Heart

Fluoride very specifically affects hearts in their early formative stages of growth, changing both shape and function. (Duffey 1957, J Embryol Exp Morph 5(4):324.) (In chickens, very high doses, negative effects.)

People that get heart disease as adults are 3 times as likely to have been born small and to have grown poorly as infants. (Barker 1989, Lancet  2:577. There is no hint of pregnancy effects in either, but there are at least two excellent reports that adult heart disease is much lower in areas with fluoride in the water, in JAMA 1966 and Nature 1978.)

There is more evidence for fluoride preventing heart defects (the most common birth defect) than any other single defect. A Harvard study showed that fluoridated water in the first 3 months of pregnancy may lower heart defects by about 50%. (Aschengrau 1993 Arch Envir Health 48(2):105-13.) This study was very broad, looking at over 1,000 birth defects (only 38 heart defects) and 25 other measures of water quality (lead content, etc). The statistics are not very strong. However, the fluoride did seem to make a difference: There were about half as many heart defects if the mothers lived in areas with fluoridated water during their first 3 months of pregnancy.

Another paper found similar results, but the study was too small for statistical significance: Gomez found that heart defects went from 6 cases/2,328 births before fluoridation to 4 cases/2,571 births after fluoride was added to the water supply. Cleft lips went from 3 cases to 1 case after fluoridation. Birth weights dropped by about 2%. Gomez 1990 Rev Dent Chile 81(3):131-135. When I started my research, the only study existing at that time found no association between birth defects and fluoridated water. Its heart data found a 16-30% increase in heart defects in fluoridated areas. This study was much broader (1,387,027 births) but not as specific (county by county data). Erickson 1976 JADA 93:981-84.)

A dental study on children with heart defects found that they have very poor teeth, even compared to their own brothers and sisters:

For your convenience I will quickly repeat the citations that show these teeth conditions are prevented by prenatal fluoride (PNF):

The biology of heart growth is indeed turning out to be very much like the biology of tooth growth. It now looks as though the mesenchyme is the driving force in the shape of the heart, just like in teeth. (Gannon 1995, Development 121(8):2439.) The majority of heart defects are in structures that arise from mesenchymal outgrowths. (Eisenberg 1995, Circulation  Research  77(1):1.) The majority of heart troubles that cause heart disease are in the places the arteries split and turn. (Biologically, these spots probably develop much like the pit and fissure area of a tooth. One of the last parts of closing is the tissue getting its identity, a part of which is  which molecules can stick to you. Heart disease is largely a problem of things sticking in the wrong places. DePaola N, write up in Discover Nov 1996, in Breakthroughs, Health. The citation on this just covers the location of the problems; the author's explanation is different.)

Ear

Long ago, before any sources of fluoride were being widely used, there was a survey done on deafness. This study was large, covering most of the school children in the state of Illinois. Having natural fluoride in the water, at the level that is about what is now used for fluoridated water, seemed to cut childhood deafness almost in half. (The numbers: Total survey 132,572 children : total defective hearing 6,328 = 4.7%; Very low F in water 109,869 children: defective hearing 5,406 = 4.9%; F in water, up to 1.4 ppm 20,488 children: defective hearing 574 = 2.8%. Lewy 1944, Archives of Otolaryngology  39:152.)

Roughly half of children with enamel defects have hearing problems. The closer the enamel defect is to the parts of teeth that form earliest in pregnancy, the greater the likelihood of hearing loss. (Murray 1987, Ear and Hearing  8(2):68.)

Children with chronic ear infections and/or asthma have more dental decay (dmft 3.0 vs. 2.1). (Holbrook 1989, Community Dent Oral  Epidemiology 17:292.)

The underlying problem with middle ear problems is structural. Most intriguing is a condition called unresolved mesenchyme. (Guggenheim 1956, Laryngoscope  66:1303.) The more of this mesenchyme there is, the more the ear structure is off (Takahara 1987, Ann Otol Rhinol Laryngol  96:333) and the more otitis media there is (Paparella 1980, Laryngoscope  90:1089).

There is a tie in between ear problems and cleft palate. The more severe the cleft, the more severe the middle ear problems. (Kitajiri 1985, Ann Otol Rhinol Laryngol  94:44.)

No one has yet to really follow up on the early 1944 observation by Lewy that deafness is cut in half by fluoridated water. He gave talks on this at least up until his 80s. The only relevant new art is a finding that the main risk factors for deafness are prematurity and/or very low birth weight. In one group of such children, less than half (40.8%) had normal hearing, and 13.4% had severe hearing impairment. (Tudehope 1992, J Paediatr Child Health 28(2):172.)

Birth weights are also lower in children with cleft lip and cleft palate. (Long 1992, Pediatrie  47(2):133 [French].) (Repeating from Gomez above),  another study shows a 67% reduction of cleft lips from adding fluoride to the water supply, but the study was stopped before it became large enough for significance.

Mouth

Children with cleft palate get more dental decay (6.15 ~vs. 4.05 dmft). (Stephen 1977, British Dental Journal  143:111.)

I would like to cite an author who has no solid tie to fluoride. An early popular nutrition writer, Addelle Davis, really had the vision as far as the importance of early pregnancy nutrition, birth defects, and the shape of the mouth. Note how easy she makes it to understand what to look for in a newborns mouth: "The ideal dental arch, or the jawbone holding the teeth, should be almost a perfect semicircle; there is plenty of room in such a mouth for all the teeth without crowding. The dental arch should not be the shape of a tall U and certainly not V-shaped, as many are. The roof of the mouth, or dental vault, should be low and rounded like the roof of a Quonset hut, not like that of a high Swiss chalet built so that snows slide off quickly." (From her 1972 book that emphasizes folic acid in early pregnancy to prevent birth defects, 20 years ahead of organized medicine.)

Birth weights are also lower in children with cleft lip and cleft palate. (Long 1992, Pediatrie  47(2):133 [French].) (Repeating from Gomez above),  another study shows a 67% reduction of cleft lips from adding fluoride to the water supply, but the study was stopped before it became large enough for significance.