The California Dental Association (CDA) joins a growing list of researchers, dental and health organizations advising against regularly mixing infant formula with fluoridated water to avoid discoloring babies' developing teeth (fluorosis). But little effort is made to inform the public, reports the New York State Coalition Opposed to Fluoridation, Inc. (NYSCOF). "Neither a nutrient nor required for healthy teeth, fluoride chemicals are added to many public water supplies and some bottled water in a failed attempt to reduce tooth decay," says attorney Paul Beeber, NYSCOF President.
"...mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis for infants primarily fed in this way may increase the chance of a child’s developing enamel fluorosis," according to the CDA's Feb 2010 Report, Oral Health During Pregnancy and Early Childhood: Evidence-Based Guidelines for Health Professionals. (1)
A 2006 California cavity epidemic study revealed that fluoridation is Ineffective (1a) In March 2006, the National Research Council (NRC) cautioned that infants can fluoride-overdose via reconstituted baby formula. (2) The American Dental Association (ADA) passed this information on to its members in a November 2006 e-gram (3) which the ADA reaffirmed and strengthened in a November 2009 News Release (4) .
The ADA defines moderate fluorosis as “All tooth surfaces affected; marked wear on biting surfaces; brown stain may be present” and severe fluorosis as “All tooth surfaces affected; discrete or confluent pitting; brown stain present.” Mild fluorosis is white spotted teeth affecting about 25% to 50% of tooth surfaces. (5) National data (1986–-1987) shows dental fluorosis is a huge U.S. problem with 62 percent of 5 - 17 year-olds afflicted with white spotted, yellow, brown and/or pitted teeth. (6) Data from 1999-2000 shows that fluorosis has increased further since then. (7 )
The Food and Drug Administration ruled that fluoridated bottled water cannot be marketed for infants as a decay preventive. ( 8 )
In November 2007, The Globe and Mail quotes ADA spokesman and University of California dental professor, Howard Pollick, as saying the ADA recommendation applies to infants under one year of age who consume a lot of formula and "are at risk for developing some level of dental fluorosis." Dr. Pollick said the risks occur at the level of fluoride recommended for U.S. water systems. (9)
Health Canada reported in 2008 "The consumption of powdered infant formula reconstituted with fluoridated water could lead to excessive intake of fluoride in infants."(10) Other government and medical groups which advise against mixing infant formula with fluoridated water:
"Studies of fluoride levels of baby formulas and cereals have shown a significant increase in the fluoride content when fluoridated water was used for processing these foods," was reported by Kumar et al. in the May 1989 American Journal of Public Health.
Some scientists tried in vain [in January 1990] to get the word out as described in "Suppression by Medical Journals of a Warning about Overdosing Formula-Fed Infants with Fluoride," published in 1997 in the Journal Accountability in Research. (17)
"Four major [fluorosis] risk factors were consistently identified: use of fluoridated drinking water, fluoride supplements, fluoride toothpaste, and infant formulas before the age of six years," reported Mascarenhas in 2000 (July-August Pediatric Dentistry). (18)
"Infant beverages, particularly infant formulas prepared with fluoridated water, can increase the risk of fluorosis in primary teeth," reported Marshall et al. in Journal of the American College of Nutrition (April 2004) (19)
"A major effort should be made to avoid use of fluoridated water for dilution of formula powders (Fluoride in Dentistry)." (20) "Our analysis shows that babies who are exclusively formula fed face the highest [fluorosis] risk," reports the Environmental Working Group. (21)
"The entire Board [Burlington VT Board of Health] holds serious concerns about the current fluoride exposure of infants between the ages of zero and six months. We deem this exposure to be a 'significant public health risk', and one that should be given immediate attention by the city and state." (22)
"Some risk of increasing fluorosis may be attributed to the ingestion of powdered infant formula reconstituted with fluoridated water," (Pizzo et al. Clinical Oral Investigations, Feb 2007) (23)
At least eleven other studies link reconstituted formula with fluorosis.(24a-k).
NYSCOF news releases in 2000, 2004, 2009 and 2010 (25a,b,c,d) cited many studies linking fluorosis to infant foods mixed with fluoridated water. (Also see: http://www.fluoridealert.org/health/infant ) "Instead of using their enormous resources to warn the public against mixing fluoridated water and infant formula, fluoridation proponents have created news releases attempting to discredit NYSCOF that actually reinforce NYSCOF's science-based information (4, 26)," says Beeber.
1) http://www.cdafoundation.org/library/docs/poh_guidelines.pdf (Page 12) 1a) http://groups.google.com/group/fluoridation-news-releases/browse_thread/thread/c7922ee2427df25c/cf8bb26da913790b?lnk=gst&q=California#cf8bb26da913790b
20) Ekstrand J. (1996). Fluoride Intake. In: Fejerskov O, Ekstrand J, Burt B, Eds. Fluoride in Dentistry, 2nd Edition. Munksgaard, Denmark. Pages 40-52.
21) Environmental Working Group, "EWG Analysis of Government Data Finds Babies Over-Exposed to Fluoride in Most Major U.S. Cities", March 22, 2006.http://www.ewg.org/node/21000
22) Burlington Board of Health (Vermont, USA) August 31, 2005. See copy of full report
23) "Community Water Fluoridation and Caries Prevention: A Critical
Review," Clinical Oral Investigations, by Giuseppe Pizzo & Maria R.
Piscopo & Ignazio Pizzo &
Giovanna Giuliana 2007 Feb 27; [Epub ahead of print]
a) J Am Dent Assoc. 2000 Jun;131(6):746-55. Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional.
b) Caries Res. 1999 Jul-Aug;33(4):267-74. Altitude as a risk indicator of dental fluorosis in children residing in areas with 0.5 and 2.5 mg fluoride per litre in drinking water.
c) Am J Epidemiol. 1998 Nov 15;148(10):967-74. Risk factors for enamel fluorosis in optimally fluoridated children born after the US manufacturers' decision to reduce the fluoride concentration of infant formula. Pendrys DG, Katz RV.
d) Aust Dent J. 1996 Feb;41(1):37-42.Fluoride content of infant formulae in Australia.
e) J Public Health Dent. 1995 Winter;55(1):57-62. Commentary on and recommendations for the proper uses of fluoride.
f) Am J Epidemiol. 1989 Dec;130(6):1199-208. Risk of enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use.
g) J Dent Res. 1988 Dec;67(12):1488-92. Risk factors for dental fluorosis in a fluoridated community.
h) Caries Res. 2003 Sep-Oct;37(5):327-34. Socio-demographic features and fluoride technologies contributing to higher fluorosis scores in permanent teeth of Canadian children. Maupomé G, Shulman JD, Clark DC, Levy SM.
I) ASDC J Dent Child. 2001 Jan-Feb;68(1):37-41, 10. Fluoride content of infant formulas prepared with deionized, bottled mineral and fluoridated drinking water.
j) J Public Health Dent. 2000 Summer;60(3):131-9. Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants.
http://www.ncbi.nlm.nih.gov/pubmed/11109209?dopt=Abstract k)1438 Fluoride content of and estimated fluoride intake from milk formula P. MOYNIHAN, V. ZOHOURI, A. JODHEEA, and A. MAGUIRE, University of Newcastle upon Tyne, School of Dental Sciences, Newcastle Upon Tyne, United Kingdomhttp://iadr.confex.com/iadr/2004Hawaii/techprogram/abstract_40477.htm