Natural Family Feature August 2003

Excerpts from Baby Matters, What Your Doctor May Not Tell You About Caring for Your Baby, Linda Folden Palmer, DC (Lucky Press)

Fluoride, Teeth, and Bones
(Excerpted from Chapter 9 -- Baby’s Nutritional Beginnings)

Reprinted with the author's permission
Unedited by BPO staff

Fluoride, like selenium, is a trace element that varies in its availability in the soil and water in different areas of the world. Dental researchers have found that higher levels of fluoride reduce the incidence of cavities in children’s baby teeth. For this reason, many public water systems around the country and around the world have added fluoride to the drinking water in an attempt to reduce dental caries. Fluoride is added to most toothpaste and is applied in some dental treatments as well. Believing breastmilk to be low in fluoride, many pediatricians and dentists are recommending fluoride supplements to breastfed babies. However, since the installation of water fluoridation and other measures beginning around 1950, the results of excess fluoride have revealed themselves.

Today, fluoridation is all around us, in 50% of U.S. drinking water, in 50% of bottled drinks, and it gets into cows and soy and thus infant formulas. Although human milk appears unaffected by the amount of fluoride ingested, concentrations of fluoride in cow’s milk can be 20 to 70 times the level found in breastmilk, depending on the level of fluoride contamination from fertilizers and pesticides the cow is exposed to.26 This fluoride is concentrated in the milk for formulas as a result of dehydration, and then more is added with the water used for rehydration. Now nearly a quarter of all our children are showing some signs of excess fluoride, or fluorosis.27,28 An early sign is altered formation and discoloration of teeth. Fluorosis is marked in 5% of these children and very great in some of those.

It is becoming increasingly apparent that high fluoride levels damage bones.29 In Morocco, a nation with rich fluoride levels in their soil and water, fluorosis is common. There, skeletal defects, such as knock knees, and joint pains and teeth abnormalities are commonly seen.30 This damage can include wearing down of teeth, as well as deviation of teeth and eventually cavities.

Moderate fluorosis, seen in some heavy drinkers of fluoridated water, juice, or soda is associated with mild teeth and bone malformations, possible nervous system alterations, osteoporosis, and eventually kyphosis, the humped upper-back. Gastrointestinal pain and damage can occur with established fluorosis as well.31 Severe fluorosis leads to misshapen major bones and other bony defects, along with neurological problems. Development of severe fluorosis is not likely except in children who especially like to swallow toothpaste and have other high fluoride sources as well.

Excess fluoride, at the level considered beneficial to teeth, causes detrimental changes in the mineralization of bones.32 Fluoride replaces magnesium in bones, making them harder. This hardness is partly desirable in teeth, giving them extra defense against destructive cavity-causing bacteria. But excess fluoride combines with available calcium and together they leave the body, leaving less calcium for bone (tensile) strength and density. Thus bones become hard, in the sense of brittle, and at the same time there is deficient bone calcium (osteoporosis), which leads to easy fractures.

The latest studies are suggesting the benefit to children’s teeth from ingested fluoride (water or supplements) is very small.33 The greatest benefits seem to be when fluoride comes into direct contact with teeth, suggesting that small amounts of fluoridated toothpaste, without swallowing it, would be the best choice for cavity reduction.

Fluoride supplementation for children is strongly associated with increased risk of fluorosis.34 Beyond supplementation, the major risk factors for fluorosis are formula feeding, weaning before 9 months of age, and swallowing toothpaste.35 Breastfeeding to at least 6 months may even protect against fluorosis in the permanent teeth.36 Breastfed infants are not drinking fluoridated water and mother’s milk provides a very consistent level of fluoride regardless of the amount the mother ingests.37 A large body of evidence points against supplementing fluoride for breastfed or other babies or older children, and it is no longer recommended by researchers, even when levels in water are low.38 Unfortunately, some doctors continue to recommend it for breastfed kids.


26. D. Chlubek, “[Interaction of fluoride with milk constituents],” Ann Acad Med Stetin (Poland) 39 (1993): 23–38.

27. K.E. Heller et al., “Dental caries and dental fluorosis at varying water fluoride concentrations,” J Public Health Dent 57, no. 3 (Summer 1997): 136–43.

28. D.J. Brothwell and H. Limeback, “Fluorosis risk in grade 2 students residing in a rural area with widely varying natural fluoride,” Community Dent Oral Epidemiol (Canada) 27, no. 2 (Apr 1999): 130–6.

29. M. Diesendorf et al., “Aust N Z J Public Health (Australia) 21, no. 2 (Apr 1997): 187–90.

30. E.H. Abdennebi et al., “Human fluorosis in Morocco: analytical and clinical investigations,” Vet Hum Toxicol (Morocco) 37 no. 5 (Oct 1995): 465–8.

31. S Dasarathy et al., “Gastroduodenal manifestations in patients with skeletal fluorosis,” J Gastroenterol (India) 31, no. 3 (Jun 1996): 333–7.

32. P.K. DenBesten, “Biological mechanisms of dental fluorosis relevant to the use of fluoride supplements,” Community Dent Oral Epidemiol 27, no. 1 (Feb 1999): 41–7.

33. N.J. Wang and P.J. Riordan, “Fluoride supplements and caries in a non-fluoridated child population,” Community Dent Oral Epidemiol (Norway) 27, no. 2 (Apr 1999): 117–23.

34. A.I. Ismail and R.R. Bandekar, “Fluoride supplements and fluorosis: a meta-analysis,” Community Dent Oral Epidemiol 27, no. 1 (Feb 1999): 48–56.

35. P.J. Riordan, “Dental fluorosis, dental caries and fluoride exposure among 7-year-olds,” Caries Res 27, no. 1 (1993): 71–7.

36. D.J. Brothwell and H. Limeback, “Fluorosis risk in grade 2 students residing in a rural area with widely varying natural fluoride,” Community Dent Oral Epidemiol (Canada) 27, no. 2 (Apr 1999): 130–6.

37. C.J. Spak et al., “Fluoride in human milk,” Acta Paediatr Scand 72, no. 5 (Sep 1983): 699–701.

38. P.J. Riordan, “The place of fluoride supplements in caries prevention today,” Aust Dent J (Australia) 41, no. 5 (Oct 1996): 335–42.

© Copyright 2002 Dr. Linda Folden Palmer, All rights reserved.

Linda Folden Palmer, DC, is the author of the healthy parenting book: Baby Matters, What Your Doctor May Not Tell You About Caring for Your Baby. She provides telephone consultations for colic, lactation difficulties, child nutrition, food allergy issues, and infant sleep challenges. Promoting attachment and natural parenting principles, she is dedicated to raising awareness about how powerfully early parenting and healthcare choices can influence a child's mental and physical outcomes. Find her at

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