Originally published in the Well Being Journal, March/April 2025 edition, my open letter addresses the American Dental Association (ADA) with an urgent appeal to reform two long-standing practices in U.S. dentistry: water fluoridation and the continued use of mercury amalgam fillings. With mounting evidence linking both to systemic health concerns, I’m calling on the ADA to align its policies with modern science and global best practices for public health.
A Call for Progressive, Evidence-Based Practices in Dentistry
The field of dentistry has long been at the forefront of preventive care, with advancements that have improved the quality of life for countless individuals. However, mounting research challenges some of the foundational practices still endorsed by the ADA. As stewards of public health, it is incumbent upon the ADA to reassess these policies and align with modern scientific evidence and best practices.
Rethink Water Fluoridation
Fluoridation of municipal water supplies has been a cornerstone of public health efforts since the mid-20th century. While initially lauded for its role in reducing dental caries, mounting research proves this practice poses significant risks to cognitive development.
A systematic review published in Environmental Research revealed a consistent link between fluoride exposure and reduced IQ scores in children. Other studies have linked fluoridated water exposure to ADHD symptoms and declines in executive functioning, even at relatively low levels.
Most of Western Europe have rejected water fluoridation, and as of 2024, approximately 98% of the Western European population was drinking non-fluoridated water. Their approaches emphasize education, access to fluoride-free oral hygiene products, and dietary improvements — strategies that avoid the potential neurotoxic effects of fluoride while still addressing dental health. The ADA’s continued endorsement of water fluoridation places the U.S. out of step with global best practices.
The U.S. National Research Council has also identified considerable evidence indicating that fluoridated water can affect thyroid function. Notably, during the 1950s, physicians in Europe and South America used fluoride therapeutically to lower thyroid activity in individuals with hyperthyroidism.
Clinical research from 1958 indicated that a fluoride dose as low as 2 to 5 mg per day over several months can suppress thyroid function. This amount falls well within the estimated daily fluoride intake range of 1.6 to 6.6 mg for people residing in fluoridated areas.1
Fluoride was first added to water in the 1940s under the misguided belief that ingesting it was necessary to prevent tooth decay. However, research has since demonstrated that fluoride’s benefits are primarily derived from topical application, not consumption. As a result, swallowing fluoride is completely unnecessary.
Continuing this outdated and harmful practice diverts attention and resources away from more effective, evidence-based strategies for improving public dental health.
Addressing the Use of Amalgam Fillings
The ADA’s ongoing support for amalgam fillings, which contain approximately 50% mercury, is another area requiring urgent reevaluation. Mercury is a known neurotoxin with far-reaching health implications, particularly for vulnerable populations such as pregnant women, children, and individuals with genetic susceptibilities.
Research from the University of Georgia has shown that individuals with more than eight amalgam fillings exhibit significantly elevated blood mercury levels — more than twice as high as those without any fillings. Health Canada took decisive action nearly three decades ago, recommending against the use of amalgam fillings in high-risk populations.
The global movement to eliminate mercury amalgam fillings is now gaining momentum, with the European Union leading the charge. The EU’s comprehensive ban on dental amalgam took effect on January 1, 2025. This includes not only the use of amalgam but also its manufacture and export. This ban sets a precedent that makes it incredibly difficult for countries like the U.S. to justify continuing the use of this archaic and hazardous material.
Numerous other countries have also taken steps to eliminate or restrict mercury amalgam use. For example:
- The Philippines, New Caledonia, Saint Kitts and Nevis, and Moldova have fully banned dental amalgam.
- Tanzania, Vietnam, and Mauritius have prohibited its use in children, pregnant women, and breastfeeding mothers.
- India’s Armed Forces and Indian Railways, the world’s largest employer, have stopped using amalgam, signaling a significant cultural and institutional shift.
These actions demonstrate a global acknowledgment of the dangers posed by mercury, not only to individual health but also to the environment.
While private dentists in the U.S. are increasingly offering mercury-free alternatives, federally funded programs, such as Medicaid and Indian Health Services, continue to rely heavily on amalgam, which means that vulnerable populations, including children, pregnant women, and those with limited access to healthcare options, remain disproportionately affected.
It is time for the U.S. to join this global movement, prioritizing safer, more sustainable materials in dental care. The growing list of countries adopting mercury-free practices underscores the feasibility of this transition.
A Call for Progressive Action
Dentistry should not exist in a vacuum, separate from broader health concerns. Emerging evidence linking fluoride, mercury, and artificial additives to systemic health risks underscores the need for a more holistic, evidence-based approach. The ADA can lead by embracing policies that prioritize safety and align with the latest scientific research.
- Discontinue support for municipal water fluoridation and advocate for non-fluoride-based caries prevention strategies.
- Phase out the use of amalgam fillings and champion the adoption of mercury-free alternatives.
Public trust in the dental profession depends on our collective commitment to innovation, integrity, and evidence-based practice. I urge the ADA to take these critical steps toward fostering a healthier, more progressive future for dental and overall health.
Sincerely,
Dr. Joseph Mercola
articles.mercola.com (Article Sourced Website)
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