Flush the anti-fluoride campaign
By Christian Trejbal
Signs have been popping up in the New River Valley. I do not mean the political signs, though there are plenty of those, too, but the blue ones that read, “End water fluoridation.”
If you have not seen one yet, head on over to the Eats Natural Foods in Blacksburg. Customers walking in the front door looking for bulk granola cannot miss the signs, pamphlets and petition, all from Fluoride Free NRV.
Becky Farnham, co-owner of Eats, explained, “It’s something that some people feel is beneficial and some people think is a poison. We carry toothpaste that doesn’t have fluoride, for example.”
Trejbal is a Roanoke Times editorial writer. He is based in the New River Valley.
September 2, 2012 - 7:52 AM
This article stated that people who don’t want fluoride in their water can just filter it out. This is very difficult and expensive to do. Most water filters do not take out fluoride, only very expensive ones like reverse osmosis filters.
The price of these filters can be too expensive for many households.
There are good people making good arguments for and against fluoride in water so I found the last sentence
of the article about “how empty it really is” to destroy what had been to that point a reasonable and thoughtful article and was totally uncalled for. I would think that other people might not want to do interviews with you if you make a habit of treating their ideas so callously.
Stan #1, it would be unhelpful to attribute false legitimacy to an unreasonable case, to those making it and to those less informed. There are many good people arguing against fluoridation, and i agree with Trejbal that they should be commended for being concerned and engaged; but they do not have good arguments, and they should be criticized for promoting bad science and undermining public health.
The body doesn’t need fluoride. Unlike nutrients that are added to food such as vit d, folic acid and iodine, which are essential for a healthy body, there is no fluoride deficiency in humans. Consuming a fluoride-free diet does not cause tooth decay. However, unlike nutrients, consuming just a little over what is recommended of fluoride can damage teeth and bones.
The EPA regulates fluoride in water as a contaminant with the safe level for children being about twice as high as “Optimal” levels for adults it’s about 4 times “optimal” No one has died from ingesting too vitamin D fortified milk, folic acid fortified breads or iodine fortified salt. But people have died from fluoridated water when accidents occur and too much flows into the water as has occurred on numerous occasions.
Further children have died from swallowing too many fluoride pills. One child died from ingesting rather than expectorating his dentist’s fluoride treatment
Thousands of calls are made to poison control every year about children who eat their fluoridated toothpaste which carries the warning to call poison control if the amount used for brushing (about a pea sized amount) is swallowed.
I’ve never seen a poison warning on bread saying if more bread is ingested than need to make a sandwich, call poison control. There’s no poison warning on milk saying if you drink too much milk you’ll get Vit D poisoning and the same goes for iodized salt.
Most of us have learned that our public officials and public associations are no infallible. Most endorsing organizations did so on the blind faith to dental organizations and never did their own research – just like this newspaper report.
New York State Coalition Opposed to Fluoridation #3:
Tooth decay is a consequence of fluoride deficiency. Meanwhile, what you call “just a little over” is more like an order of magnitude at least (unless you’re talking about the mildest fluorosis), and “when accidents occur” people have died from pure water too. These are the kinds of silly arguments that dupe well-meaning people into promoting bad policy.
The idea that no major dental organization has done its homework despite a half-century of continuous vitriol and fearmongering is, frankly, ludicrous. I did my own homework when the local campaign started last September and a friend of mine gave me Mr. Steinberg’s pamphlet. It’s almost complete nonsense, and it seriously troubles me that activists are wasting their time and energy on campaigns like this when they’re desperately needed elsewhere.
For anyone interested, systematic reviews of the fluoridation literature can be found here, here, and here, for example. (Short version: It works, and the trick is to keep both decay and fluorosis low. This is why it’s called optimal water fluoridation.)
I’ve read a lot of bad things about Fluoride. My wife and I have never allowed our sons to be administered a Fluoride rinse at the dentist. Brushing, flossing and keeping other sugary foods to minimum is all that is needed. The risks of Fluoride far outweigh any benefits. Just my opinion.
From personal experience in the early 1970′s before floridation, children with facial abscesses and swollen painful jaws secondary to decayed teeth was a daily occurrence in the local ER’s. That does not happen nearly as often now and the primary reason is floridation.
To discontinue floridation would be cruel and hurt poor children the most! It is a very effective and cheap public health provision.
Stan Davis is correct: fluoride removal requires a reverse osmosis filter, which cost at least about $250. Activated alumina is another option; AA will remove some fluoride, but it has poor effectiveness in the high-pH water found in the NRV. Also, activated alumina is fairly expensive because it requires frequent replacement.
Christian Trejbal has not provided a convincing argument that my case is “empty”. His argument is based entirely on assurances from the CDC and ADA. But the science contradicts these organizations.
The case against fluoride is well supported by the science, a good selection of which is available on our website for download: http://www.fluoridefreeNRV.org.
Mr Trejbal should follow his own good advice to “never passively accept the edicts of science and government”. In the case of fluoride, science and the government are in disagreement. The science shows its harmful, while the government says its safe. I’ll go with the science, thank you.
JimW #5, what risks have you read about? Many have been exaggerated or fabricated (in the sense that they are risks of chronic fluoride exposure but not at optimal fluoridation levels) by organizations like the Fluoride Action Network, as outlined here, and so far i’ve failed to find any besides fluorosis that are based on robust evidence.
John R #6, fluoridation is certainly part of the reason, but from what i can tell there’s honest debate over how much is due to fluoridation versus wider-spread use of dentifrices and improved dental care, though all are considered important. Still, overall, healthier teeth amidst a steady rise in sugar consumption is telling.
Dan #7, we can make “the science” say whatever we want, provided we are willing to be selective in the literature we cite (rather than accept the “mountain of contrary evidence” Mr. Trejbal referred to in full). This is why systematic reviews, like the one above that found “no clear evidence of other potential adverse effects” than fluorosis, are so important.
Let their teeth go back to rotting and let freedom ring!
Cory Brunson:
I agree with you that NYSCOF uses weak arguments that should not enter the debate. There are much better and more valid arguments against fluoridation.
The idea that cavities are a “fluoride deficiency” disease is utterly ridiculous and completely wrong. Fluoride is not an essential nutrient, and has no known normal, healthful biochemical function in the human body, or biochemistry generally. There are many examples of cultures with very low cavity rates that never used fluoride and had very low exposure to fluoride. Cavities are caused by deficiency of vitamins and nutrients, most notably vitamins D and K2, and magnesium, phosophate and other minerals. Likely other nutrients are important as well.
Cavities are tooth infections, and fluoride works precisely because it is toxic. Fluoride ions inhibit bacterial growth and kill bacteria, and glycolysis enzymes specifically. Fluoride works TOPICALLY, when it is applied directly to the teeth. Systemically ingested fluoride is not effective for preventing cavities.
Fluoride is basically a topical antibiotic for the teeth. To argue that fluoride is some kind of nutrient because it prevents cavities when applied topically is simply not logical. By this illogic, I could say that sunburn is a sunblock deficiency.
Fluoride is a toxic ion, just like the toxic elements lead, mercury, arsenic, cadmium etc. Like these toxic metals, fluoride bioaccumulates in the body over a lifetime. Levels increase over time. And as the levels increase, the toxic effects increase.
The bioaccumulative nature of fluoride is one important reason why short-term toxicity studies are not valid for assessing the public health risk of long-term water fluoridation.
Dental fluorosis is a toxic effect. It is tooth damage. Today, rates of dental fluorosis are alarmingly high, with about 40% of all children affected to some degree. http://en.wikipedia.org/wiki/Dental_fluorosis The incidence of dental fluorosis has about doubled in the last 25 years.
There is no “optimal fluoridation” level. The levels which are observed to reduce cavities are the same levels that cause fluorosis. They overlap. its not possible to “prevent” cavities in a group of people without also causing fluorosis. See for example the Iowa Fluoride Study papers by Warren et al. I can provide them if you email me.
The observed cavities reduction from fluoride ingestion is not a REAL cavity reduction. This is because fluoride causes delayed tooth eruption. And delayed tooth eruption causes a misleading, entirely erroneous observation of cavity reduction. The size of the delayed tooth eruption effect is large enough to account for the observed cavity reduction. Proponents of fluoridation completely ignore this important effect of fluoride, which is another example of their unscientific approach to the issue.
Also, fluoride DOES cause adverse effects at dosages received from fluoridated water. Specifically, impaired thyroid function is caused at dosages received from fluoridated water, particularly in people with iodine deficiency. This is clearly stated in the 2006 National Research Council review of fluoride toxicity. Relevant sections of this important review are available on our website.
The bad science claims and specious arguments are made by fluoridation advocates. They overestimate what population based epi studies are able to observe, they mischaracterize the science of fluoride toxicity, and they lie about fluoride dangers to protect their own reputation. It is an egregious case of politics trumping science.
The medical establishment does get things completely wrong sometimes. Its happened before. The reason is because of politics: powerful reputations that need to be protected, sources of funding not offended, and the like. It took the medical community over 17 years to recognize that stomach ulcers were caused by H pylori infection. Thats 17 years after H Pylori infection was PROVEN to cause stomach ulcers. There are many other examples. The medical science field is the SLOWEST of all areas of science to acknowledge scientific results and cast off old, conservative ways of thinking.
John R:
You are correct that cavities incidence has declined greatly since the 1960s and 1970s. However, there is really no reason to believe the water fluoridation is responsible for this. The CDC loves to credit itself for this improvement in dental health, but they have no scientific basis for doing so. For the CDC is all about politics, and making themselves look good.
There is no correlation between water fluoridation and rates of cavities incidence. States and localities with high and low rates of water fluoridation have basically the same cavity rates.
Countries that ended water fluoridation in the 1970s (or that never started), experienced the same reduction in cavities during this period.
Therefore, it is not possible for water fluoridation to be responsible for the large reduction in cavities. My belief is that the reduction in cavities is due to the large increase in use of topical fluoride-fluoridated toothpaste and fluoride treatments. Its likely there are other causes as well.
There is no reason to believe that water fluoridation should be credited with the large reduction in cavities incidence observed since the 1960s.
For areas without fluoridation (well water), the pediatrician’s prescribed fluoride drops to be used in infant formula. At least they did in the 80′s when I had two babies.
Dan #10, do you not see how slanted this line of reasoning is? Pick isolated studies to back up sensational claims, but dismiss an entire literature on the grounds that every researcher involved somehow forgot to account for an already well-understood phenomenon. Bear in mind that neither of us are experts. Anyway, on with the details.
This “essential nutrient” business is semantic. Fluoride is a nutrient (look it up in the DRIs), it appears naturally in water (often at higher levels than optimal), and it’s beneficial in several ways, including enamel strengthening and remineralization. I said that decay is a consequence of fluoride deficiency, which it is. It is also a consequence of other poor dietary choices; the availability of fluoride does not suddenly make sugar healthy, any more than decreased sugar intake makes fluoride irrelevant.
Ditto calling something “toxic”. Demonstrate a toxic effect on humans at municipal fluoride levels and we’ll have something to talk about. (I already mentioned fluorosis. You might not be aware that the monstrous 40% figure you cite refers overwhelmingly to its mild form. From the NRC report you cite: “The prevalence of severe enamel fluorosis is very low (near zero) at fluoride concentrations below 2 mg/L. However, from a cosmetic standpoint, the SMCL does not completely prevent the occurrence of moderate enamel fluorosis.”) Meanwhile, you’re missing quite a bit of ongoing discussion in the literature over topical and systemic applications (which are seen as complementing each other).
I don’t think you’re quite getting what’s meant by “optimal”. The goal is to minimize the aggregate harm both of tooth decay and of fluorosis. If the ranges didn’t overlap then “optimal” would just refer to anywhere along the interval between them. As it is, “optimal” means not allowing one to plague us while we obsess over the other.
I’ve read the Iowa study, thanks. Have you read the discussion section? in particular, the part about the study’s limitations and various possible interpretations? As i alluded above, it is unreasonable to accept wholesale the cautious conclusions of isolated studies but dismiss the larger body of research. To reiterate, cherry-pick well enough and “the science” says whatever we want.
This isn’t the first time i’ve come across the “delayed eruption” hypothesis — NYSCOF cites several studies that are mostly irrelevant (e.g. animal studies, human studies in endemic fluoride areas) — but so far as i can tell the literature isn’t there to support it (and some refutes it). Cite away if you’ve got the evidence.
I’ve also read the NRC report — which was likewise not concerned with optimal water fluoridation in the first place. For example, the table you cite on endocrine effects is unfortunately misleading; if you look at the studies it cites, you’ll find that (a) the fluoride levels being compared are either at or much higher than the EPA optimal — that is, the most they say is that optimal levels are better than much higher levels — and (b) a slew of confounding factors, some arising from various groundwater contaminants, could not be accounted for. It’s worth noting that the report itself concluded only that even effects at these higher levels were possibilities worth researching further.
Regarding your last two paragraphs: If you’re arguing that medical research is completely unreliable, then there’s obviously nothing for me to say. If not, however, then the onus is still on you to demonstrate that the consensus in support of water fluoridation is wrong. Pardon my naiveté, but scientific consensus seems much more often to be right, and increasingly so with time.
Sandi #12: I don’t know what they say about drops nowadays, but the CDC advises limited use of fluoridated water in infant formula.
Sandi Saunders:
Prescribing fluoride drops to infants is medical malpractice. Fluoride causes thyroid impairment, which can result in permanent brain damage. There is strong scientific evidence that this is the mechanism by which fluoride causes low intelligence.
Cory:
The evidence regarding delayed tooth eruption is there. So is the analysis by Komarek et al showing that it accounts for the apparent but illusory cavity reduction. This research has never been followed up, but it should be.
Its quite understandable that prior research on water fluoridation would completely miss the delayed tooth eruption effect. Detecting it requires building a relational database tracking each individual tooth and its time of eruption. There is only one study that I know about that has data on this detailed level-the one used in the Komarak paper. if you know about other research contradicting the delayed tooth eruption effect, please do let me know.
The seminal reference on delayed tooth eruption is Leroy 2003. http://www.ncbi.nlm.nih.gov/pubmed/14986914
Though they describe the effect as “minimal” Komarak showed quantitatively that it was still enough to overwhelm the cavity-preventative effect.
Fluoride is NOT a nutrient, despite it appearing in the DRI. The National Academy of Sciences agrees with me that fluoride is not a nutrient. it has no known biological/biochemical function, unlike every other known nutrient.
Fluoride is toxic at dosages received from fluoridated water. Specifically, it causes impaired thyroid function and impaired glucose tolerance (diabetes) at dosages received from 0.7ppm fluoridated water. This comes directly from the 2006 NRC review. See pages 263-264, and pages 430-433.
The 40% figure is about 1/2 in the mild form. Mild tooth damage is tooth damage. Its obvious why you want to downplay this adverse effect.
I understand what you are trying to get at with “optimal”. My point is that even so-called “optimal” fluoridation causes tooth damage-i.e. dental fluorosis.
I understand the problems with cherrypicking science. Thats why I rely mostly on reviews and meta-analysis studies, like the 2006 NRC review, the 2000 York report, and the like. The 2006 NRC review is really all I need to de-bunk the “fluoridation is safe” nonsense.
The 2000 York report is also quite devastating for fluoride advocates. They state that the quality of the research is low, and that the size of the cavity reduction is quite a bit lower than claimed. The York report is a very good, very thorough study on water fluoridation efficacy. I am aware that they conclude fluoride does reduce cavities.
I dont have a problem with accepting that water fluoridation may prevent cavities. I know the science is at least equivocal on that point. The delayed tooth eruption effect may not be real. But my point is that fluoride benefits are not proven to the level they must be to justify a compulsory medication program of adding medications to the public water supply. If thats even possible-I submit that a very high level of proof should be required to add drugs to the water supply.
Your claims that “the NRC report is “not concerned with optimal water fluoridation…” is specious and frankly ridiculous. What matters is DOSAGE. And the NRC review is absolutely relevant to dosages that people receive from 0.7ppm fluoridated water. You are absolutely in the wrong on this point Cory. Read pages 260-267 and pages 430-433.
What table do i cite regarding endocrine effects? I dont cite a table. I cite the conclusions on page 263, for example. And the conclusions are clear, especially when viewed in light of the intake tables on pages 430-433. The fluoride concentrations in this table are 0.7ppm-the exact same concentration added to our water.
I would really like for you to be more clear about this Cory, because the thyroid effect argument is the best argument against fluoridation.
Which studies are you talking about when you say “if you look at the studies it cites?
You mention an “EPA optimal” level. There is no such thing. The EPA has MCL and MCLGs.
Also, are you talking about DOSAGE, or CONCENTRATION? They are very different.
The onus is on you to demonstrate its safe and effective. You are the one advocating compulsory medical treatments to those who do not want it. Such outrageous policy should really be illegal, as it is in europe.
Cory
I dont argue that medical research is “completely unreliable”. So please stop throwing around absurd straw-man arguments like this.
I meant what I said: that medical authorities get things wrong sometimes, sometimes because of politics. its a pretty simple concept that really should be easy to accept.
There is NOT consensus scientific support in favor of water fluoridation. there is majority support. Several authors of the 2006 NRC review are opposed to water fluoridation.
When I state that advocates “overestimate what population based epi studies are able to observe” I am talking about for example, safety studies reviewed in the York report that do not find adverse effects. Water fluoridation trials are not randomized and well-controlled. There are huge confounders, with people moving around, drinking water from different sources, different populations etc. Even the fluoride intake levels in the experimental and control groups overlap in some cases. Yet, fluoridation advocates point to studies such as this and declare that such studies prove it safe. Really whats happened is that the studies were not well designed to find these adverse effect. And even small adverse effects can have HUGE public health consequences. Cheng et al describe this problem well:
“The methodological challenges of detecting harms of long term exposure to fluoridation are further illustrated by a case-control study on hip fracture in England.12 It reported “no increase” in risk associated with average lifetime exposure of ≥0.9 part per million fluoride in drinking water. Although exemplary in many other aspects, the study had less than 70% power to identify an odds ratio of 1.5 associated with exposure. If the odds ratio was only 1.2—which would mean more than 10 000 excess hip fractures a year in England if the population was so exposed—the study would have a less than one in five chance of detecting it.”-Cheng et al, BMJ 2007.
You’re a math guy, right Cory? You understand this argument, correct? The same argument can be applied to every other possible adverse effect: diabetes, arthritis, thyroid disease, and so on. There is evidence that fluoride causes all these adverse effects.is
Finally, you really need to justify the poor ethics of adding a bioaccumulative and toxic substance to the water supply. If you think fluoride is wonderful, then great-go take it yourself. Fluoride supplements are widely available and cheap. It makes no sense to force your personal choices on everyone. By advocating and defending fluoridation, you are supporting this government intrusion into personal medical decisions. Everyone is responsible for their own healthcare choices.
Well thanks for that indictment Dan Steinberg! Expecting parents to question or even ignore what a doctor tells you or prescribes to you is not something most of us are inclined to do.
To further prove my unfitness as a mother, I took a medication for morning sickness for over 6 months that was subsequently pulled from the market.
Both my children are healthy, intelligent, gainfully employed and happy citizens who still have strong teeth. But thanks everso for your “concern”. Are you against vaccines too?
Maybe you should be advocating with the AMA instead of a blog. Just sayin’.
Sandi:
I didnt criticise you personally or say you were “unfit”. I criticized the pediatrician that prescribed it.
What do vaccines have to do with fluoride?
Why the personal attacks?
Dan #15, i’ll only address the stuff you’re not repeating (with no better sourcing) from previously.
If you find a copy of Komárek et al, i’ll be glad to read it, but you still seem to be basing you’re entire refutation of efficacy on one analysis, which i already stressed is unwise.
You’re denying that fluoridation prevents tooth decay. (That’s what it is to “teach the controversy” when there is no controversy. The onus is on the research community to demonstrate that fluoridation is effective, and they have done so by any reasonable standard.) I’m downplaying fluorosis (which is predominantly cosmetic) relative to decay. Which of us is staking an extreme position here?
You’ve widely cited the table on page 262 and the surrounding text (the table lists the studies that motivate the discussion). The studies cited there are available online; i’ll drop this thread until you’ve looked at them. (That you consider the thyroid stuff the best evidence against fluoridation does help me relax, though.)
Optimal levels also allows more tooth decay to occur than higher levels would. The whole point is that fluorosis has already been factored into the recommendations.
The entire “compulsory medication” bit is nonsense as well, not the last reason for which being that fluoride occurs naturally in water already. Anyone who wants to can look up the legal precedent — which exists because people have already successfully argued the case for fluoridation, several times over. The ADA cites some of it here.
You’re right; i meant the HHS recommended (optimal) level. I was talking about concentration in the water supply, though it’s also true that dosages were measured in various ways (when at all) and were the sources for many of the comparisons.
There’s a book in the VT library you might want to check out: Scientific Knowledge in Controversy by Brian Martin. As part of his research, he systematically inquired as to whether various countries (including many in Europe) had instituted “bans” against fluoridation. Let me know what you think.
#16, there’s not much here to respond to, though i will relieve you of (a) a perceived insult and (b) a misunderstanding: (a) I was merely laying out two options, not accusing you of either, so no strawmanning was intended. Yes, scientific consensus can be wrong, but this is extremely atypical, which leaves the burden with you. (b) Two or three authors of the NRC report (including Thiessen and Limeback) were already opposed to fluoridation before authoring the report. Presumably they were included as authors to placate antifluoridationists, who would otherwise call foul. The consensus, as you say, is there. It’s still no more difficult to find individual medical professionals who think fluoridation doesn’t work (e.g. around .2% of dentists) than to find scientists who think evolution doesn’t work.
What “personal attacks”? Not agreeing with your analysis makes it a personal attack?
I have found that quite often there is a direct link to the Fluoride haters and the Vaccine scare mongers. It was a simple question, sir. Why do you choose not to answer it?
My children had one of the best and most sought after pediatricians in the Roanoke Valley and forgive me for trusting him more than people who see monsters in every situation.
Very little that we put into our bodies or absorb from the atmosphere has no side effects or consequences. Is the possible trade off worth it? I do not know. While I respect the concern anyone has and appreciate the passion attached, I do not think yours is the only voice worth hearing. Physicians do not deliberately mislead, misdiagnose, or mistreat a patient. And I believe you go too far in calling it “malpractice”!
Cory:
You are taking the extreme position, except for your argument that water fluoridation reduces tooth decay. Its reasonable to argue that water fluoridation does reduce tooth decay. I agree there is evidence for that. However, my personal opinion is that this is false-because of Komarek, because of the delayed tooth eruption effect, because ALL the fluoridation trial studies are low quality with lots of confounders, and because its not biologically plausible (ingested fluoride has a very small effect on saliva concentrations-too low to do anything). But I understand these things are equivocal.
The harm from fluoride is not equivocal. Its clear that fluoride is harmful at dosages received from fluoridated water. Especially for people that are already sick. Especially because fluoride bioaccumulates (like lead, mercury, arsenic etc).
The ethics of the practice are also not equivocal. It is absolutely an egregious violation of medical ethics to force fluoride population-wide. Everyone is dosed, even me, despite my attempts to avoid it.
I know about the court cases. these court cases are also egregious violations of ethics and logic. They are an outrage. They are based on scientific nonsense, and sophistry.
When it comes to dental fluorosis you only mention mild fluorosis. Well, water fluoridation also increases severe and moderate fluorosis. The incidence in these more severe types of fluorosis is about 3% of the population. These people are being substantially harmed by fluoridation. Its not ethical for the government or anyone else to force this choice (higher risk of fluorisis vs lower cavities) on the public without informed consent.
Fluoride is a medication/drug. Look up the definition. A drug is any non-food substance used for treating/preventing a medical condition. Fluoride cannot be considered a food because it has no known biological/biochemical function. magnesium can be considered a “food”-its a necessary component in over 300 metalloenzymes. Fluoride has no such function.
Just because a substance is a natural contaminant does not make it a food, and does not mean its safe to “merely adjust” the levels. Lead, arsenic, mercury, cadmium etc are all occasional water contaminants. Would you argue that mercury is not a drug, and not harmful if it was discovered that mercury had some medical use? Actually, mercury DOES have some medical uses-it can be used as a partially effective treatment for syphilis and other infectious diseases. It was used for this purpose for many years, up until the 1930s or 1940s in fact. Some say that mercury salts can prevent cavities, too, since it has very powerful antimicrobial effects in ionic form.
Again, I wouldnt call support for water fluoridation a “consensus”; I would describe it as a majority opinion. There is quite a long list of experts opponents on fluoridealert for example. And I have many books on the subject with opinions of experts. Its true that scientific consensus is rarely wrong. But majority opinion is wrong far more often. And that is especially the case in medical science, IMO. I dont think its productive to argue about what percentage of scientists believe what. Rather, the scientific literature is what counts.
There are quite a number of references on page 262. Can you please be more specific? I am not going to download and search through all these papers to go looking for support for your arguments. Besides, you have not been specific about how these studies have been misinterpreted. I feel that you are asking me to do your arguing for you.
There is a consensus among the authors of the 2006 NRC review (12 nationally-recognized experts in fluoride toxicology) that adverse thyroid effects begin at 0.01mg/kg/day for iodine-deficient people. You really need to respond to this, because its my best argument.
Email me at dodanimalgmail.com and I will send you the Komarek reference, and the Leroy reference. And maybe other stuff.
Seriously, we should meet sometime so that I can show you some materials that are hard or impossible to access in electronic form.
Sandi
OK so the vaccine question was an attempt to attack by associating me with a different movement entirely. Thats what I figured, and thats why I didnt respond.
I never argued that my opinion is the “only voice worth hearing”. I merely offered my opinion, because well, this is a comment section of an article about my fluoride campaign.
If you dont think its malpractice to give fluoride to infants, I suggest you read pages 262-263 of the 2006 national Research Council review of fluoride toxicity. here it is:
“Thyroid Function
Fluoride exposure in humans is associated with elevated TSH concentra- tions, increased goiter prevalence, and altered T4 and T3 concentrations; similar effects on T4 and T3 are reported in experimental animals, but TSH has not been measured in most studies. In animals, effects on thyroid func- tion have been reported at fluoride doses of 3-6 mg/kg/day (some effects at 0.4-0.6 mg/kg/day) when iodine intake was adequate (Table 8-1); effects on thyroid function were more severe or occurred at lower doses when iodine intake was inadequate. In humans, effects on thyroid function were associated with fluoride exposures of 0.05-0.13 mg/kg/day when iodine intake was adequate and 0.01-0.03 mg/kg/day when iodine intake was inadequate (Table 8-2).
Several sets of results are consistent with inhibition of deiodinase activity, but other mechanisms of action are also possible, and more than one might be operative in a given situation. In many cases, mean hormone concentrations for groups are within normal limits, but individuals may have clinically important situations. In particular, the inverse correlation between asymptomatic hypothyroidism in pregnant mothers and the IQ of the offspring (Klein et al. 2001) is a cause for concern. The recent decline in iodine intake in the United States (CDC 2002d; Larsen et al. 2002) could contribute to increased toxicity of fluoride for some individuals.”
Be aware that 0.01 and 0.05mg/kg/day are very small amounts easily exceeded in infants (because they are so small). The NRC expressed concern about the thyroid effects because impaired thyroid function in an infant causes permanent brain damage. These are the scientific facts.
Any doctor who thinks PERMANENT BRAIN DAMAGE in an infant is an acceptable risk for a small reduction in cavities risk needs to have his head examined.
Cory:
Here is a quote from one of the great figures in 20th century science, Richard Feynman. I think you would do well to consider the implications for your arguments about fluoridation, since they seem to rely heavily on the opinions of (so-called) experts at the CDC, ADA, etc.
“Science is the belief in the ignorance of experts.”
― Richard P. Feynman
Dan S, did you totally miss the part where I said “In the 80′s”? Quoting a 2006 reference manual seems fair to you?
Also, it is NOT “a different movement entirely”, many of the people who protest Fluoride also protest and refuse vaccines. Believe it or not, you are not the only one who reads.
Sandi
Its a different movement with some of the same people, thats all.
Pediatricians are still routinely recommending fluoride for infants. Most pediatricians (and dentists) are completely unaware of the 2006 NRC review.
Your 1980s pediatrician can certainly be excused for not being aware of the 2006 NRC review. LOL
When fluoride is ingested during the developement of the teeth, fluorapatite crystals are formed in the developing tooth enamel.
This makes the tooth enamel more resistant to acid decalcification. Decay forming bacteria in the mouth forms acid which decalcifies the tooth enamel and causes tooth decay. Thus fluoride treated enamel is more resistant to tooth decay. This is a scientific fact.
Fluoride is a naturally occurring element in the soil and water supply, the concentration varies with locality. Many years ago, the first connection between fluoride and tooth decay prevention was made by observing an area in Texas which had unusually high levels of naturally occurring fluoride in the ground water. The local population had very little tooth decay compared to the general population.
Fluoridation directly reduces tooth decay, a proven fact. The optimal concentration in the water supply is about 1 part per million which is a safe level.
Of course you don’t have to take my word for the safety and public health benifits of fluoridation.
Here is what the Dept. of Health and Human Services, Centers for Disease Control and Prevention has to say:
“The safety of fluoride in drinking water at levels recommended for preventing tooth decay has been affirmed by numerous scientific and professional groups. Scientists have found a lack of evidence to show an association between water fluoridation and a negative impact on people, plants, or animals.”
http://www.cdc.gov/fluoridation/safety.htm
This is one issue where the federal government and I agree!
Here is a policy statement on fluoridation from the American Academy of Environmental Medicine:
http://www.aaemonline.org/images/FluorideResolution.pdf
American Academy of Environmental Medicine 7701 East Kellogg •
Wichita, KS 67207
Tel: (316) 684-5500 • Fax: (316) 684-5709 http://www.aaem.com
Founded in 1965 as a non-profit medical association, the AAEM brings together physicians and scientists interested in the complex relationship between the environment and health. With an elite membership of highly trained physicians and clinicians, the Academy is committed to advancing the field of Environmental Medicine through member development and education, public awareness and research.
Whereas the International Academy of Oral Medicine and Toxicology (IAOMT) has been instrumental in supporting scientific medical research identifying the inherent health dangers associated with the use of fluoride in public water and food supplies, and;
Whereas, scientific research has clearly identified that fluoride is a known toxic substance that adversely affects human health, and;
Whereas, fluoride is a known neurotoxin and carcinogen even at the levels added to the public water supplies as promoted by the American Dental Association (ADA) and the United States Public Health Service (USPHS), and;
Whereas the American Academy of Environmental Medicine educates physicians and the public about the dangers of and subsequent prevention and treatment of environmental toxicity, and;
Whereas the time is ripe for recognizing like-minded and synergistic participants in the field of environmental medicine, therefore be it resolved that:
The American Academy of Environmental Medicine (AAEM):
1. Supports banning the addition of fluoride or products containing fluoridetopublicwatersuppliesandtoany substancesintendedfor human consumption.
2. Supports the efforts of the International Academy of Oral Medicine and Toxicology (IAOMT) and like-minded organizations in addition to any legislative efforts that effectively reduce the environmental andhumanexposure tofluoride.
Approved by the Board of Directors of the American Academy of Environmental Medicine on October 25, 2006
And here is the policy position from the International Academy of Oral Medicine and Toxicology:
http://iaomt.guiadmin.com/wp-content/uploads/article_IAOMT-Fluoridation-Position.pdf
IAOMT http://iaomt.org/
Policy position on ingested fluoride and fluoridation
“In IAOMT’s ongoing examination of the toxicological data on fluoride, the Academy has made several preliminary determinations over the last 18 years, each concluding that fluoride added to the public water supply, or prescribed as controlled-dose supplements, delivers no discernible health benefit, and causes a higher incidence of adverse health effects.
This current policy position by IAOMT confirms those earlier assessments and asserts that there is no discernible health benefit derived from ingested fluoride and that the preponderance of evidence shows that ingested fluoride in dosages now prevalent in public exposures aggravates existing illnesses, and causes a greater incidence of adverse health effects.
Ingested fluoride is hereby recognized as unsafe, and ineffective for the purposes of reducing tooth decay.”
Dan #21, again i’m ignoring rehashed talking points.
Your personal opinion, to put it mildly, does not overturn the consensus of researchers who have devoted their working lives to the study of human health. Yes, that optimal water fluoridation protects against tooth decay is a consensus reached by these researchers; i was (i thought clearly) not referring to support for fluoridation, which is a policy issue.
When you say “harm from fluoride”, are you referring to anything other than fluorosis? If so, then you are taking yet another extreme position, against the balance of the existing body of evidence.
From the decision in Coshow v. Escondido: “City’s use of HFSA to fluoridate its drinking water does not force Coshow to do anything. Fluoridation occurs before it enters each household and stops with the water faucet. The HFSA in the water is not directly introduced into Coshow’s or other residents’ bloodstreams. Because Coshow is not compelled to drink the fluoridated water, his freedom to choose not to ingest HFSA remains intact.” You’re entitled to find the decision unfair, but you’re disingenuous to claim that you’re being “dosed”.
On the subject of disingenuity, enamel remineralization and the conversion of hydroxyapatite into fluorapatite are, i believe, biochemical processes; and the range of natural fluoride levels in groundwater includes the HHS optimal. Live or die by the “nutrient” and “toxin” labels if you want; it doesn’t change the science, the ethics, or the legality.
I focused on mild fluorosis because it is by far the most common form. Meanwhile, you speak of “informed consent” as though fluoridation were a municipal secret.
The absurd literature at FFNRV is both highly selective and highly opaque; reading over it the past several months, i’ve scoured the internet and library and sought out expert opinion in order to put various of your claims into proper context (e.g. next paragraph) — essentially doing your research for you. You can stand to do your own digging if you honestly want to know what you’re talking about.
“There is a consensus among the authors of the 2006 NRC review (12 nationally-recognized experts in fluoride toxicology) that adverse thyroid effects begin at 0.01mg/kg/day for iodine-deficient people. You really need to respond to this, because its my best argument.” Good grief.
The authors reached “consensus” on no such thing. The quotes you’ve pulled describe the research under review; they do not constitute any sort of conclusion of the authors, unanimous or not. (Dr. Thiessen in particular, being an immutable fluoridation opponent since before the review, does not speak for the authors.)
The authors’ main conclusion in this section, as in most other sections, is that more research is needed.
You have singled out the efficacy research as being of low quality, despite its immensity. The quality of the comparatively sparse research under review here is generally lower still. By your own standards, there is effectively no cause here for concern. Further research is of course warranted, but these studies are a far cry from conclusive.
Specifically, the 0.01mg/kg/day figure refers to goiter, and again your case hinges on a single study: Day and Powell–Jackson. The library is taking a while to send it to me, so by principle of charity let’s assume that it’s of good methodological quality. One study does not by itself overturn a discipline. If you actually supported good science, you would be clamoring for this research to be pursued further (or looking up whether it already has) — for instance, in the United States (see “confounding factors” below).
Part of the reason for doing further research before jumping to policy recommendations is the multitudinous ways scientists can be duped into meaningful results out of innocuous data. We rely on each other for validation.
(Meanwhile, looking at the other two studies cited, Desai et al did not consider low-fluoride and low-iodine regions, and Jooste et al found no relationship with fluoride levels at or below optimal. It is indeed a single study you’re pointing to.)
The severity of iodine deficiency throughout the Himalayans, where Day-Powell–Jackson was conducted (discussed in Stewart) makes extrapolation to regions with typical levels especially tenuous — and this ignores the wide range of other likely confounding factors that would need to be addressed.
Iodine deficiency is a problem of its own, and deserves to be addressed as such. Supposing that the risk were adequately demonstrated, depriving the entire population of optimal fluoridation would, it seems to me, not be the proper course of action. I’m not qualified to say for sure, but it looks cheaper (given the savings of fluoridation) and more ethical (given the benefits) to simply provide lower-fluoride water (by filter, for instance) to those who might actually need it.
Ultimately, it comes down to the need for a robust literature. Single studies of high quality have produced all manner of nonsense results (ESP, for instance). Meanwhile, there’s no telling how many studies of fluoride levels and iodine deficiency have been shelved or rejected because their results were less exciting. None of this makes Day-Powell–Jackson invalid; it means that, as the authors said several times, more (and more relevant) research is required, especially for these results to bear upon fluoridation. One of the cornerstones of science is reproducibility, and good science is not just reproducible, but reproduced. This paper may be good science; your extrapolations and inferences from it are not.
Keep in mind that i’m not an expert. There may be a variety of other reasons to be highly suspicious of this hypothesis. I’m just suggesting some basic reasons we should not expect the research community to reinvent itself over it. It may also be worth quoting the end of the final chapter of the NRC report: “Recommendation: To develop an MCLG that is protective of severe enamel fluorosis, clinical stage II skeletal fluorosis, and bone fractures, EPA should update the risk assessment of fluoride to include new data on health risks and better estimates of total exposure (relative source contribution) in individuals and to use current approaches to quantifying risk, considering susceptible subpopulations, and characterizing uncertainties and variability.” I find it telling that their recommendation seems not to be based at all on your “best argument”.
I thought i’d come across that Feynman quote recently, and i was right! It seems to be a popular trope among anti-fluoridationists nowadays, as this comment thread illustrates.
Anyway, it has become clear, by such cumulative hints as buckling down on personal belief, semantics, or unresponsiveness when confronted with contrary evidence (not to mention your willingness to wax deontological or cite sources you demonize when it suits your needs), that you’re not interested in reexamining your own position. (How ironic that you characterize the CDC as too entrenched in their position to acknowledge contrary evidence.)
John R #27, your sourcing is fine and your support noble. As you can see, however, there’ll be no convincing someone who believes in a massive conspiracy to suppress anti-fluoridation research. Any science or health organization that disagrees is conveniently part of the conspiracy, or simply “unaware” that their entire discipline is a lie; while contrarians, almost by default, are speaking truth to power. Here‘s an illuminating article about denialism in general that you (and Sandi #20) might enjoy.
Thank you Cory. I am certainly not equipped or educated enough to argue science. That is why I tend to trust scientists and doctors who are. Sometimes a dead mouse is a sign of plague, but most of the time, it is just a dead mouse. When I hear hoof-beats, I tend not to think zebras.
Call me a cynic, but the moment a new villain is described as “causing” __________ (fill in the blank as you will), there are suddenly diagnoses of that phenomenon in greater numbers. That is not to say that there is no harm in any substance. There is always a point where too much is harmful. The very nature of so many “spectrum diseases” is cause for concern about how the human body acts and reacts to everything. I applaud those who study and share findings, but scare mongers and charlatans, though a minority in the field, are very vocal. It is very hard to tell the good guys from the bad guys as both are passionate, articulate and have data.
Sandi #31, thanks. Indeed, we all rely on experts in our day-to-day lives. (In our scientific world, we stand on the shoulders of giants just to keep our heads above water.) We all succumb to attractive nonsense from time to time, and i think that we owe it to each other to learn how to watch out for it. And of course there are exceptions to your good rule of thumb; the toxoplasmosis–schizophrenia link might turn out to be one of them.
Your last point is salient, though i might be reinterpreting it. I am not the best communicator for this cause, partly because i am not an expert and partly because i have grown furious about this and similar campaigns since i started reading up on them last year. I will try to moderate my tone a bit. To Dan #21, i apologize for letting my own suspicious come across as an accusation in my penultimate paragraph in #30.
Cory:
As I have pointed out, and substantiated, there is no consensus. The statements from the two professional organizations AAEM and IAOMT should make that crystal clear. The IAOMT has about 600-700 members. Also, There are at least 3 members of the NRC review committee who are publicly opposed to fluoridation. And one of them, Dr Thiessen, is a nationally-recognized expert on fluoride and risk-analysis specifically.
Why dont you spend a week trying to avoid ALL municipal water? And then let me know how easy it is. You will probably FAIL, because almost all canned food, beer, drinks, soda, condiments, restaurant food, restaurant drinks, drinking water on VT campus, in every workplace, gym and public establishment, is fluoridated. Water fluoridation is compulsory medication.
The “logic” in Coshow v. Escondido is psychotic. This is simply a case of the courts not willing to counter the powerful forces in government and establishment medicine behind fluoridation. My own personal doctor is an MD/PhD from Yale medical school. He is very opposed to fluoridation and supports my campaign.He says its just bizarre to distribute drugs via the water supply. However, under no circumstances will he make any public statements or publicly endorse my campaign, because he fears the campaign of harrassment and intimidation and the risk to his professional career.
I dont believe in and I have never asserted a conspiracy. Once again, Cory, you are putting words in my mouth and “strawmanning”. I allege there has been a mistake, likely due to political influence and a desire to protect bureaucratic reputations. Thats very different. ZThe sotry behind water fluoridation is explained in this book: http://www.amazon.com/The-Fluoride-Deception-Christopher-Bryson/dp/1583227008/ref=sr_1_1?ie=UTF8&qid=1347126694&sr=8-1&keywords=fluoride+deception
About 10% of the general population in the USA, and 15% of women of childbearing age, are moderately/severely iodine-deficient. These numbers are replicated and come from NHANES surveys by the CDC. So I would think you would be very interested in making sure that water fluoridation is safe for these people.
The 0.01mg/kg figure may rely on one study, but there are EIGHT studies listed in table 8-2 that support the assertion that thyroid effects occur in the ranges given (i.e. 0.03 and 0.05 mg/kg/day dosage levels). 0.01mg/kg is the lowest end of the range (and easily exceeded by most people drinking fluoridated water), but dosages of fluoride from fluoridated water alone can exceed 0.05 mg/kg day. And when fluoride from ALL sources is considered (as in the Iowa Fluoride Study), 0.05mg/kg/day is exceeded in about 30-40% of children up to four years of age, with fluoridated water being the largest or one of the largest sources.
Your biggest mistake, Cory, is arguing that residual scientific uncertainty is logical reason to assume safety. This is backwards and simply not logical. Ever heard of the precautionary principle? The existing scientific evidence is indicating a potentially very serious problem at these dosage levels. Its not logical to use scientific uncertainty as a reason to continue with a medical intervention, especially a compulsory intervention.
I’d like to remind you that 5% of the US population has a thyroid disorder.
It just doesnt make any sense to argue “fluoride should continue to be added to the water until its PROVEN to be harmful”. Rather, advocates have to prove its safe. And they have not done so. In fact, the existing evidence shows they are likely to be wrong, most egregiously in the case of thyroid effects.
Dr John Doull, toxicologist and Chair of the NRC fluoride committee, has publicly stated “The thyroid changes do worry me.” Thyroid effects occur at the lowest dosage levels. Dr Doull is author of a widely used textbook on toxicology and one of the most well-known toxicologists in the world. Thats why he was chair of the NRC review.
What a ringing endorsement for safety!
You are correct to point out that I did overstate the case, however. Mea culpa. I should have phrased what I wrote more carefully. I was sloppy. There was not a consensus on the committee that these thyroid effects DO occur (i.e. absolute proof), but rather, there was agreement that there is evidence showing that they occur. Big difference.
You state: “depriving the entire population of optimal fluoridation would, it seems to me, not be the proper course of action.”
not adding fluoride to the water is not “depriving” anyone of anything. FFNRV is not a campaign to ban fluoride. Fluoride is and always will be available in supplements (and pesticides, pollution etc).
Would you like to meet sometime Cory? I think it would be engaging to continue this discussion in person. I have a few things You should see.
Cory:
There is one more very important fact about the thyroid effects I forgot to mention. Decades ago, doctors in Europe used fluoride to treat hyperthyroidism (overactive thyroid).
Dr Connett states in his book:
“Doses as low as 0.9-4.2 mg fluoride/day were enough to reduce the basal metabolic rate of hyperthyroid patients and alleviate their condition.”
These dosages overlap with dosages many people receive from fluoridated water alone.
Here is the abstract of the paper Dr Connett used to substantiate the above-statemnt.
EFFECT OF FLUORINE ON THYROIDAL IODINE METABOLISM IN HYPERTHYROIDISM
PIERRE-M. GALLETTI, M.D., PH.D* and
GUSTAVE JOYET, D.Sc.
- Author Affiliations
The Department of Medicine and Radiology, Kantonspital Zurich, Switzerland
↵* Present address: Assistant Professor of Physiology, Division of Basic Health Sciences, Emory University, Georgia, U.S.A.
Abstract
Prolonged administration of a daily dose of 5-10 mg. of fluoride to patients with hyperthyroidism may cause clinical improvement together with a significant fall in the level of plasma protein-bound iodine and a reduction in the basal metabolic rate. Studies with radioactive fluorine failed to demonstrate any important accumulation of fluorine within the thyroid in vivo. Thyroidal, blood and urinary radioiodine studies suggest that fluorine inhibits the thyroid iodide-concentrating mechanism. Fluorine does not impair the capacity of the gland to synthesize thyroid hormone when there is an abundance of iodide in the blood. However, inhibition of the thyroidal concentrating capacity when the total iodide pool is low will impose a critical limitation of hormonal synthesis, and may explain the therapeutic effect.
I suggest reading this page on the thyroid effects:
http://www.fluoridealert.org/issues/health/thyroid/
Dan #33, again leaving out things already adequately addressed:
You might be unaware, but there are plenty of “professional organizations” and people who have actually earned PhDs in the relevant fields who vociferously oppose scientific consensus on a variety of things we all take for granted. And, like i said before, it makes some sense to include fluoridation opponents in a toxicology review, to ensure that no lines of inquiry are ignored. This paragraph is bunk.
Your own dubious ethics run counter to those of something like a dozen state supreme courts. That doesn’t make you wrong, of course, but it does suggest that you might want to take a closer look at yourself. “Your own personal doctor” is not suddenly an authority on these matters because your Gish gallop — probably delivered unopposed — convinced him. (Here, by the way, is another term that anyone reading should familiarize themselves with.)
You theorize (baselessly) that the CDC distributes false information in order to “make themselves look good” or because “they cannot admit they have made a mistake”, and that other major health organizations do the same for political or financial reasons. Yet i’m pretty sure that none of these organizations have admitted to this. Whether you admit it or not, this is conspiracy theorizing. Extremely interestingly, you subsequently cite a popular piece of conspiracy theorizing. (Don’t worry. The warped reasoning that leads to this kind of thing fascinates me, and Bryson’s and Connett’s books are on my list.)
Are you going to drop your claim to the hazards of 0.01 mg/kg/day? If not, then i need no clearer indication that you are being intellectually dishonest. If so, then i call upon you (again) to do your own homework for the rest of the NRC endocrine discussion — which, it is already clear from the present discussion, you have not yet done.
“Your biggest mistake, Cory, is arguing that residual scientific uncertainty is logical reason to assume safety.” You’re right! How appalling of me. I should have argued that the (actually quite massive) uncertainties involved nonetheless should not be dismissed outright but warrant further research. Good catch.
I just read a great article about merchants of doubt much like the FAN (though the FAN is, intriguingly, something of a mirror image of the smoking–lung cancer deniers of yore). It happened to include a quote that expresses elegantly what i would have just said more technically: “To wait for certainty is to wait forever. The fundamental paradigm of public health is and must be to protect people on the basis of the best evidence currently available…do not demand certainty where it does not and cannot exist.” The thrust is that the weight we ascribe a concern should reflect the weight of the evidence for it.
My heart didn’t quite skip a beat at your quote from Dr. Doull. Sounds like he does hope for more research to be conducted, though. Good idea.
Dan, at the risk of overlooking an upcoming response, i’ll be moving on to more productive pursuits. I’ll come back once i’ve had a look at Day-Powell–Jackson, since i’ve already committed myself to addressing this part of your case. I’ve already dug into several others (including T1 and T3 concentrations, IQ, and the relative standards of the FDA (which regulates fluoride in bottled water) and the EPA (municipal water)), and they have each collapsed upon inspection. As i’ve said a few times now, it’s your responsibility as a concerned citizen to make an educated and robust case, and not simply throw the kitchen sink in hopes that people will collapse under the onslaught.
First i’ll summarize the exchange and my position. You’re welcome to the last word.
Much of the confusion the FFNRV campaign generates derives from the conflation of ethics and law and science. It was poor judgment on my part to be drawn into that haze, and i’ll not be doing it again. Our ethics as people are, by and large, the same; most of our moral disagreements arise from incongruous models of reality. The facts are what matter.
In this spirit, let’s review our shared premises:
1. We agree that policy should reflect the best evidence available. In particular, we agree that policy should include optimal water fluoridation; we only disagree on what level is optimal (unless you think communities with high natural levels of fluoride in their water should be left to suffer the consequences).
2. We agree that there is general agreement among experts that sufficiently high levels of fluoride in drinking water reduce tooth decay and cause (dental and skeletal) fluorosis. We agree that other possible hazards warrant sufficient research to incorporate the risks into recommended optimal fluoridation levels.
3. We presumably agree that at least one side of the pro/anti fluoridation debate is well-intentioned but ill-informed — that is, that this debate would still happen in the absence of ill will on anyone’s part. (Otherwise you are conspiracy theorizing — or what might better be described as conspiracy fantasizing.) We also at least agree that there are cranks who should essentially be ignored. (I don’t know of any pro-fluoridation cranks but it wouldn’t surprise me to learn that they exist.)
4. We agree that the body of literature concerning a subject is of much greater weight than any single study within it.
The basic reasons that i take the position i do, none of which you have even tried to refute, are as follows:
1. Fluoride occurs naturally in water, so a priori there’s nothing uncouth about adjusting the level slightly up or down. The question is then one of optimal health, as gauged by the best evidence available.
2. Optimal levels incorporate risk of caries and fluorosis, since these are the consequences of varying levels of fluoride in drinking water that have been adequately demonstrated. (The extent of fluorosis is no more or less important than that of caries.) As dental care becomes more accessible and personal hygiene better practiced, the relative risks will change and the optimal fluoride level with it. The personal responsibility angle is a red herring, considering the wide range of legislation already in place to correct for unhealthy or otherwise unsafe lifestyles.
3. Before looking at the evidence directly, the “meta-evidence” of scientific controversies generally indicates, over decades, decreased dogma and close-mindedness within institutionalized science and a general tendency for contrarian cliques to sprout within any discipline, with our without clear financial incentives. My hypothesis that the minuscule minority is wrong is wholly in keeping with these trends, while your hypothesis that the vast majority is wrong runs contrary to them.
4. The evidence for any specific harmful effect of current optimal levels of fluoride in drinking water (aside from fluorosis) appears to lie between suggestive and nonexistent. That there are dozens of such purported harms, the cumulative evidence for which might be substantial if it were instead for one specific harmful effect, is unsurprising within a literature that is littered with isolated positive results that just didn’t stand up to replication. The politics of science itself favors positive results to negative, so this is what we should expect. (This, incidentally, is why i’m not willing to go down every rabbit hole you point to. I’ve gone down enough to learn that they are largely substantive.)
Elements of the discussion that i find essentially irrelevant include the following:
* Whether we classify fluoride as a “nutrient”, “drug”, or “toxin”. This only seems to matter insofar as the terminology has procedural (e.g. legal) implications, and you’ve already indicated (by your dismissal of case law) that you find such implications secondary at best.
* That fluoride is difficult to completely avoid in everyday life. The weight of the available evidence is against any unexpected serious harm at currently optimal levels, and if this changes then optimality will be lowered. We’ll never avoid fluoride completely, any more than we’ll avoid arsenic completely.
* The existence of individuals who take any specific stance on fluoridation. Their stances neither preclude nor weaken a consensus.
* Any notion of “natural rights” or appeal to “religious freedom”. Since we’re talking about public health, it should be obvious why.
I find it unfortunate that you’ve entrenched yourself in pseudoscience, but that is a risk assumed by all who embark on intellectual pursuits. Certainly by challenging authority and assumptions you are doing something of a public service, though i do wish you’d apportion yourself humility proportionate to the weakness of your case.
Cory:
You are accusing me of pseudoscience? Thats rich.
yes, I am accusing the CDC of exactly that. They have committed themselves to an insane policy, and they persist in the nonsense because to admit they have made a mistake would severely damage their reputation. The CDC has made mistakes like this before, such as the recent (2010) scandal in which they were caught INTENTIONALLY LYING about lead contaimination in the DC water supply to protect their reputation. Read this:
”
CDC misled District residents about lead levels in water, House probe finds. Some District water tested in 2004 contained high levels of lead.
By Carol D. Leonnig
Washington Post Staff Writer
Thursday, May 20, 2010
The nation’s premier public health agency knowingly used flawed data to claim that high lead levels in the District’s drinking water did not pose a health risk to the public, a congressional investigation has found. And, investigators determined, the agency has not publicized more thorough internal research showing that the problem harmed children across the city and continues to endanger thousands of D.C. residents. ”
This is the agency you hold out as a model of integrity?
No I am not going to drop my claims about 0.01mg/kg/day, because the observation at 0.01mg/kg is consistent with a large body of scientific results proving that fluoride has adverse thyroid effects at dosages close to this level. The 0.01mg/kg effects are merely an association from one study-I understand that. But its an association thats entirely expected from well-established science at not much higher dosage levels.
To clarify: my “best argument” is the adverse thyroid effect generally, not the 0.01mg/kg association specifically. I wasnt clear about that before. Sorry about that.
You are wrong about scientific uncertainty being justification for fluoridation. Water fluoridation is a medical intervention. Hence, those proposing it must carry the burden of proof-that it is safe and effective. I find it outrageous that the uncertainties regarding water fluoridation safety are STILL being discussed 60 years after it was first recommended.
We have a drug regulatory apparatus in this country, and here is how it works: drugs must be proved safe and effective BEFORE marketing. This has not been done for water fluoridation. Considering the fact that water fluoridation is population-wide compulsory medication, effecting everyone in all health conditions, the burden to prove safety is that much higher.
Hence, it is HIGHLY inappropriate for fluoridationists to demand proof of harm before they stop. To reiterate, safety should have been proven before fluoridation began. There should be no Dr Doulls out there wondering about the thyroid effects 60 years after the advent of fluoridation.
This is an argument grounded in medical ethics, rational public policy and logic. And you lose it absolutely, no matter how uncertain or certain the links are to harmful effects.
I dont conflate science and ethics. Water fluoridation inherently touches on both. The ethics must be considered in view of the science, and thats exactly what I have done. The science simply does not support your assertion that forcing fluoride on the public is ethical.
The shared premises are reasonable. However, I would say that 1) fluoride should be treated like any other hazardous contaminant: establishing a max level based on science and the cost of reducing it. 2)BOTH sides of the fluoridation debate today are well-intentioned. However, the pro-fluoride side in the distant past (1940s-1950s), was NOT well-intentioned. At that time, corporate self-interest was pushing the pro-fluoridation movement. Business interests sought to downplay the hazards of fluoride, just as they did with leaded gasoline, tobacco, and asbestos. In fact, if you read Chris Brysons book, you will learn that the exact same corporate PR people, “scientists” and lawyers were involved in fluoride as well as tobacco and leaded gasoline.
Cory-You are being disingenuous when you say that I have “not even tried” to refute your 4 arguments. I have refuted them ALL. Here, I will do so again, in abbreviated form:
1) Lead, mercury, cadmium and other toxic substances are also natural water contaminants. Adding additional contaminants is NOT made ethical by their natural presence. I really dont see how anyone could argue against that.
2) The risk/reward is not the governments decision to make. Thats a personal health decision, based on INDIVIDUAL health needs. What do you tell someone with a thyroid disorder who has perfectly fine teeth, or dentures? Take one for the team? FFNRV has several supporters with thyroid conditions. They very much would like to AVOID the risk of fluoride. Besides, the risk/reward is poor for fluoridation, IMO, and in the opinion of a substantial number of doctors, including my own.
3) Thats an interesting argument I have not heard before-that dogma tends to weaken over time. I’m not sure i agree. And I think that opposition to fluoridation has grown in recent years-its more accepted today than it was in the 1950s or 60s. In any case, I wouldnt describe fluoridation opposition as “miniscule”. When fluoridation is voted on by referendum, fluoridationists most often lose. I’d like to speak with you about this in person sometime because it would be an interesting discussion.
4) I’d say that harmful effects from water fluoridation are almost certain, for several reasons:
A)the widespread overexposure to fluoride from all sources (about 50% of children ages 2-4 receive over 0.05mg/kg/day),
B)the bioaccumulative nature of fluoride (it accumulates in bones over a lifetime), and can accumulate to levels associated with arthritis after about 30-40 years of drinking fluoridated water,
C) the high incidence of iodine deficiency (10-15%) which greatly increases sensitivity to fluoride, and
D)the dosing of vulnerable population groups-infants, kidney disease victims, thyroid disease sufferers, and people with other disease conditions.
Remember, not only must you prove fluoride is safe, you have to prove its safe for EVERYONE. And I dont mean safe in the “absolute” sense-I mean safe in the risk/reward sense. Is it safe for those with kidney disease, who cannot excrete it, and therefore have much higher blood levels? The evidence strongly suggests that its not. What about infants? Infants have extremely high exposure levels-often exceeding 0.1 or even 0.2mg/kg/day.
The nutrient vs. toxic categorization is extremely important. Nutrients are absolutely safe at physiological levels of exposure, and do not bioaccumulate at these exposure levels. There is no such exposure level for toxins if they bioaccumulate. Fluoride bioaccumulates.
Your complete avoidance argument is reasonable. No element or chemical can be completely avoided. But this isnt an argument for fluoridation. I have an inherent right to informed consent, and putting fluoride in the water supply violates that right.
Sorry, but multiple expert individuals and professional organizations opposing a consensus DO weaken a consensus. There is not consensus support for fluoridation, as the AAEM and IAOMT statements make perfectly clear. The IAOMT has about 700 professional members (dentists, mostly) Additionally, at least 4 members of the 12 NRC fluoride review committee members are publicly opposed to fluoridation. Would you consider 66% support to be consensus?
The principle of informed consent is a bedrock foundation of medical ethics, since the time of Hippocrates. I have a medical ethics text with detailed explanations of what practices and procedures that doctors must follow to protect every patients right to informed consent. I find it amazing that you would denigrate this principle. Not even vaccines can be forced on people.
And then you have to end with an insult. Nice one.
Nevertheless, we should meet sometime. For one thing, I’d like to show you the fluoride intake data from the Iowa Fluoride Study. Its unpublished, but I have it. I like to see you try to explain why the exposure levels in the Iowa fluoride study are safe.