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Abstract: Fluoride has no tangible health benefits other than preventing dental caries and there
is a small difference between its minimum effective dose and its minimum toxic dose. Leading
global organizations currently recommend fluoride supplementation because they recommend high carbohydrate diets which can cause dental caries. Low-carbohydrate diets prevent dental caries making such fluoride recommendations largely unnecessary. A dental organization was among the first to
initiate the public health recommendations which started fluoride-supplemented high-carbohydrate
nutritional guidelines. This start required expert panels at this dental organization to reverse on three
key scientific points between 1942 and 1949: (1) that topical fluoride had potential harms, (2) that
dental caries was a marker for micronutrient deficiencies, and (3) that low-carbohydrate diets are
to be recommended for dental caries prevention. Internal documents show that private interests
motivated the events which led these expert panels to engage in pivotal scientific reversals. These
private interests biased scientific processes and these reversals occurred largely in an absence of
supporting evidence. It is concluded that private interests played a significant role in the start of
public health endorsements of fluoride-supplemented high-carbohydrate nutritional guidelines.

Philippe P. Hujoel 1,2
1 Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA;; Tel.: +1-(206)-543-2034; Fax: +1-(206)-685-4258
2 Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98195, USA

Keywords: fluoride; sugar; nutritional guidelines; dental caries; nutritional deficiencies; professional
organizations; evidence-based medicine

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