Fluoride is the only chemical added to water for the purpose of medical treatment. The U.S. Food and Drug Administration (FDA) classifies fluoride as a drug when used to prevent or mitigate disease (FDA 2000). As a matter of basic logic, adding fluoride to water for the sole purpose of preventing tooth decay (a non-waterborne disease) is a form of medical treatment. All other water treatment chemicals are added to improve the water's quality or safety, which fluoride does not do. Fluoridation is unethical. Informed consent is standard practice for all medication, and one of the key reasons why most of Western Europe has ruled against fluoridation. With water fluoridation we are allowing governments to do to whole communities (forcing people to take a medicine irrespective of their consent) what individual doctors cannot do to individual patients. While referenda are preferential to imposed policies from government, it still leaves the problem of individual rights versus majority rule. Put another way: Does a voter have the right to require that their neighbor ingest a certain medication (even if it is against that neighbor's will)? The dose cannot be controlled. Once fluoride is put in the water it is impossible to control the dose each individual receives because people drink different amounts of water. Being able to control the dose a patient receives is critical. Some people (e.g., manual laborers, athletes, diabetics, and people with kidney disease) drink substantially more water than others. The fluoride goes to everyone regardless of age, health or vulnerability. According to Dr. Arvid Carlsson, the 2000 Nobel Laureate in Medicine and Physiology and one of the scientists who helped keep fluoridation out of Sweden: "Water fluoridation goes against leading principles of pharmacotherapy, which is progressing from a stereotyped medication -- of the type 1 tablet 3 times a day -- to a much more individualized therapy as regards both dosage and selection of drugs. The addition of drugs to the drinking water means exactly the opposite of an individualized therapy" (Carlsson 1978). People now receive fluoride from many other sources besides water. Fluoridated water is not the only way people are exposed to fluoride. Other sources of fluoride include food and beverages processed with fluoridated water (Kiritsy 1996; Heilman 1999), fluoridated dental products (Bentley 1999; Levy 1999), mechanically deboned meat (Fein 2001), tea (Levy 1999), and pesticide residues (e.g., from cryolite) on food (Stannard 1991; Burgstahler 1997). It is now widely acknowledged that exposure to non-water sources of fluoride has significantly increased since the water fluoridation program first began (NRC 2006). Fluoride is not an essential nutrient (National Research Council [NRC] 1993; Institute of Medicine [IOM] 1997, NRC 2006). No disease has ever been linked to a fluoride deficiency. It has never been shown that ingested fluoride is needed to produce decay-free teeth. Not a single biological process has been shown to require fluoride. On the contrary there is extensive evidence that fluoride can interfere with many important biological processes. Fluoride interferes with numerous enzymes (Waldbott 1978). In combination with aluminum, fluoride interferes with G-proteins (Bigay 1985, 1987). Such interactions give aluminum-fluoride complexes the potential to interfere with signals from growth factors, hormones and neurotransmitters (Strunecka & Patocka 1999; Li 2003). More and more studies are indicating that fluoride can interfere with biochemistry in fundamental ways (Barbier 2010). The level in mothers' milk is very low. Considering reason #6 it is perhaps not surprising that the level of fluoride in mother's milk is remarkably low (0.004 ppm, NRC, 2006). This means that a bottle-fed baby consuming fluoridated water (0.6 – 1.2 ppm) can get up to 300 times more fluoride than a breast-fed baby. There are no benefits (see reasons #11-19), only risks (see reasons #21-36), for infants ingesting this heightened level of fluoride at such an early age (an age where susceptibility to environmental toxins is particularly high). Fluoride accumulates in the body. Healthy adult kidneys excrete 50 to 60% of the fluoride they ingest each day (Marier & Rose 1971). The remainder accumulates in the body, largely in calcifying tissues such as the bones and pineal gland (Luke 1997, 2001). Infants and children excrete less fluoride from their kidneys and take up to 80% of ingested fluoride into their bones (Ekstrand 1994). The fluoride concentration in bone steadily increases over a lifetime (NRC 2006). No health agency in fluoridated countries is monitoring fluoride exposure or side effects. No regular measurements are being made of the levels of fluoride in urine, blood, bones, hair, or nails of either the general population or sensitive subparts of the population (e.g., individuals with kidney disease). There has never been a single randomized clinical trial to demonstrate fluoridation's effectiveness or safety. Despite the fact that fluoride has been added to community water supplies for over 60 years, "there have been no randomized trials of water fluoridation" (Cheng 2007). Randomized studies are the standard method for determining the safety and effectiveness of any purportedly beneficial medical treatment. In 2000, the British Government's "York Review" could not give a single fluoridation trial a Grade A classification – despite 50 years of research (McDonagh 2000). The U.S. Food and Drug Administration (FDA) continues to classify fluoride as an "unapproved new drug." Swallowing fluoride provides no (or very little) benefit Benefit is topical not systemic. The Centers for Disease Control and Prevention (CDC, 1999, 2001) has now acknowledged that the mechanism of fluoride's benefits are mainly topical, not systemic. There is no need whatsoever, therefore, to swallow fluoride to protect teeth. Since the purported benefit of fluoride is topical, and the risks are systemic, it makes more sense to deliver the fluoride directly to the tooth in the form of toothpaste. Since swallowing fluoride is unnecessary, and potentially dangerous, there is no justification for forcing people (against their will) to ingest fluoride through their water supply. Fluoridation is not necessary. Most western, industrialized countries have rejected water fluoridation, but have nevertheless experienced the same decline in childhood dental decay as fluoridated countries. (See data from World Health Organization presented graphically in Figure 1).

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