Ireland’s Fluoride Debate: A Tale of Superheroes, Conspiracy Theories, and Scientifically Illiterate Politicians


The recent appearance of Aisling Fitzgibbon’s cartoon comic superhero alter ego “The Girl against Fluoride” and an impending court case challenging the practice of fluoridating Irish water reveals pseudo-science, conspiracy theories and mass hysteria that would be more befitting  of a script for a Marvel comic book story. Bogeymen, government conspiracies and a plot to poison our water are foiled by a sexy caped superhero who restores our precious water supply and brings the evil villains to justice.


The World Health Organisation spearheaded a campaign to eradicate Polio through a worldwide vaccination campaign that saw the disease completely eradicated in the US. WHO data from around the world showed less than a thousand cases and was a major success for global science and public healthcare on a mass scale. The last leg of this journey would prove more difficult. Wars and unrest in Somalia and Nigeria made eradication there near to impossible. However one of the most difficult challenges for the eradication programme was Pakistan under the Taliban. Clerics in the Northwest of the country declared the vaccine un-Islamic and ordered that a Jihad be waged against vaccination teams. They preached that the western infidel was planning on sterilising the women of the country. The United Nations Polio vaccination team withdrew from Pakistan in 2012, following the fatal shooting of two and the injuring of a third vaccination worker. In November 2013 Islamic militants in the Northwest Territory kidnapped 11 teachers who were engaged in vaccination in schools. The suspension of vaccination has resulted in a resurgence of Polio in Pakistan and is being spread to Saudi Arabia by pilgrims taking part in the Hajj. Many more have travelled to Syria to fight in the civil war against the country’s president. 10 new cases were identified in Syria, a country that had been disease free for 14 years. Despite the valiant efforts of a heroic organisation and as a result of evidence denial bought about by religious and cultural superstition, as well as a deeply entrenched paranoia against westerners, the World Health Organisation has declared the Middle East to be a Polio emergency zone. It has warned that the disease could make a full global resurgence.

The above example is one of the many I have come across in the battle we face between scientific progress and the worst elements of human psychology and tribal superstitious belief. In pre-enlightenment Europe, rule by authority was the order of the day. The Pope and Kings decreed what their people should believe and think and those who dared to question or offer evidence against the status quo faced extreme punishment, imprisonment or death. The dawn of the enlightenment across Europe gave rise to a revolution in thought.  New freedoms allowed academics to question perceived wisdom that was held for centuries. Evidence and peer review were the new pillars on which belief was based upon. Primitive belief systems morphed into new branches of science. The make-believe world of Astrology became demoted to the back pages of tabloid newspapers while Astronomy developed new and ever changing models of the universe. Alchemy became chemistry which later developed sub disciplines such as pharmacology, which would cure conditions that were once terminal. Our medicine, communication, food and travel and just about everything we do in life became vastly improved as a result of valuing evidence over emotion or the unquestioned authority of individuals. Our knowledge of the world has grown faster in the last four centuries than in the entire history of mankind. As the American Astrophysicist Neil DeGrasse Tyson put it, “In the four centuries since Galileo first gazed at the stars, we have put a man on the moon”.

In the west we largely take this scientific and material progress for granted. We presume that less enlightened non evidence based belief is beneath us and by and large we have abandoned the cognitive processes of our hunter-gatherer ancestors. The reality is we all engage in evidence denial as we are hard-wired by evolution to think in superstitious terms. Establishing causal relationship does not come naturally and such disposition is one of the main contributors to the war that is waged between cultural superstition and the scientific method. Sometimes the decrees of peer reviewed research don’t fit with our gut feeling and all too often we are unwilling to accept that the scientific method is a better adjudicator of what is real. We are primed to respect authority figures and we are more inclined to believe that which comforts us. We find it easier to believe that which our tribe does and despite the best efforts of society to end racism and xenophobia, we are hard-wired to distrust outsiders. We are more likely to be influenced by those who show us love and we are more likely to make bad or impulsive decisions or be unduly influenced when we are under stress. We are more likely to believe those who claim authority in any given subject and we place more trust in those who mimic our own behaviour. I am firmly of the belief that anyone can be conditioned to believe just about anything and in the age of science and reason, this vestige of our evolutionary past rarely works in our favour. I have shown this pattern of behaviour among religious people on several occasions, not least in my quest to expose Lorna Byrne and Eben Alexander.

However traditional religion is far from the only form of cultural evidence denial. In this blog I will show just how easy it is for secular society to embrace other forms of quasi-religious, non evidence based dogma that has been utterly rejected by the scientific community on the basis of decades of peer reviewed research. Public opinion is being driven further and further away from the views held by almost every distinguished academic and professional body, including national dental associations, the medical profession and public health charities. The parallels with religion are uncomfortable and are glaring from the start. They are also every bit as insidious.

Anti-fluoride dogma has reached the heart of Europe. Just like the example of the Polio vaccination programme in Pakistan, decades of peer reviewed science is being thrown to the side-line as legislators invoke notions of personal liberty and paranoia (about a chemical already found in nature that shows absolutely no evidence of toxicity at the levels currently in the water supply) to deny the public of one of the cheapest remedies we know of in the prevention of dental caries. The Centers for Disease Control were so passionate in its advocacy of water fluoridation that it compared the practice to the recognition of the dangers of tobacco, as one of the greatest public health achievements of the twentieth century. In over half a century since the fluoridation of the US water system, they have not changed their position on this.

The History of adding fluoride to public water systems


Anti-fluoride paranoia began to surface almost as soon as the US administration began adding fluoride to public water. The cavity preventing properties of fluoride were first discovered by research carried out by Dr Fredrick McKay. The examination of several thousand children in a region of Colorado known as Pikes Peak in 1909, identified a condition that was first termed “Colorado brown stain”. The researchers observed that despite dental discolouration, the children who presented with this condition had significantly less cavities than control groups in other areas. A fluorine containing material known as cryolite was found to be abundant in the rock of the Pikes Peak region. This fluorine reacted with water from rain and snow to become fluoride. The condition Colorado brown stain later became known as fluorosis and was a result of over exposure to fluoride. The beneficial effects of fluoride were quickly seized upon and the public were educated about the benefits of fluoride addition to public water as well as the dangers of over exposure. The extensive fluoridation of the US water supply resulted in rampant paranoia bearing many similarities to that we see in Ireland today. Anti-fluoride lobbyists have been linked to the anti-vaccination movement from the beginning. This was noted by the US court system, where in 1954, the supreme court of Oklahoma compared fluoride addition to the public water system with mandatory vaccination. As paranoia ensued, it moved into even more bizarre areas. Notions of communist conspiracies began to surface. This was the belief that agents of the State were turning to communism and trying to dumb down the brains of the public by the addition of fluoride to the water.

The arguments used by Anti-fluoride groups


1)      Anti-fluoride lobbyists state: Fluoride is a toxic substance & Ireland is only one of two countries in the world to mandate its use in the water supply.

While it is true that Ireland and Singapore are the only two countries to enact legislation to this effect, most other developed countries in the world do offer some method of universal fluoridation. The scientific consensus among the vast majority of academics of all developed countries is that it is beneficial and at regulated levels, it poses no known risk to human health.  Anti-fluoride lobbyists cite France, Spain, Germany and Switzerland as examples of countries that have removed fluoride from their water supply due to fears of toxicity. This is simply untrue. While they have indeed removed it from the water supply they have replaced the practice with table salt fluoridation as the relatively small water supplies of these countries make it impractical. Ireland may well indeed take this route at some stage or we may continue the practice of water fluoridation. While it is true that high levels of fluoride are indeed toxic, the levels in the water supply are well below these limits. Even if the maximum fluoride limit is exceeded due to lack of proper water monitoring, the vast majority of dentists are in agreement that mild fluorosis is the only known negative impact of this.

The lack of water vigilance argument has often been used as a reason to drop mandatory fluoridation. However this argument is to accept practices that are utterly intolerable and unlike the fluoride debate, lack of water quality monitoring has given rise to serious health concerns.  Ironically the anti-fluoride lobbyists don’t seem to realise that the chlorine in their water poses a much greater degree of risk to public health. Research in the journal of epidemiology, originating in Norway presents the possibility that chlorinated water can gave rise to a 14% increase in the rate of spina-bifida births when compared with non-chlorinated water. Unlike the erroneous data published by those engaging in anti-fluoride paranoia, this data is from a well-respected source.

Sub- optimal levels of chlorine pose a real danger of mass water borne diseases such as cryptosporidiosis. This was to be realised in Roscommon in October 2013 due to lack of proper implementation of water quality systems. Cryptosporidium can give rise to serious illness in those who have low immunity such as the elderly or those on immunosuppressant medication or those suffering from HIV infection.  Higher levels of chlorination can increase the risk of spina-bifida, as well as having other potentially unknown consequences. Ironically it is because chlorine has not been classified as a medicine (neither has fluoride been classified as a medicine but anti-fluoride groups mistake its FDA status for this)  that this threat has gone under the radar. It is the very beneficial properties of fluoride that has attracted attention from this group of scientifically illiterate individuals. The irony becomes even greater when one grasps the fact that chlorine can react with components in the water to become by-products such as bromoform and  dibromochloromethane that have proven toxicity.  These chlorine by-products have been linked to cardiac disease and liver and kidney cancer.

While anti-fluoride mass delusion drives unfounded fears and paranoia; the scientific world has been placing more emphasis on dealing with the real dangers of chlorinated water.  Chloramine treatment is a promising alternative. While this is also chemically based, the by-products of chloramine are less toxic and more powerful against pathogens such as Helicobactor Pylori and E. Coli infection. Another method being tested is ozonation. In this method, Ozone is blasted through the water. While this is effective at sterilisation, it has the disadvantage of not being permanent and thus other disinfecting agents are still required. UV radiation has also been tried but has similar limitations to Ozone, in that it is not permanently present in the water and cannot remove bacterial toxins etc.

The fact that the global scientific community deal with problems associated with potential chlorine toxicity show that the west is not bought up and controlled by the chemicals industry and that the scientific community use the best available evidence at their disposal to carefully balance the need for water sterilisation with that of making sure that exposure to toxic chemicals is kept to a minimum. If they do this with chlorine, there is absolutely no rational reason to believe they don’t do likewise with fluoride. Yet the pages of many anti-fluoride websites make the claim that western countries are controlled by the chemicals industry and are using cheap industrial fluoride. They are indeed using cheap industrial fluoride but that is why it is such an effective dental remedy especially in countries like Ireland and America that offer little or no State sponsored access to proper dental services.

2)   Anti-fluoride lobbyists state: Fluoridation of the municipal water supply amounts to mass medication and denies people of democratic choice.


The Nuremberg code relating to medical consent has often been used as an argument by anti-fluoride lobbyists. The use of this as an argument undermines the spirit of which this declaration was meant to achieve. The Nuremberg convention was held in post WWII Germany in the aftermath of some of the most heinous medical experiments ever witnessed. This article from wiki shows the depravity of the Nazi regime in its abhorrent use of medical experimentation that resulted in the death of at least half of the unwilling participants. The experiments involved unconscionable torture. Sulphonamide antibiotics were trialled by infecting those incarcerated in concentration camps with Clostridium bacteria. Others involved tying boys to a chair and exposing them to repeated small hits on the head with a hammer until they became insane. Other victims were used in freezing experiments and were placed in a tank of freezing water for up to five hours.

The public revulsion toward this ghastly form of medical experimentation was to change the face of medical ethics across the world. Consent to medical procedures was put at the core. However the Nuremberg code of medical ethics was never designed to prevent scientifically accredited public health initiatives from operating. The anti-fluoride lobby cite that fluoride is a medicine without Food and Drug Administration approval. They are correct in this. However what they fail to mention is that neither do national aviation authorities approve car drivers licences or vice versa. The FDA has absolutely no authority over municipal water supplies. What they have jurisdiction over is products containing fluoride. Needless to mention, the FDA has approved countless fluoridated tooth paste, mouth washes and even fluoridated bottled water! This is yet again another example of how a quasi-religious world-view can either accidently or deliberately misrepresent facts.  Public health initiatives such as mandatory vaccination and water fluoridation have been deemed necessary by many courts as they have come to the conclusion that this form of preventative intervention is different to consent to private medical treatment as the effects are communal.

Some have argued that fluoridated water is undemocratic. So is the addition of chlorine to water, as is mandatory vaccination and the addition of iodine to bread and table salt to prevent thyroid issues. Both vaccinations and iodine also amount to mass medication.  As a society we have both rights and duties. Government has a duty to promote the health of its citizens through practical and scientifically peer reviewed methods. It also has a duty to periodically review these methods and allow such things as international scrutiny to ensure bad practice is not putting its citizens at risk. This is exactly what is about to happen as the government have announced their intention to bring in another group of international experts. A previous panel established in 2007 recommended the continuation of the practice.  I do not believe scientific decisions relating to mass public health should be decided by democratic means. Certainly the scientific reports and recommendations should be made available to the electorate and they should have the right to submit their opinion. Recent anti-vaccination hysteria in the US is a prime example of the disparity between the views of the scientific community versus those of the general public. Unfortunately this has resulted in the return of measles to New York City.

The double edged sword of the government supposedly granting people the choice not to be forced to drink fluoridated water is denying others the right to the cheapest and often the only external method of prevention of oral cavities. This is of particular importance in disadvantaged communities. Unfortunately politicians and scientists are all too often at odds with one and other. Political expediency often necessitates such things as parliamentarians declaring that the electorate are smart enough to make up their own mind on such matters and that they deserve a say. I will not win an election by uttering the following remark that society at large is far from capable of making these decisions. Firstly in relation to this and other emotive public health decisions, many have not made themselves familiar with the data necessary to make such a decision and even if they had, they lack the requisite scientific understanding to interpret data. We need only look to Cork County Council to establish the fact that many of our elected leaders are not exactly well versed in the scientific method and have little idea of the subject matter they are trying to discuss. As a nation this should make us cringe with embarrassment.

Last week the Irish Examiner reported that Cork County Council became the first to condemn the use of fluoride in the public water system. As taken directly from the article

FFT spokesman Owen Boyden said: “I also welcome news that a review is to be carried [out] by outside experts. I guess the Government is doing this because it’s feeling the pressure from the public. But there is already enough scientific evidence out there which tells us we need to stop it now.”


Fianna Fáil councillor Pat Murphy said when he was growing up he got water from a well and his teeth are fine. “Anyway there’s enough fluoride in toothpaste. It’s time we stopped this,” said Mr Murphy. 



In recent times TD Luke Ming Flanagan took part in a photo-shoot with Aisling Fitzgibbon (aka The Girl against Fluoride). Statements and actions of elected representatives such as these should evoke feelings of national embarrassment. Firstly fluoridation of some sort, be it the fluoridation of table salt or the municipal water system is supported by almost every national dental and public health association including the World Health Organisation and the Centers for Disease Control. The latter has described the process as one of the top ten public health initiatives of the twentieth century. This has not changed. The countries in Europe that have dropped the practice have done so as a result of supposed ethical/ legal reasons or adverse public opinion that is entirely unjustified by scientific data.  Many others have simply substituted the practice with the fluoridation of table salt for financial reasons. The vast body of scientific and academic consensus across the developed world still support the practice of fluoridation of one form or another. Comments from public representatives would have one believe that the practice was outdated, ineffective, backward and fraught with risk to public health.

It would take a much more extensive blog to illustrate just how far from reality this notion is. The most comprehensive means available to achieve this objective is to literally post links on the opinion of global dental and public health authorities and let the reader decide for themselves.

1)    Irish Dental Association“The health effects of fluoride are continuously under review all around the world with no evidence of any adverse effects of community water fluoridation. Dental fluorosis in Ireland is a primarily aesthetic concern and is less difficult to treat than dental decay. The IDA recommends that all members of the profession continue to endorse the benefits of this important public dental health measure”. 

2)  British National Health Service “There have been some concerns that fluoride may be linked to a variety of health conditions. Reviews of the risks have found no evidence to support these concerns and the general consensus is that water containing the correct amount of fluoride and fluoride toothpaste has a significant benefit in reducing tooth decay”.

3) World Health Organisation importance of effective use of fluoride for the prevention of dental caries has been emphasized in World Health Assembly Resolutions (3-5). A WHO Expert Committee Report on fluorides and oral health published in 1994 (6) detailed the scientific evidence available for use of fluoride and the recommendations for its use in public health programmes. The World Oral Health Report (2003) (2) further underlined the need for integrating oral disease prevention with national and community health programmes based on common risk factor approaches, and incorporating fluoride programmes for the prevention of dental caries”.

 4) Centers for Disease Control “For 65 years, community water fluoridation has been a safe and healthy way to effectively prevent tooth decay. CDC has recognized water fluoridation as one of 10 great public health achievements of the 20th century”.

5) Canadian Cancer Society “Health Canada has established the maximum acceptable concentration of fluoride in drinking water to be 1.5 milligrams per litre (mg/L). Water containing fluoride at or below this level does not pose a health risk. An optimal concentration of fluoride in drinking water to promote dental health is 0.7 mg/L for communities wishing to fluoridate their water supply”.

6) National Cancer Institute (USA) “A possible relationship between fluoridated water and cancer risk has been debated for years. The debate resurfaced in 1990 when a study by the National Toxicology Program, part of the National Institute of Environmental Health Sciences, showed an increased number ofosteosarcomas (bone tumors) in male rats given water high in fluoride for 2 years (4). However, other studies in humans and in animals have not shown an association between fluoridated water and cancer (57)”.


7)  New Zealand Cancer Society/Ministry for Health “It is accepted by an overwhelming majority of the mainstream scientific, dental and medical authorities that there is no connection between cancer rates in humans and water fluoridation”.

 8) Australian Dental Association “Health and scientific authorities around the world have endorsed fluoridation for decades, and the number of people around the world drinking fluoridated water continues to grow. Where water fluoridation is impractical, many countries around the world use fluoridated salt or other forms of fluorides as alternatives”.


9)  American Academy of Pediatrics“The American Academy of Pediatrics endorses and accepts as its policy the Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States”.

 The following website illustrates the weight of scientific opinion on the issue of fluoridation better than I could possibly do in this blog. It lists close to 100 international organisations that recommend the practice.


 3) Anti-fluoride lobbyists state: Recent studies have shown that due to better health care and education that fluoridation of water is no longer necessary.

While it is true that most countries in Europe have experienced a decline in dental caries over the past few decades even without having a fluoridated water system; this is yet another way in which data can get misinterpreted. Better standards of dental care and better availability of information on dental hygiene as well as changes in culture in relation to oral hygiene most probably accounted for this decline. Another significant factor is the greater availability of fluoridated toothpaste. Pseudo-scientific websites such as show precisely why public health policy needs to be decided by scientific peer review and not by popular mandate. Ironically the data they present is from the World Health Organisation, one of the most passionate bodies in favour of fluoridation.  The improvements in oral health(reduction in cavities)  in these countries is almost certainly due to numerous factors such as better access to dental care as well as several other parameters not relating to the efficacy or otherwise of fluoride as a preventative agent of dental caries. The fact that dental health has improved overall with or without the use of fluoride says nothing about its efficacy. We cannot use international comparisons to determine the efficacy of fluoride, as any scientific experiment has to be vigorously controlled. This task is difficult enough even for the scientific community to achieve, which is why several studies need to be undertaken and an overall consensus gathered in a process known as meta-analysis of multiple studies.The tactics employed by the above website are a classic case of selective use of data and are seen in many other pseudoscientific campaigns from climate change deniers, anti-vaccination lobbyists to creationists who deny the fact of Darwinian evolution.

Another variant of this bogus argument is the claim that there are no recent studies which suggest beneficial properties of fluoride. Again this shows a complete ignorance of recent research. One tragic example of a successful campaign to remove fluoride from the water of a region in New South Wales resulted in a threefold increase in the number of cavities in children aged 6 when compared with areas of the Australian State that had access to fluoridated water. Retrospective analysis of health records in New South Wales revealed that close to one in a hundred children in non-fluoridated regions had to be hospitalised as a result of severe dental complications. The New South Wales average is approximately 0.3% Yet another recent Australian study that revealed the same findings.

A 2006 study in Brazil yet again showed that fluoridation of water supply is even more important in disadvantaged areas. The York University retrospective study carried out in 2000 revealed that children between the ages of 5-12 were almost 15% more likely to be free of dental caries in areas where fluoride was added to water. This study included a 9 year period after which fluoride had been added to toothpaste. Although the study was of relatively low quality, it found no evidence of negative side effects other than fluorosis.

A systemic review of water fluoridation carried out by the NHS in 2000 reaffirmed well established evidence that fluoride does reduce the level of dental caries as well as finding no evidence of a link to bone fractures or any form of cancer. Similar studies across the world show that there is a substantial body of evidence to suggest that fluoride added to public water supplies does in fact reduce the incidence of dental caries. The evidence also suggests that better living standards and access to better dental treatment will also reduce the incidence of this condition. It may indeed be true that one day it is no longer necessary to add fluoride to our water, but Ireland is more like a third world country when it comes to dental health. In the absence of first world dental health care and as the Irish Dental Association have warned, we have a diet high in sugar; fluoridation of water offers a proven method of prevention of dental caries and subsequent dental problems. I remain wedded to evidence based policy as opposed to dogma on this and every issue and if future evidence suggests that fluoridation of the water supply offers no additional benefit to dental health then and only then should it be time to drop the practice. As with this and every other aspect of public health policy, it should be subject to regular review with regard to risk/benefit analysis. As of now I see no compelling reason not to believe the opinion of the vast majority of health authorities from almost every developed country in the world, that fluoride addition to water or other sources should play a role in public health policy at least in the short to medium term.

The Girl against Fluoride: A case study in pseudo-scientific paranoia.


Recently Aisling Fitzgibbon has become the face of the anti-fluoride movement in Ireland. A cursory glance at her facebook page reveals just how strong this movement is in Ireland. At the time of writing this blog, her facebook page had gathered in excess of 19,000 likes. However her grasp of scientific data was not quite as impressive. Her website is a temple to pseudo-scientific argument of the most pernicious kind. She claims that fluoride in our water is toxic. She claims fluoride doesn’t prevent dental decay. She even claims it has not been tested for safety. I have already shown how false all these statements are. She claims fluoride has been linked to cancer, thyroid disease and lower IQ. (The latter statement is the result of a study in China that looked into toxic levels of fluoride in a dump that were multiples of times greater than what is permitted in the public water supply). She even calls for the heads of public officials involved in the fluoridation of water. I will leave it to Geoff Lillis to document just how mind bogglingly unscientific Aisling Fitzgibbon’s world-view actually is.

Anti-scientific paranoia has consequences


 Fluoridation of Irish water will always remain a thorny and controversial issue. Its future may well indeed be uncertain. However this subject remains one of many examples of how a culture that is not well versed in the scientific method can consume itself in unjustified fear and potentially make poor decisions at government level. We cling to a pipe dream of having pure water whereas the reality is no country is capable of delivering pure water that is free of chemicals or even potential risk. Even if fluoridated water only had a small role in the prevention of dental cavities, all the body of scientific evidence suggests that the chlorine in our water should be of much greater public health concern. The by-products of chlorine include known carcinogens. Credible research published in a respectable scientific journal has linked chlorinated water to spina-bifida. Yet all the focus of these groups appears to be on the perceived risks associated with the fluoridation of water. Anti-fluoride mass delusion even spawned the idea that fluoridated water could cause a 7 point drop in IQ, a view that became viral as a result of a complete and utter misinterpretation of a study of the toxic effects of exposure to extremely high doses of fluoride, much greater than what is delivered to municipal water supplies.

Some have cited that we have no way of controlling the level of fluoride in the water supply. If this is the case, then it should also apply to chlorine levels. Good science would dictate we should focus on water quality instead and that ongoing trials into fluoride’s beneficial properties should continue and that it should only be removed if there is good evidence that it is of little value in the prevention of dental problems. Last week measles made a return to New York City as a result of anti-vaccination hysteria based on a campaign of pseudo-science of the highest order.  While the Irish nation debates the issue of fluoride in our water supply, I can only wish that the overcoming of scientific illiteracy among some of our parliamentarians was as high up on the government agenda.