In addition to the questionable ethics of adding a chemical to public water that has nothing to do with treating the safety of the water and everything to do with treating the  people who use the water, the fluoride ion’s capacity for chronic adverse effects lies at the heart of the water fluoridation debate.

Everyone agrees that at certain rates of exposure, fluoride ions inside the human body can cause acute adverse effects such as major damage to the brain(central nervous system) thyroid gland, stomach, kidneys, skeletal connective tissue, bone shape and density, as well as the colour, strength and shape of teeth.

The 70 year old debate is not about fluoride’s capacity for acute adverse effects, but rather about fluoride’s capacity for chronic adverse effects.

In other words how little internal daily exposure to fluoride can cause or contribute to long term deleterious effects. 

Also, everyone varies in their susceptibility to toxicological effects of any substance because people’s tissues, glands and organs vary in their capacity to absorb toxins and resilience to the effects of toxins depending on a number of factors such as:
- Overall nutrient and toxin levels
- Ability to excrete toxins via breathing, sweating, pooping, and peeing
- The health of various physiological systems that are involved in rendering toxins available for excretion such as the lymphatic system, liver, bowels and kidneys to name a few of the major systems involved.

Note: when it comes to clearing the body of fluoride, the health of the kidneys is of particular importance as they are responsible for ridding the body of approximately 50% of any fluoride ingested. In other words, people who suffer from kidney disease will be less able to excrete fluoride and therefore more susceptible to having it make it's way into various tissues, glands and organs. In countries where medical professionals test people's levels of fluoride, blood and especially urine tests are routine. 

Fluoridation defenders routinely claim that the level of fluoride they want added to water would not expose anyone to any deleterious effects, and that all of the published scientific research indicating adverse effects is simply wrong. 

Freedom of choice and safe water advocates who oppose adding fluoridation chemicals to public water point out that:

• People of sound mind have the right to choose which medications and health interventions they and their children will engage in.

• The right to choose which medical treatments one engages in becomes even more important for controversial medical treatments. Note: many people choose to not even use fluoridated toothpaste which exposes people to far less fluoride than fluoridated water. Also, school fluoride rinse programs require parents to give their consent before their child participates and here again a fluoride rinse that is spat out exposes a child to far less fluoride than fluoridated water.

• Adding a medical treatment to public water does not allow for dosage control or the right to consent.

• People vary significantly in the amount of water they drink, cook with and bath in. Yes, fluoride passes through the skin.

• People vary significantly in their body mass and overall physiological susceptibility to absorb fluoride into tissues, glands and organs.

• Fluoride absorption from toothpastes, mouthwashes, conventionally grown and especially processed foods and drinks have increased significantly since the 70s resulting in many children and adults now exceeding the daily limits set by the very associations promoting water fluoridation.

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Many Safe Water Advocates who oppose fluoridating water also point to the large, and still growing, body of published research demonstrating that the fluoride ion's capacity for chronic adverse effects is much greater than what US and CND dental and public health association's claim.

According to the research, those most susceptible are bottle fed babies who's formula is mixed with fluoridated water, children and adults deficient in iodine, children and adults with kidney disease, children and adults who consume a lot of conventionally grown and especially processed foods and drinks. Teas, especially bottled ice teas, certain boxed cereals, mechanically deboned chicken are exceptionally high in fluoride averaging 7 to 9 times more fluoride than fluoridated water.

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As far as safety studies go, the gold standard in safety testing requires animal toxicity studies followed by randomized human control studies, and most people are quite dismayed when they discover that
no such studies exist demonstrating the safety of the products used to fluoridate public water.