124 l © 2025 American Dental Association
Fluoridation Facts
337. Macek MD, Matte TD, Sinks T, Malvitz DM. Blood lead concentrations in children and method of water fluoridation in the United States,
1988–1994. Environ Health Perspect. 2006 114(1):130–134.
338. Brown MJ, Margolis S. Lead in drinking water and human blood lead levels in the United States. MMWR Suppl. 2012 61(4):1–9.
339. US Department of Health and Human Services. Fluoridation Growth Data Table (1940–2014). Statement on the Evidence Supporting the
Safety and Effectiveness of Community Water Fluoridation. Atlanta, Georgia: Centers for Disease Control and Prevention 2015.
340. Ruckart PZ, Jones RL, Courtney JG, et al. Update of the blood lead reference value -United States, 2021. MMWR Morb Mortal Wkly Rep.
2021 70(43):1509–1512.
341. Egan KB, Cornwell CR, Courtney JG, Ettinger AS. Blood lead levels in US children ages 1-11 years, 1976-2016. Environ Health Perspect.
2021 129(3):37003.
342. Roscoe RJ, Ball W, Curran JJ, et al. Adult blood lead epidemiology and surveillance--United States, 1998–2001. MMWR Surveill Summ.
2002 51(11):1–10.
343. American Water Works Association. Internal corrosion control in water distribution systems. 2nd ed. Denver, Colorado 2017.
344. US Enviornmental Protection Agency. Optimal corrosion control treatment evaluation technical recommendations for primacy agencies and
public water systems. Office of water 2016. https://www.epa.gov/sites/default/files/2019-07/documents/occtmarch2016updated.pdf.
Accessed May 13, 2025.
345. Masters RD, Coplan MJ. Water treatment with silicofluorides and lead toxicity. Int J Environ Stud. 1999 56(4):435–449.
346. Urbansky ET, Schock MR. Can fluoridation affect lead(II) in potable water? hexafluorosilicate and fluoride equilibria in aqueous solution.
Int J Environ Stud. 2000 57(5):597–637.
347. Finney WF, Wilson E, Callender A, Morris MD, Beck LW. Reexamination of hexafluorosilicate hydrolysis by 19F NMR and pH measurement.
Environ Sci Technol. 2006 40(8):2572–2577.
348. National Institute on Aging. What Causes Alzheimer’s Disease? Accessed January 25, 2025. https://www.nia.nih.gov/health/alzheimers-
causes-and-risk-factors/what-causes-alzheimers-disease.
349. Varner JA, Jensen KF, Horvath W, Isaacson RL. Chronic administration of aluminum-fluoride or sodium-fluoride to rats in drinking water:
alterations in neuronal and cerebrovascular integrity. Brain Res. 1998 784(1-2):284–298.
350. Health media watch: study linking fluoride and Alzheimer’s under scrutiny. J Am Dent Assoc. 1998 129(9):1216–1218.
351. Lidsky TI. Is the aluminum hypothesis dead? J Occup Environ Med. 2014 56(5 Suppl):S73–S79.
352. Emsley CL, Gao S, Li Y, et al. Trace element levels in drinking water and cognitive function among elderly Chinese. Am J Epidemiol.
2000 151(9):913–920.
353. American Heart Association. Coronary artery disease – coronary heart disease. Accessed March 20, 2025. https://www.heart.org/en/health-
topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease.
354. US Department of Health Education and Welfare Public Health Service. Misrepresentation of Statistics on Heart Deaths in Antigo, Wisconsin.
Division of Dental Health Preventive Practices Branch. Bethesda, MD: National Insititutes of Health 1972.
355. Li Y, Berenji GR, Shaba WF, et al. Association of vascular fluoride uptake with vascular calcification and coronary artery disease.
Nucl Med Commun. 2012 33(1):14–20.
356. Gucciardi A. Interesting study reveals atherosclerosis-fluoride link. 2012. Accessed March 21, 2025. https://naturalsociety.com/breaking-
fluoride-linked-to-1-cause-of-death-in-new-research/.
357. Geever EF, Leone NC, Geiser P, Lieberman J. Pathologic studies in man after prolonged ingestion of fluoride in drinking water. I. Necropsy
findings in a community with a water level of 2. 5 ppm. J Am Dent Assoc. 1958 56(4):499–507.
358. Ludlow M, Luxton G, Mathew T. Effects of fluoridation of community water supplies for people with chronic kidney disease.
Nephrol Dial Transplant. 2007 22(10):2763–2767.
359. Ludlow M. 2011 Review of Kidney Health Australia Fluoride Position Statement: Kidney Health Australia 2011.
360. Kidney Health Australia. Fluoride position statement: 2018 review. 2018. Accessed March 20, 2025. https://assets.kidney.org.au/
resources/2018-review-of-fluoride-position-statement_final.pdf#:~:text=There%20is%20no%20evidence%20that%20consumption%20
of%20optimally,only%20limited%20studies%20addressing%20this%20issue%20are%20available.
361. National Kidney Foundation. Fluoride intake and chronic kidney disease. 2008. Accessed March 21, 2025. https://www.kidney.org/sites/
default/files/docs/fluoride_intake_in_ckd.pdf.
362. Surgeon General’s advisory on treatment of water for use in dialysis. FDA Drug Bull. 1981 11(1):3.
363. National Archives and Records. Federal Register: drinking water technical assistance implementation plan for control of direct and indirect
additives to drinking water and memorandum of understanding between the environmental protection agency and the food and drug
administration 1979. p. 42775–42778.
364. American Water Works Association. About: who we are. Accessed March 20, 2025. https://www.awwa.org/who-we-are/#overview.
365. NSF. About NSF. Accessed March 24, 2025. https://www.nsf.org/about-nsf.
366. American National Standards Institute (ANSI). About ANSI: Introduction. Accessed January 25, 2025. https://www.ansi.org/about_ansi/
overview/overview?menuid=1.
367. Kelechava B. NSF/ANSI 60-2024: drinking water chemicals health effects. American National Standards Institute (ANSI) 2024.
Accessed March 20, 2025. https://blog.ansi.org/nsf-ansi-60-2024-drinking-water-chemicals-health/
368. Kelechava B. NSF/ANSI 61-2024: Drinking water system components – health effects. American National Standards Institute (ANSI) 2025.
Accessed March 20, 2025. https://blog.ansi.org/nsf-ansi-61-2023-drinking-water-system-components/
369. Deeds F, Thomas JO. Comparative chronic toxicities of fluorine compounds. Exp Biol Med. 1934 31(7):824–825.
370. McClure FJ. A review of fluorine and its physiological effects. Physiol Rev. 1933 13(3):277-300.
Fluoridation Facts
337. Macek MD, Matte TD, Sinks T, Malvitz DM. Blood lead concentrations in children and method of water fluoridation in the United States,
1988–1994. Environ Health Perspect. 2006 114(1):130–134.
338. Brown MJ, Margolis S. Lead in drinking water and human blood lead levels in the United States. MMWR Suppl. 2012 61(4):1–9.
339. US Department of Health and Human Services. Fluoridation Growth Data Table (1940–2014). Statement on the Evidence Supporting the
Safety and Effectiveness of Community Water Fluoridation. Atlanta, Georgia: Centers for Disease Control and Prevention 2015.
340. Ruckart PZ, Jones RL, Courtney JG, et al. Update of the blood lead reference value -United States, 2021. MMWR Morb Mortal Wkly Rep.
2021 70(43):1509–1512.
341. Egan KB, Cornwell CR, Courtney JG, Ettinger AS. Blood lead levels in US children ages 1-11 years, 1976-2016. Environ Health Perspect.
2021 129(3):37003.
342. Roscoe RJ, Ball W, Curran JJ, et al. Adult blood lead epidemiology and surveillance--United States, 1998–2001. MMWR Surveill Summ.
2002 51(11):1–10.
343. American Water Works Association. Internal corrosion control in water distribution systems. 2nd ed. Denver, Colorado 2017.
344. US Enviornmental Protection Agency. Optimal corrosion control treatment evaluation technical recommendations for primacy agencies and
public water systems. Office of water 2016. https://www.epa.gov/sites/default/files/2019-07/documents/occtmarch2016updated.pdf.
Accessed May 13, 2025.
345. Masters RD, Coplan MJ. Water treatment with silicofluorides and lead toxicity. Int J Environ Stud. 1999 56(4):435–449.
346. Urbansky ET, Schock MR. Can fluoridation affect lead(II) in potable water? hexafluorosilicate and fluoride equilibria in aqueous solution.
Int J Environ Stud. 2000 57(5):597–637.
347. Finney WF, Wilson E, Callender A, Morris MD, Beck LW. Reexamination of hexafluorosilicate hydrolysis by 19F NMR and pH measurement.
Environ Sci Technol. 2006 40(8):2572–2577.
348. National Institute on Aging. What Causes Alzheimer’s Disease? Accessed January 25, 2025. https://www.nia.nih.gov/health/alzheimers-
causes-and-risk-factors/what-causes-alzheimers-disease.
349. Varner JA, Jensen KF, Horvath W, Isaacson RL. Chronic administration of aluminum-fluoride or sodium-fluoride to rats in drinking water:
alterations in neuronal and cerebrovascular integrity. Brain Res. 1998 784(1-2):284–298.
350. Health media watch: study linking fluoride and Alzheimer’s under scrutiny. J Am Dent Assoc. 1998 129(9):1216–1218.
351. Lidsky TI. Is the aluminum hypothesis dead? J Occup Environ Med. 2014 56(5 Suppl):S73–S79.
352. Emsley CL, Gao S, Li Y, et al. Trace element levels in drinking water and cognitive function among elderly Chinese. Am J Epidemiol.
2000 151(9):913–920.
353. American Heart Association. Coronary artery disease – coronary heart disease. Accessed March 20, 2025. https://www.heart.org/en/health-
topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease.
354. US Department of Health Education and Welfare Public Health Service. Misrepresentation of Statistics on Heart Deaths in Antigo, Wisconsin.
Division of Dental Health Preventive Practices Branch. Bethesda, MD: National Insititutes of Health 1972.
355. Li Y, Berenji GR, Shaba WF, et al. Association of vascular fluoride uptake with vascular calcification and coronary artery disease.
Nucl Med Commun. 2012 33(1):14–20.
356. Gucciardi A. Interesting study reveals atherosclerosis-fluoride link. 2012. Accessed March 21, 2025. https://naturalsociety.com/breaking-
fluoride-linked-to-1-cause-of-death-in-new-research/.
357. Geever EF, Leone NC, Geiser P, Lieberman J. Pathologic studies in man after prolonged ingestion of fluoride in drinking water. I. Necropsy
findings in a community with a water level of 2. 5 ppm. J Am Dent Assoc. 1958 56(4):499–507.
358. Ludlow M, Luxton G, Mathew T. Effects of fluoridation of community water supplies for people with chronic kidney disease.
Nephrol Dial Transplant. 2007 22(10):2763–2767.
359. Ludlow M. 2011 Review of Kidney Health Australia Fluoride Position Statement: Kidney Health Australia 2011.
360. Kidney Health Australia. Fluoride position statement: 2018 review. 2018. Accessed March 20, 2025. https://assets.kidney.org.au/
resources/2018-review-of-fluoride-position-statement_final.pdf#:~:text=There%20is%20no%20evidence%20that%20consumption%20
of%20optimally,only%20limited%20studies%20addressing%20this%20issue%20are%20available.
361. National Kidney Foundation. Fluoride intake and chronic kidney disease. 2008. Accessed March 21, 2025. https://www.kidney.org/sites/
default/files/docs/fluoride_intake_in_ckd.pdf.
362. Surgeon General’s advisory on treatment of water for use in dialysis. FDA Drug Bull. 1981 11(1):3.
363. National Archives and Records. Federal Register: drinking water technical assistance implementation plan for control of direct and indirect
additives to drinking water and memorandum of understanding between the environmental protection agency and the food and drug
administration 1979. p. 42775–42778.
364. American Water Works Association. About: who we are. Accessed March 20, 2025. https://www.awwa.org/who-we-are/#overview.
365. NSF. About NSF. Accessed March 24, 2025. https://www.nsf.org/about-nsf.
366. American National Standards Institute (ANSI). About ANSI: Introduction. Accessed January 25, 2025. https://www.ansi.org/about_ansi/
overview/overview?menuid=1.
367. Kelechava B. NSF/ANSI 60-2024: drinking water chemicals health effects. American National Standards Institute (ANSI) 2024.
Accessed March 20, 2025. https://blog.ansi.org/nsf-ansi-60-2024-drinking-water-chemicals-health/
368. Kelechava B. NSF/ANSI 61-2024: Drinking water system components – health effects. American National Standards Institute (ANSI) 2025.
Accessed March 20, 2025. https://blog.ansi.org/nsf-ansi-61-2023-drinking-water-system-components/
369. Deeds F, Thomas JO. Comparative chronic toxicities of fluorine compounds. Exp Biol Med. 1934 31(7):824–825.
370. McClure FJ. A review of fluorine and its physiological effects. Physiol Rev. 1933 13(3):277-300.
