle B. (1993). Allergy and hypersensitivity to fluoride. Fluoride 26(4):267-73. (See paper)

Waldbott GL. (1968). Hydrofluorosis in the U.S.A. Fluoride 1: 94-102.

Waldbott GL. (1958). Allergic reactions from fluorides. International Archives of Allergy 12: 347-355. (See study)

Waldbott GL. (1956). Incipient fluorine intoxication from drinking water. Acta Medica Scandinavica 156: 157-168. (See summary)

Zanfanga PE. (1976). Allergy to fluoride. Fluoride 9(1): 36-41. (See paper)

Allergy to Topical Fluorides (back to top)

Blasik LG, Spencer SK. (1979). Fluoroderma. Archives of Dermatology 115:1334-5. (See abstract)

Brun R. (2004). Recurrent benign aphthous stomatitis and fluoride allergy. Dermatology 208: 181. (See report + commentary)

Douglas TE. (1957). Fluoride dentifrice and stomatitis. Northwest Medicine 56: 1037-1039. (See study)

McCaffery K. (2003). Fluoride and dermatitis. Journal of the American Dental Association 134: 1166-1167.

Mellette JR, et al. (1983). Perioral dermatitis. Journal of the Association of Military Dermatologists 9: 3-8. (See study)

Mellette JR, et al. (1976). Fluoride tooth paste: A cause of perioral dermatitis. Archives of Dermatology 112: 730-731. (See study)

Saunders MA. (1975). Fluoride toothpastes: A cause of acne-like eruptions. Archives of Dermatology 111: 793. (See study)

Shea JJ, et al. (1967). Allergy to fluoride. Annals of Allergy 25:388-91. (See study)

XIII. FLUORIDE & CARIES (Tooth Decay) (back to top)

Decline of Caries in Western Industrialized Societies (Irrespective of Fluoridation) (back to top)

Bratthall D, Hansel-Petersson G, Sundberg H. (1996). Reasons for the caries decline: what do the experts believe? European Journal of Oral Science 104:416-22. (See abstract)

Colquhoun J. (1997). Why I changed my mind about Fluoridation. Perspectives in Biology and Medicine. 41:29-44. (See paper)

Diesendorf M. (1986). The mystery of declining tooth decay. Nature 322: 125-129. (See paper)

Glass RL. (1981). Secular changes in caries prevalence in two Massachusetts towns. Caries Research 15: 445-50. (See abstract)

Gray AS. (1987). Fluoridation: time for a new base line? Journal of the Canadian Dental Association 53: 763-5. (See abstract)

Haugejorden O. (1996). Using the DMF gender difference to assess the "major" role of fluoride toothpastes in the caries decline in industrialized countries: a meta-analysis. Community Dentistry and Oral Epidemiology 24(6):369-75. (See abstract)

Kalsbeek H, Verrips GH. (1990). Dental caries prevalence and the use of fluorides in different European countries. Journal of Dental Research 69(Spec Iss): 728-32. (See abstract)

Leverett DH. (1982). Fluorides and the changing prevalence of dental caries. Science 217(4554):26-30. (See abstract)

Marthaler TM, et al. (1996). The prevalence of dental caries in Europe 1990-1995. ORCA Saturday afternoon symposium 1995. Caries Research 30(4):237-55. (See abstract)

Neurath C. (2005). Tooth decay trends for 12 year olds in nonfluoridated and fluoridated countries. Fluoride 38:324-325. (See paper)

Petersson GH, Bratthall D. (1996). The caries decline: a review of reviews. European Journal of Oral Science 104(4(Pt 2)):436-43. (See abstract)

Reich E. (2001). Trends in caries and periodontal health epidemiology in Europe. International Dental Journal 51(6 Suppl 1):392-8. (See abstract)

WHO (Online). WHO Oral Health Country/Area Profile Programme. Department of Noncommunicable Diseases Surveillance/Oral Health. WHO Collaborating Centre, Malmo University, Sweden. (See data)

Caries Decline in Belgium - (Unfluoridated Water, Fluoridated Salt):

Carvalho JC, et al. (2001). The decline in dental caries among Belgian children between 1983 and 1998. Community Dentistry and Oral Epidemiology 29(1):55-61. (See abstract)

Caries Decline in Denmark - (Unfluoridated Water, Unfluoridated Salt):

Petersen PE. (1992). Effectiveness of oral health care--some Danish experiences. Proceedings of the Finnish Dental Society 88(1-2):13-23. (See abstract)

Caries Decline in Finland - (Unfluoridated Water, Unfluoridated Salt):

Vehkalahti M, Rytomaa I, Helminen S. (1991). Decline in dental caries and public oral health care of adolescents. Acta Odontologica Scandinavica 49(6):323-8. (See abstract)

Caries Decline in France - (Unfluoridated Water, Fluoridated Salt):

Obry-Musset AM. (1998). [Epidemiology of dental caries in children] [Article in French] Arch Pediatr. 5(10):1145-8. (See abstract)

Caries Decline in Germany - (Unfluoridated Water, Fluoridated Salt):

Gulzow HJ. (1990). [Preventive dentistry in the Federal Republic of Germany] [Article in German] Oralprophylaxe. 12(2):53-60. (See abstract)

Caries Decline in Greece - (Unfluoridated Water, Unfluoridated Salt):

Athanassouli I, et al. (1994). Dental caries changes between 1982 and 1991 in children aged 6-12 in Athens, Greece. Caries Research 28(5):378-82. (See abstract)

Caries Decline in Iceland - (Unfluoridated Water, Unfluoridated Salt):

Einarsdottir KG, Bratthall D. (1996). Restoring oral health: On the rise and fall of dental caries in Iceland. European Journal of Oral Science 104(4 ( Pt 2)):459-69. (See abstract)

Caries Decline in The Netherlands - (Unfluoridated Water, Unfluoridated Salt):

Truin GJ, et al. (1994). Caries prevalence in Belgium and The Netherlands. International Dental Journal 44(4 Suppl 1):379-8. (See abstract)

Caries Decline in Norway - (Unfluoridated Water, Unfluoridated Salt):

Birkeland JM, Haugejorden O. (2001). Caries decline before fluoride toothpaste was available: earlier and greater decline in the rural north than in southwestern Norway. Acta Odontologica Scandinavica 59(1):7-13 (See abstract)

Kallestal C, et al. (1999). Caries-preventive methods used for children and adolescents in Denmark, Iceland, Norway and Sweden. Community Dentistry and Oral Epidemiology 27(2):144-51. (See abstract)

Caries Decline in Sweden - (Unfluoridated Water, Unfluoridated Salt):

Stecksen-Blicks C, Holm AK. (1995). Dental caries, tooth trauma, malocclusion, fluoride usage, toothbrushing and dietary habits in 4-year-old Swedish children: changes between 1967 and 1992. International Journal of Paediatric Dentistry 5(3):143-8. (See abstract)

Caries Decline in Switzerland - (Unfluoridated Water, Fluoridated Salt):

Menghini G, et al. (2003). [Caries prevalence among students in 16 Zurich districts in the years 1992 to 2000 Schweiz Monatsschr Zahnmed 113(3):267-77. (See abstract)

Marthaler TM. (1991). [School dentistry in Zurich Canton: changes as a result of caries reduction of 80 to 85 percent] [Article in German] Oralprophylaxe. 13(4):115-22. (See abstract)

NIDR's National Survey of Dental Health in US (Largest dental survey conducted in US): (back to top)

Brunelle, JA, Carlos JP. (1990). Recent trends in dental caries in U.S. children and the effect of water fluoridation. Journal of Dental Research 69(Special edition): 723-727. (See paper)

Heller KE, et al (1997). Dental caries and dental fluorosis at varying water fluoride concentrations. Journal of Public Health Dentistry 57(3): 136-143. (See abstract)

Hileman B. (1989). New studies cast doubt on fluoridation benefits. Chemical and Engineering News May 8. (See article)

Yiamouyiannis JA. (1990). Water fluoridation and tooth decay: Results from the 1986-87 national survey of U.S. schoolchildren. Fluoride 23: 55-67. (See paper)

Fluoridation Cessation Studies (back to top)

Burt BA, et al. (2000). The effects of a break in water fluoridation on the development of dental caries and fluorosis. Journal of Dental Research 79(2):761-9. (See abstract)

Kunzel W, et al. (2000). Decline in caries prevalence after the cessation of water fluoridation in former East Germany. Community Dentistry and Oral Epidemiology 28(5): 382-389. (See abstract)

Kunzel W, Fischer T. (2000). Caries prevalence after cessation of water fluoridation in La Salud, Cuba. Caries Research 34(1): 20-5. (See abstract)

Maupome G, et al. (2001). Patterns of dental caries following the cessation of water fluoridation. Community Dentistry and Oral Epidemiology 29(1): 37-47. (See abstract)

Seppa L, et al. (2000) Caries trends 1992-98 in two low-fluoride Finnish towns formerly with and without fluoride. Caries Research 34(6): 462-8. (See abstract)

See also:

Ziegelbecker R. (1998). Fluoridation in Europe. Fluoride 31: 171-174.

Critique of Early Fluoridation Trials (back to top)

Sutton P. (1960) Fluoridation: Errors and Omissions in Experimental Trials. Melbourne University Press. Second Edition. (See report).

Sutton P. (1996). The Greatest Fraud: Fluoridation. A Factual Book. Kurunda Pty, Ltd, PO Box 22, Lorne, Australia 3232.

Ziegelbecker R. (1970). A critical review on the fluorine caries problem. Fluoride 3: 71-79. (See abstract)

Fluoride's Topical Vs. Systemic Effects (back to top)

Burt BA. (1999). The case for eliminating the use of dietary fluoride supplements for young children. Journal of Public Health Dentistry 59: 269-74. (See abstract)

Burt BA. (2004). Pre- and posteruptive fluoride: Do both actions control caries? Journal of Public Health Dentistry 64(Special Issue): 47-49.

Carlos JP. (1983). Comments on Fluoride. Journal of Pedodontics Winter: 135-136.

CDC. (2001). Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Mortality and Morbidity Weekly Review 50(RR14):1-42. (See report )

CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. Mortality and Morbidity Weekly Review 48(41): 933-940. (See report)

Featherstone J.D.B. (1999) Prevention and reversal of dental caries: role of low level fluoride. Community Dentistry and Oral Epidemiology 27:31-40. (See abstract)

Featherstone, J.D.B. (2000). The Science and Practice of Caries Prevention. Journal of the American Dental Association 131: 887-899. (See abstract)

Fejerskov O. (2004). Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Research 38: 182-91. (See abstract)

Fejerskov O, et al. (1981). Rational use of fluorides in caries prevention. Acta Odontologica Scandinavica 241-249. (See abstract)

Heifetz SB, Proskin HM. (1995). Serendipitous results of a pilot study: precaution indicated. Journal of Clinical Dentistry 6(1):117-9. (See abstract)

Hellwig E, Lennon AM. (2004). Systemic versus topical fluoride. Caries Researh 38: 258-62. (See abstract)

Leverett DH. (1991). Appropriate uses of systemic fluoride: considerations for the '90s. Journal of Public Health Dentistry 51: 42-7. (See excerpt)

Levine, R.S., (1976). The action of fluoride in caries prevention: a review of current concepts. British Dental Journal 140: 9-14.

Locker, D. (1999). Benefits and Risks of Water Fluoridation. An Update of the 1996 Federal-Provincial Sub-committee Report. Prepared for Ontario Ministry of Health and Long Term Care. (See report )

Limeback, H. (1999). A re-examination of the pre-eruptive and post-eruptive mechanism of the anti-caries effects of fluoride: is there any caries benefit from swallowing fluoride? Community Dentistry and Oral Epidemiology 27: 62-71. (See abstract)

Mirth DB et al. (1985). Comparison of the cariostatic effect of topically and systemically administered controlled release fluoride in the rat. Caries Research 19: 466-74.

Fluoride and Pit & Fissure Decay: (back to top)

Gray AS. (1987). Fluoridation: time for a new base line? Journal of the Canadian Dental Association 53: 763-5.

Pinkham JR, ed. (1999). Pediatric Dentistry Infancy Through Adolescence. 3rd Edition. Philadelphia: WB Saunders Co.

Raloff J. (1984). Dental study upsets the accepted wisdom. Science News 125(1): January 7.

Scholle R. (1984). Editorial: Preserving the perfect tooth. Journal of the American Dental Association 108:448.

White B. (1993). Toward improving the oral health of Americans: an overview of oral health status, resources and care delivery . Public Health Reports 108(6): 657-672.

See also:

Fluoride Action Network. (2005). Fluoride's Impact on Smooth Tooth Surfaces vs Pits & Fissures. Compilation of Reports. (See compilation)

Fluoride & Baby Bottle Tooth Decay (back to top)

Barnes GP, et al. (1992). Ethnicity, location, age, and fluoridation factors in baby bottle tooth decay and caries prevalence of Head Start children. Public Health Reports 107: 167-73. (See abstract)

Kelly M, Bruerd B. (1987). The Prevalence of Baby Bottle Tooth Decay Among Two Native American Populations. Journal of Public Health Dentistry 47:94-97.

Shiboski CH, et al. (2003). The association of early childhood caries and race/ethnicity among California preschool children. Journal of Public Health Dentistry 63(1):38-46. (See abstract)

Von Burg MM, et al. (1995). Baby bottle tooth decay: a concern for all mothers. Pediatric Nursing 21:515-519. (See abstract)

Elevated Fluoride Exposure Increases Tooth Decay (back to top)

Awadia AK, et al. (2002). Caries experience and caries predictors - a study of Tanzanian children consuming drinking water with different fluoride concentrations. Clinical Oral Investigations (2002) 6:98-103. (See abstract)

Binbin W, et al. (2005). Dental caries in fluorine exposure areas in China. Environmental Geochemistry and Health 27:285-8. (See abstract)

Budipramana ES, et al. (2002). Dental fluorosis and caries prevalence in the fluorosis endemic area of Asembagus, Indonesia. International Journal of Paediatric Dentistry 12(6):415-22. (See abstract)

Ekanayake L, Van Der Hoek W. (2002). Dental caries and developmental defects of enamel in relation to fluoride levels in drinking water in an arid area of sri lanka. Caries Research 36(6):398-404. (See abstract)

Grobleri SR, et al. (2001). Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa. International Journal of Paediatric Dentistry 11(5):372-9. (See abstract)

Grobler SR, van Wyk CW, Kotze D. (1986). Relationship between enamel fluoride levels, degree of fluorosis and caries experience in communities with a nearly optimal and a high fluoride level in the drinking water. Caries Research 20:284-8.

Mann J,et al. (1990). Fluorosis and dental caries in 6-8-year-old children in a 5 ppm fluoride area. Community Dentistry and Oral Epidemiology 18(2):77-9. (See abstract)

Mann J, et al. (1987). Fluorosis and caries prevalence in a community drinking above-optimal fluoridated water. Community Dentistry and Oral Epidemiology 15(5):293-5. (See abstract)

Olsson B. (1979). Dental findings in high-fluoride areas in Ethiopia. Community Dentistry and Oral Epidemiology 7(1):51-6. (See abstract)

Ramseyer WF, et al. (1957). Effect of Sodium Fluoride Administration on Body Changes in Old Rats. Journal of Gerontology 12: 14-19. (See excerpt)

Retief DH, et al. (1979). Relationships among fluoride concentration in enamel, degree of fluorosis and caries incidence in a community residing in a high fluoride area. Journal of Oral Pathology 8: 224-36. (See abstract)

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London. (See excerpts)

Smith MC, Smith HV. (1940). Observations on the durability of mottled teeth. American Journal of Public Health 30: 1050-1052.

Teotia SPS, Teotia M. (1994). Dental caries: a disorder of high fluoride and low dietary calcium interactions (30 years of personal research). Fluoride 27: 59-66. (See abstract | See study)

Wondwossen F, et al. (2004). The relationship between dental caries and dental fluorosis in areas with moderate- and high-fluoride drinking water in Ethiopia. Community Dentistry and Oral Epidemiology 32: 337-44. (See abstract)

Ziegelbecker R, Ziegelbecker RC. (1993). WHO data on dental caries and natural fluoride levels. Fluoride 26: 263-266. (See excerpt)

See also:

Steelink C. (1992). Fluoridation Controversy. (Letter). Chemical Engineering News July 27: 2-3.

Fluoride & Delayed Eruption of Teeth: (back to top)

Ainsworth NJ. (1933). Mottled teeth. British Dental Journal 55: 233-250.

Campagna L, et al. (1995). Fluoridated drinking water and maturation of permanent teeth at age 12. Journal of Clinical Pediatric Dentistry 19(3):225-8. (See abstract)

Feltman R, Kosel G. (1961). Prenatal and postnatal ingestion of fluorides - Fourteen years of investigation - Final report. Journal of Dental Medicine 16: 190-99.

Freitas JA, et al. (1971). Influence of fluoridation in the chronology of eruption of permanent teeth. Estomatologia e Cultura 5: 156-165.

Krook L, et al. (1983). Dental fluorosis in cattle. Cornell Veterinarian 73(4):340-62. (See abstract)

Kunzel VW. (1976). [Cross-sectional comparison of the median eruption time for permanent teeth in children from fluoride poor and optimally fluoridated areas] Stomatol DDR. 5:310-21. (See abstract)

Lemmon JR. (1934). Mottled enamel of teeth in children. Texas State Journal of Medicine 30: 332-336.

Leroy R, et al. (2003). The effect of fluorides and caries in primary teeth on permanent tooth emergence. Community Dentistry and Oral Epidemiology 31(6):463-70. (See abstract)

Limeback, H. (2002). Systemic Fluoride: Delayed Tooth Eruption and DMFT vs Age Profiles. abstract presented at IADR/AADR/CADR 80th General Session. San Diego, California. March 6-9. (See abstract)

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London. (See excerpts)

Short EM. (1944). Domestic water and dental caries. VI. The relation of fluoride domestic waters to permanent tooth eruption. Journal of Dental Research 23:247-255.

Virtanen JI, et al. (1994). Timing of eruption of permanent teeth: standard Finnish patient documents. Community Dentistry and Oral Epidemiology 22(5 Pt 1):286-8. (See abstract)

See also:

Nadler GL. (1998). Earlier dental maturation: fact or fiction? Angle Orthod. 68(6):535-8. (See abstract)

XIV. DENTAL FLUOROSIS (back to top)

Mechanism of Action (back to top)

Aoba T, Fejerskov O. (2002). Dental fluorosis: chemistry and biology. Critical Review of Oral Biology and Medicine 13: 155-70. (See abstract)

Dean HT. (1936). Chronic endemic dental fluorosis (mottled enamel). Journal of the American Medical Association 107: 1269-1273.

DenBesten PK, et al. (2002). Effects of fluoride on rat dental enamel matrix proteinases. Archives of Oral Biology 47: 763-770. (See abstract)

DenBesten P (1999). Biological mechanism of dental fluorosis relevant to the use of fluoride supplements. Community Dentistry and Oral Epidemiology 27: 41-7. (See abstract)

Everett ET, et al. (2002). Dental fluorosis: variability among different inbred mouse strains. Journal of Dental Research 81: 794-8. (See abstract)

Fejerskov O, et al. (1990). The nature and mechanisms of dental fluorosis in man. Journal of Dental Research 69(Spec Iss): 692-700. (See abstract)

Matsuo S, et al. (1998). Mechanism of toxic action of fluoride in dental fluorosis: whether trimeric G proteins participate in the disturbance of intracellular transport of secretory ameloblast exposed to fluoride. Archives of Toxicology 72: 798-806. (See abstract)

Milan AM, et al. (1999). Fluoride alters casein kinase II and alkaline phosphatase activity in vitro with potential implications for dentine mineralization. Archives of Oral Biology 46: 343-51. (See abstract)

Milan AM, et al. (1999). Altered phosphorylation of rat dentine phosphoproteins by fluoride in vivo. Calcified Tissue International 64: 234-8. (See abstract)

Schuld A. (2005). Is dental fluorosis caused by thyroid hormone disturbances? Fluoride 38: 91-94.

Susheela AK, Bhatnagar M. (1999). Structural aberrations in fluorosed human teeth: Biochemical and scanning electron microscopic studies. Current Science 77: 1677-1680. (See study)

Ouyang W, et al. (2000). [Effect caused by uptake of different levels of calcium to enamel fluorosis in rats] [Article in Chinese]. Zhonghua Kou Qiang Yi Xue Za Zhi. 35: 47-9. (See abstract)

Current Rates of Dental Fluorosis (back to top)

Centers for Disease Control and Prevention. (2005) Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002. Morbidity and Mortality Weekly Report Surveillance Summaries 54:1-43. (See paper)

Clark DC. (1994). Trends in prevalence of dental fluorosis in North America. Community Dentistry and Oral Epidemiology 22: 148-52. (See abstract)

Griffin SO, et al. (2002). Esthetically objectionable fluorosis attributable to water fluoridation. Community Dentistry and Oral Epidemiology 30(3):199-209. (See abstract)

Heller KE, et al (1997). Dental caries and dental fluorosis at varying water fluoride concentrations. Journal of Public Health Dentistry 57(3) 136-143. (See abstract)

Lalumandier JA, et al (1995). The prevalence and risk factors of fluorosis among patients in a pediatric dental practice. Pediatric Dentistry 17:1, 19-25. (See abstract)

Leverett D. (1986). Prevalence of dental fluorosis in fluoridated and nonfluoridated communities--a preliminary investigation. Journal of Public Health Dentistry 46(4):184-7. (See abstract)

Levy SM, et al. (2006). Use of the fluorosis risk index in a cohort study: the Iowa fluoride study. Journal of Public Health Dentistry 66:92-6. (See abstract)

McDonagh M, et al. (2000). A Systematic Review of Public Water Fluoridation. ("The York Review.") NHS Center for Reviews and Dissemination. University of York. September 2000. (See report)

Rozier RG. (1999). The prevalence and severity of enamel fluorosis in North American children. Journal of Public Health Dentistry 59(4):239-46. (See abstract)

Tabari ED, et al. (2000). Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy. British Dental Journal 189(4): 216-220. (See abstract)

Williams JE, et al. (1990). Community Water Fluoride Levels, Preschool Dietary Patterns, and The Occurrence of Fluoride Enamel Opacities. Journal of Pub Health Dentistry 50:276-81. (See abstract)

Dental fluorosis more prevalent among African-Americans (back to top)

Butler WJ, et al. (1985). Prevalence of dental mottling in school-aged lifetime residents of 16 Texas communities. American Journal of Public Health 75(12):1408-12. (See abstract)

Centers for Disease Control and Prevention. (2005) Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002. Morbidity and Mortality Weekly Report Surveillance Summaries 54:1-43. (See paper)

Kumar JV, Swango PA. (2000). Low birth weight and dental fluorosis: is there an association? Journal of Public Health Dentistry 60(3):167-71. (See abstract)

Kumar JV, Swango PA. (1999). Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. Community Dentistry and Oral Epidemiology 27(3):171-80. (See abstract)

Heller KE, et al. (2000). Water consumption and nursing characteristics of infants by race and ethnicity. Journal of Public Health Dentistry 60(3):140-6.(See abstract)

Perceptions/Psychological Effects of Dental Fluorosis (back to top)

Chikte UM, et al. (2001). Perceptions of fluorosis in northern Cape communities. South African Dental Journal 56(11):528-32. (See abstract)

Edwards M, et al. (2005). An assessment of teenagers' perceptions of dental fluorosis using digital simulation and web-based testing. Community Dentistry and Oral Epidemiology 33:298-306. (See abstract)

Griffin SO, et al. (2002). Esthetically objectionable fluorosis attributable to water fluoridation. Community Dentistry and Oral Epidemiology 30(3):199-209. (See abstract)

Jones J, Glasser G. (2002). The Psychological Impact of Dental Fluorosis. National Pure Water Association. Wakefield, UK. (See paper)

Lalumandier JA, Rozier RG. (1998). Parents' satisfaction with children's tooth color: fluorosis as a contributing factor. Journal of the American Dental Association 129: 1000-6.

Martinez-Mier EA, et al. (2004). Development of a questionnaire to measure perceptions of, and concerns derived from, dental fluorosis. Community Dental Health 21:299-305. (See abstract)

McKnight CB, et al. (1998). A pilot study of esthetic perceptions of dental fluorosis vs. selected other dental conditions. ASDC Journal of Dentistry for Children 65(4):233-8, 229. (See abstract)

Milsom KM, et al. (2000). A comparison of normative and subjective assessment of the child prevalence of developmental defects of enamel amongst 12-year-olds living in the North West Region, UK. Public Health. 114(5):340-4. (See abstract)

Rahmatulla AH. (1995). Clinical evaluation of two different techniques for the removal of fluorosis stains. Egyptian Dental Journal 41(3):1287-94. (See abstract)

Riordan PJ. (1993). Perceptions of dental fluorosis. Journal of Dental Research 72(9):1268-74.(See abstract)

Rodd HD, Davidson LE. (1997). The aesthetic management of severe dental fluorosis in the young patient. Dental Update 24(10):408-11. (See abstract)

Si Y, et al. (2006). [Evaluation of the public on the psychosocial effects of fluorosis]. Zhonghua Kou Qiang Yi Xue Za Zhi. 41(3):172-4. (See abstract)

Sigurjons H, et al. (2004). Parental perception of fluorosis among 8-year-old children living in three communities in Iceland, Ireland and England. Community Dentistry and Oral Epidemiology 32(Suppl 1):34-8. (See abstract)

Spencer AJ, et al. (1996). Water fluoridation in Australia. Community Dental Health 13(Suppl 2):27-37. (See excerpt)

Welbury RR, Shaw L. (1990). A simple technique for removal of mottling, opacities and pigmentation from enamel. Dental Update 17(4):161-3. (See abstract)

Williams DM, et al. (2006). Attitudes to fluorosis and dental caries by a response latency method. Community Dentistry and Oral Epidemiology 34:153-9. (See abstract)

Woodward GL, Main PA, Leake JL. (1996). Clinical determinants of a parent's satisfaction with the appearance of a child's teeth. Community Dentistry and Oral Epidemiology 24:416-8.

Dental fluorosis & Bone fracture (back to top)

Alarcon-Herrera MT, et al. (2001). Well water fluoride, dental fluorosis, bone fractures in the Guadiana Valley of Mexico. Fluoride 34: 139-149.(See study)

Fluorosis & Caries (back to top)

Awadia AK, et al. (2002). Caries experience and caries predictors - a study of Tanzanian children consuming drinking water with different fluoride concentrations. Clinical Oral Investigations (2002) 6:98-103. (See abstract)

Budipramana ES, et al. (2002). Dental fluorosis and caries prevalence in the fluorosis endemic area of Asembagus, Indonesia. International Journal of Paediatric Dentistry 12(6):415-22. (See abstract)

Chibole O. (1988). Dental caries among children in high fluoride regions of Kenya. Journal of the Royal Society of Health 108: 32-33.

Cortes DF, et al. (1996). Drinking water fluoride levels, dental fluorosis, and caries experience in Brazil. Journal of Public Health Dentistry 56: 226-8. (See abstract)

Ekanayake L, Van Der Hoek W. (2002). Dental caries and developmental defects of enamel in relation to fluoride levels in drinking water in an arid area of sri lanka. Caries Research 36(6):398-404. (See abstract)

Grobleri SR, et al. (2001). Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa. International Journal of Paediatric Dentistry 11(5):372-9. (See abstract)

Ibrahim YE, et al. (1997). Caries and dental fluorosis in a 0.25 and a 2.5 ppm fluoride area in the Sudan.International Journal of Paediatric Dentistry 7(3):161-6. (See abstract)

Manji F, Kapila S. (1986). Fluorides and fluorosis in Kenya. Part III: Fluorides, fluorosis and dental caries. Odonto-stomatologie tropicale 9:135-9.

Mann J,et al. (1990). Fluorosis and dental caries in 6-8-year-old children in a 5 ppm fluoride area. Community Dentistry and Oral Epidemiology 18(2):77-9. (See abstract)

Mann J, et al. (1987). Fluorosis and caries prevalence in a community drinking above-optimal fluoridated water.Community Dentistry and Oral Epidemiology 15(5):293-5. (See abstract)

Nanayakkara D, et al. (1999). Dental fluorosis and caries incidence in rural children residing in a high fluoride area in the dry zone of Sri Lanka. Ceylon Journal of Medical Science 42:13-17.

Olsson B. (1979). Dental findings in high-fluoride areas in Ethiopia. Community Dentistry and Oral Epidemiology 7(1):51-6. (See abstract)

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London. (See excerpts)

Smith MC, Smith HV. (1940). Observations on the durability of mottled teeth. American Journal of Public Health 30: 1050-1052.

Teotia SPS, Teotia M. (1994). Dental caries: a disorder of high fluoride and low dietary calcium interactions (30 years of personal research). Fluoride 27(2): 59-66. (See abstract )

Vignarajah S. (1993). Dental caries and enamel opacities in children residing in urban and rural areas of Antigua with different levels of natural fluoride in drinking water. Community Dental Health 10: 159-166.

Wondwossen F, et al. (2004). The relationship between dental caries and dental fluorosis in areas with moderate- and high-fluoride drinking water in Ethiopia. Community Dentistry and Oral Epidemiology 32: 337-44. (See abstract)

Risk Factors for Fluorosis (back to top)

Angmar-Mansson B, Whitford GM. (1990). Environmental and physiological factors affecting dental fluorosis. Journal of Dental Research 6(Spec Iss): 706-13. (See abstract)

Behrendt A, Oberste V, Wetzel WE. (2002). Fluoride concentration and pH of iced tea products. Caries Research 36(6): 405-410. (See abstract)

Bentley EM, et al. (1999). Fluoride ingestion from toothpaste by young children. British Dental Journal 186(9):460-2. (See abstract)

Burt BA. (1999). The case for eliminating the use of dietary fluoride supplements for young children. Journal of Public Health Dentistry 59: 269-74. (See abstract)

Brothwell D, Limeback H. (2003). Breastfeeding is protective against dental fluorosis in a nonfluoridated rural area of Ontario, Canada. Journal of Human Lactation 19: 386-90. (See abstract)

Clark DC, et al. (1994). Influence of exposure to various fluoride technologies on the prevalence of dental fluorosis. Community Dentistry and Oral Epidemiology 22: 461-4. (See abstract)

Diesendorf M, Diesendorf A. (1997). Suppression by medical journals of a warning about overdosing formula-fed infants with fluoride. Accountability in Research 5:225-237. (See paper)

Ekstrand J. (1989). Fluoride intake in early infancy. Journal of Nutrition 119(Suppl 12):1856-60.

Erdal S, Buchanan SN. (2005). A quantitative look at fluorosis, fluoride exposure, and intake in children using a health risk assessment approach. Environmental Health Perspectives 113:111-7. (See abstract)

Fein NJ, Cerklewski FL. (2001). Fluoride content of foods made with mechanically separated chicken. Journal of Agricultural Food Chemistry 49(9):4284-6. (See abstract)

Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60(3):131-9. (See abstract)

Fomon SJ, Ekstrand J. (1999). Fluoride intake by infants. Journal of Public Health Dentistry 59(4):229-34. (See abstract)

Franzman MR, et al. (2006). Fluoride dentifrice ingestion and fluorosis of the permanent incisors. Journal of the American Dental Association 137:645-52. (See abstract)

Griffin SO, et al. (2002). Esthetically objectionable fluorosis attributable to water fluoridation. Community Dentistry and Oral Epidemiology 30(3):199-209. (See abstract)

Heilman JR, et al. (1999). Assessing fluoride levels of carbonated soft drinks. Journal of the American Dental Association 130(11):1593-9. (See abstract)

Heilman JR, et al. (1997). Fluoride concentrations of infant foods. Journal of the American Dental Association 128: 857-863. (See abstract)

Ismail AI, Bandekar RR. (1999). Fluoride supplements and fluorosis: a meta-analysis. Community Dentistry and Oral Epidemiology 27(1):48-56. (See abstract)

Kiritsy MC, et al. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association 127(7):895-902. (See abstract)

Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23. (See abstract)

Levy SM, et al. (1995). Sources of fluoride intake in children. Journal of Public Health Dentistry 55(1):39-52. (See abstract)

Lewis DW, Limeback H. (1996). Comparison of recommended and actual mean intakes of fluoride by Canadians. Journal of the Canadian Dental Association 62: 708-715. (See abstract)

Marshall TA, et al. (2004). Associations between Intakes of Fluoride from Beverages during Infancy and Dental Fluorosis of Primary Teeth. Journal of the American College of Nutrition 23(2):108-16. (See abstract)

Mascarenhas AK. (2000). Risk factors for dental fluorosis: a review of the recent literature. Pediatric Dentistry 22(4):269-77. (See abstract)

Mascarenhas AK, Burt BA. (1998). Fluorosis risk from early exposure to fluoride toothpaste. Community Dentistry and Oral Epidemiology 26(4):241-8. (See abstract)

Massler M, Schour I. (1952). Relation of endemic dental fluorosis to malnutrition. Journal of the American Dental Association 44: 156-165. (See excerpt)

Murray MM, Wilson DC. (1948). Fluorosis and nutrition in Morocco. British Dental Journal 84: 97.

Pendrys DG. (2000). Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional. Journal of the American Dental Association 131: 746-55. (See abstract)

Pendrys DG, Katz RV. (1998). Risk factors for enamel fluorosis in optimally fluoridated children born after the US manufacturers' decision to reduce the fluoride concentration of infant formula. American Journal of Epidemiology 148: 967-74. (See abstract) .

Pendrys DG, et al. (1994). Risk factors for enamel fluorosis in a fluoridated population. American Journal of Epidemiology 140: 461-71. (See abstract)

Turner SD, et al. (1998). Impact of imported beverages on fluoridated and nonfluoridated communities. General Dentistry 46(2):190-3. (See abstract)

Level of fluoride in infant-formula made with fluoridated water is 100-200 times higher than fluoride level found in women's breast milk:

Ekstrand J. (1989). Fluoride intake in early infancy. Journal of Nutrition 119(Suppl 12):1856-60.

Ekstrand J, et al. (1984). Fluoride balance studies on infants in a 1-ppm-water-fluoride area. Caries Research 18:87-92

Ekstrand J, et al. (1981). No evidence of transfer of fluoride from plasma to breast milk. British Medical Journal (Clin Res Ed). 283: 761-2.

Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60:131-9. (See abstract)

Institute of Medicine. (1997). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. National Academy Press.

XV. FLUORIDE: NOT an ESSENTIAL NUTRIENT (back to top)

Alberts B, Shine K. (1998). Letter to Albert Burgstahler, from Bruce Alberts, President, National Academy of Sciences, and Kenneth Shine, President, Institute of Medicine. November 18. (See letter)

National Academy of Sciences. (1989). Recommended Dietary Allowances: 10th Edition. Commission on Life Sciences, National Research Council, National Academy Press. (See report)

National Research Council (1993). Health Effects of Ingested Fluoride. National Academy Press, Washington DC. See page 30. (See report)

XVI. SOURCES OF FLUORIDE EXPOSURE (back to top)

Behrendt A, Oberste V, Wetzel WE. (2002). Fluoride concentration and pH of iced tea products. Caries Research 36: 405-410. (See abstract)

Bentley EM, et al. (1999). Fluoride ingestion from toothpaste by young children. British Dental Journal 186: 460-2. (See abstract)

Brothwell D, Limeback H. (2003). Breastfeeding is protective against dental fluorosis in a nonfluoridated rural area of Ontario, Canada. Journal of Human Lactation 19: 386-90. (See abstract)

Burgstahler AW, et al. (1997). Fluoride in California wines and raisins. Fluoride 30: 142-146. (See abstract)

Chan JT, Koh SH. (1996). Fluoride content in caffeinated, decaffeinated and herbal teas. Caries Research 30:88-92. (See abstract)

Department of Health & Human Services (DHHS). (1991). Review of Fluoride: Benefits and Risks. Report of the Ad Hoc Committee on Fluoride. Page 17.

Diesendorf M, Diesendorf A. (1997). Suppression by medical journals of a warning about overdosing formula-fed infants with fluoride. Accountability in Research 5:225-237. (See paper)

Dolan T, et al. (1978). Determination of fluoride in deboned meat. Journal of the Association of Official Analytical Chemists 61: 982-985. (See abstract)

Ekstrand J. (1989). Fluoride intake in early infancy. Journal of Nutrition 119(Suppl 12):1856-60.

Ekstrand J, et al. (1981). Pharmacokinetics of fluoride gels in children and adults. Caries Research 15:213-20.

Ekstrand J, Ehrnebo M. (1980). Absorption of fluoride from fluoride dentrifices. Caries Research 14: 96-102.

Erdal S, Buchanan SN. (2005). A quantitative look at fluorosis, fluoride exposure, and intake in children using a health risk assessment approach. Environmental Health Perspectives 113:111-7. (See abstract)

Farkas CS. (1975). Total fluoride intake and fluoride content of common foods: a review. Fluoride 8: 98-105. (See abstract)

Fein NJ, Cerklewski FL. (2001). Fluoride content of foods made with mechanically separated chicken. Journal of Agricultural Food Chemistry 49: 4284-6. (See abstract)

Field RA, et al. (1976). Characteristics of mechanically deboned meat, hand separated meat and bone residue from bones destined for rendering. Journal of Animal Science 43: 755-762.

Fomon SJ, Ekstrand J, Ziegler EE. (2000). Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants. Journal of Public Health Dentistry 60: 131-9. (See abstract)

Fomon SJ, Ekstrand J. (1999). Fluoride intake by infants. Journal of Public Health Dentistry 59: 229-34. (See abstract)

Franco AM, et al. (2005). Total fluoride intake in children aged 22-35 months in four Colombian cities. Community Dentistry and Oral Epidemiology 33:1-8. (See abstract)

Franzman MR, et al. (2006). Fluoride dentifrice ingestion and fluorosis of the permanent incisors. Journal of the American Dental Association 137:645-52. (See abstract)

Full CA, Parkins FM. (1975). Effect of cooking vessel composition on fluoride. Journal of Dental Research 54: 192.

Heilman JR, et al. (1999). Assessing fluoride levels of carbonated soft drinks. Journal of the American Dental Association 130: 1593-9. (See abstract)

Heilman JR, et al. (1997). Fluoride concentrations of infant foods. Journal of the American Dental Association 128: 857-863. (See abstract)

Jackson RD, et al. (2002). The fluoride content of foods and beverages from negligibly and optimally fluoridated communities. Community Dentistry and Oral Epidemiology 30: 382-91. (See abstract)

Johnson SA, DeBiase C. (2003). Concentration levels of fluoride in bottled drinking water. Journal of Dental Hygiene 77:161-167. (See abstract)

Kiritsy MC, et al. (1996). Assessing fluoride concentrations of juices and juice-flavored drinks. Journal of the American Dental Association 127: 895-902. (See abstract)

Levy SM, et al. (2003). Patterns of fluoride intake from 36 to 72 months of age. Journal of Public Health Dentistry 63: 211-20. (See abstract)

Levy SM, Guha-Chowdhury N. (1999). Total fluoride intake and implications for dietary fluoride supplementation. Journal of Public Health Dentistry 59: 211-23. (See abstract)

Levy SM, et al. (1995). Sources of fluoride intake in children. Journal of Public Health Dentistry 55: 39-52. (See abstract)

Lewis DW, Limeback H. (1996). Comparison of recommended and actual mean intakes of fluoride by Canadians. Journal of the Canadian Dental Association 62: 708-9, 712-5. (See abstract)

Lung SC, et al. (2003). Fluoride concentrations in three types of commercially packed tea drinks in Taiwan. Journal of Exposure Analysis and Environmental Epidemiology 13: 66-73. (See abstract)

Marshall TA, et al. (2004). Associations between Intakes of Fluoride from Beverages during Infancy and Dental Fluorosis of Primary Teeth. Journal of the American College of Nutrition 23:108-16. (See abstract)

Martinez-Mier EA, et al. (2003). Fluoride intake from foods, beverages and dentifrice by children in Mexico. Community Dentistry and Oral Epidemiology 31: 221-30.

Mascarenhas AK. (2000). Risk factors for dental fluorosis: a review of the recent literature. Pediatric Dentistry 22(4):269-77. (See abstract)

Mascarenhas AK, Burt BA. (1998). Fluorosis risk from early exposure to fluoride toothpaste. Community Dentistry and Oral Epidemiology 26: 241-8. (See abstract)

Marier JR. (1977). Some current aspects of environmental fluoride. Science of the Total Environment 8: 253-65. (See abstract)

Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081. (See report).

Marier J, Rose D. (1966). The Fluoride Content of Some Foods and Beverages - a Brief Survey Using a Modified Zr-SPADNS Method. Journal of Food Science 31: 941-946. (See abstract & excerpt)

Pang D, et al. (1992). Fluoride intake from beverage consumption in a sample of North Carolina children. Journal of Dental Research 71: 1382-1388.

Prival M, Fisher F. (1974). Adding fluorides to the diet. Environment 16: 29-33.

Stannard JG, et al. (1991). Fluoride levels and fluoride contamination of fruit juices. Journal of Clinical Pediatric Dentistry 16(1):38-40. (See abstract)

Taves DR. (1983). Dietary intake of fluoride ashed (total fluoride) v. unashed (inorganic fluoride) analysis of individual foods. British Journal of Nutrition 49: 295-301.

Turner SD, et al. (1998). Impact of imported beverages on fluoridated and nonfluoridated communities. General Dentistry 46(2):190-3. (See abstract)

Tong YS, et al. (1983). Fluoride content of commercial teas and effect of drinking milk. Journal of Dental Research 62(AADR Abstracts): 915.

USDA (2004). USDA National Fluoride Database of Selected Beverages and Food. Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture. (See report)

Warnakulasuriya S, et al. (2002). Fluoride content of alcoholic beverages. Clinica Chimica Acta 320(1-2):1-4. (See abstract)

Warren DP, et al. (1996). Comparison of fluoride content in caffeinated, decaffeinated and instant coffee. Fluoride 29: 147-150.

Warren JJ, Levy SL. (1999). Systemic fluoride: Sources, amounts, and effects of ingestion. Dental Clinics of North America 43: 695-711. (See abstract)

Wei SY, Hatab FN. (1987). Fluoride content of dried seafoods (abstract). Journal of Dental Research 66: 957.

Whyte MP, et al. (2005). Skeletal fluorosis and instant tea. American Journal of Medicine 118:78-82. (See press release)

XVII. NUTRITONAL DEFICIENCIES EXACERBATE FLUORIDE'S TOXICITY (back to top)

Agency for Toxic Substances and Disease Registry (ATSDR) (1993). Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine (F). U.S. Department of Health & Human Services, Public Health Service. ATSDR/TP-91/17. (See report)

Antonyan OA. (1980). Lipid peroxidation in fluorosis and the protective role of dietary factors. Zh Eksp Klin Med. 20(4): 381-388. (See abstract)

Chen YC, et al. (1997). Nutrition survey in dental fluorosis-afflicted areas. Fluoride 30(2):77-80. (See abstract)

Ekambaram P, Paul V. (2001). Calcium preventing locomotor behavioral and dental toxicities of fluoride by decreasing serum fluoride level in rats. Environmental Toxicology and Pharmacology 9(4):141-146. (See abstract)

Krishnamachari KA, Krishnamachari K. (1973). Genu valgum and osteoporosis in an area of endemic fluorosis. The Lancet 2(7834):877-879. (See abstract)

Li G, Ren L. (1997). [Effects of excess fluoride on bone turnover under conditions of diet with different calcium contents] Zhonghua Bing Li Xue Za Zhi. 26(5):277-80. (See abstract)

Lin Fa-Fu, et al (1991). The relationship of a low-iodine and high-fluoride environment to subclinical cretinism in Xinjiang. Iodine Deficiency Disorder Newsletter. Vol. 7. No. 3.(See study)

Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081. (See report).

Massler M, Schour I. (1952). Relation of endemic dental fluorosis to malnutrition. Journal of the American Dental Association 44: 156-165. (See excerpt)

Ouyang W, et al. (2000). [Effect caused by uptake of different levels of calcium to enamel fluorosis in rats] [Article in Chinese]. Zhonghua Kou Qiang Yi Xue Za Zhi. 35(1):47-9. (See abstract)

Pandit CG, et al. (1940). Endemic fluorosis in South India. Indian Journal of Medical Research 28: 533-558.

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.

Suttie JW, Faltin EC. (1973). Effects of sodium fluoride on dairy cattle: influence of nutritional status. American Journal of Veterinary Research 34: 479-483.

Tazhibaev ShS, et al. (1987). [Modifying effect of nutrition on the mutagenic activity of phosphorus and fluorine compounds]. Vopr Pitan. (4):63-6. (See abstract)

Teotia SPS, Teotia M. (1994). Dental caries: a disorder of high fluoride and low dietary calcium interactions (30 years of personal research). Fluoride 27(2): 59-66. (See abstract )

Teotia M, Teotia SP, Singh KP. (1998). Endemic chronic fluoride toxicity and dietary calcium deficiency interaction syndromes of metabolic bone disease and deformities in India: year 2000. Indian Journal of Pediatrics 65(3):371-81. (See abstract)

Teotia SPS, et al. (1984). Environmental Fluoride and Metabolic Bone Disease, An Epidemiological Study (Fluoride and Nutrition Interactions) Fluoride 17(1): 14-22.

Zhao W, et al. (1998). Long-term effects of various iodine and fluorine doses on the thyroid and fluorosis in mice. Endocrine Regulations 32(2):63-70. (See abstract)

See also:

Susheela AK, Bhatnagar M. (2002). Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants. Molecular and Cellular Biochemistry 234-235(1-2):335-40. (See abstract)

XVIII. ACUTE TOXICITY of FLUORIDE (back to top)

Akiniwa, K. (1997). Re-examination of acute toxicity of fluoride. Fluoride 30: 89-104. (See paper)

Augenstein WL, et al. (1991). Fluoride ingestion in children: a review of 87 cases. Pediatrics 88: 907-12. (See abstract)

Eichler HG, et al. (1982). Accidental ingestion of NaF tablets by children--report of a poison control center and one case. International Journal of Clinical Pharmacology, Therapy and Toxicology 20: 334-8. (See abstract)

Gessner BD, et al. (1994). Acute fluoride poisoning from a public water system. New England Journal of Medicine 330:95-9. (See abstract)

Gleason MN, Gosselin RE, Hodge HC, Smith RP. (1969). Clinical Toxicology of Commercial Products. 3rd Ed. Williams & Wilkins, Baltimore.

Hodge HC, Smith FA. (1965). Fluorine Chemistry Vol. IV. Academic Press, New York.

Shulman JD, Wells LM. (1997). Acute fluoride toxicity from ingesting home-use dental products in children, birth to 6 years of age. Journal of Public Health Dentistry 57: 150-8. (See abstract)

Waldbott GW. (1979). Another fluoride fatality - a physician's dilemma. Fluoride 12(1): 55-57. (See paper)

Whitford GM, et al. (1990). Acute oral toxicity of sodium fluoride and monofluorophosphate separately or in combination in rats. Caries Research 24: 121-126. (See abstract)

Whitford GM. (1987). Fluoride in dental products: safety considerations. Journal of Dental Research 66: 1056-60. (See abstract)

See also:

Fluoride Action Network. (2005). Estimated Minimum Lethal Dose of Fluoride. Fluoride Health Effects Database. (See report)

XIX. SYSTEMIC FLUORIDE NEVER APPROVED BY FDA (back to top)

Food & Drug Administration. (2000). Letter from Melinda K. Plaisier, Associate Commissioner for Legislation, FDA, to Congressman Ken Calvert. Dec 21, 2000. (See letter)

Kelly JV. (2000). Letter to Senator Robert Smith, Chairman of Environment and Public Works Committee, U.S. Senate, August 14, 2000. (See letter)

XX. ALTERNATIVES TO FLUORIDE (back to top)

Xylitol (back to top)

Alanen P, et al. (2000). Sealants and xylitol chewing gum are equal in caries prevention. Acta Odontologica Scandinavica 58(6):279-84. (See abstract)

Alanen P, et al. (2000). Xylitol candies in caries prevention: results of a field study in Estonian children. Community Dentistry and Oral Epidemiology 28(3):218-24. (See abstract)

Autio JT. (2002). Effect of xylitol chewing gum on salivary Streptococcus mutans in preschool children. ASDC Journal of Dentistry for Children 69(1):81-6, 13. (See abstract)

Calamari SE, et al. (1997). Effects of xylitol, sorbitol and fluoride mouthrinses on glucose clearance in adolescents. Acta Odontologica Scandinavica 10(1):25-36. (See abstract)

Edgar WM. (1998). Sugar substitutes, chewing gum and dental caries--a review. British Dental Journal 184(1):29-32. (See abstract)

Gales MA, Nguyen TM. (2000). Sorbitol compared with xylitol in prevention of dental caries. Annals of Pharmacotherapy 34(1):98-100. (See abstract)

Hayes C. (2001). The effect of non-cariogenic sweeteners on the prevention of dental caries: a review of the evidence. Journal of Dental Education 65(10):1106-9.(See abstract)

Hildebrandt GH, Sparks BS. (2000). Maintaining mutans streptococci suppression with xylitol chewing gum. Journal of the American Dental Association 131(7):909-16. (See abstract)

Honkala S, et al. (1999). Use of xylitol chewing gum among Finnish schoolchildren. Acta Odontologica Scandinavica 57(6):306-9. (See abstract)

Hujoel PP, et al. (1999). The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. Journal of Dental Research 78(3):797-803. (See abstract)

Isokangas P, et al. (2000). Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. Journal of Dental Research 79(11):1885-9. (See abstract)

Isokangas P, et al. (1993). Long-term effect of xylitol chewing gum in the prevention of dental caries: a follow-up 5 years after termination of a prevention program. Caries Research 27(6):495-8. (See abstract)

Lynch H, Milgrom P. (2003). Xylitol and dental caries: an overview for clinicians. Journal of the Californian Dental Association 31(3):205-9. (See abstract)

Machiulskiene V, et al. (2001). Caries preventive effect of sugar-substituted chewing gum. Community Dentistry and Oral Epidemiology 20 29(4):278-88. (See abstract)

Makinen KK, et al. (1998). Physical, chemical, and histologic changes in dentin caries lesions of primary teeth induced by regular use of polyol chewing gums. Acta Odontologica Scandinavica 56(3):148-56. (See abstract)

Makinen KK, et al. (1998). A descriptive report of the effects of a 16-month xylitol chewing-gum programme subsequent to a 40-month sucrose gum programme. Caries Research 32(2):107-12. (See abstract)

Makinen KK, et al. (1996). Conclusion and review of the Michigan Xylitol Programme (1986-1995) for the prevention of dental caries. International Dental Journal 46(1):22-34. (See abstract)

Makinen KK, et al. (1996). Polyol-combinant saliva stimulants and oral health in Veterans Affairs patients--an exploratory study. Special Care in Dentistry 16(3):104-15. (See abstract)

Petersson LG, et al. (1991). Caries-preventive effect of dentifrices containing various types and concentrations of fluorides and sugar alcohols. Caries Research 25(1):74-9. (See abstract)

Rekola M. (1986). Changes in buccal white spots during 2-year consumption of dietary sucrose or xylitol. Acta Odontologica Scandinavica 44(5):285-90. (See abstract)

Roberts MC, et al. (2002). How xylitol-containing products affect cariogenic bacteria. Journal of the American Dental Association 133(4):435-41. (See abstract)

Scheie AA, Fejerskov OB. (1998). Xylitol in caries prevention: what is the evidence for clinical efficacy? Oral Disease 4(4):268-78. (See abstract)

Scheinin A, et al. (1993). Xylitol-induced changes of enamel microhardness paralleled by microradiographic observations. Acta Odontologica Scandinavica 51(4):241-6. (See abstract)

Scheinin A, et al. (1985). Collaborative WHO xylitol field studies in Hungary. VII. Two-year caries incidence in 976 institutionalized children. Acta Odontologica Scandinavica 43(6):381-7. (See abstract)

Simons D, et al. (2002). The effect of medicated chewing gums on oral health in frail older people: a 1-year clinical trial. Journal of the American Geriatric Society 50(8):1348-53. (See abstract)

Simons D, et al. (1999). The effect of xylitol and chlorhexidine acetate/xylitol chewing gums on plaque accumulation and gingival inflammation. Journal of Clinical Periodontology 26(6):388-91. (See abstract)

Soderling E, et al. (2000). Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. Journal of Dental Research 79(3):882-7. (See abstract)

Soderling E, et al. (1991). Long-term xylitol consumption and mutans streptococci in plaque and saliva. Caries Research 25(2):153-7. (See abstract)

Soderling E, Scheinin A. (1991). Perspectives on xylitol-induced oral effects. Proceedings of the Finnish Dental Society 87(2):217-29. (See abstract)

Steinberg LM, et al. (1992). Remineralizing potential, antiplaque and antigingivitis effects of xylitol and sorbitol sweetened chewing gum. Clinical Preventive Dentistry 14(5):31-4. (See abstract)

Tanzer JM. (1995). Xylitol chewing gum and dental caries. International Dental Journal 45(1 Suppl 1):65-76. (See abstract)

Trahan L, et al. (1996). Emergence of multiple xylitol-resistant (fructose PTS-) mutants from human isolates of mutans streptococci during growth on dietary sugars in the presence of xylitol. Journal of Dental Research 75(11):1892-900. (See abstract)

XXI. REVIEWS of the SCIENTIFIC LITERATURE (back to top)

Agency for Toxic Substances and Disease Registry (ATSDR) (1993). Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine (F). U.S. Department of Health & Human Services, Public Health Service. ATSDR/TP-91/17. (See report)

American Dental Association. (1999). Fluoridation Facts. (See report)

CDC. (2001). Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Mortality and Morbidity Weekly Review 50(RR14):1-42. (See report )

CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. Mortality and Morbidity Weekly Review 48(41): 933-940 October 22, 1999. (See report)

Colquhoun J. (1997). Why I changed my mind about Fluoridation. Perspectives in Biology and Medicine 41:29-44. (See report)

Colquhoun J. (1987). Education and Fluoridation in New Zealand: an historical study. PhD thesis, University of Auckland, NZ.

Connett P, et al. (2001). Fluoridation: Time for a Second Look? Rachel's Environment and Health News May 10. No. 724. (See report)

Connett P. (2000). Fluoride: A Statement of Concern. Waste Not #459. Canton NY. (See report)

Department of Health and Human Services. (1991). Review of fluoride: benefits and risks. Report of the Ad Hoc Subcommittee on Fluoride. Washington, DC. (See synopsis)

Diesendorf M, et al. (1997). New evidence on fluoridation. Australian & New Zealand Journal of Public Health 21: 187-190. (See report)

Diesendorf M. (1995). How science can illuminate ethical debates: a case study on water fluoridation. Fluoride 28: 87-104. (See report)

Diesendorf M, Sutton P. (1986). Fluoride: New Grounds for Concern. The Ecologist 16(6). (See report)

Environment Canada. (1993). Inorganic Fluorides: Priority Substances List Assessment Report. Government of Canada, Ottawa. (See report)

Greater Boston Physicians for Social Responsibility. (2000). Known and suspected developmental neurotoxicants. pp. 90-92. In: In Harms Way - Toxic Threats to Child Development. Greater Boston Physicians for Social Responsibility: Cambridge, MA. (See excerpt)

Groth, E. (1973), Two Issues of Science and Public Policy: Air Pollution Control in the San Francisco Bay Area, and Fluoridation of Community Water Supplies. Ph.D. Dissertation, Department of Biological Sciences, Stanford University, May 1973.

Hileman B. (1988). Fluoridation of water. Questions about health risks and benefits remain after more than 40 years. Chemical and Engineering News August 1, 1988, 26-42. (See report)

Hirzy JW. (1999). Why EPA's Headquarters Professionals' Union Opposes Fluoridation. National Treasury Employees Union Chapter 280. May 1. (See report)

Limeback H. (2000). Why I am now officially opposed to adding fluoride to water. (See report)

Liteplo RG, et al. (1994). Inorganic fluoride: Evaluation of risks to health from environmental exposure in Canada. Journal of Environmental Science and Health. Part C, Environmental Carcinogenesis & Ecotoxicology Reviews 12: 327-344.

Locker D. (1999). Benefits and Risks of Water Fluoridation. An Update of the 1996 Federal-Provincial Sub-committee Report. Prepared for Ontario Ministry of Health and Long Term Care. (See report )

Mancuso N, et al. (1997). Natick Fluoridation Study Committee Report. (See report)

Marier J, Rose D. (1977). Environmental Fluoride. National Research Council of Canada. Associate Committe on Scientific Criteria for Environmental Quality. NRCC No. 16081. (See report).

McDonagh M, et al. (2000). A Systematic Review of Public Water Fluoridation. ("The York Review.") NHS Center for Reviews and Dissemination. University of York. September 2000. (See report | See peer review of study | See letter from Chair of Advisory Board)

National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA's Standards. National Academies Press, Washington D.C. (See report | See discussion about report)

Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.

Taskforce on Fluoridation. (1997). The Lord Mayor's Taskforce on Fluoridation - Final Report. (Brisbane, Australia). (See report)

Waldbott GL, Burgstahler AW, and McKinney HL. (1978). Fluoridation: The Great Dilemma. Coronado Press, Inc., Lawrence, Kansas.

World Health Organization. (2002). Environmental Health Criteria 227: FLUORIDES. World Health Organization, Geneva. (See report)

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