Removal Of Fluoride From Water Supply May Affect Ears As Well As Teeth

The addition of fluoride to public water supplies is considered to be one of the top ten greatest health achievements of the 20th century, according to the U.S. Centers for Disease Control. Also included in this list are vaccination, recognition of tobacco products as health hazards, and improved motor vehicle safety mechanisms such as seat belts, child safety seats and motorcycle helmets. Fluoride’s presence in drinking water supplies has led to substantial reduction in dental caries (cavities) in both adult and pediatric populations.

Several large population studies, especially those in areas of lower income households, have shown that addition of fluoride to the public water supply reduces dental disease by more than 25%. Individuals who do not have ready access to preventive dental care, which should include biannual examinations and cleanings, as well as access to and use of fluoridated toothpaste, have benefited substantially by the addition of fluoride in consumed water. Conversely, absence of fluoride has led to increase in poor dental health in these populations.

Fluoride, which is a naturally occurring mineral in our water, soil and air, has been added in a tightly regulated concentration to public water supplies for over 7 decades, with remarkable results in both children and adults. In the early to mid 20th century, older adults quite commonly developed such severe dental decay, necessitating complete dental extractions followed by dentures by the 7th or 8th decades of life.

In the later years of the 20th century, bottled water, both flat and carbonated, became all the rage, both for adults and children. Most of these products did not contain fluoride, and children who relied more on bottled water than tap water were seen to have uptick in dental caries. Some of the bottled water products, especially designed for children, began adding fluoride to their products.

Yes, toothpaste for children ages two years and older contains fluoride, but sadly not all can rely on regular tooth brushing and access to fluoridated toothpaste. Thus the addition of fluoride to publicly accessible drinking water has led to dramatic reduction in dental disease. The upcoming administration’s appointee for the U.S. Health Secretary, Robert F. Kennedy, has stated that there is no clear evidence that fluoride is beneficial, and that there are potential risks of cancer development due to fluoridated water. Multiple groups including the National Research Council, the Carcinogen Identification Committee and the American Cancer Society have found no direct link between fluoride exposure and cancer, especially with the low levels present in drinking water.

A lesser known benefit of fluoridated drinking water is its impact on individuals with a condition called otosclerosis. This is a condition where the tiny bones of the middle ear develop excess bony growth, which impairs the conduction of sound and leads to hearing loss. When ossicles do not have the ability to transmit vibrations from the eardrum to the inner ear structures, sound moves more slowly, and a type of hearing loss called conductive hearing loss is the most notable type of hearing issue in patients with otosclerosis. This is typically seen in adults after age 25 or 30, and can progress with age. Treatments include simply monitoring if the hearing loss is mild, hearing aids, or surgery to repair the tiny stiffened ear bones.

Several studies have found that individuals with otosclerosis who chose not to undergo surgery will have significantly steeper decline in hearing if they are in an area with non-fluoridated water compared with those who live in areas with fluoride added to public water supplies.

While the issue of hearing loss and fluoridated water focuses on a small group of individuals, approximately 3 million adults in the U.S., it is yet another independent benefit of the presence of small amounts of fluoride being present in public drinking water.