Table 2.

Increasing opposition to fluoridation

Reasons to oppose fluoridation	References
Fluoride intake through fluoridated water is uncontrollable, since people are receiving varying doses regardless of age, health status, and individualized therapy.	35
Water might get contaminated with toxic chemicals while being fluoridated. Not all countries provide certificates of analysis and the amounts of contaminants in chemicals added to water.	37
Excessive fluoride intake may cause dental fluorosis.	50
Studies on animals and humans concerning fluoride intake showed neurotoxic, nephrotoxic, and other adverse effects even when small doses are administered.	39, 40, 43, 48
Fluoride can be received from sources other than fluoridated water, including ingested (mechanically deboned meat, pesticide residue, and tea) and non-ingested products (fluoridated toothpaste).	52, 53, 55
The fluoride benefit is topical rather than systemic, so it is better to be directly delivered to the teeth.	56
In fluoridated low-income countries, tooth decay is widely spread and is mainly caused by the absence of dental care and poor hygiene.	34
The effectiveness of fluoridation was not validated by any randomized controlled trial. The US Food and Drug Administration have classified fluoride as an “unapproved new drug”. As of January 2012, over 4,000 professionals have signed a memorandum to end water fluoridation worldwide.	58, 60, 61