Tactics and common arguments of the anti-fluoridationists

Anti-fluoridation activists have celebrated their recent win in Hamilton (see Hamilton City Council reverses referendum fluoridation decision) and are moving on with their plans for similar victories in other New Zealand communities. While most of the newspaper and TV polls show a clear majority support for fluoridation these activists managed to achieve a victory in Hamilton by relying on a raft of arguments which misrepresent or distort the science. They used the facade of science to attack the reality of science.

In essence this is the same as the “sciency” sounding tactics of the climate change and evolution science denial movements. These tactics of the anti-fluoridationists were analysed by Jason M Armfield in his 2007 paper When public action undermines public health: a critical examination of  antifluoridationist literature. Tactics like:

  • Selective reporting of studies and results,
  • Downplaying or ignoring the evidence,
  • Ignoring ecological factors in comparing communities,
  • Fear mongering,
  • Misrepresentation of evidence,
  • Using half-truths and “The Big Lie,”
  • Innuendo,
  • Follow the leader arguments.

In short – bamboozling with science.

The paper provides a clear and well documented description of the anti-fluoridationist tactics. It does briefly give examples and citations to show how the science gets distorted, although detailed discussion of the science is not the main purpose of the paper. It’s a useful resource for anyone trying to come to grips with the “Gish galloping” claims made by these activists.

One of the tables in the paper provides a handy list of common arguments used together with brief rejoinders. It’s a handy summary and I have reproduced the content below – the fluoridationist claim, followed by the real situation:


Water fluoridation confers no oral health benefit:

Numerous systematic literature reviews from a number of countries have found water fluoridation to provide a significant caries preventive effect.

Water fluoridation causes hip fractures, cancers, Alzheimer’s, reduced intelligence in children, etc.:

Research finding associations between water fluoridation and various diseases offer no proof, as causality cannot be established in these studies. Water fluoridation opponents handpick studies and may misrepresent the results so as to support their views. Large-scale systematic reviews have not confirmed any associations between water fluoridation and the large list of diseases linked to it by opponents of water fluoridation.

Fluoride is a toxic poison:

Fluorine is a naturally occurring element that, like many other natural substances, can be toxic if consumed in excess. Water fluoridation ensures ingestion of fluoride well below any toxic level, both for adults and children. Fluoride is used in rat poison and other dangerous substances. It is dose that determines the level of toxicity. Many essential and commonly occurring elements form poisonous or toxic substances.

Numerous other countries have rejected water fluoridation:

Some other countries have elected not to introduce water fluoridation because they prefer, or already have, other approaches to improving dental health. Nonetheless, many countries do have water fluoridation and benefits are conferred to all people, including those at high risk who may not effectively use individual fluoride exposures.

Water fluoridation is supported only by ‘shoddy’ science:

Decades of research and hundreds of scientific articles published in peer-reviewed journals support water fluoridation. This research is so convincing that almost all major dental and health authorities support it.

There should be a public plebiscite. It is undemocratic to have water fluoridation forced upon us:

In almost all democratic systems representatives of a population are elected to make decisions on behalf of the population. Plebiscites or public referendums are not required to pass legislation that is compatible with the constitution or charter under which the country operates. Water fluoridation fits within a government’s duty of care to the country’s citizens.

Tooth decay has declined in countries with and those without water fluoridation. Water fluoridation makes no difference:

Declines in tooth decay have occurred as a result of changing exposures to fluoride and dietary changes. Regardless, water fluoridation reduces tooth decay above and beyond these other effects. Ecological comparisons of some countries with others offer no support for or against water fluoridation as many other factors may account for differences in disease experience from one country to the next. Water fluoridation does make a difference.

Most people do not want water fluoridation:

Independent research in most places where water fluoridation is being considered shows that people support water fluoridation. Generally, the more knowledge people have the more likely they are to support it.

Water fluoridation is costly and not economically viable:

Research has previously found water fluoridation to be cost-effective. Newer technologies have made water fluoridation cost-effective for increasingly smaller populations. In addition to being cost-effective, it is also necessary to keep in mind the reduction in dental disease and therefore the pain and suffering reduced as a result of water fluoridation.

Water fluoridation infringes freedom of choice and individual rights and is unconstitutional:

Adding fluoride to water is just one of many instances where a chemical or nutrient is added to a food or beverage for public health benefits. It already occurs in water with the addition of chlorine, which aids greatly in eliminating water borne disease, as well as in several foodstuffs. Water fluoridation sets no precedent.

Water fluoridation is being pushed on us as a result of ‘big business’ interests:

The scientists researching the effectiveness of water fluoridation as well as health officials and dentists do not receive money from sugar, aluminium or any other companies for their research or opinions.

There is more caries in fluoridated X than in non-fluoridated Y. This proves water fluoridation does not work:

Ecological comparisons involving the arbitrary selection of fluoridated and non-fluoridated communities or areas do not provide credible evidence of the effectiveness or otherwise of water fluoridation as any differences may be the result of other factors which are linked to tooth decay but differ across the areas. Scientific research has found water fluoridation to be effective.

We should wait until water fluoridation is proved to be safe:

Water fluoridation has been implemented in some places for more than half a century – long enough that any dangers would be apparent if they existed. The weight of evidence strongly indicates that water fluoridation is safe.


I think this list provides a good starting point for sensible discussion.

Thanks to Jason M Armfield (2007): When public action undermines public health: a critical examination of  antifluoridationist literature. Australia and New Zealand Health Policy 2007, 4:25

See also: Fluoridation

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303 responses to “Tactics and common arguments of the anti-fluoridationists

  1. Your arguments sounds very similar to the tactics used by environmental NGOs. e.g Greenpeace who tried to ban chlorine in the 1980s, the anti-nuke brigade, the anti-GMO activists, the US EPA classifying CO2 as a pollutant, etc

  2. I don’t know if you have ever noticed, Andy, the “anti-nuke brigade” enjoy widespread public support in New Zealand.

  3. The anti-nuclear campaign in NZ was based on nuclear bomb testing in the south pacific. I don’t recall this having anything to do with an anti-nuclear power position.

  4. Andy, who is the “you” your refer to? And what are the “arguments” you complain about – those used by the anti-fluoridationists or Armfield’s brief rejoinders?

  5. The “You” I am referring to is you Ken

    You (as in “Ken”) claim that the anti-fluoridationists are “anti-science” and are behaving like Creationists

    So, I am using the same arguments to claim that anti-GMO- anti-nuke etc, are also like “Creationists”

    Of course, I don’t actually think that; I am merely pointing out the flaws in your argument

  6. Andy, the anti-nuclear campaign in NZ was actually a confused mixture of both. I was active at the time because of the nuclear weapons threat (specially concerned about the danger of short range nuclear weapons in Europe). Testing in the Pacific had declined as an issue. But many in the campaign were more motivated by opposition to nuclear power – although that was not a realistic possibility in NZ at the time.

  7. Why were they opposed to nuclear power? Was it based on a rational, fact based decision, or an emotional response to Chernobyl etc?

  8. This was before Chernobyl. Don’t ask me to second guess other people’s reasons – I actually did not agree with them.

    But most people are motivated by emotional feelings, even when they try to be rational and use evidence. We are just not a rational species.

  9. Andy, why not discuss the issues – there are plenty of specifics in my list. Your are just confused about great creationists and GMOs. You don’t make sense and I can’t understand what point you are making. I suspect that neither can you.

    More specifically I would compare the pseudoscience of the antifluoridationists to the pseudoscience, emotional cherry picking and confirmation bias ofthe climate change contrarians a pseudosceptics.

  10. If you can’t understand my points then there is little point in further discussion

  11. Especially if you can’t understand them either. Time to run away?

    Why not debate the specific claims and refutations on the list? That’s the whole point if blog discussions.

  12. Greenpeace was described as “anti-science, anti-intellectual and ultimately annti-human”, by Patrick Moore in his book “Confessions of a Greenpeace Dropout”

    Greenpeace forms quite a powerful voice across the world, forming public opinion on various matters. In the 1980s, they tried to ban all materials based on chlorine, for example PVC.

    I don’t see much difference between the anti-fluoride campaigners and Greenpeace in this respect

    On the actual topic of fluoride, is there any actual benefit to this? What is wrong with toothpaste with fluoride in it? Why do we need to chemically treat the water?

  13. I’ll ignore your little rant about Greenpeace – it’s irrelevant.

    Yes, the benefits of frequent intake of F at low levels to dental health is well established. I don’t think there is anything wrong with toothpaste containing F – most do these days, don’t they? The law require chemical treatment of water in public supply to overcome hazards. To make it safe. There are stringent standards for microbiological and chemical contaminants in public water supplies. I actually never hear people complain about that – even libertarians. Strange that.

  14. The water in Christchurch was completely untreated until the earthquakes. Now it has a disgusting chlorinated taste.

  15. Perhaps you should campaign against chlorination, then. It is obviously having a bigger negative effect than F.

  16. I’ll ignore your little rant about Greenpeace – it’s irrelevant.

    It was hardly a rant, it was a direct quote from a book written by one of the founding members of Greenpeace. Of course, you and your “climate scientist” friends are quite happy to have this anti-science NGO on your side, because it is not about science, it is all about your little statist friends strutting around trying to get their thieving little hands in every aspect of our lives

  17. You are ranting again, Andy.

  18. I don’t need to campaign against chlorine in water in ChCh because I have moved away. We now have a four million dollar water treatment plant to fund from a town of 1000 people, in order to comply with government regulations

  19. Talking about ranting. What the hell happened to Kyle who commented in the previous post the other day?:

    “Ken I look forward to poking holes in your list of counter arguments tomorrow. I want everyone to know If I don’t respond to them it’s because Ken blocked me from doing so. Bad Kenny!”

    Haven’t heard a peep from Kyle – if Kyle is tuning in I will just repeated my response to that silly comment:

    “And yes, I want every one to know if you don’t respond to my blog post tomorrow it’s because you have no reply as I am well know for not blocking anyone except extreme trolls.”

  20. It is quite natural for people to rant on your blog Ken. You put up these ridiculous arguments that have more holes than a golf course and then defend them without conceding that your critics might have a point or two

  21. If there are holes in my post above, Andy – get stuck into them. Ranting is not going to identify my mistakes – and if I have made mistakes then I am happy to acknowledge and withdraw.

    Don’t blame me for your anger problems.

  22. Ken, you say, “In almost all democratic systems representatives of a population are elected to make decisions on behalf of the population.”

    Isn’t that exactly what’s happened in Hamilton???

  23. Ken, would you consider one more filling per mouth a public health issue? In 12 year olds the diffence between fluoridate and non-fluoridated areas in less than that.

  24. Actually, Ron, I didn’t say that – Armfield did. I hope I have made clear I have effectively copied a table from his paper. The link is provided if you want to read it yourself.

    Personally, I think referenda are important and think Hamiltonians would have been happy of the decision to stop fluoridation had been made by a referenda. But the fact is a binding referendum had already decided to continue fluoridation and recently polling by the City Council showed that Hamiltonians still support fluoridation.

    The mayor, and the council, made it clear that they feel they should not be in the position of deciding such issues – it should be up to central government (and presumably under advise of government experts). Yet, 7 Councillors decided the issue – after excluding a number of Councillors because they were either on the local health board or had previously expressed and opinion!

    No wonder many Hamiltonians are pissed off.

  25. Ron, playing with statistics to get one filling per person is dishonest. It is well established tooth decay is not unifirmly distributed through the population. And actual fillings will, I am sure, drastically under reflect the real situation for the economically and socially disadvantaged section of the community.

    The I guess those people don’t concern you, do they?

  26. I think what is dishonest is turning Ron’s comment into a political statement that he didn’t make

  27. Andy, you are seeing a discussion which started on my syndicated blog at SciBlogs. This point has been made and discussed frequently. Not the first time I have made that criticism of Ron’s dishonest manipulation of statistics.

    Health authorities, while they may use filling numbers as a measure are clear that the benefits of fluoridation occur mainly in the disadvantaged sections of the population.

  28. I note you were copying a table…

    I don’t think a referendum some 9 years ago where 26.6% voted in favour carries much weight these days, especially when the Public Health industry spent so much money in support. Imagine if John Key said we aren’t going to have an election next year because a binding election 2 years ago was still valid… people change their mind… I think you said somewhere else that you changed yours in relation to some aspect of nuclear energy. In 2005, Hamilton Council voted 6 to 5 to remain with fluoridation.

    The council voted 9-4 last year to drop another referendum after legal advice that it could not automatically remove fluoridation because it would “give rise to process risks around consultation”.

    I note your concern that only 7 councillors voted in favour of removing fluoride… and five abstained because of competing interests. If they had all voted against the motion it would have still past 7-6… much, much more compelling than a 26.6%.

    I heard the Mayor say their polling showed a 52/48 split among the public.

    Things have changed. Pro fluoride advocates need a new game plan. Maybe they could lobby Fonterra to add flouride to the Milk in Schools programme… I suspect if that happened the uptake of free breakfasts in schools would fade somewhat.

    I can’t see any uprising in Hamilton as a result of the decision… those pissed off are a few sci-sceptic-bloggers and some DHB staff.

  29. If disadvantaged kids have poor dental health then wouldn’t it be better to find the source of the problem rather than the brute-force approach adopted by mass-fluoridation?

    For example, school dental nurses can provide tooth cleaning advise, suggest lower intake of sweet drinks (if this is a problem) etc.

    I am guessing that it has quite a lot to do with diet, especially the intake of drinks like Coke

  30. Ron, the referendum was 6 years ago. Recent. And because it was so recent many citizens must have assumed, like me, that any discussion this time would also go to a referendum. And, yes I would be pissed off if Key called off next year’s election because we had one 2 years ago. It would be dishonest for him to claim that election was no longer valid and he was going to consider who should be government after behind doors discussion of presentations by activist groups!

    And WTF. You objected to our public health authorities contributing to the discussion. What planet are you on. You want to exclude experts from discussions!!

    The mayor was dishonest going on about a change in support – WTF – both the council newsletter poll and their on-line poll still showed very clear support for fluoridation. Perhaps we should really have given the last election to Labour because the last election show a decrease in the margin! Again, what planet are you on?

    I don’t know where you got the 52/48 split from (although the mayor was working hard to downplay the poll). The Quarterly resident’s Survey showed 50.2% support for Fluoridation and 31% opposition. The no-line survey showed 56.1% support and 43.9% opposed.

    So, the council’s 7/1 vote was really out of step with the voters, wasn’t it?

    No wonder many Hamiltonians are pissed off. You may not see any “uprising” – why should you. But the mistake will probably have an effect at the next election.

  31. Of course it has a lot to do with diet, Andy. Things are never simple – but research does show that fluoridation helps – and I really feel a lot of empathy for kids, who for whatever reason not their fault, have poor oral health. Even a little help matters.

    Fluoridation – brute force. Hamilton’s intake from the Waikato river can sometimes be about 0.6 ppm F. Treatment probably lowers this but this brute force is simply adjusting for deficiency levels (the target is 0.7 – 1.0 ppm F).

    You should be complaining about all the Cl in the water. It’s a dangerous chemical.

  32. Christ, there’s a lot of Gish Galloping going on today.

  33. Ken, I’m amazed for someone defending the faith that you haven’t read the science. I have. I read the DHB evidence; I’ve read the MOH extensive info; I’ve tralled through Pubmed for relevant science; I’ve read the York Report… so don’t come at me claiming dishonesty a distortion of the science. In every paper/submission I’ve read the science talks about mean/median missing teeth/fillings etc (DMFS). A few give a SD…

    eg,

    http://www.health.govt.nz/publication/our-oral-health-key-findings-2009-new-zealand-oral-health-survey

    Or a paper from NZ
    RESULTS:
    Caries prevalence and severity was consistently lower for children in the fluoridated area for both age groups, and within all subgroups. Five-year-olds in the fluoridated area had 2.63 dmfs (sd, 5.88), and those in the non-fluoridated area 3.80 dmfs (sd, 6.79). For 12-year-olds the respective figures were 1.39 DMFS (sd, 2.30) and 2.37 DMFS (sd, 3.46). Multivariable analysis confirmed the independent association between water fluoridation and better dental health.

    CONCLUSIONS:
    This results of this study show children living in a fluoridated area to have significantly better oral health compared to those not in a fluoridated area. These differences are greater for Maori and Pacific children and children of low socio-economic status.

    http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=Retrieve&list_uids=15346876&dopt=abstractplus

    I’m not anti-fluoride at all, but I do enjoy being entertained by apologists on both sides allowing emotion to overtake objectivity.

    So a question I have n

  34. I’m not anti-fluoride at all, but I do enjoy being entertained by apologists on both sides allowing emotion to overtake objectivity.

    That is my position too, as it happens.

  35. Not sure what happened there… it just posted mid stream…

    My question is this… Let’s agree that the above results are statistically significant… “Five-year-olds in the fluoridated area had 2.63 dmfs (sd, 5.88), and those in the non-fluoridated area 3.80 dmfs (sd, 6.79). For 12-year-olds the respective figures were 1.39 DMFS (sd, 2.30) and 2.37 DMFS (sd, 3.46).”

    Do you consider the ~1 DMFS per mouth of such Public Health significance that you would make it a public health issue of it and start a war?

    If the issue is about something worse than 1 filling (on average) then the pro-fluoride folk need to argue their case accordingly… but I’ve seen no evidence that that’s the case… can you point me to the DHB submission that bypassed DMFS per mouth and talked about serious health issues? They did talk about the number of admissions to hospital for teeth related matter that required an anesthetic. for the whole of the waikato (2-3x hamilton population…) with no analysis…

  36. Ken… ok, the referendum wasn’t 9 years ago (nor 6) it was 2006 (7 years) and in science and political terms that is not recent.

  37. OK. Andy, so you are teasing the antifluoridationists too. I would like to see that for my own amusement. Whereabouts is it happening? On one of their blogs, perhaps?

  38. Ron, care to share with us what has happened in the last 6 years of science to make Hamiltonians change their mind?

    Oh, by the way – please don’t ignore that council polling shows they haven’t changed their minds.

  39. Ken commented, “I don’t know where you got the 52/48 split from…” I heard Julie Hardaker say so on TV.

    And where did I say that experts should give evidence?

    Ken, our legal system trusts ‘experts’ so much that we don’t trust them to make really important decisions… our parliament is full of ordinary [sic] people, and important crime is assessed by ordinary folk (jurors)… as a rule we don’t trust experts to make decisions because, by and large, they sing the pipers song.

  40. No Ken, don’t be paranoid. This is the only blog that I am reading this about.

    My point is, as I have stated earlier, is that it is very easy to take a swipe at people for being “anti-science”. You can apply this to GMO, nuclear energy, etc.

    Science can only influence public policy where a number of competing agendas may be at play, it cannot provide a definitive answer.

  41. Andy, pity – I was looking forward to it. I know of at least 2 anti-fluoridation blogs but they are really half hearted and I would like to see a good debate.

    Of course you can describe people in the climate sceptics, GMOS, anti-nuclear movement, etc. as anti- science. No surprise there – as I said before we are not a rational species.

    On political issues of course science cannot provide answers. And Fluoridation is a social and political issue. Science can’t tell us whether we should fluoridate our water or not. That is in he end a political decision – one Hamiltonians made 6 years ago and still support.

    But science does get dragged in to inform. Look at all the atrocious “sciency” sounding claims the anti-fluoridations make. Surely the experts should be asked to make their evaluation of these claims.

    It’s a complex issue – and if we are to attempt to make a rational decision we should not be shutting up the professional experts who might actually know something about the issue.

    They may not be able to make the political decision of how we treat our water supply for us but they can certainly put into context and correct the claims of the anti-fluoridations. They are telling some real porkies.

  42. Chris Kyle Link

    We are having the same issue with immunization here in Australia
    Using poor arguments to support non vaccination -funny how 3rd world would love to have access to the unused drugs with their appalling infant mortality rate

  43. Yes, Andy – Richard picked that up a few days back. The Civilian has another spoof on the Hamilton City Council now, I think.

  44. Ron, you asked a quesiton a while back that I have only just seen. Its an old issue we have really thrashed out. Can I suggest you go back to your previous comment and read the conclusiuons of the paper you quoted me. I think that should show you where you are going wrong.

  45. Andy, the satire is very good… I like the parody on getting All Blacks to support public health issues as a means of influence. The article missed an opportunity to promote contraceptionization of the water supply… “In honour of the development, Henley and his partner were planning on naming their forthcoming eighth child “Mountain Blast”.”

  46. Ken, do you mean this?

    CONCLUSIONS:
    This results of this study show children living in a fluoridated area to have significantly better oral health compared to those not in a fluoridated area. These differences are greater for Maori and Pacific children and children of low socio-economic status.

    http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=Retrieve&list_uids=15346876&dopt=abstractplus

    Let’s accept the first sentence is correct… even the second… What does the word “significantly” mean? Is that statistical significance? Maybe.

    Can you answer this… Is it clinically significant? If one looked into the mouths of 100 fluorinated and 100 non-fluoridated mouths could anyone notice the difference? I doubt that very much… especially if they were randomised.

  47. we don’t trust experts to make decisions because, by and large, they sing the pipers song.

    Ah yes, the piper. Either him/her or “them/they”.

    Spooky.

    At the heart of of all science denial it’s always down to a conspiracy.

  48. Yes, that”a it. And I notice you still ignore the second sentence.

    As for “significantly” – yes it does usually mean statistical significance and any scientific report. Not maybe. The only question really is level of significance and that usually depends on the field. In this case I would think 95%.

    The statistical significance relies to the actual measurement. I imagine “looking into the mouths” would have an extremely large variability. Such studies would probably be laughed at.

  49. Ken, you’ve accused me a few times of being dishonest regarding use of means for cavities etc. I’ve been trawling through more pro-fluoride sites… especially the MOH.

    In ALL of there data they use mean/median… they don’t separate severity/seriousness but bundle it up as teeth missing/fillings etc.

    Take a look at this spreadsheet… based on this fluoride protects from fluorosis… interesting.

    http://www.health.govt.nz/system/files/documents/publications/chapter6-data-nzohs.xls

  50. Wow… next spreadsheet offers some hope… now, where’s the breakdown into flouride/non-fluorise… this is the data that potentially makes or breaks the pro-fluoride case.

    http://www.health.govt.nz/system/files/documents/publications/appendixb-data-nzohs.xls

  51. Richard, it has nothing to do with science… as Ron Brierley once said when asked about his success, “I make a decision and then I go and buy an expert to justify it.”

  52. Ron, unfortunately the approach “I make a decision and then I go and buy an expert to justify it.” is really quite normal for most people. We are not a rational species. We invest emotion in a position and fall into the trap of confirmation bias to support our preconceived positions.

    However, the social and methodological nature of science works to reduce this effect. To enable a more objective approach to things. That is one of the reason scientists and science have such a high public standing. It is one if the reasons why scientific comments on issues such as fluoridation can be more honest, and useful, than activist comments.

    I am putting up a post tomorrow dealing with just one of the anti-fluoridation claims and showing how this confirmation bias has led them to be quite dishonest and misrepresent the science.

  53. So Andy is an anti-flouride kook as well as being a climate denier?

    No I am not an anti-flouride kook. I stated this upthread. Also, I do not deny the climate

    So tell me, as I am pro-nuclear energy and pro-GMO, are you also pro, or an anti-science creationist type Cedric?

    No other viewpoints are allowed.

  54. By the way, I do think there is a Kook element to the anti-flouride campaigners. I read on Facebook someone claiming that it was used by Hitler to make the population more compliant

    On the other hand, there may be more rational reasons to be anti, perhaps even based on an old fashioned cost/benefit analysis.

  55. Cedric, can you explain what a kook is? I’ve never heard the term before.

  56. Be careful of those cost/benefit analyses. Just think of what the outcome could be applying it to something like cancer and chemotherapy. How do you take into account benefits of well-being and the cost of pain, misery and death?

  57. Ken, most industries apply a finite cost to human life in their accounting procedures.

    However, I don’t think loss of life is an issue here.

  58. Loss of life is a definite issue with chemotherapy and simple inhumane cost/benefit would decide against it in most cases.

    Tooth decay does cause a lot of misery, physical and mental. But then again mainly with economically and socially disadvantaged sections of the community and the people who go in for cost/benefit analysis probably have a fudge factor to reduce their importance.

    Applying a “finite cost to human life” is a very political/ideological position.

  59. Of course, but let’s say that I spent a million dollars flouridating the water in Hamilton, and that saved one filling (for sake of argument). Perhaps this is not the best way to spend our money?

  60. The value of statistical life (VOSL) was established at $2 million in 1991, following a willingness to pay (WTP) survey carried out during 1989/1990. It is indexed to average hourly earnings (ordinary time) to express the value in current prices. The same VOSL has been used in all safety evaluations across all three transport modes (road, maritime and aviation), as decided by the Government in 1991 (NZ Gazette notice 4983).

    The updated value of statistical life is $3.77 million per fatality, at June 2012 prices.

    http://www.transport.govt.nz/ourwork/Land/landsafety/TheSocialCostofRoadCrashesandInjuries/

    There are other aspects to CBA… what if that money was spent on something that had a bigger return on investment? So lost opportunity is another factor.

  61. Sure, Andy, but that is not the case. The savings in reduced fillings easily out-ways the cost of fluoridation. That’s the impersonal, inhumane, cost/benefit analysis. But health professionals don’t, and shouldn’t, stop there. They take into account the suffering in the more disadvantaged sections if the community which is not indicated by the simple cost/benefit analysis – but is in their research.

    But take the situation of someone our age, retired, not planning to work again, drawing a pension from private or public scheme but has cancer. Surely a cost/benefit analysis would suggest chemotherapy should not be done – just to get a few extra years of (unproductive) life. And the cost of expensive drugs. And the saving to the state and insurance companies it they popped off now.

  62. Ken says, “But take the situation of someone our age, retired, not planning to work again, drawing a pension from private or public scheme but has cancer. Surely a cost/benefit analysis would suggest chemotherapy should not be done – just to get a few extra years of (unproductive) life.”

    Ken, how crassly inhumane! As if life is redacted down to whether one is productive or not then we’d put permanently disabled people down, we’d let old folk die at home with no care… and certainly we’d not be spending millions on influenza vaccine on the elderly when the science shows clearly they offer not much more than hope and profits for the medical/pharmaceutical establishment.

    What’s is the productive worth of a nana or poppa? Imagine if we said to grandchildren, sorry, nana or poppa has past their used-by date, they are no longer productive, therefore we’ll put them down. Extreme? Maybe…

    But we’re talking about a missing tooth at worst… not a terminal illness.

  63. So, Ron, how do you take into account death and misery in a simple cost/benefit analysis? Wouldn’t that just be inhumane – how could we agree on a dollar value for a specific life and specific misery?

  64. Standard CBA in NZ usually uses the Ministry of Transport’s WTP for death… at present $3.77 million per fatality… Disability can be factored in using fractions based on work originally out of, if I remember correctly, The Netherlands… it’s commonly used… I doubt tooth decay ranks high in terms of fractions.

  65. This from 40 years ago… see bullet point 1… Note their consistent use of averages…

  66. No I am not an anti-flouride kook. I stated this upthread.

    Then what’s your beef with flouride?

    So tell me, as I am pro-nuclear energy and pro-GMO, are you also pro, or an anti-science creationist type Cedric?

    I’m not a creationist of any flavour. I urinate on them. Religious nutters of all stripes have fallen like wheat before the scythe once I get stuck into them.

    Also, I do not deny the climate…

    So…you’ve changed your position and now accept what NASA and every single scientific community on the planet has been telling the public?
    Really?
    …..
    ….
    Really?
    NASA Earth Science – Climate Change and the Global Ocean

  67. So Ron, could you get in touch with the Waikato Health Board and tell them they can spend up to $3.77 million on any new wonder cancer treatment for my partner who has terminal cancer? If her specific life is worth that much your cast/benefit analysis indicates its a no-brainer.

  68. Ken, I would like to offer my sympathy to you and your partner. It must be a very hard time for you both.

  69. Ken, I can’t imagine for one minute what you and your partner are going through, but I suspect it is a cry for such hope that drives good people to spend good money on any wonder treatment for any condition in the hope that they will be the breakthrough cure. I guess if the DHB did spend $3.77 million in the hope of a miracle the DHB would be seen as being humane and caring. I struggle when people, such as skeptics, get up in arms about a DHB spending a fraction of that [under duress I might add] on hi dose intravenous vitamin C on a man with terminal influenza and then get up in arms when the now fit and well person claims his survival was due to the vitamin C. How bizarre.

    I trust you now understand somewhat why good people spend good money on hope. In my opinion, it would be inhumane and unethical to deny them that right; but good people do.

  70. We are not into miracle cures. But my point is that while at the national level investment in health and pharmac may consider to some extent cost/benefit analyses (and probably are far more effected by just what is available rather than consider ingthe cost of a life) at the individual level we do the best we can for empathetic reasons. The oncologist and nurses are not doing cost/benefit analyses – just working within their regulations and budgets and doing a magnificent job because they care.

    It’s the same with oral health. It’s one thing to do a cost/benefit analysis to show that fluoridation actually saves resource but I also pick up from health professionals they have empathetic reasons for concentrating on the benefit that the disadvantaged sections of the community get from fluoridation. Those advantages will only partly show up in the cost/benefit analysis they quote.

  71. Ken, with respect, your local oncologist and nurses are doing cost/benefit analyses, even when working within their budgets… perhaps more so when working within their budgets, because budgets/financial constraints/limited resources are actually what necessitates cost benefit analyses. Where there is hope (efficacy) more money is spent… when there is lack of efficacy then less money (resources) are spent. Empathy is often the only and appropriate response when their is little hope.

    There is societal risk and there is individual risk… as you infer.

  72. Ron, our oncologist discusses treatments with us. He is upfront, stating things like the %age success rate possible from previous use but no way does he say don’t use a treatment because the success rate is usually low. He acknowledges that is is up to us – he may recommend but we decide. For example – his so called cost/benefit analysis would probably indicate the current treatment is pointless, the success rate is low. But that has not been an issue.

    Where I see cost/benefit coming in has been only in regards to which drug Pharmac funds. But we are still given advice and choice – just that for unfunded drugs we have to finance ourselves.

    Empathy is an essential requirement in the health service, surely. And while a cost benefit analysis of fluoridation may indicate benefits, those in touch with the reality of the disadvantaged sector, and aware of the scientific finding regarding, for example, extra benefit to Maori and Pacifica, go beyond the naive averages you have been quoting.

    As they should.

  73. Ken, those naive averages are the DHB’s, MOH’s and WHO’s, not mine. Pretty much all of the science, including the DHB’s submission was based on averages/medians.

    You and your oncologist have obviously been working through informal cost benefit analyses… we do it all the time even at the supermarket… what’s the cost of this chocolate bar on the rack beside the checkout… ‘a dollar or two, and an extra inch on the waste line.’ and the benefit? ‘Yum.’

    There are other costs that need to be factored in at a personal level, which obviously you will be working through, things like, quality of life, dignity, etc. These are not factors not usually considered in formal Pharmac level CBA’s.

    Pharmac have a finite budget (set by others) and they do formal cost benefit analyses to ration that funding… to get best bang for their buck… there are notable exceptions… Drugs like herceptin are primarily approved for political reasons, not based on CBA.

  74. I struggle when people, such as skeptics, get up in arms about a DHB spending a fraction of that [under duress I might add] on hi dose intravenous vitamin C on a man with terminal influenza and then get up in arms when the now fit and well person claims his survival was due to the vitamin C. How bizarre.

    That is not at all bizarre, the claim as to the cause of recovery is not supported by the evidence available.

  75. Ron – I am well aware the naive averages are not yours. Never claimed otherwise. But you continue to use them naively, ignoring the second sentence in the conclusion you quoted. Such naive averages, while showing that fluoridation works and is cost effective, do not tell you the story for the people who suffer most from poor oral health. The health boards and professionals are aware of this and point to the second sentence, stressing that water fluoridation is actually a better way of reaching these people than other methods suggested – at least in NZ.

    Maybe in Germany fluoridated salt works better than it would here.

    Another factor, which even the professionals may not be properly aware of, is that many disadvantaged people are not getting fillings so this leads to even greater misrepresentation of their situation.

  76. Even more ludicrous than claiming effectiveness of vitamin C are those people who attribute their cure to Jesus and ignore the role played by modern medicine and health professionals.

    Bloody rude.

  77. Richard, you’ve taken my comments about vitamin C out of context.

    Ken, for many people it’s not either/or, but both/and.

    For Alan Smith it is totally logical for him to attribute his “miraculous” recovery to vitamin C… the experts had written him off… the only obvious thing that changed was the vitamin C… whether that was the healing factor, who knows… given that it was the families insistance on not turning off life support, and giving vitamin C a go, one could rationally argue that without the vitamin C he would have died because the life support would have been turned off.

  78. You know, Ron, I’m not particularly familiar with Alan Smith, but I am fairly sure that he’s not promoting the wonders of vitamin C on the basis that it works by motivating people not to switch off life support.

  79. Chris.. I agree… but in fact the family’s push for vitamin C did in fact save his life… otherwise his life-support would have been switched off by the Experts who said his white-out lungs had no hope of recovery. The rest is history.

  80. Again, Ron, I’m not familiar with the case, but I would assume that the decision of whether or not to switch off life support is normally made by family (or according to the individual’s own wishes if they’re known), rather than experts. The experts were certainly advising that it be switched off, but I’m having a bit of trouble finding any reputable sources saying that they could have done so against the family’s wishes. Rather, the legal tussle was over whether intravenous vitamin C would be administered.

    With your apparent familiarity with the case, you may be able to correct me on that, but as it stands, I’m unconvinced the family decided not to switch off the life support on on the basis of their hopes of a vitamin C cure.

    Which, I suppose, adds up to a certain doubt on my part that Smith’s recovery can be attributed to intravenous vitamin C doses even in the “motivation not to switch off life support” sense.

  81. I suppose I may be being a tad pedantic here, but the whole “the experts would have switched off life support” bit bugs me.

  82. Chris, that’s a fact. It took the intervention of a lawyer (Mai Chen) to prevent them turning it off and giving vitamin C.

  83. As with Chris I find that unusual but perhaps the patient had signed a do not resuscitate order before treatment.

    In any case, both the family and RonL are wrong to conclude that the vitamin megadose was the medical reason for recovery. That any skeptic would take a similar stance is neither surprising nor bizarre. However, the possibility that it was the reason for recovery exists and, dependent upon existent research, it seems arguably reasonable to justify calls for further investigation.

  84. Richard, I haven’t said that I had “conclude[d] that the vitamin megadose was the medical reason for recovery.” I have said that it is a logical explanation given the fact that the ‘experts’ had said that the flu was terminal and that there was no hope of recovering from the ‘white-out’ pneumonia. Ken has raised the importance of empathy in medicine. I wonder where the empathy is in the skeptics circles when dealing with issues like this?

    I totally agree with your last sentence. Anyone who has looked at mega-dose vitamin C treatment of pneumonia will know that there is sound and plausible evidence to warrant further study… but it won’t happen any time soon.

  85. I got a mega dose of Vitamin C for pneumonia. I am still alive, that is all I can say

  86. RonL, it is not a logical explanation. It is a logical possibility.

  87. Andy, that’s only part of it.

    ‘I got pneumonia. It was so bad the xrays of my lungs showed white-out. The best experts told my family that it was terminal and there was no hope and that life support will be turned off. My family had done some homework and asked that the hospital give me a chance with hi dose vitamin C. The doctors refused. My family got a lawyer involved who threatened court action. The doctors relented and gave the treatment on condition if it hadn’t worked in a day or two they would turn the life support off. They gave the vitamin C, I recovered and am still alive. Why do you not accept that given I was condemned to death and am now fit and well and the only thing that changed was the vitamin C… why do you reject a cause and effect?’

    Richard, the above is factual. Therefore it is a reasonable explanation noting that a reasonable explanation is not absolute proof.

  88. I wonder where the empathy is in the skeptics circles when dealing with issues like this?

    What are you talking about? That skeptics should jump to conclusions in order to be sympathetic toawrd a grieving family?

  89. RonL, it seems bizarre to me that you label a skeptic position on cause of recovery as being the same and then retreat to occupy the same space yourself.

  90. Andy, my ex has had one pneumonia several times, and one of sons once. At no time did they take a massive dose of Vitamin C. They are still alive, that is all I can say.

    Bit of a waste of electrons and time, eh?

  91. I don’t know Ken, I got pneumonia in Morocco years ago. I got wheelchaired off the plane, dumped in a French hotel and was injected with a massive dose of Vitamin C and Aspirin on New Years Eve, and left there by myself whilst the doctors went off partying on New Years Eve

    I had a massive fever and almost died; I wasn’t really in a position to have a philosophical discussion at the time.

  92. Ah, Aspirin, the wonder drug!

    As I said, a waste of electrons and time.

  93. Yes, Ken, actually your entire blog is a waste of electrons and time,

  94. As Sheldon’ mother says:

    And that is your opinion.

  95. Your last comment is a waste of bandwidth and electrons.

  96. Ken, I get entertained by so-called skeptics arguing/discussing issues based on emotion and lack of science. I note that empathy is now the standard that determines action. Empathy for some child with rotten teeth because they suck on sugary and acid drinks all day, and no empathy for someone whose family insisted that their loved one be treated with high-dose vitamin C after being told science had nothing to offer him… he was technically dead.

    mmmm… rabidly support fluoridated water to save on average half a filling per mouth under the guise of being an empathetic skeptic… and yet rubbish claims that high-dose vitamin C saved a life which experts had said was snuffed.

    With respect, An empathetic skeptic is almost an oxymoron… but a highly highly entertaining one… :-)

    Having dug further, I now see the MOH/WHO data on NZ shows that over the past 50 years or so DMFT have declined from 7 to 1.2 per mouth in 12 year olds in areas where water is fluoridated and 7 to 1.6 per mouth in 12 year olds in areas without fluoride. so the difference is 0.4 fillings per mouth… now that should excite anyone trying to impose a solution on the whole population.

    When one looks at the vast majority of countries that haven’t introduced mandatory fluoridation, the decline has been similar.

    Now that should give an empathetic skeptic food for thought, don’t you think?

    With that, I’m moving on to more productive (though vastly less entertaining) tasks de jour… ie, work. (ps: I reserve the right to pop in again if life becomes too boring.)

  97. Ron. we all make value judgements – and these have an emotional basis.

    You do so too. For example the statement disparaging“Empathy for some child with rotten teeth because they suck on sugary and acid drinks all day” is laden with nasty political and ideological value judgement. There is no empathy for the child with poor oral health (whatever the reason) and an ideological judgment blaming that child without any evidence whatsoever. You are blaming kids who are economically and socially disadvantaged for their situation, a situation they have no control over.

    Your ideological, anti-empathetic, blinkers stop you from seeing the actual conclusions drawn from the scientific work. You will go as far as quoting those conclusions but ignore that second sentence and pretend the overall average applies to everyone. Incredibly naïve.

    You are discussing the issue based on your emotion, not science (which must include that second sentence). But your emotion is inhumane, non-empathetic and ideologically nasty.

    As for your “digging further” – your emotionally driven interpretation and cherry picking of data on this issue shows you are not a credible source of objective evidence. I am always happy to look at information you might link to – but your opinions alone are worthless.

  98. Gosh, Ken… so violently personal and taking what I said totally out of context.
    I said, “I note that empathy is now the standard that determines action. Empathy for some child with rotten teeth because they suck on sugary and acid drinks all day, and no empathy for someone whose family insisted that their loved one be treated with high-dose vitamin C after being told science had nothing to offer him… he was technically dead.”

    I made no “nasty political and ideological value judgement…” Those are really strong and emotive words for someone claiming to be an objective skeptic.

    Take a read of this science and please make objective comment on it.

    http://exacteditions.theecologist.org/browsePages.do?issue=5395&size=3&pageLabel=243
    scroll through to the end of the article… using arrows to change page.

  99. ps… your vitriolic response above seems to be a cry for me not to leave the discussion… awe, shucks :-)

  100. Ken, how do you explain this? And remember, this is not my science… just trying to work out why there is so much emotion thrown at forcing fluoride down peoples throats in the name of empathy…, not science… empathy!

    http://www.fluoridealert.org/uploads/who_data01.jpg

    And I’ve been to the WHO website in sweden to check the trends.
    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/According-to-Alphabetical/CountryArea-N/

    For NZ in 2009
    DMFT in fluoridated areas: 1.2, DMFT in non-fluoridated areas: 1.6

    ie, a difference of 0.4 missing teeth OR fillings PER mouth…..

    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/WPRO/

  101. Bugger, I thought you had pissed off, Ron.

    None so blind who can’t see. An established fact – children of the economically and socially disadvantaged suffer most from poor oral health.

    Your ideologically driven opinion – not fact – these kids have bad oral health because they “suck on sugary and acid drinks all day”.

    Obvious conclusion – it’s their own fault – let them rot.

    An excuse to do nothing.

    Ron, I was neglected, socially and economically disadvantaged as a child. I didn’t have access to sugary and acid drinks – let alone suck on them all day.. I suffered bad oral health – miserably. I remember wishing and fantasising at the time that someone would save me, remove me from that situation. One of my brothers had been adopted out and I always wished I had been too.

    Sure a sample of 1 and anecdotal – but infinitely more than you can drag up.

    People like you have no idea – and no intention of understanding. I can’t respect such deliberate ignorance because it is so inhumane.

  102. Thanks to Ron for providing a graph showing no correlation between oral health and fluoride

    This is really my point a while back. If it doesn’t do any good, it is a waste of money that could be better spent on other health issues

  103. Poor old Andy – so gullible when it suits him. Grabbing at the straw of a suitable diagram from the F action network, not bothering with the supporting text or methodology. Even how each country was characterised. Bloody hell, you wouldn’t last in a scientific job..

    Have a look at my post yesterday which took one of the claims of the FANNZ on fluoridation chemical used in Hamilton and showed how it was completely incorrect and had used citation dishonestly. This is a claim common only promoted by see activists and it is completely wrong.

    In fact, Andy, have a look at that post and make your comments there. They might then be more substantive than the pathetic discussion going on here.

  104. Ken, again, personal and emotional. Anecdote 2. I was brought up in relatively poor rural NZ in the 50s/60s. had a few fillings… nothing extraordinary. Moved to Wellington in the mid 70′s. After TWO (just 2) visits to the dentist it dawned on me that my mouth (and my wife’s) were full of black fillings. Every molar drilled to the max. Asked why… it was new policy… teeth rotted, amalgam didn’t. Result? In my 60′s we are having to choose between getting teeth extracted or spending good money on crowns because the amalgam fillings are breaking up…

    So that’s two (three if you include my wifes) anecdotes. Our kids don’t have fillings. Why? Probably multifactorial… they routinely brushed their teeth. Their Plunket nurse checked their teeth when young. Their school had a much more efficient dental service. Their dental nurse/dentist put sealers on their teeth. What used to be drilled out no longer is. Fluoride in water. Fluoride in tooth paste. Dental floss. Better understanding of tooth decay per se.

    Fact, most kids who live in fluoridated areas have no fillings.
    Fact, most kids who DON’T live in fluoridated areas have no fillings.

    Fact, in NZ, 12 year olds who live in unfluoridated areas have 0.4 more missing teeth or fillings per mouth than those who live in fluoridated areas.

    Fact, sugary drinks are a significant cause of severe dental decay.

    As a skeptic, you should know that science has moved on… you can’t impose your beliefs based on what happened 60 years ago into a so-called debate of science.

    Every baby born now gets a toothbrush and toothpaste given to them by Plunket at the age their first tooth is expected to break through. Things have changed.

  105. We are not talking about the science here – and how could we when you rely on the anti-fluoridationist’s pseudoscience publications. You aren’t interested in he science.

    We are talking about ideological attitudes.

    See, again you just prove you don’t understand – you talk about your fillings – I had no fillings. I would not have counted in the stats you often refer to. No fillings, no visits to dentists. I just didn’t face that horrible problem you had with fillings.

    Disadvantaged people can be so effected by their situation they will a avoid health authorities, dentists, school health checks (they were really pathetic in my day and may still be).

    And all you can do is fool yourself into thinking deprived kids are to blame for their situation because they suck on surgery drinks all day. That is an ideologically and emotionally driven position with political consequences.

    You just have no idea of how the other half live, do you?

  106. See Ken,… that graph was WHO data… yet you discount it because of where it came from. I provided a link to the original source… but nah, it’s anti!

    As a skeptic who operates a public blog you really should keep emotion and subjectivity out of it… argue your case on the evidence… not just skeptic’s empathy. Skeptics are supposed to focus on hard cold facts… not emotion.

    This is MOH/WHO official data.

    And I’ve been to the WHO website in sweden to check the trends.
    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/According-to-Alphabetical/CountryArea-N/

    For NZ in 2009
    DMFT in fluoridated areas: 1.2, DMFT in non-fluoridated areas: 1.6

    ie, a difference of 0.4 missing teeth OR fillings PER mouth…..

    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/WPRO/

    And yet you claim it’s from the ‘anti-fluoride’ brigade.

    How absolutely bizarre.

    In this day and age with free dental service (especially for the under-privileged) there is no excuse for mouths full of missing teeth. I even saw a free service on TV a few weeks back where decaying teeth are capped with cheap generic caps and fall out when the milk teeth normally fall out.

    If empathy is the driver for skeptics desire to help the poor then channel your energy to actually making a difference, because if your argument holds re the benefits of fluoride then there should be vastly more DMFT in unfluoridated areas than there are… your argument, even when marinated with empathy, holds no scientific weight.

  107. No Ron, I ignored it because there was no supporting description, evidence or methodology. I had no way of interpreting it.

    Andy accepted it because he felt it fitted his preconceived position (it neither supported or disagreed with my current understanding – how could it without the supporting information).

    I know Andy from way back – he is very happy to interpret any old out of context rubbish on climate change (listen to him talk about he last 16 years surface temperatures) to find his own pre-conceived position.

    Actually. One thing I have learned in my days is always be suspicious of people, like you, who will promote things like that graph which is so obviously out of context.

    Why not have a go at my post from yesterday – the discussion is not going anywhere here.

  108. I don’t have a “pre-conceived position” on fluoride. If governments and councils want to piss away millions of dollars of taxpayers money on treatments that have no proven benefits because it makes some handwringing “liberals” feel good then that is fine with me.

    After all, we pour millions away on worthless projects like Novopay. I personally have worked on IT projects where we have pissed away 10s of millions of dollars of taxpayers money for no societal benefit whatsoever

    Some people might think this is immoral or wrong, but who cares? Lets stick to our dogma and positions and the poor will remain poor and the vested interests will remain rich.

  109. Ken, there was a song that came out of deprivation… was called, “How bizarre, How Bizarre.”

    You say ” how could we when you rely on the anti-fluoridationist’s pseudoscience publications. You aren’t interested in he science. ”

    How bizarre… I did not rely on any anti-fluoridationist’s pseudoscience publications… I presented a graph taken from the WHO database. I verified that it was accurate and gave the links to the primary source of data.

    How bizarre that an objective skeptic would deny the evidence. Evidence-denialism I believe it could be called.

    Go and look at the evidence for yourself.

    You say, “Disadvantaged people can be so effected by their situation they will a avoid health authorities, dentists, school health checks (they were really pathetic in my day and may still be).”

    I wonder why? Could it be that these empathising skeptic-driven do-gooders know best and ram their remedies and potions down their throats?

    You say these people, these “health authorities and dentists were really pathetic in my day and may still be” and yet you blindly trust them today?

    How absolutely bizarre… in fact that is scary bizarre. It totally defies logic. It beggars belief that a self-proclaimed empathetic skeptic could possibly these so-called experts having proclaimed them to be “pathetic in my day and may still be.”

    Bizarre!

  110. Ron, the problem with cherry picking to support your own preconceived position is that you expose yourself too easily. You have referenced a graph from the F alert network – no data on the graph, straight lines, etc. no supporting methodology. The you claim it originated from the WHO – yet in 1993 the WHO produced an average figure of 1.5 and your graph said 4.0 and only fluoridated!

    Your information, your claim they were the same.

    Can you not see why I don’t find you a credible source of information.

  111. Ron, you dishonestly put words into my mouth.

    I have never claimed to blindly trust health authorities and dentists – not by any means.

    And you just prove again you have absolutely no idea what it is like for deprived people. The reason people like me avoided dentists, health check ups, etc., is we were ashamed – we felt guilty, and we blamed ourselves and our families. We couldn’t change things.

    No bloody idea- yet you think yourself so important you can tell us why deprived kids are the way they are.

    You should learn to listen, and learn to shut up or a while. You might actually learn something.

    As for your claims about the sedate your referred to – what a silly claim to make. You didn’t verify the data was accurate – I have just shown you data from the two sources are widely different.

    You didn’t even bother looking.

  112. Andy, I was involved in probably the most costly cock-up in wasted money on computer systems in NZ’s history.

    In the 1980′s the government de jour decided it wanted a nationwide medical laboratory computer system. A working group was set up that brought a number of senior laboratory scientists to Green lane hospital in Auckland for 2-3 days per week for several years. They were put up in motels. Two DEC 10 computers were installed… one in the Mt Smart area in Auckland and one in Christchurch. The project folded after about $40 million was spent. The final straw was disagreement as to whether the results forms were printed in portrait or landscape… I kid you not.

  113. Andy, you are in denial. If your don’t have a preconceived position why clutch at that silly diagram of Ron’s, even Ron’s attempt to back it up shows some bodies been fiddling things.

    And why expose a strongly held ideological bias with your talk about “pissing away” “no proven benefits” “handwringing liberals” “sticking to your dogma..”

    Clearly in denial.

  114. In denial?

    I am only in agreement with Ron that we waste a lot of money here and in other countries that could be better spent. This is my only argument.

    If Fluoride in water is a cost-effective treatment, then go for it. Otherwise, I’d rather see the issues treated more close up and personal, like a school nurse etc.

    In fact a school dental nurse may be able to pick up other health issues at the same time. Isn’t this the Green’s latest policy proposal anyway? (i.e school nurses for low decile schools)

  115. LOL Ken

    Take at look at the graph… note they are all straight lines showing trends… Look at where NZ starts… 1977… and ends… they have drawn a straight line from beginning to end…. it doesn’t show each individual point… when I saw that the first thing I did was go to the source to check for myself… the bottom line is that whether fluoridated or not all countries shown have dramatic declines in DMFT over the past 30-40 years.

    So, your claim is false… again. “You didn’t verify the data was accurate – I have just shown you data from the two sources are widely different. ”

    I did, and it was. The two sources agree… one is a straight line trend of first and last data, the second are the actual data.

  116. “A straight line trend of first and last data” eh. You aren’t a fan of Mad Monckton, are you. He’s always pulling that trick.

  117. Andy, a while back you said “Thanks to Ron for providing a graph showing no correlation between oral health and fluoride.”

    The graph showed nothing of the sort – although Ron claimed it did. It had no accompanying explanation or methodology, and Ron’s attempt to say it was WHO data showed it didn’t agree with the WHO data.

    Such an act of straw clutching shows a preconceived position, one based on denial.

    Even after all this time you have not taken on board that fluoridation has proved to be cost effective. Only the most extreme nutters deny that. Even Ron accepts it.

  118. Are you calling me an extreme nutter Ken?
    I guess a few years working as a government IT contractor might have tipped me over the edge.

    Thankfully I am away from that Kafaesque world now

  119. No, Andy, but I guess you are sensitive to the charge. Perhaps you often face that accusation?

    I would call you and Ron contrarians on this issue, but definitely showing some pretty strong confirmation bias. On this issue the mutters claim F was used by the Nazis to keep the population subdued.

    Mind you, I know Ron has been called a nutter by others. He seems to have a whole raft off issues he pretends special knowledge on. I get the impression he like’s to look down on scientists who probably are sorts in their own field.

  120. Ken & Andy

    Where did I claim there was no correlation between oral health and fluoride.

    I presented a graph and said, “And I’ve been to the WHO website in sweden to check the trends.
    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/According-to-Alphabetical/CountryArea-N/

    For NZ in 2009
    DMFT in fluoridated areas: 1.2, DMFT in non-fluoridated areas: 1.6

    ie, a difference of 0.4 missing teeth OR fillings PER mouth…..

    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/WPRO/

    Note I explicitly referred to CHECKING THE TRENDS. The graph clearly showed exactly the same trends for both fluoridated and non-fluoridated…

    I asked Ken to explain it… he has not been able/willing to, other than throw emotional language and attempt to discredit the data with a great deal of flailing of mouth and arms.

    Ken, please explain the parallel decline in DTFM in both fluoridated and non fluoridated areas around the world, including in New Zealand?

  121. Ken said, “I get the impression he like to all down to scientists who probably are sorts in this feld.”

    Is that some kind of code? :-)

  122. Ron, I didn’t make that claim – Andy did.

    And give up the graph – it’s a dog. Andy was a fool to take anything from it – mind you he is a fan of the Potty Peer who is always drawing trends from 2 data points, carefully chosen, of course.

  123. OK, Ken who is a fan of that master of pseudo-science Micheal Mann, the biggest fraudster in science today. What would YOU know about anything Ken?

    (* lights touchpaper, stands well back *)

  124. Come on. let’s have some irrelevant videos about NASA, I know you want to..

  125. By the way Ken, at what point did you come to the conclusion that I am a fan of “Mad Monckton”?

    Would you like to make up any other shit about me while you are at it?
    I am sure we’d love to flood your blog with entirely irrelevant drivel about anything we can think of
    Look at the price of eggs!

    Oh what is the world coming to?

    And look at the muck in ‘er. Shut that door!

  126. Andy, you know that is a diversion. I have written about Mann’s work in several of my posts. I reviewed his excellent book. If you were really interested in discussing that work or my review you would have contributed to the discussion at the time.

    Of course you still can – but the fact that you are diverting here up suggested this discussion has run its natural course. Nothing new is coming up and instead people are getting into irrelevancies.

    However, why not read my post from yesterday and discuss that. I assert that the anti-fluoridationists have been lying to us. I analysed there claims and their citation.

    Mind you, the fact that you have ignored that post could indicate you agree with it.

    Meanwhile I am getting some, light entertainment watching the videos from the Hamilton City Council’s sham consultation. There are quiet a few laughs there – where do these people come from?

  127. Oh, I am sorry, Andy. I realise that after his visit here a number of the climate change pseudosceptics were turned off Monckton and there are divisions in the old “movement..” So perhaps you are in transition. After all, you are tending to deny your denial lately.

    Anyway, I guess you probably agree that his graphs of trends with 2 points are classic Monckton.

  128. How can a denier deny his denial when he was never in denial in the first place,?
    Of course, the non-denier may claim that he was in denial about something that is not possible to deny, unless the denial is a projection from another party who is projecting their denial on the supposed denial of the supposed denier who now claims to be a non-denial of an undeniable position?

    I hope that clears things up

  129. Now that is definitely denial!

  130. Yes, I can’t deny that Ken

  131. Ken said, “There are quiet a few laughs there – where do these people come from?”

    Are you watching the DHB presentations? :-)

  132. No Ron , it’s the 3rd video and I have yet to see anyone speak in favour of fluoridation. Perhaps those 70% who voted in the referendum didn’t get an invitation.

  133. If you are going through the videos sequentially then the against come first, the pros second.

  134. By the way, Ken, there are some loud laughs to be had too… on both sides of the argument.

  135. They seemed to topics at least one against at the end, my mate Ted Ninnes. He should know better than to spout that rubbish about fluoridation being a con by the fertiliser companies.

  136. I don’t know about loud laughs – I am finding it extremely boring. So much rubbish being presented as if it were fact.

  137. “So much rubbish being presented as if it were fact.” Afraid that carries on right through.

  138. Alright, Ron, let’s run with your purported figures for the sake of argument. 0.4 cavities/lost teeth per child per year if we cut fluoridation, cost of fixing each cavity at $100 (lower end according to Consumer magazine), gives us cost per head of $40, as contrasted with a cost per head of water fluoridation of 50 cents (for Wellington – regional figures may vary, but are pretty unlikely to go very high).

    Demonstrated negative effects of fluoride in water at the concentrations used: Zero.

    So, even assuming your figures are accurate (which appears to be in doubt), the benefits of fluoridating water are ridiculously greater than the costs.

    Of course, if the costs are concentrated amongst the poorest members of society, cutting fluoridation amounts to a transfer of wealth away from them and to ratepayers, who get a whopping 50 cents extra a year. My word, think what we could all do with that money. Assuming of course that none of the poor are able to draw on public health resources to get their cavities fixed, thus raising our taxes.

    Remind me, do you have a non-economic argument against water fluoridation? Or do you expect us all to cave at your assertion that cutting fluoridation of water will result in a “mere” 0.4 cavities less per person?

  139. Sorry, “0.4 MORE cavities per person.” Pretty significant error there.

  140. Chris said, “Alright, Ron, let’s run with your purported figures for the sake of argument. 0.4 cavities/lost teeth per child per year if we cut fluoridation,”

    Chris, where did you get that nonsense from? Your data is false.

  141. Our posts crossed… indeed, it is a significant error.

  142. The data is not mine. It’s the MOHs via the WHO.

  143. Chris, re-reading I see you haven’t realised your original mistake…

  144. Yes Chris, you’ve taken RonL’s point out of context.

  145. I got a mega dose of Vitamin C for pneumonia. I am still alive, that is all I can say

    So what?
    Medical claims don’t rest on ancedotal evidence. We still do tests.
    It would be wonderful not to have to do all those expensive tests. Think of the time and money we could save!
    Only, in the real world, science doesn’t work like that. The boring old-fashioned way of doing a massive round of tests is still considered to be the best way of figuring out if something actually helps or not.
    The plural of anecdote is not data.

    The Problem with Anecdotes by QualiaSoup

  146. I don’t have a “pre-conceived position” on fluoride.

    You don’t? Oh goo…

    If governments and councils want to piss away millions of dollars of taxpayers money on treatments that have no proven benefits because it makes some handwringing “liberals” feel good then that is fine with me.

    Sounds like cut-and-paste from a climate denier argument.
    Let’s see..

    “If governments and councils want to piss away millions of dollars of taxpayers money on researching climate that have no proven human basis because it makes some handwringing “liberals” feel good then that is fine with me.”

    Gosh, it works. What were the chances?
    Is there more?

    “Some people might think this is immoral or wrong, but who cares? Lets stick to our dogma and positions and the poor will remain poor and the vested interests will remain rich.”

    Dang, I didn’t even have to change the labels on that one. Too easy. :)
    Science denialism: Only the labels change. (Sometimes, not even the labels)

    OK, Ken who is a fan of that master of pseudo-science Micheal Mann, the biggest fraudster in science today. What would YOU know about anything Ken?

    Andy, fraud is a crime. That is…it’s illegal. People go to prison for fraud. If you have evidence of someone committing fraud then…call the police. Now.
    (shrug)
    Anything else is bullshit.

    Climate deniers talk tough about suing or going to court or whatever. It’s an old stand-by. Yet climate deniers do very badly in front of a judge.
    NIWA, anyone?

  147. Yes, Chris Huhne went to prison for fraud, or conspiring to pervert the cause of justice. He was former climate change minister in the UK.

    Tim Yeo has just been busted for conflict of interest and other corruption. Another piece of slime feeding off the trough of climate change alarmism.

    Lots more to go yet though,

  148. Sorry I meant the course of justice, not the cause.

    Freudian slip I guess

  149. Chris Huhne was a politician. In February 2012, Huhne resigned from the Cabinet when he was charged with perverting the course of justice over a 2003 speeding case. He went to jail for eight months.

    Irrelevence much?

    Tim Yeo is a…politician. Had a love child, helped “coach” a solar energy company executive for an appearance before the Energy and Climate Change Select Committee. Later he stood down from the committee Chair due to the scandal.

    Irrelevence much?

    Michael Mann.
    Not a politician.
    Accused of fraud by old kooky people on blogs.
    Fraud is a crime.
    People go to prison for fraud. If you have evidence of someone committing fraud then…call the police. Now.
    (shrug)
    Anything else is bullshit.

  150. You know what? You’re quite right. Bad error on my part, indicating that I should be damned sure of my calculations before arguing with somebody over the internet. I’m sure I’ve had precisely zero impact on your position.

    Accordingly, I refer you to the CDC website, which has some rather higher-quality cost-benefit analyses than my own error-prone back-of-the-envelope calculations.
    http://www.cdc.gov/fluoridation/benefits.htm#3
    http://www.cdc.gov/fluoridation/fact_sheets/cost.htm

    The economic case, it seems, still stacks up.

  151. Chris, they are most interesting “Fact” sheets. The CBA is based on work done in the 70′s/80′s… Garcia said in her 1989 paper, “Because the results of studies performed during the early 1970s would probably not portray a realistic picture of caries experience today, the first criterion was to limit the studies to those conducted in recent years.
    Although a number of studies published in the late 1970s met this criterion, they were not included in the review because data had been collected up to ten years earlier, making them too old for use in the workshop.”

    Doesn’t that apply today too? Wouldn’t data from 30 years ago be too old to use in the enlightened 2013????

    Based on the above, I doubt this could be called high quality.

    That said, as Ken has mentioned above, I have never argued that a case can’t be made for adding fluoride to water simply on economics. If economics was the only reason for doing things we’d all have a QR code with NHI number and other relevant details embedded on our forehead at birth.

    Are you suggesting that because an economic case can be made it is OK for the State to mandate mass medication, direct where we live, how we live, etc.

    I suspect an economic case could be made for banning the production and sale of butter. Are you advocating that we should do that? What about Coca Cola? Should we ban that because it causes severe tooth decay? Should we ban nipples on bottles because they encourage sipping of sugary juices?

  152. Have a look at this website commenting on quality of studies. I’m not agreeing with them, just pointing out that studies need to be weighed up and critically analysed. If 50-70% of dentists prescribed fluoride supplements even in fluoridated areas what does that say? What’s the compounding effects?

    http://andevidencelibrary.com/evidence.cfm?evidence_summary_id=251208&auth=1

  153. The question of “mass medication” (misleading name) and personal freedom is, I think, the best argument the anti-fluoridationists have. Unfortunately, as is often the case with political activists, they end up destroying their argument because they feel the need to throw in others which have no basis. From claims about the Nazis using F to claims that HFSA contains toxic levels of arsenic.

    This personal freedom argument is political, values based – and science (more correctly pseuodscience) is being used dishonestly to promote political values. We should only be approaching it as a political, values, question and stop pretending it is a scientific one. To just give science it’s proper role, to provide required information to enable us to make sensible political/values decisions.

    We are a social species and living in a society requires give and take. People have their own detailed politics and values. Mine are on obviously different to yours, Ron. But, clearly, mine are more consistent with the majority of Hamiltonians, than yours, or the 7 city councillors, are. Democratic decisions may not satisfy everyone but those who are not satisfied should not expect minority decisions to prevail.

    Given that Hamiltonians had shown their opinion in a non-binding referendum (yes 6 years ago, but when I asked you Ron what had changed in that time you avoided answering) and recent polls still show overwhelming support fluoridation the I think it was unethical for the council to refuse to take the issue to another referendum and to vote the way they did.

    But let’s be sensible when we discuss these values. If your are to compare adjustment of a deficient element to banning the sale of butter, etc., then you are in the ballpark of saying we should not chlorinate our water supply, add flocculents, etc. That we should do nothing to treat our water to make it safe, we should not pasteurise milk, out controls on food additives, etc.

    I think arguments about correcting a deficiency, or contamination, in our water supply can be made both ways, but sensibly we should confront the question of correcting deficiency/surplus rather than thinking of medication. I know that at least some of the HFSA produced as a by product in the fertiliser industry is being disposed of by adding it back into the fertiliser. It could be, given the contamination of our water ways by agriculture, that in a few years time our water treatment plant will have the task of removing F to bring it down into the 0.7 – 1.0 ppm range. Will the antifluoridationists then become active, demanding that our council not do this because it is “mass medication?

  154. An interesting post, Ken. Councillors are elected democratically to make decisions on a community’s behalf. 7 Councillors is a majority (total 13) even if only 8 voted.

    A referendum where 38% of a population vote is hardly compelling… and a lot happens in 7 years.

    It’s good to see you acknowledging that it’s a political issue. It’s certainly not a compelling public health issue. Chlorination is quite different… many people can die from infected water. Many more can suffer from infected water. Flocculation is another matter… much of that is to remove other chemicals added to clarify/purify water.

    I have no problems with pasteurization… I do with laws preventing people from buying unpasteurised milk/cheese.

    I suspect of CaF or NaF were used there would be less heat in the anti-F argument. For the record, wasn’t HSFA a by-product of the Aluminium industry?

    My understanding, from reading the Hamilton City Council advice, was the reason they didn’t proceed with a referendum was because their legal advisers said it wouldn’t cut the mustard regarding consultation requirements under the LGA… It will be interesting to see how the Sth Taranaki Judicial Review pans out.

  155. Ron, CaF could not be used (it is very insoluble). NaF is used overseas (I don’t know about NZ). In NZ HFSA and the sodium salt are the most common used..

    They are a by-products of phosphate fertiliser manufacture. But that’s just a perspective issue – in other countries where phosphorites are the main mineral source of F the P fertiliser is a by-product (or “waste” product) of F production. Much of the internationally available NaF probably is sourced from phosphorites as the HFSA is here. Fluorite ore (CaF is actually a diminishing raw material.

    The antifluoridationist are outright lying about FHSA as my post on Tuesday showed. It actually has very low levels of impurities, especially toxic heavy metals. And think about it. The use of chemicals in NZ public water supply treatment is regulated and contaminated chemicals would just not be accepted. Regulations cover NaF as well as HFSA as it’s sodium salt. (I provided a link to those standards in my post).

    This issue of the lies told about HFSA by the anti-fluoridations is a hot one for me because I actually did some research on this material and we analyses it for toxic elements. The water treatment plants also are required to obtain analytical certificates for the materials they use so will be well aware that toxic elements is not an issue.

    Currently I am trying to find out if the Hamilton City Council took advice from their water engineers before their vote. Dave MacPherson assures me they did but there is no record of a submission I can find. Dave refuses to say whether he believed his own engineers or the activists presentations on this issue. (He seems to be very ideologically driven on this question and perhaps if anyone should have been excluded from voting it is him).

    Chlorination and flocculation are no different in essence. They are still a political decision. Many people process their water to remove Al and Cl. (As a chemist I personally thinking chlorination is more dangerous to our health than fluoridation. In fact some industries have stopped using Cl2 and now use H2O2. I would have thought water treatment plants should be converting to something safer like UV treatment.)

    I actually suspect that people who currently filter their water (currently claiming to remove F) will continue to do so.

    But, given that your values/political view leads you to oppose fluoridation will you oppose the removal of F when it reaches 1 ppm and above. And how will you square that (values-wise) with your current stance?

    Perhaps one way of seeing this as an attitude which exist in the US where they have both deficient and excess natural F. To them fluoridation actually means processing to being the F concentration into the range of 0.7 – 1.00 ppm. This means they actually have to remove F in some areas. The maximum allowed used to be 4 ppm but I think it may now have been lowered to 1 ppm, or is in the process of being lowered.

    PS – what “added” chemical specifically is removed by flocculation? Surely it’s used to remove natural colloids and organic matter. Serious question so please don’t ignore.

    PPS – so you think a total vote of 7 is more democratic than a 70% vote where 38% of the citizens turned out? Perhaps those 7 should now be given the task of voting for the next councillors rather the allow the citizens to decide because their usual low turnout is not “compelling.”?

  156. I’m sorry, Ron, I was under the impression that you were disputing the economic case.

    Shall we perhaps establish what you are disputing, rather than you simply railing against any and all studies anybody has ever produced? Because I’ll be perfectly honest, your assertion that studies need to be weighed and critically analysed is a bit of a red herring. The implication being that such critical analysis has not already been conducted by those institutions advocating fluoridation.

  157. Ken said, “But, given that your values/political view leads you to oppose fluoridation will you oppose the removal of F when it reaches 1 ppm and above. And how will you square that (values-wise) with your current stance? ”

    The two are totally different… besides, I’ve never said I was anti-fluoridation, nor have I said I was anti-fluoride. I’m certainly pro-choice, and I certainly don’t think the pro-fluoridation argument is based on compelling evidence… it’s based more on, “we’re the experts; how dare you question us!”

    My experience in life is that many ‘experts’ by and large are ideologically, career, and pocket driven.

    Many experts views are dictated by their terms of employment. The MOH even tags funding to groups, such as Maori welfare groups, to acceptance and support of certain positions. I know for a fact that funding was threatened if they did not publicly support the MeNZB vaccination programme.

  158. Chris, you held up a study based on 30 year old data as convincing evidence… even the source document of that study said that would be a nonsense.

    My point is that preventing 0.4 DMFT per person over many years is not a compelling public health issue. To make mass medication mandatory to save, what is essentially a cosmetic issue, is an abuse of power. Yeah, yeah, I can hear the screams of “Lack of empathy” but in an era when food is highly processed, and the rise and rise of smoothies, vitamisers, etc, and from professional experience, no one is going to die from a lack of one or two teeth… even a mouth full of teeth… so we are not talking about life/death issues.

    I repeat, My point is that preventing 0.4 DMFT per person over many years is not a compelling public health issue.

    Ken talks of fluoride being an essential element… it is not. Not by any definition… at least based on current knowledge it’s not.

  159. Ken, re: “PS – what “added” chemical specifically is removed by flocculation? Surely it’s used to remove natural colloids and organic matter. Serious question so please don’t ignore. ”

    Point noted.

  160. Ron, thanks for conceding in the flocculation issue but you have avoided my simple question regarding a wider application of fluoridation concepts – one we may well face down the track.

    As for the question of F being an essential element – I will post separately on this, describing a study showing the negative effects of both low and high F levels.

    I keep telling you the world is not simple and most elements present problems at deficiency levels as well as excess levels. Personally I think this is also true for F, from my own work with apatite s. But there is also medical work supporting this.

  161. Ron, I’ll ignore your ideological rants about “experts.” The very fact that you feel the need to challenge scientists and find your arguments knocked down suggest you are wrong. And it is cowardly, and conspiracy theory driven, to raise such arguments when clear scientific facts are being discussed. It exposes your own weakness when you do this.

    It’s a cowardly diversion.

  162. Ken, give me one reason why the public should trust scientists.

  163. Ken, you certainly like marinating your science/objective/skeptic beliefs with diatribes and personal attacks.

    If I was a coward, do you think I’d be engaging in a discussion like this???

    It wasn’t that long ago that “experts” were saying selenium wasn’t an essential element. Boron is still denied as being an essential element in some “expert” scientific quarters. It wasn’t that long ago that expert scientists believed PMS was a mental illness. Some now believe that arsenic is an essential element (it may well be.) It is somewhat paradoxical, don’t you think, that “experts” can be so certain about scientific “facts” which keep changing all the time.

    I believe it was Albert Einstein who rightly said, “If we knew what it was we were doing, it would not be called research, would it?” And yet ‘researchers’ and ‘experts’ believe that they are the font of all knowledge and fact.

    The simple fact is that 0.4 DMFT per person is not a significant public health issue, despite the rhetoric about empathy, etc. The simple fact is that we can be empathetic about a gazillion things; that does make it right/wrong to use empathy as the driver for societal level decisions. If empathy was the driver then we wouldn’t be bothered with science or objectivity. Sure, empathy is an important aspect of humanity, but don’t mention that to ACC for example as they take 8 weeks to consider an application for urgent surgery for an extremely painful and debilitating torn knee-cap caused by an accident. Don’t talk about empathy to the DHB when they have a waiting list a mile long for hip replacements… And yet they pull out the empathy card to try and rationalise mandatory mass medication… how bizarre!

  164. Ron, my use of cowardly was to describe you argument, not you. I thought that was clear.

    I repeat, plying the man rather than the ball is a sign that the facts don’t support your case.

    A mate of mine worked very closely on Se and I am sure we were aware of its essential nature a very long time ago. But your point about the dynamic nature of scientific knowledge is true. That is why I am happy to argue that perhaps F is an essential element because of its role in the structure and solubility of bioapatites. I will do a blog article on that in the next few days seeing it’s relevant to current concerns.

    To claim that researchers and experts believe they are the font of all knowledge is just childish – as you quote from Einstein shows. That is a cowardly argument because its playing the man rather than the ball. If you query and idea of research conk union you should argue it out against the facts of reality, not make it personal. When you do it’s a sign that you don’t think facts are on your side.

    I wish you would stop ranting – it makes you look like a nutter and doesn’t contribute to the discussion.

  165. Andy, do you ever consult your doctor, take your car to the garage, Emily a builder or plumber, etc. etc.

    You actually have plenty of reasons to out your trust in expert knowledge when your own is not there.

  166. Yes I do consult my doctor etc.
    There are plenty of reasons to trust experts.
    However, when scientists refer to you as a “denier” a “creationist”, block you from Facebook and Twitter, refuse to present their data, then that trust tends to get lost.

    Furthermore, when other more open scientists don’t stand up for their profession, then they all get dragged down to the same level

  167. Andy, scientists are actually human, you know. And arguments can be made for blocking people from what is after all a personal social media instrument. But I certainly don’t go to scientists for advice on social media. Or my doctor, mechanic, etc.

    Why don’t you go and have a bitch to Treadgold who regularly bans/blocks commenters and alters their comments. As you well know. In his case he usually does this in an emotional fit because he has been caught out lying or similar. He blocked me for simply asking him to apologise for the clearly incorrect claim slandering NZ scientist back n 2009. I think he is embarrassed about that and would really just like people to mention it.

    I am really surprised you are silly enough to complain here about scientist blocking trolls.

  168. Ken said, “I repeat, plying the man rather than the ball is a sign that the facts don’t support your case. ”

    So why do you keep using insulting language?

    As for trusting scientists… goodness, gracious me. Even our legal system doesn’t trust scientists per se. Experts aren’t decision makers… they are at best advisers. Ask two experts and you’ll get at least three opinions.

    In economics, there’s an old saying, “If you lay all the economists in the world end to end they still would not be able to make a decision.”

    If science was so black and white the research labs would no longer be needed. Experts are at best advisers; many of them are biased, have vested interests and some of them are downright incompetent.

    You asked Andy, “do you ever consult your doctor, take your car to the garage, Emily a builder or plumber, etc. etc. ”

    Of course he does… the operative word is ‘consult.’ He then makes a decision… he doesn’t (I hope) leave the decision making to the doctor/mechanic/builder etc; they influence the decision making, but they aren’t the decision-makers.

  169. Gee, Ron, for somebody who apparently does not dispute the cost-effectiveness of fluoridation, you certainly are obsessed with discrediting the notion. Perhaps you might care to explain what has changed to invalidate the results? Or present more recent, contradictory studies? Because a brief literature search certainly indicates that fluoridation remains cost-effective.

    But of course you don’t dispute that, so this is a senseless conversation. Shall we consider it closed?

  170. Ron, I’ll let you into a secret – well actually it’s not a secret. Scientists don’t trust scientists. They insist on facts, evidence. In my research I always consulted others, and read the literature. But my scientific decisions and conclusions relied in facts, not authority.

    Science is never black and white – although if you listened to he anti-fluoridationists you might be forgiven to think they are making that claim.

    You consult your doctor because you trust her about your health to a degree – same with your mechanic. And when I consult my doctor my trust always involves wanting to know the facts. And she gives me the facts, my blood pressure, my lipid values. She doesn’t hide them.

    The government consults climate scientists because they are the obvious ones to trust for information on the climate. However, those scientist clearly don’t make decisions for the government. They don’t want to. But they do the best to give an overview of current knowledge, and an idea of the degrees of certainty.

    But an informed decision, even a political one, is much better than an uninformed one. Unfortunately, because of the unbalanced nature of their consultation process and gerry meandering of the process the HCC decision was pretty uninformed.

  171. Chris, I think the real issue is political/values based. Ron insists on looking at only an average for the decreased number of fillings and rejects any concern about the reality that average means for the economically and socially disadvantaged sections of the community, which show values higher than the average. He blames, without justifying in any way, the problem on their sucking sweet drinks etc as this they should be left to suffer in their own misery.

  172. Is an average of 0.4 cavities per person not a significant public health issue? What an interesting assertion. I’m glad you’re here to tell us these things with your extensive expertise in the subject. What if that average is not evenly distributed? Does it become a public health issue then?

    Please enlighten us with the criteria by which you have determined that these cavities would not represent a drain on our public health system, and would not negatively impact peoples’ lives.

    I recall seeing a news article which showed people with serious problems queuing up at a dental clinic when they offered a day of free treatment for those in need. That certainly doesn’t sound like a non-issue to me, and this is in a city which does fluoridate its water. Stack that extra 0.4 cavities on top of the existing issues and you exacerbate an already significant problem.

  173. Yes I do consult my doctor etc.
    There are plenty of reasons to trust experts.

    If you had cancer, you’d be prepared to listen to a cancer specialist?
    I’d hope so.
    Cancer isn’t a joke.
    Of course, it’s possible that the one individual cancer specialist is wrong or a secret quack or something. Which is why you can double check what your doctor says with the big-name medical communities and get as many second opinions as you like.

    Humans changing the chemical composition of the atmosphere and thereby screwing around with the thermostat isn’t a joke.
    Of course, it’s possible that the one individual climate specialist is wrong or a secret Commie/ wierdo or something. Which is why you can double check what any one scientist says with the big-name scientific communities and get as many second opinions as you like. In fact, you can double check with ALL of the scientific communities. NASA is good start.

    For a very long time, the medical community knew that tobacco was dangerous. The tobacco lobby, however, didn’t just roll over. They fought back tooth and nail with a well-funded disinformation campaign which almost premanently stalled the public heath campaign to inform the public. The consensus on the dangers of tobacco was well established back in the 50′s. Yet the public didn’t know because of the way they were manipulated.

    People back then and now denied the evidence that tobacco was a serious health risk. The evidence was there. The science was there and in overwhelming numbers…yet people denied it.

    Science denialism is a real thing. It’s not just on climate change.
    There’s vaccine deniers too.
    They threaten the health of your family and your community.
    If you have grandchildren, anti-vaxxers should be you mortal enemies.
    They are science deniers.
    Read about how they frame their arguments. They’d disturb you about how similar they are to climate denier arguments.

    People also deny NASA went to the moon. Again, there’s a scientific consensus but certain tightly-bound groups are determined to deny the evidence that is simply overwhelming.

    Denialism is real. The way that people prop up their denialism is the same. The same rationalizations are used. The same talking points,

    However, when scientists refer to you as a “denier” a “creationist”, block you from Facebook and Twitter, refuse to present their data, then that trust tends to get lost.
    Furthermore, when other more open scientists don’t stand up for their profession, then they all get dragged down to the same level.

    Case in point.
    “However, when scientists refer to you as a “denier” an “anti-vaxxer”, block you from Facebook and Twitter, refuse to present their data, then that trust tends to get lost.
    Furthermore, when other more open scientists don’t stand up for their profession, then they all get dragged down to the same level.”

    Only the labels change.

    Penn and Teller – Vaccinations (Full Episode)

  174. Chris asked, “Perhaps you might care to explain what has changed to invalidate the results?”

    One thing is the on-going decline of cavities in BOTH fluoridated and non-fluoridated areas which diminishes the equation.

    The second is that the benefits do not mount to one of public health warranting mandatory mass medication of the entire population.

    Based on the available data, if you took one hundred kids from fluoridated areas and randomly paired them up with 100 kids from non-fluoridated areas and got 10 experts to pick which one lived in fluoridated/non-fluoridated ares, the vast majority would choose by guesswork.

    Ken says, “Science is never black and white – although if you listened to he anti-fluoridationists you might be forgiven to think they are making that claim. ”

    Ken, that argument cuts both ways.

    I have no doubt that having breakfast before school is incredibly important to kids long term health and wellbeing… ad no doubt a good economic case could be made… but we don’t mandate that every kids has to have breakfast… as much as we want to, ad as much as empathy dictates we do.

    We don’t mandate that kids wear shoes, or warm clothing in winter… maybe we should!

    We don’t mandate that landlords provide warm/dry homes… maybe we should. All of these can be proven to be cost effective…

    Ken says, “Ron insists on looking at only an average for the decreased number of fillings and rejects any concern about the reality that average means for the economically and socially disadvantaged sections of the community, which show values higher than the average. ”

    Ken, I’m only using the MOH/WHO data and published studies… show me the data that justifies mass medicating the masses for the possible benefit of the few. Even the MOH and Waikato DHB haven’t presented that evidence to make a case (that I’ve seen, anyways.)

    Ken, you claim, “He blames, without justifying in any way, the problem on their sucking sweet drinks etc as this they should be left to suffer in their own misery.”

    Have you always been a liar? I have never said that at all.

    I have never blamed ‘the problem’ on kids sucking sweet drinks, nor have I said they should be left to suffer in their own misery.

    That is your own lie. How Bizarre for someone claiming to represent the moral scientific high ground.

    Why do you need to resort to lying to try and justify the unjustifiable?

    Google these three words… sugary drinks decay

    Google this

    site:www.ncbi.nlm.nih.gov/pubmed/ sugary drinks decay

    Based on the science I read, sugary drinks are a major cause of tooth decay… as are the use of bottles with sippers/tits on them.

    Please don’t resort to lying and rewriting people’s comments to prop up your belief system… it is not a good look for a moral skeptical scientist.

    On that note, I really do have work to do.

  175. Ron, I rest my case on the evidence of your comments to this post. You have continually tried to avoid the issue of socially and economically disadvantaged people and what this means for the average figures. And you have continually tried to excuse that by using disparaging and uninformed comments on how nasty those people are.

    It’s an old debate issue and I don’t intend getting involved in that further on this thread.

    As for arguments cutting both ways. Almost all the anti-fluoridationists who made submission in Hamilton used arguments which were outright lies or misinformed. The HFSA one is clear as I showed in my Tuesday post, yet even those who should know better fell back on that dishonest argument.

    Now, if there are clear claims of black/white science made by the scientific side to the argument you are welcome to highlight and criticise them. In fact, this was recently done on one of the SciBlogs posts where a number of us disagreed with the PM’s science advisor saying the science on fluoridation was largely settled.

    We have critiqued such comments made by people on the scientific side yet you blatantly ignore the outright lies being told by the anti-fluoridationists.

  176. Just had a quick look on Dr God’s website. I see why you are annoyed with her…

    “But irrespective of the conclusions that the scientific community has reached, scientists do not have a privileged position within a values debate beyond clarifying when science is being misused. Such values based debates should focus on any real issues of contention and be resolved through the political process – whether local or nationally.”

    http://www.pmcsa.org.nz/blog/what-is-in-the-water/

    that’s EXACTLY what Hamilton City Council has done…
    LOL

  177. Funny Cedric, I was blocked from Mann’s Facebook page for saying something along the lines “these projections don’t sound very scary”

    That was my second and last comment.

    I guess that is how he “reaches out” to the public, in only a way that Mikey can

  178. Ron, you really are blinkered. The debate did not focus on the real, political, issues of contention. Most, if not all, antifluoridation submitters made misleading or completely dishonest claims which were, as far as I can see, not countered. The example I keep repeating is that of HFSA – can you find any submission from the water engineers? Anything actually describing the toxic element content of the material used?

    If the debate had been limited to, and focused on, the political/values issue instead of Gish galloping into pseudoscientific nonsense the issues would have been a lot clearer.

    Scientists could have played an important role in clearing up that misinformation.

    But who the F is Dr God – sounds like you have some sort of problems?

  179. Ken, you say, “Most, if not all, antifluoridation submitters made misleading or completely dishonest claims which were, as far as I can see, not countered. The example I keep repeating is that of HFSA – can you find any submission from the water engineers? Anything actually describing the toxic element content of the material used?”

    This speaks a great deal about the calibre of the Pro case. They knew what would be thrown at them and failed to address it… well, well… So poke the borax at them… it’s their fault!

    As for Dr God… I’m so sorry, I should have referred to his full titleof Sir Professor Dr God KNZM, OMG, LOL.

    At least he trumped science with values and politics, and rightly so.

  180. Ron, I agee, that the pro-science people bear responsibility for their defeat. That is something that has been and is being discussed, although I guess you don’t move in those circles.

    In fact, my post today on science and activism covers this issue.

    I really see the Hamilton defeat as a victory in the sense of driving home this lesson. It will probably mean that scientific experts network more effectively, and on the fluoridation issue specifically, some activist groups are formed.

    It is already encouraging parliamentarians to recognise the need for a clear national policy and this will require a lot more scientific involvement. Such a policy will make it far more difficult for the antifluoridationists to pick off individual councils.

    So I am a really very positive about what is happening. And you must certainly have noticed a lot of science blogging on the issue, TV coverage and media opinion criticising the Hamilton decision.

    There is nothing wrong with the scientific arguments for fluoridation. But the important things are:

    1:Their effective presentation which may involve networking and activism along the lines use by the pseudoscience people.

    2: Far more effective countering of the misinformation and outright lies those people use.

    If you are observant you may well be aware that work is already proceeding along those lines.

    As for your comments on the PM’s science advisor – pure childishness.

  181. I see, Ron, that you haven’t been able to produce any papers contradicting the cost-effectiveness of fluoridation, which would surely be your easiest route to demonstrating the paper had been invalidated. More recent papers have certainly superceded these studies, but they continue to show that fluoridation is cost-effective.

    “One thing is the on-going decline of cavities in BOTH fluoridated and non-fluoridated areas which diminishes the equation”

    Does it? I don’t recall any lines on that anti-fluoride graph of yours showing the differences between populations with or without fluoridated water within the same country, which would seem to be the absolute minimum required to try and correct for differing public health policies (such as, say, fluoridated salt), naturally occurring fluoride levels and the like. What, exactly, was the difference between rates of tooth decay in US populations with or without fluoridated water thirty years ago? Or here, for that matter?

    I doubt the lines would be parallel, but I’m sure as hell not convinced that the gap has closed sufficiently to bring the benefits of fluoridation down to less than 50 cents per person.

    “The second is that the benefits do not mount to one of public health warranting mandatory mass medication of the entire population.”

    I’m sorry, what bearing does the question of whether fluoridation is moral have on whether it is cost-effective? Your second point is utterly irrelevant so far as invalidating the paper or the cost-effectiveness of fluoride goes.

    Rather, you seem to be trying to convince me that, given a lower monetised benefit, your purported moral issues around “mass medication” now outweigh the cost-effectiveness of fluoridation. This is a separate issue, and you’re really not doing your case any good by confusing it with cost-effectiveness, which, once again, you supposedly do not dispute.

    Never mind that, if we had mandatory fluoridation of the entire population’s water supply, the Hamilton City Council would not have been able to remove their fluoridation in the first place. Let’s overlook, as well, that if people really feel strongly enough about it, they can filter their water or get bottled unfluoridated water. Hardly mandatory, then, more a question of who constitute dissenters and what they’re opting out of.

    “Based on the available data, if you took one hundred kids from fluoridated areas and randomly paired them up with 100 kids from non-fluoridated areas and got 10 experts to pick which one lived in fluoridated/non-fluoridated ares, the vast majority would choose by guesswork.”

    Attempting to pervert statistics by stating that experts would need to use guesswork to determine which population individual kids came from cuts no ice with me. The very point of statistics is to reveal population trends which would not be apparent to casual observation, and to establish whether these trends are correlated with particular factors.

    The statistics show very clearly that there is a negative correlation between fluoridation and cavities, and that this correlation is more pronounced amongst the disadvantaged. You yourself have delivered quotations to that effect. And scientists are very clear as to the causative mechanisms underlying this correlation.

    Of course, it may be that you don’t actually dispute any of the points I’ve made. I find it difficult to tell. As it stands, I’m inclined to think your objections to fluoridation are ideological in nature.

  182. Ken said, “Ron, I agee, that the pro-science people bear responsibility for their defeat. That is something that has been and is being discussed, although I guess you don’t move in those circles.”

    Ken, I move more in pro-circles than anti-circles. I have a client I work on regarding other matters who could be described as anti… I have another client I work on other matters who could be described as pro— that places me as a centrist.

    I sit comfortably with that.

  183. No Ron, I was meaning scientific circles – that’s where the debate is occurring.

    By the way, the Waikato Time is reporting that the Hamilton decision may be reversed. There is a move within council to take the decision to a referendum at the next election. The decision may be made next month – which I guess illustrates there has been a lot of opposition.

    That should be the best political solution – and the antifluoridationists are going to look bad opposing a referendum.

  184. Funny Cedric, I was blocked from Mann’s Facebook page for saying something along the lines “these projections don’t sound very scary”
    That was my second and last comment.
    I guess that is how he “reaches out” to the public, in only a way that Mikey can…

    Only it’s not just Mann. Any more that it’s just Darwin or the Surgeon General or Buzz Aldrin.
    There still NASA and every single scientific commmunity on the planet to explain away.

    People handle deniers in different ways. Some people block them on the internet….but that doesn’t mean that evolution isn’t real or that vaccines protect children or that climate change isn’t real.
    Buzz Aldrin can punch a denier in the face but… that does not mean that NASA never went to the moon.

    Buzz Aldrin punches Bart Sibrel after being harassed by him

  185. *typo*
    …but that doesn’t mean that evolution isn’t real or that vaccines *don’t* protect children…

  186. Ken said, “It will probably mean that scientific experts network more effectively, and on the fluoridation issue specifically, some activist groups are formed.”

    Ken, they already have… and what’s more, it’s funded by the MOH.

    As for the excitement about Hamilton having a referendum… by pick is it’s just a councilor mouthing off in the hope of getting some votes… politicians tend to do that.

    I read today that Christchurch dentists are talking about the ‘appalling teeth’ in Christchurch compared to Dunedin… look forward to seeing the stats.

  187. Bloody hell, Ron, you chop and change. You have gone from saying we scientists do a bad job on the fluoridation issue and now say we do a good job. No wonder people don’t take you seriously.

    As for the referendum, you may well have to eat your hat there to. Dave Macpherson, a rabid antifluoridationist, is now saying he would support a referendum once the decision is made. We have 3 weeks to get him to vote for it.

    I think councillors are starting to take on board the degree of local and national concern at their mistake.

    And they can’t pull the tricks they pulled last time. It will be a simple vote – no exclusions.

    And councillors who do vote against a referendum will look very bad – it is election year.

  188. Ken, who said anything about a good job? There you go, making stuff up again.

  189. Go to bed, Ron. You are burbling.

    I am off myself – busy day tomorrow talking to our councillors.

  190. Ken said, “You have gone from saying we scientists do a bad job on the fluoridation issue and now say we do a good job.”

    Where did I say anyone was doing a good job? Why do you make stuff up?

  191. Ken said, ““A straight line trend of first and last data” eh. You aren’t a fan of Mad Monckton, are you. He’s always pulling that trick.”

    He’s referring to my earlier post of a legitimate graph showing a parallel decline in tooth decay in fluoridated and non-fluoridated countries.

    http://www.fluoridealert.org/uploads/who_data01.jpg

    And I’ve been to the WHO website in sweden to check the trends.
    http://www.mah.se/CAPP/Country-Oral-Health-Profiles/According-to-Alphabetical/CountryArea-N/

    Ken, I’m at a loss why you throw insults whenever someone presents objective evidence. How can one have a logical discussion with skeptics if they not only ignore, but slander anything they see as evidence that contradicts their own belief system?

  192. Plot the data yourself, Ron. Not just the first and last points, the data for all years. It will look completely different.

    Two data points must be close to the ultimate in cherry-picking.

    Why do want to hide the rest of the data? And how can you talk about a trend when you ignore most of the data?

  193. Now just so I understand things… firstly. it’s not my graph… it’s a simple graph showing a trend apparent in fluoridated countries and non-fluoridated countries alike. Are you saying that using such a graph without all the clutter/detail is pseudoscience?

  194. The “clutter/detail” is almost all the data. To put a straight line between only two points is not honest. And to then pretend it represents the real data is doubly dishonest.

  195. I should add, Ron, that is only the start of the problems with that approach. Another obvious one is ignoring all the confounding factors involved in such broad comparisons. One just can’t draw conclusions from such weak data and methodology even after including all the data.

  196. Who’s pretended it is ‘all’ the real data. The graph is demonstrating a consistent trend across a number of countries with and without fluoridation.

    So you’ve said it’s dishonest… doubly dishonest. Are you suggesting that real scientists wouldn’t use a graph like that?

  197. Are you saying that using such a graph without all the clutter/detail is pseudoscience?

  198. Ron, the trends on those plots are dishonest – plot the data yourself and you will see that.

    The important thing is to realise there is a huge amount of crappy stuff like this on the Internet. You are only using this cherry picked example because you think it fits your case. An intelligent observer looks below the surface to check the data and methodology.

    The important thing in this issue is dietary intake of F and there is no indication of that at all. But it’s not worth discussing because the graphs don’t represent all the data and the quality of the data and methodology are not suitable even if the data was plotted honestly. Think about he data for NZ for example – it’s average data, not differentiated according to F intake and yet on the graph labelled as fluoridated.

    Christ, these guys are just so dishonest.

  199. Look, Rin, that graph is just so crappy I would feel dirty discussing it further – and I am off to bed. But why don’t you get stuck into my post tomorrow where some good science will be illustrated.

  200. So the members of the European Commission’s Scientific Committee on Health and Environmental Risks (SCHER) are obviously dishonest… pseudoscientists, even anti-fluoridation… you should have a look Figure 2 in “Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water.”

    http://ec.europa.eu/health/scientific_committees/environmental_risks/docs/scher_o_139.pdf

    Ken your problem is that you are blinkered to any evidence that undermines your belief system. The facts are that, as the York Review found, the benefits of Fluoride are not as significant as believed, the quality of evidence of effectiveness is poor, there is an undeniable evidence base that tooth decay has declined over the past 40 years in a large number of countries regardless of whether fluoridation has been utilised or not, as well as in fluoridated and non-fluoridated regions within countries (such as New Zealand) that do fluoridate.

    You see, Ken, what you are expressing as fact is your opinion… others far more qualified than me obviously are of the view that your opinion is quite wrong…

  201. “So the members of the APS are obviously dishonest… pseudoscientists, even anti-global warming… you should have a look at their website and Monckton’s paper.
    Ken your problem is that you are blinkered to any evidence that undermines your belief system. The facts are that, as the IPCC found, the rates of warming are not as significant as believed, the quality of evidence of effectiveness is poor, there is an undeniable evidence base that ice coverage has increased over the past 40 years in a large number of glaciers (especially they Antarctic) regardless of whether the Earth really is warming or not.
    You see, Ken, what you are expressing as fact is your opinion… others far more qualified than me obviously are of the view that your opinion is quite wrong…”

    IPCC Admit Critical Errors in 2007 Climate Report

  202. Don’t be silly Ron. No one disputes that oral health has improved over recent years, irrespective of current residence in a region where the public water supply is fluoridated or not. That is ot an issue. There are a lot of dietary and social factors in this, apart from fluoridation of a particular water supply. That’s why the whole field is so complicated and research has to be considered intelligently and critically. I make this point in my post today where the possibility of detecting effects on bone fractures would be extremely difficult in the USA but is possible in rural Chinese communities.

    Unfortunately when research is not approached critically one can only fall back on to cherry picking to support a pre-conceived idea. Bad science.

  203. Tooth decay is caused by Global Warming.

    The evidence is overwhelming

  204. There you go again, Ken. Response through insults.

    You say, “No one disputes that oral health has improved over recent years, irrespective of current residence in a region where the public water supply is fluoridated or not. That is ot an issue. There are a lot of dietary and social factors in this, apart from fluoridation of a particular water supply. That’s why the whole field is so complicated and research has to be considered intelligently and critically.”

    You say, that is ot [sick] an issue. Of course it’s an issue. In fact, that is one of the central issues regarding the credibility of the science being put up to ram fluoride down every ones throat. You say there are a lot of social and dietary factors involved… absolutely… if these (and other) factors are involved then where is the intelligent critical review of policy to reduce decay ‘even further.’ It is patently clear that fluoride in water is not the main factor that has resulted in a dramatic decline in DMFT over the past 40 years. As I mentioned in an earlier post, one of those is that teeth are drill out and filled with amalgam ‘just in case’ as happened in the 70′s. Another is the use of fluoride and chlorhexidine varnishes. Another is realising that something that looks like it might be decay may not be decay. Another is the marketing of tooth care… etc, etc.

    But the ‘ram fluoride down everyones throats’ skeptics society have only one tool… and we know that if the only tool you have is a hammer, then every problem looks like a nail.

  205. You have a point there – but it is the wrong way around. In the US recommended levels of public water fluoridation are dependent on local climate. Where temperatures are higher the recommended levels are lower because more water is drunk.

    So haven’t the anti people been a bit slow? Shouldn’t they take up the issue of global warming as an argument to reduce F levels, or stopping fluoridation altogether?

    I thought they had thrown in everything possible – including the kitchen sink. But you seem to have hit on a new argument for them.

    As for researchers exploiting the availability of funding for climate change work – here’s another project:

    The effect of global warming on dental fluorosis!

  206. It’s not an issue for me, Ron. I am not interested in debating a non-issue – or bothering myself with your cherry picked crappy figures.

    Bloody hell, 2 point trends. That would certainly make research cheaper – we are getting to almost a theological level of science.

  207. Pingback: Is fluoride an essential dietary mineral? | Open Parachute

  208. LOL Ken… you should read this… I know it’s only a cherry picked review by the EC, (and god forbid that I would be seen thinking the the EC was the font of good) but they put the graph into context.
    Of course, as a blue blooded member of the Hamilton Branch of the Objective Skeptics Fraternity, one wouldn’t want to let the facts get in the way of a good belief system. Would one? :-)

    I’m looking more closely at the NZ trends as we speak… they are interesting. The last MOH doc I just read said that DMFT numbers were falling in unfluoridated areas but rising in fluoridated areas… At the mo I’m scratching my head trying to understand their arguments. I keep having to look at the Waikato DHB presentation to see these horendous photos of USA children being presented to Hamilton Councillors in the name of objective New Zealand and local experts.

  209. “Of course it’s an issue. In fact, that is one of the central issues regarding the credibility of the science being put up to ram global warming down every ones throat. You say there are a lot of atmospheric and meteorological factors involved… absolutely… if these (and other) factors are involved then where is the intelligent critical review of policy to increase warming ‘even further.’ It is patently clear that carbon dioxide in the atmosphere is not the main factor that has resulted in a dramatic decline in sea ice over the past 40 years. As I mentioned in an earlier post, one of those is the El Ninio Effect that happens every cycle. Another is sunspot activity. Another is realising that something that looks like the world is warming up but may not be warming up. Another is the Earth tilt… etc, etc.

    But the ‘AGW’ believers society have only one tool… and we know that if the only tool you have is a hammer, then every problem looks like a nail.”

    (sniff)
    So very beautiful.

  210. Cedric, this is a classic example of evidence of the Objective Skeptic Society being a belief based organisation. Claiming that anyone who has a different point of view on subject A automatically has a similar point of view on Subject B is more akin to followers of some kind of fundamentalist religious sect.

  211. Hmm, perhaps another example is in order…

    “Of course it’s an issue. In fact, that is one of the central issues regarding the credibility of the science being put up to ram Nanny Statism down every ones throat. You say there are a lot of carcinogenic and health factors involved… absolutely… if these (and other) factors are involved then where is the intelligent critical review of policy to increase the risk of cancer ‘even further.’ It is patently clear that smoking cigarettes is not the main factor that has resulted in a dramatic increase in lung cancer rates over the past 40 years. As I mentioned in an earlier post, one of those is the air pollution that happens every city. Another is dietry activity. Another is realising that something that looks like cigarettes causes cancer but may not be actually causing cancer. Another is industrial toxins… etc, etc.

    But the ‘Nanny State Smoke Nazi’ believer society have only one tool… and we know that if the only tool you have is a hammer, then every problem looks like a nail.”

    tobacco_papers

  212. Cedric, there is a world of difference between 0.4 fillings per mouth and the adverse effects of smoking… That’s the New Zealand (uncontrolled) stats regarding the difference between 12 year old children living in fluoridated versus unfluoridated areas. It’s worth noting that the MOH claims that for a decade or so tooth decay was getting worse in fluoridated areas and better in non-fluoridated areas.

    It wasn’t that long ago that medical scientists and doctors rabidly endorsed the health benefits of smoking… for a large fee of course… that was back in the day when doctors were saying the science was settled… LOL

  213. Cedric, if you weren’t aware of how medical doctors propped up the tobacco industry by reassuring the public about the health benefits of smoking certain brands (the ones that paid them truck-loads of money) then in the absence of access to the archives so you can see for yourself have a read of this.

    “Abstract

    In the 1930s and 1940s, smoking became the norm for both men and women in the United States, and a majority of physicians smoked. At the same time, there was rising public anxiety about the health risks of cigarette smoking. One strategic response of tobacco companies was to devise advertising referring directly to physicians. As ad campaigns featuring physicians developed through the early 1950s, tobacco executives used the doctor image to assure the consumer that their respective brands were safe.

    These advertisements also suggested that the individual physicians’ clinical judgment should continue to be the arbiter of the harms of cigarette smoking even as systematic health evidence accumulated. However, by 1954, industry strategists deemed physician images in advertisements no longer credible in the face of growing public concern about the health evidence implicating cigarettes.”

    Am J Public Health. 2006 February; 96(2): 222–232.
    “The Doctors’ Choice Is America’s Choice”
    The Physician in US Cigarette Advertisements, 1930–1953
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470496/pdf/0960222.pdf

  214. “Not one single case of throat irritation”: misuse of the image of the otolaryngologist in cigarette advertising.
    Samji HA, Jackler RK.
    Laryngoscope. 2008 Mar;118(3):415-27.
    Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.

    Abstract

    Early in the last century, when questions about the health effects of smoking became a topic of widespread discussion, tobacco companies undertook a multi-faceted campaign to allay the public’s fears. As terms like “smoker’s cough” and “coffin nails” (referring to cigarettes) began to appear in the popular vernacular, tobacco marketers recognized the need to counter this threat to their livelihood. One strategy was to use endorsements by healthy and vigorous-appearing singers, radio stars, and actors. Another was to raise fears over weight gain: “Reach for a Lucky instead of a sweet.” Among the more reprehensible tactics was the utilization of the image of the noble and caring physician to sell cigarettes: doctors were depicted both as satisfied and enthusiastic partakers of the smoking habit (e.g., “More doctors smoke Camels”). Images of medical men (and a few token women) appeared under warm reassurances of the safety of smoking. Frequently, images appeared of a head-mirrored “throat doctor,” smiling benignly, while indicating that the company’s product would do no harm. Indeed, many cigarette ads, especially for menthol brands, suggested a therapeutic soothing benefit from smoking. Liberal use was also made of pseudo-scientific medical reports and surveys. Our intention is to tell, principally through advertising images-the story of how, between the late 1920s and the early 1950s, tobacco companies used deceptive and often patently false claims in an effort to reassure the public of the safety of their products.

  215. Ron, your straw clutching at the tobacco industry is intriguing.

    It’s well docUmented how certain right wing think tanks launched attacks on the growing scientific evidence against smoking in that period. They used former scientists, and sometime current scientists, to pretend their attack was actually scientifically based. Of course these individuals often belonged to, and were paid by, these conservitave groups – and the industry.

    The same tactic is being used on the pseudoscientific attacks on climate science. Often the indivduals, and the conservative think tanks, are the same.

    Their tactic of using scientists in such attacks was part of their scheme of casting doubt on the science. A scheme well documented.

    Now, of course, the anti-dluoridationists are doing the same. They acknowledge that their public activity is aimed at “casting doubt on the science.” They will use individual scientists, dentists and doctors in the saame way the tobacco industry did and the fossil fuel industry does. They will use citations to the literature dishonestly, poison the well to attmept to discredit specialist evidence (consider their attack on the MOU and DHBs) etc.

    You might have noticed, Ron, several of my last few posts have exposed individual cases of such dishonest use of science, scientists and scientific citations.

  216. Ken, I didn’t bring the Tobacco issue into the discussion… just pointed out that scientists and doctors have always followed the money (not all of them.) That’s the case today as much as it was back in the dark ages.

    I’m not an anti-dluoridationist. Neither am I anti-fluoride.

    I’m analysing the MOH data. I only have data rounded to two significant figures at present, but using the MOH’s own data, approximately 45% of 12 year olds living in non-fluoridated areas and 55% in fluoridated areas have no DFMT.

    When one spreads the average of 1.4 and 1.2 (n-F vs F) over those who have DMFT then based on their argument the difference is only 0.24 decayed, missing or filled teeth per person.

    ie, one extra DMFT per four people. That is hardly a public health issue warranting mass medication.

    By the way, Ken, did you see this scandalous graph in the BMJ?

    http://www.ncbi.nlm.nih.gov/pmc/artticles/PMC2001050/bin/chek459826.f1.jpg

  217. Ken, would you classify these graphs as scandalous too?

    http://www.fluorideresearch.org/384/files/384324-325.pdf‎

  218. Ken, I’ve finally got the Waikato data from the MOH. OMG!

    What if I was to tell you that for 5 year olds there was less DMFT/decay in non-fluoridated areas than fluoridated areas? I don’t recall that science being put to the Hamilton Council, do you?

    What’s your take on that?

  219. Ron, I honestly question your claim that you’re not anti-fluoride, given that, overwhelmingly, everything you say here revolves around trying to discredit the arguments used to justify fluoridation of water.

    And you are clearly spending a LOT of time on this. Not necessarily conclusive, but I would kind of like to know what motivates you.

    As to your apparently having MOH data, I’m curious as to whether you’re using the raw data or whether you’re looking at studies which correct for factors other than fluoridation. You know, natural fluoride levels, socioeconomic status, degree of dental care, all those little things which are necessary in order to fend off allegations of cherry-picking data.

  220. What’s your take on that?

    Both links are a waste of time.

  221. Hi Richard

    What links are a waste of time and why? I haven’t posted any links to the Waikato data yet.

  222. The last two you posted.
    Link fail.

  223. Yes, Ron is Gish Galloping.

    Bugger bothering to check links or reliability of quotes.

  224. Richard, try this url to the BMJ article. The one above was a ‘copy url link’

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2001050/figure/fig1/

    The other one is correct as it reads above, but has extra baggage when you click it.

  225. Incidentally, both your links are broken, and I’m ever so slightly sceptical as to the reliability of information originating from any organisation calling itself the “international society for fluoride research.” That’s an exceedingly narrow focus for a reputable research institution.

  226. Pingback: Getting a grip on the science behind claims about fluoridation | Open Parachute

  227. Ken, I’ve never heard the term Gish Galloping before reading some of the sciblog articles… If it means going back through the data then yes, it is. That’s all I’m doing is trying to get my head around the data. Are you expecting me just to accept what you are saying without critical analysis?

    I’m reading the MOH’s own data… and it shows that for the Waikato in 2011 (the latest data), for 3,689 five year olds, 2,246 were DMFT free (60.88%) and there were 8,113 DMFT giving an average of 2.2 DMFT per mouth.

    When that is broken down into chidlren living in fluoridated/non-fluoridated areas that was 57.6% caries free / 2.29 DMFT per mouth for fluoridated areas and 64.12% caries free / 2.11 DMFT per mouth for non-fluoridated areas.

    For Maori, caries free are 32.34 and 51.72% respectively. Fluoridated vs unfluoridated.

    Chris B asks, “As to your apparently having MOH data, I’m curious as to whether you’re using the raw data or whether you’re looking at studies which correct for factors other than fluoridation. You know, natural fluoride levels, socioeconomic status, degree of dental care, all those little things which are necessary in order to fend off allegations of cherry-picking data.”

    Can someone point me to where these studies have been published and tell me if they were presented to the Hamilton City Council? I’d love to see them.

  228. Chris B said, “and I’m ever so slightly sceptical as to the reliability of information originating from any organisation calling itself the “international society for fluoride research.” That’s an exceedingly narrow focus for a reputable research institution.”

    Chris, I don’t approach my research by rejecting information based on the cover. We brought our three children up to look for the chocolates… that’s what I do. I saw the paper. It is essentially presenting similar data to three other graphs I’ve linked on here… all the data comes from the WHO. The BMJ article is a solid paper written by mainstream evidence-based medical experts. I’ve explained why the links were broken above… nothing sinister.

    I look at the evidence and reach conclusions from there. The facts are that the effects/benefits of fluoridating water have been grossly exaggerated. The science clearly demonstrates that the effects are a small fraction of a cavity per mouth. I haven’t seen any data regarding gross dental decay in New Zealand, or any data showing that fluoridation prevents such decay in New Zealand. I’m looking for it. But each stone I turn says much the same… the benefits are not as much as proclaimed.

    When I see a paper from an anti-fluoride website I critique it exactly the same as from a pro-fluoride website. I check, as much as I can, the primary data to verify its veracity.

    I am not anti-fluoride at all… I am pro evidence-based policy. As far as I can see there is policy being vigorously promoted without a very strong evidence base.

    It is quite clear that the science is not settled as far as some of the extreme claims being made are concerned…

    Chris, can you please post on here the studies which gave you the courage to refer to, “studies which correct for factors other than fluoridation. You know, natural fluoride levels, socioeconomic status, degree of dental care, all those little things which are necessary in order to fend off allegations of cherry-picking data.” ”

    I look forward to reading them for myself.

  229. Ken, I understand why you would cry out to God, despite claiming not to be a believer. When I saw the Waikato, that was my imediate response too…

    “the MOH’s own data… and it shows that for the Waikato in 2011 (the latest data), for 3,689 five year olds, 2,246 were DMFT free (60.88%) and there were 8,113 DMFT giving an average of 2.2 DMFT per mouth.

    When that is broken down into chidlren living in fluoridated/non-fluoridated areas that was 57.6% caries free / 2.29 DMFT per mouth for fluoridated areas and 64.12% caries free / 2.11 DMFT per mouth for non-fluoridated areas.

    For Maori, caries free are 32.34 and 51.72% respectively. Fluoridated vs unfluoridated.

  230. I have seen the journal Fluoride described as an anti-fluoride publication which does not have the same rigorous standards for peer review and integrity that are required of full-fledged scientific journals.

    It has links to individuals in NZ and seems to include some zany people on its editorial board.

  231. Providing a link to this data you seem intent on drip-feeding us would be a good start, Ron. Because without a good deal better context than you have seen fit to provide, I’m going to go ahead and assume that there’s nothing in there which would prompt the MOH to alter its stance on fluoridation.

    http://www.health.govt.nz/our-work/preventative-health-wellness/fluoridation

  232. Yes, I know that was your response too, Ron. It’s just that it made me think we were a group of 13 year old school girls at a slumber party. Hence my reaction.

  233. Ken, you should be careful. Big Brother will be monitoring your conversations for terrorist activity… I have no experience what-so-ever what a 13 year old school girls slumber party would be like so I will have to bow to your obvious superior understanding of such activities… :-)

  234. MOH data for 5 & 12 year olds for 2011. Note: It’s actually year 8 students so would be age 12/13.

    http://www.health.govt.nz/system/files/documents/pages/age5-year8-oral-health-data-2011.xls

  235. Yes, I have 3 granddaughters.

    However, here’s how I describe it. At that age young girls are very social and quite insincere.

    OMG is usually an indication of insincerely acting to be included in the social group.

  236. So where does the insincerity come into it… and for the record, I had two 13 year old daughters at one stage and neither of the were insincere. I suspect you’ve reached a conclusion based on personal anecdote. It happens. As for the fluoride discussion, that’s what I’m attempting to avoid. I’m trying to bypass all that crap from both extremes and focus on the actual evidence which is very difficult to extract…

  237. OMG, Ron, so what was all that crap with 2 data point trends? Doesn’t seem sincere to me.

  238. I’m going to go ahead and assume that there’s nothing in there which would prompt the MOH to alter its stance on fluoridation.

    http://www.health.govt.nz/our-work/preventative-health-wellness/fluoridation

    But Chris, those health professionals are all deliberately lying to us (or extremely incompetent, which, I gather, is Ron’s angle).

    Mendacity or incompetence, which is it Ron?

  239. Richard, before one can have an informed discussion one needs to have information.

    The days when people blindly accept the words of protagonists or antagonists are long gone. We encourage people to get educated so that they can make decisions for themselves. We encourage people to go to university so they can critically evaluate what’s put in front of them and make informed decisions.

    All I see coming back are insults and innuendo.

    What I’m saying is that the decision-makers should be given objective information… not emotive packaging fluffed up to make it look wonderful or dangerous as the case may be.

    The evidence doesn’t show “In this case, the science says that fluoridation is safe, the side effects are pretty much solely cosmetic and minor, and the health benefits to society are tremendous.”

    “the science says that fluoridation is relatively safe at levels applied to drinking water, the side effects are pretty much solely cosmetic and minor, and the health benefits to society are moderate at best based on poor science.”

    Based on available information including data from the Waikato, the benefits claimed by health officials and proponents are grossly exaggerated. The risks claimed by opponents are grossly exaggerated.

    Health official did not (as far as I can see) present information based on the Waikato. Scary photos used in their presentations appear to be sourced from the USA.

  240. The trends go back several decades. I still haven’t worked out if they were two point trends or trend lines. Whatever, they show the facts… significant parallel falls in tooth decay in both fluoridated and non0fluoridated areas.

    I’ve just seen some WHO data saying 95% of NZ children had their teeth sealed. I wonder what impact that had. Still looking for raw data re years used.

  241. I’m glad that an anonymous guy on the internet can clear this issue up for us.
    Get us all the right information and present it to us so cogently. All the stuff that those incompetent organizations entrusted to oversee our health systems have missed, probably deliberately, the arsewipes.

  242. Never heard of the word… I’m focusing on trying to sort the science from the rhetoric.

  243. I’m righteously outraged Ron.
    Heads should roll.

  244. Interestingly, Ron, it seems that you’ve only been presenting the figures for five-year-olds, whereas the data for year 8 Waikato children shows the opposite pattern. Also, you neglected to mention that mean DMFT for 5-year-old Maori children is still higher in non-fluoridated areas of the Waikato (3.53, as opposed to 3.33), despite quoting us the overall figures (this means more decayed, missing or filled teeth distributed among fewer people, ie some inequality at work here).

    Now, if that doesn’t constitute cherry-picking data to support a pre-conceived viewpoint, I don’t know what does.

    I don’t really have time to go through and run some statistical tests, and there isn’t any data on confounding factors available, but overall, the data looks pretty suggestive that water fluoridation is beneficial to dental health.

    Remind me, is this something that you genuinely dispute, or are you disputing the degree to which fluoridation is beneficial?

  245. Chris, nothing sinister… as I said, “I’m reading the MOH’s own data…” Work in progress… started with 5yo… hadn’t looked at 12yo data in detail.

    If you average them out there hardly any difference. As you say, with out all the confounders being taken into account, such as sealing of kids teeth, definitive conclusions can’t be drawn… my point is that the data do not support the claims of ‘tremendous’ health claims.

    The ongoing declines are the same for both fluoridated and non-fluoridated areas…

    Here’s data for 1990-1999

    http://www.health.govt.nz/system/files/documents/pages/age5-year8-oral-health-data-1990-99.xls

    I’ve done some sorting and graphs showing near universal parallel declines…

    It would be interesting to see 100 fluoridate kids and 100 non-fluoridated kids paired up and get some experts to classify them in F and NF… given ~55% in both groups would have no decay the results would be interesting. We are talking average differences of about 0.3 fillings/missing teeth per mouth… hardly clinically significant… hardly a public health issue worth having a war over by mandation mass medication.

  246. mandation??? not sure where that word came from; :-)

  247. Ron, I have said this before: Do not attempt to pervert statistics by insisting that experts will not be able to tell whether individual children are from fluoridated or non-fluoridated areas based on their teeth.

    Whilst true, this is utterly irrelevant from a statistical or public health perspective. I could say the very same thing about experts’ ability to tell whether kids were Maori or Pakeha based on their teeth alone, and there are some pretty glaring differences between the two populations.

  248. Interesting debate here, though I feel for Ken having to explain to people when they’re not actually providing constructive criticism.

    I’ve noticed a trend amongst those who are anti-fluoride. Once you reveal the shoddiness and out-right lies in their “science”, they switch to the “why should I have it forced on me” argument.

    That’s the same sort of selfish thing a hard right libertarian would say, in regards to paying taxes that goes to things they don’t agree with. It’s shocking that we live in a world where we care more for the privilege than the underprivileged.

    My nephew is one of those kids who need fluoride; both his parents suffer from severe mental illness and can’t afford much. They also don’t comprehend the importance of dental health, and so my poor nephew doesn’t brush his teeth, as they don’t either.

    I think everyone needs to spend some time with those in disadvantaged situations, so they can fully understand why we do things for the good of society.

  249. Also, you are, yet again, asserting without evidence that 0.3 caries per mouth are not clinically significant. And ignoring the fact that these caries are not evenly distributed throughout the population.

    Presumably the figure is statistically significant, otherwise you wouldn’t be quoting it. So, shall we assume that you do not dispute that fluoridation has benefits? And that the economic case remains sound, if perhaps not of such a high monetised value as it was in the past?

  250. Ken, I didn’t bring the Tobacco issue into the discussion… just pointed out that scientists and doctors have always followed the money (not all of them.) That’s the case today as much as it was back in the dark ages.

    If you don’t want tobacco brought into the discussion then…stop using their talking points. All I have to do is take your words and switch the labels around. I’ve done it twice not with no trouble at all. It works perfectly. If you don’t want to be labeled a science denier then you have to stop sounding like them.

    DOUBT – The climate Reality Project

  251. Chris said, “Also, you are, yet again, asserting without evidence that 0.3 caries per mouth are not clinically significant. And ignoring the fact that these caries are not evenly distributed throughout the population.”

    Chris, where is the data to show how many children we are talking about. If you are saying the MOH stats is rubbish and irrelevant, why aren’t they publishing the important stuff?

    I can only go on what’s available. I’m trying to find the data to support the ‘scary public health issue.’

    To date I haven’t found it… just bland statements. Where is the data? Can you provide links to it seeings you obviously know. I can’t find it in any of the Waikato DHB presentations… maybe it’s there. If so, where? I can’t find it.

    For the record, I have no doubt that fluoride reduces cavities. The question is one of how much. I have significant doubts about the benefits of fluoridation. As you point out, without the analysis of the confounding factors, the science doesn’t provide the answer.

    In my opinion, based on what I’ve seen so far, The benefits and risks are exaggerated.

  252. Ron, it is absolutely stupid to think one can have a rational discussion about complex data presented piecemeal by an ideologically motivated commenter in the comments section of this blog. I certainly won’t wast my time on it, considering the low credibility you have presented in the past.

    Tell you what, collect your data, do you statistical analysis, tweak out the influencing factors and then write it up. With your high professional standing it could go into a credible journal (although perhaps you would prefer Fluoride – I hear is easy to get through the peer review).

    Failing that why not post it as an article on your own blog. That way all the information and background would be present and we could all come along and make a critical assessment of you data and arguments.

    It would be a pity to waste all your brilliant work by putting it in about the 260th comment here. No one of any sense is going to wade through all this rubbish just to check you out.

    Alongside that you could prepare your ideas in a presentation to submit to hearings when then Wellington City Council is railroaded by the anti-fluoridation groups. Should be in the near future. And it should be a good bun fight.

    But don’t waste your time and data here.

  253. “For the record, I have no doubt that the planet is warming. The question is one of how much. I have significant doubts about the benefits of reducing carbon emissions. As you point out, without the analysis of the confounding factors, the science doesn’t provide the answer.
    In my opinion, based on what I’ve seen so far, The risks are exaggerated.”

    Yes, so much…doubt. Significant doubts. And…you have them.

    Smoke Screen: The Pursuit of Creating Doubt

  254. …To date I haven’t found it… just bland statements. Where is the data?…

    I think that is part of Chris’s point.

    Your lack of having all the relevant data hasn’t prevented you from announcing your definitive conclusions.

  255. Cedric, I find it quite revealing that you are incapable of engaging with the science. In case you hadn’t noticed, this is a discussion about Fluoride.

  256. The problem is, Ron, that the risks are not so much exaggerated as invented. At the concentrations we’re talking about, they have to date been indistinguishable from zero.

    By contrast, we are supposedly agreed that the benefits of fluoridation are non-zero.

    So the science seems pretty clear as to whether or not we should fluoridate our water.

    People will periodically come out with cost-benefit analyses, these two being examples:
    http://www.ncbi.nlm.nih.gov/pubmed/11357915
    http://www.ncbi.nlm.nih.gov/pubmed/20415910

    Oh, and I’ll thank you not to try and put words in my mouth about the quality of the MOH data.

  257. Richard, where have I announce definitive conclusions? I’m finding it quite revealing that so-called objective skeptics bag people for challenging scientific opinion but are incapable of presenting the evidence when challenged.

    Chris & Ken, I take it you don’t have the information you say is required to reach conclusions. I might just have to put an OIA request in and see what falls out of the tree.

  258. Ron, the professionals, expert in this area, have the information that is available or can be obtained. They have the skills to analyse that information and come to conclusions about the cost effectiveness and humanity of possible public health approaches.

    Most people are happy to let them do the job they are paid for. After all their work is going to be of much higher quality than that of an unpaid person off the street without the skills, but a big and arrogant obsession.

    Of course I don’t have the information or experience required to reach conclusions – I am happy that our tax dollars enable us to employ people to do the job.

    Put in your OIA requests, select your 2 data points and plot your trends. But the fact that you restrict yourself to giving us a running commentary illustrates an obsession, rather than ability to produce meaningful conclusions.

    And you have the arrogance to imply there is a conspiracy preventing the experts we pay from coming to reasonable and evidence based conclusions.

    Isn’t that a bit arrogant?

  259. Richard, where have I announce definitive conclusions? I’m finding it quite revealing that so-called objective skeptics bag people for challenging scientific opinion but are incapable of presenting the evidence when challenged.

    You are shifting the burden of proof.
    “Challenges” are neither here nor there. If you make a claim about flouride (or any other scientific topic) then you have to provide evidence.
    It’s not up to some other person to spoon feed you just because you are issuing “challenges”. That’s a mug’s game.

    “I find it quite revealing that you are incapable of engaging with the science. In case you hadn’t noticed, this is a discussion about any science denier topic randomly chosen. The talking points remain the same. Only the labels change.
    Richard, where have I announce definitive conclusions about “global warming/tobacco/ moonlandings”? I’m finding it quite revealing that so-called objective skeptics bag “moon landing deniers/ tobacco deniers/climate deniers” for challenging scientific opinion on “evolution/ vaccines/bigfoot” but are incapable of presenting the evidence when challenged.
    I take it you don’t have the information you say is required to reach conclusions.

    The burden of proof

  260. Chris, re: “By contrast, we are supposedly agreed that the benefits of fluoridation are non-zero.

    So the science seems pretty clear as to whether or not we should fluoridate our water. ”

    There is a difference between fluoride and fluoridation. The evidence is clear that there are benefits derived from topical fluoride, and regular fluoride varnish (and chlorhexidine varnish). The evidence is poor and equivocal regarding meaningful benefits of fluoridation.

    I suspect the benefits of fluoridation are non-zero, but not clinically significant. I think we agree that in the absence of confounding analysis the science is not settled.

    Gluckman quite correctly pointed out last week that science does not and should not determine values based decisions such as whether to mass fluoridate or not.

  261. Chris, the first CBA paper you link to is a shorter version of the original 1999 ESR paper which was based on 1996 data comparing wellington children with Chirstchurch children and using USA data for adults. No inputs were included regarding the costs of people avoiding the use of fluoride whether by use of filters of bottled water.

    Based on DMFT the rate of decay has fallen 44% in Christchurch’s non-fluoridated areas since 1996 (1.7 to 0.99). Wellington’s fluoridated areas have declined 36% (1.08 to 0.7.)

    I suspect a CBA nearly 17 years old using out of date, uncontrolled groups and overseas data and missing a significant portion of the costs is legitimately questioned.

  262. Ken, if, the professionals, expert in this area, have the information that is available or can be obtained, where is it? I thought science (good science that is) was meant to go through a peer review process…

    They may have the skills to analyse that information and come to conclusions about the cost effectiveness but as Gluckman said, they are not qualified any more than anyone else regarding values decisions re humanity of possible public health approaches.

  263. I guess they left you out of the peer review, Ron, not seeing you as a peer and all that.

  264. Ron, your dismissal of the benefits of fluoridation as being “grossly” overstated etc/ad nauseum, are definitive conclusions.
    You have definitively concluded that the message of health professionals as delivered to the public is flawed.
    Logically, such misinformation from authorities in the face of information from the anti-fluoridation lobby is a result of incompetence or mendacity on the part of authorities, you seem reluctant to say which.

  265. Cedric… LOL… I take it you can’t provide the evidence either… where’s the evidence of the dramatic benefits of fluoridating water… ?????? Come on, front up… where is it? I doubt 0.3 DMFT in a 12 year old warrants intervention that forces mandatory anything on anyone.

    Where’s the evidence. If you were a real skeptic you’d be able to front up…

  266. Cedric, I think I’m in good company…

    Given the certainty with which water fluoridation has been promoted and opposed, and the large number (around 3200) of research papers identified,
    the reviewers were surprised by the poor quality of the evidence and the uncertainty surrounding the beneficial and adverse effects of fluoridation.

    Studies that met the minimal quality threshold indicated that water fluoridation reduced the prevalence of caries but that the size of the effect was uncertain. Estimates of the increase in the proportion of children without caries in fluoridated areas versus non-fluoridated areas varied (median 15%, interquartile range 5% to 22%). These estimates could be biased, however, because potential confounders were poorly adjusted for.

    Water fluoridation aims to reduce social inequalities in dental health, but few relevant studies exist. The quality of research was even lower than that assessing overall effects of fluoridation. The results were inconsistent—fluoridation seemed to reduce social inequalities in children aged 5 and 12 when measured by the number of decayed, missing, or filled teeth, but not when the proportion of 5 year olds with no caries was used.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2001050/

  267. Just reading that paper myself, Ron. It’s one that I put in the low quality range – making quite a few unsubstantiated statements.

    Ah, the joy of cherry-picking.

  268. Ken, LOL… that’s interesting given a key author is the God-Father of modern evidence-based medicine.

    What’s your take on the York report then?

  269. Cedric… LOL… I take it you can’t provide the evidence either…

    Burden of proof.

    …where’s the evidence of the dramatic benefits of fluoridating water… ?????? Come on, front up… where is it?

    Burden of proof. It does not shift.
    (shrug)
    Where’s the evidence of the dramatic benefits of vaccines?
    Where’s the evidence of the dramatic benefits of evolution?
    Where’s the evidence of the dramatic benefits of quitting smoking?

    Where’s the evidence. If you were a real skeptic you’d be able to front up…

    I’m not the one making a claim.
    You don’t get any special privileges. There’s no reason for anyone to just blindly trust you. If you want to stand in opposition to the mainstream science on any issue then…you have to have something solid. A tonne of solid stuff. A mountain of it, really. There has to be a reason to take your word on something rather than say…the NIH or the CDC or the Surgeon General.

    It’s the same with climate deniers.
    It’s them versus NASA and every single scientific community on the planet.

    As noted in Oral Health in America: A Report of the Surgeon General, community water fluoridation continues to be the most cost-effective, equitable and safe means to provide protection from tooth decay in a community. Scientific studies have found that people living in communities with fluoridated water have fewer cavities than those living where the water is not fluoridated. For more than 50 years, small amounts of fluoride have been added to drinking water supplies in the United States where naturally-occurring fluoride levels are too low to protect teeth from decay. Over 8,000 communities are currently adjusting the fluoride in their community’s water to a level that can protect the oral health of their citizens.

    Over 170 million people, or 67 percent of the United States population served by public water supplies, drink water with optimal fluoride levels for preventing decay. Of the 50 largest cities in the country, 43 are fluoridated. Although water fluoridation reaches some residents in every state, unfortunately, only 24 states are providing these benefits to 75 percent or more of their residents.

    A significant advantage of water fluoridation is that all residents of a community can enjoy its protective benefit—at home, work, school, or play—simply by drinking fluoridated water or beverages and foods prepared with it. A person’s income level or ability to receive routine dental care is not a barrier to receiving fluoridation’s health benefits. Water fluoridation is a powerful strategy in our efforts to eliminate differences in health among people and is consistent with my emphasis on the importance of prevention.

    The U.S. Centers for Disease Control and Prevention has recognized the fluoridation of drinking water as one of ten great public health achievements of the twentieth century. Water fluoridation has helped improve the quality of life in the United States by reducing pain and suffering related to tooth decay, time lost from school and work, and money spent to restore, remove, or replace decayed teeth. An economic analysis has determined that in most communities, every $1 invested in fluoridation saves $38 or more in treatment costs. Fluoridation is the single most effective public health measure to prevent tooth decay and improve oral health over a lifetime, for both children and adults.

    Now you can ignore the consenus on fluoridation of drinking water.
    You can.
    You can go to blogs and cherry-pick studies and even quote individual scientists and not-so-scientists and various “think tanks”.
    But the climate deniers can do that too.
    So can the anti-vaxxers.
    And the creationists.
    And the moon landing deniers.

    Everything you are saying works perfectly well for these other groups. Only the labels have changed. Your taunts, your cherry picking and the enshrining of your own doubts as if they were somehow important.

    I doubt 0.3 DMFT in a ….

    Doubt. That word again. Hmm.

  270. Cedric, none of that is primary evidence. It is a mix of truth and hype.

    The simple fact is that 0.3 DMFT is not a public health issue of any major degree.

    Your argument is no different to people proclaiming the inflated benefits of homeopathy, or multi-vitamins, or amber necklaces.

    Over 170 million people, or 67 percent of the United States population served by public water supplies, drink water with optimal fluoride levels for preventing decay. Of the 50 largest cities in the country, 43 are fluoridated… so what? This says nothing about the benefits… over 70 percent of New Zealand adults use dietary supplements and alternative medicines… so what? X% percent believe in God… Y% don’t believe in God,… so what?

    I’m intrigued that a so-called objective skeptic would accept the word of someone without critically evaluating it. What you have presented is not evidence of effectiveness… it is some fact packaged as evidence.

  271. Ron, is the Surgeon General lying about fluoridation of water supplies or is the Surgeon General just incompetent in assessing its benefits?

  272. Cedric, none of that is primary evidence.

    Well, the same could be said about the NASA website or the site of any scientific community focused on communication to the general public.

    It is a mix of truth and hype.

    Says who? You.
    In the scientific credibility contest, it’s you versus the scientific community.
    The scientific community wins.
    That goes for the risks of smoking tobacco, evolution, the safety of vaccines etc.

    Your argument is no different to people proclaiming the inflated benefits of homeopathy, or multi-vitamins, or amber necklaces.

    Ok, demonstrate it.
    Can you think of a Surgeon General’s report that has anything positive to say about homeopathy, or multi-vitamins or necklaces?
    How about the CDC? Or the NIH?

    My methodology is rock solid. It’s mainstream. I’m getting my science information from the various scientific communities. I’m happy to get it from all of them and contrast and compare.
    On the other hand, I never get my scientific information from anonymous people on the internet with possibly cherry-picked studies.
    I’m smarter than that.

    This says nothing about the benefits…

    The Surgeon General seems to think that there are benefits.
    So do all the medical communities on the planet.
    Should I just believe you…or them?

    I’m intrigued that a so-called objective skeptic would accept the word of someone without critically evaluating it.

    You are building a strawman and ignoring the reality of what is happening.
    I’m not accepting the word of someone.
    For example, I’m not accepting…your word.
    You are just some guy on the internet with mystery doubts.
    Hugely unimpressive.

    However, on health issues? I go directly to the various health communities such as…the CDC or the NIH etc. and find out what they have to say.
    It turns out that they have quite a lot to say on the issue of fluoride and it’s all very positive.
    It’s like the issue of climate change.
    I go straight to the NASA website….or the Royal Society…or the AAAS or the USGS or the CSIRO.
    Anonymous people on the internet? Not so much.

    Science Works! How the Scientific Peer Review Process works

  273. Ron, is the Surgeon General lying about fluoridation of water supplies or is the Surgeon General just incompetent in assessing its benefits?

    Sooner or later, it boils down to global scientific conspiracy theories.
    Let the wriggling commence.

  274. Yes, Ron, I am aware that the first paper is old. This would be one reason why I included the more recent one, which I note you did not bother with. Shall we assume that none of your “this is old” objections apply to that one? Shall we further assume that you are unable to produce any papers which suggest fluoridation is not cost-effective?

    I am beginning to get a sense of banging my head against a brick wall in regards to your continued insistence that you are the arbiter of what is clinically significant. Surely the individual cavities are clinically significant, since people are expected to get them treated. Surely, further, they are statistically significant, meaning they are an identifiable consequence of lack of fluoridation, otherwise you would be arguing that they did not exist, rather than trying to convince us that your precious figure of 0.3 caries per mouth is not worth bothering about.

    So, what you are actually arguing is that the social good involved in preventing them is not significant. Which brings us back to those cost-effectiveness studies you seem to so dislike. Barring some earth-shattering revelation, I’m going to go ahead and assume we haven’t hit the break-even point yet (50 cents per person, remember), let alone crossed into negatives.

    Oh, and as a sceptic, my default position is to go with the scientific consensus over some random person on the internet who has read all the denialist propaganda and assures me that he can pick out the bits which are valid. It’s an attitude that stands me in good stead for such diverse topics as the various flavors of creationism, climate change, and anti-vaccination.

    The scientists may be wrong on a given issue, but they’ll get there in the end, and they’ll be able to provide solid evidence of what they got wrong, why and what new theory best describes our observations of reality.

    At best, your argument amounts to “this worked in the past, but maybe it doesn’t any more, so we should do away with it until we know for sure, even though it causes no harm and some people might lose out if we’re wrong.”

    I suppose there might be a valid argument about individual rights, but we never seem to get there. Rather you continue to bang on about how the scientific community has exaggerated stuff, but you’re on to them.

  275. Chris, the second abstract refers back to the 90′ and beyond… can’t find the whole paper so can’t make comment. Again, I see no evidence in the abstract relating to the high cost of bottled water/filtered water for those wanting to avoid its use. Nor the cost to disadvantaged having to buy appropriate water for babies/infants formula given quantified over-dosing beyond upper safe limits.

    So we are talking about 4 issues… the science regarding effectiveness (about 0.3 DMFT per mouth at 12 years) and its clinical significance (need to consider confounding factors which don’t appear to have been published (point me to literature if they have), safety (babies/infants fed formula would be most significant from my reading), CBA (haven’t seen any that includes cost of avoidance) and values relating to rights/wrongs/ethics/freedom of choice etc.

    One thing that crosses my mind… I haven’t gone looking for the science yet so it might be there. If babies/infants who are formula fed with fluoride enriched formula and fluoridated water are getting high levels of intake (which they are) and given socially disadvantaged have the lowest breast feeding rates (ie, highest formula feeding rates) then by definition these kids must have excellent teeth. But I keep hearing from well meaning objective skeptics that these kids from poor areas have rotten teeth… I wonder why given that fluoride is supposed to prevent such decay….

  276. OMG, Ron. Of course that crossed your mind. You are well know for empathising with the situation of socially and economically disadvantaged people.

  277. Chris said, “Oh, and as a sceptic, my default position is to go with the scientific consensus over some random person on the internet who has read all the denialist propaganda and assures me that he can pick out the bits which are valid.”

    For I start, I have not read ‘all the denialist propaganda.’ Not even a small portion of it. I have mostly been searching Pubmed, and googling for science and official reports… trying to track down the original data… ie, applying first principles… trying to go back to source.

    Chris, as a scientist (and I’m assuming you at least work in the sciences… maybe even health sciences as you have actually been the most objective responder to my posts to date) then I’m surprised your default position is ‘consensus.’ ‘Consensus’ is the antitheses of discovery and innovation… it is a sexed up name for ‘status quo.’ If everyone based their opinion on “Consensus” nothing would change.

    I find that a paradox… even an oxymoron… scientific consensus.

    You say, “It’s an attitude that stands me in good stead for such diverse topics as the various flavors of creationism, climate change, and anti-vaccination.”

    Without getting into any of these totally unrelated topics (again, bundling them all up and claiming they are the same is grossly unscientific) I wonder what the consensus would be about creationism if one lived in a Bhuddist country, or an animistic country or Italy or Mexico. I guess the consensus would be flavoured by the dominant culture.

    As I said, scientific consensus is about maintaining the status quo… it is about turf protection.

    Now, given Gluckman’s correct statement about the fact that fluoridation isn’t dictated by the science, but informed by it, and that the decision should be made by ordinary citizens, not scientists, I would suggest the following might go some way toward a consensus.

    1. Use NaF rather than HFA… removes the ‘waste product’ argument.
    2. Given the plethora of fluoride in other food sources and toothpaste, reduce the levels to the lower end of the range (reduces significantly usafe argument).
    3. Give 1 litre per day of free non-fluoridated water to mothers of all infants (to 12 months.)
    4. Provide free NF water or means to de-fluoridate drinking water to those who apply.

    Then do a cost benefit analysis and see what the real CBA is.

    Then ask yourself, If the CBA of X is positive should it be made mandatory?

    eg: Let’s start with Contraception. Why don’t we put contraception in our water supply, especially in poor areas as this would remedy a social inequality.

    I can see the scientific consensus agreeing that this would be scientifically sound, so what’s the problem?

    I can see the economists consensus that the CBA is positive,… so what’s the problem?

    Scientific consensus once held that the earth was flat… scientific consensus once held that the sun rotated around the earth. That was so enshrined in society’s thinking that we still talk about ‘the sun rising.’ It doesn’t… the earth rotates.

    Scientific consensus once believed that letting blood was best medical practice.

    Scientific consensus is not a scientific argument, and it is not part of the scientific method. It’s what people do when they don’t want to think outside the square. In fact, many scientists go along with the consensus because to do otherwise would ostracize them… cut short their career path. Many scientists (and others) funding is predicated on a particular belief… fluoride is one such example. Imagine if the Plunket society expressed concern about babies getting too much fluoride… and yet aren’t they supposed to be protecting the wellbeing of preschoolers? Oh, I see… they have a dilemma… but their voice gets lost in the ‘consensus.’

    How sad. If all members of a committee think the same, then the committee is redundant. Get two lawyers in a room and there will be three opinions… On most issues, where there are two scientists in a room there will be two opinions… on some issues, such as fluoride, it seems that if there are two scientists in the room their will be either a ‘scientific consensus’ or a crucifixion.

    I guess your introduction of religion into the fluoride debate has relevance.

    A skeptic basing their opinion on consensus? How bizarre.

  278. Ken said, “OMG, Ron. Of course that crossed your mind. You are well know for empathising with the situation of socially and economically disadvantaged people.”

    Ken you don’t know me at all… you are speaking from a position of ignorance.

    Why not address the issue…

    If babies/infants who are formula fed with fluoride enriched formula and fluoridated water are getting high levels of intake (which they are) and given socially disadvantaged have the lowest breast feeding rates (ie, highest formula feeding rates) then by definition these kids must have excellent teeth. But I keep hearing from well meaning objective skeptics that these kids from poor areas have rotten teeth… I wonder why given that fluoride is supposed to prevent such decay….

  279. Ron, is the Surgeon General lying about fluoridation of water supplies or is the Surgeon General just incompetent in assessing its benefits?

    Fair question.

  280. Ron, the second paper is freely available. Following the links is straightforward.

    I see that, once again, you are griping about the age of the paper. Here’s something which may come as a shock to you: scientific papers are not invalidated just because they are old. Maybe the facts have changed in the interim, but you’re not going to demonstrate that by griping about how old a given paper is. What you need is for somebody to go out and do the research, or to do some solid research yourself and publish the results. But, at every turn, you reach for that figure of 0.3 and declare victory.

    The best argument you have presented to date is of reduced benefits, which, as I have stated, is only going to be convincing if the costs cease to stack up or somebody demonstrates harm.

    While I doubt it’s possible for anybody to read all the denialist literature, you do rather undermine your case by promptly trotting out arguments which really seem to be pandering to that camp.
    1) Considering the waste product argument is a load of nonsense in the first place, why should we think that changing the method of fluoridation will cause it to magically disappear?
    2) Plethora? Really? I count water and toothpaste. Otherwise I assume we’re mostly talking about food products processed in fluoridated areas. Perhaps you might care to demonstrate that the total amount of fluoride in peoples’ diets exceeds recommended guidelines?
    3) What the hell kind of public health message are we sending if we supply new mothers with unfluoridated water? Is the maximum dosage different for infants? Do we have evidence that they’re getting more fluoride in their diets than the rest of us? What is your rationale beyond pandering to peoples’ attempts to prey upon parents’ fears?
    4) You know, this one is actually a somewhat valid point. Still, I’m inclined to think that people are perfectly capable of paying for non-fluoridated water of their own accord, and I seem to recall that there is free spring water available in Wellington, yet this is still not good enough. After all, collecting it is inconvenient.

    You do rather undermine your case, however, by comparing fluoridation to compulsory mass-medication. Now, considering that it is very possible to opt-out, albeit at an expense, the word “compulsory” clearly does not apply. So, I’ll chalk that up as another piece of evidence that you’ve read too much denialist propaganda, shall I? Attempting to compare fluoridation to mass birth control? Yes, I’m sure that seeking positive outcomes in dental health is morally equivalent to restricting peoples’ reproduction. That’s not a straw man argument at all.

    Now, people routinely conduct cost-benefit analyses. If the scientific papers on the topic are not good enough for you, their age ought to be easy to correct for. Read the papers, figure out what the assumptions were, and recalculate based on your own figures for modern differences between fluoridated and non-fluoridated areas. Don’t forget to adjust costs for inflation.

    One annoyance of discussing this with you is that you periodically try to shift the playing field. If something is morally wrong, that remains true, regardless of whether a cost-benefit analysis stacks up. I don’t think anybody has yet argued that the problem is so severe that expediency trumps morality.

    We were, I believe, arguing over whether fluoridation is cost-effective. Not over whether it is moral. Whilst I am happy to have that conversation, it is a different long, drawn-out argument, and I am unimpressed by your attempts to conflate the two questions.

    On scepticism, I will note that I said that my default position was to go with the scientific consensus. That is my starting point, not my end point. If the evidence looks shoddy or non-existent, I’ll go looking for other viewpoints and see how they stack up (neoclassical economics is a good example here). But I’m not simply going to accept somebody’s word for it that the evidence is shoddy.

    If somebody does come out with evidence against a particular paradigm, I am quite willing to be swayed, but that evidence will be treated with all due scepticism. People may fall at the first hurdle if I spot some particular bias which hurts their objectivity. That doesn’t necessarily mean the case is closed, but I will go elsewhere in search of information. Which is a bit of a problem where you’re concerned, because I’m not convinced of your objectivity, and those other sources of information seem to disagree with you.

    As you have deduced, I do have a science degree, which means that, given time and resources, I daresay I could conduct some research of my own on the topic. I also have a fairly good idea of how I’d go about it. Thus far, I see little confluence between my approach and yours.

    Right. I think I’ll pack it in for a while.

  281. For I start, I have not read ‘all the denialist propaganda.’

    To be a denialist (for any topic) you don’t have to read all of it.

    I have mostly been searching Pubmed, and googling for science and official reports… trying to track down the original data… ie, applying first principles… trying to go back to source.

    Thereby cherry-picking. You are letting your own confirmation bias run riot.
    Why should we just blindly trust you to look at the “right” science and the “right” original data or your personal interpretation of it? That would be very gullible of us and…it’s not going to happen.

    ‘Consensus’ is the antitheses of discovery and innovation… it is a sexed up name for ‘status quo.’ If everyone based their opinion on “Consensus” nothing would change.

    Scientists work very hard to get their ideas accepted as a consensus. That’s why they argue all the time and publish. Nobel Prizes are not awarded to people who just go along with the status quo.

    Without getting into any of these totally unrelated topics (again, bundling them all up and claiming they are the same is grossly unscientific) I wonder what the consensus would be about creationism if one lived in a Bhuddist country, or an animistic country or Italy or Mexico. I guess the consensus would be flavoured by the dominant culture.

    Bait and switch. Nobody here is talking about “consensus” as in what do people in Mexico think. Duh!
    We’re talking about the scientific consensus. As in the working scientists from all the relevent communities on the planet. It’s not the same thing at all.
    People in Mexico might think that smoking is ok but…the Surgeon General is still putting warnings on cigarette packets.

    It has often been written on this blog and elsewhere that the mark of a true crank is hatred of the scientific consensus, be it consensus regarding the theory of evolution, the science that says homeopathy is impossible, anthropogenic global warming; various areas of science-based medicine; or the safety and efficacy of vaccines. Perhaps the most famous expression of distrust of a scientific consensus is the famous speech by Michael Crichton, in which he famously said:

    “Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus.
    There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.”

    To which I (and many others) responded, “Bullshit! Period.”

    In fact science is all about coming to a consensus, but it’s about coming to a consensus based on data, experimentation, and evidence, a consensus that has reproducible results that are, as Crichton put it, verifiable by reference to the real world. After all, what is a scientific theory like the theory of evolution or Einstein’s theory of relativity but a statement of…
    (Link)

    Ron, is the Surgeon General lying about fluoridation of water supplies or is the Surgeon General just incompetent in assessing its benefits?
    Fair question.

    Very fair question. Indulge in your inner conspiracy theorising. Set it free.

  282. I am thinking of closing off this thread. None of the current discussion is new – nor does it relate to the topic of the post.

    Shifting it to a more relevant post might freshen it up – and make it more accessible to readers.

  283. nor does it relate to the topic of the post.

    Hmm, I think the comment thread is narrowing in on the crux of the matter: the conspiracy belief that is necessary to justify dismissal of the mainstream consensus position when one refuses to enter the publishing arena.

  284. Several have asked, is the Surgeon General lying about fluoridation of water supplies or is the Surgeon General just incompetent in assessing its benefits?

    The Surgeon Generals (4 of them) were making unsubstantiated statements… The evidence doesn’t support such a dramatic claim… decay has declined in parallel in both fluoridated and non fluoridated areas, a point conveniently ignored by consensusism.

  285. I’ve been fascinated that so-called objective skeptics are unwilling to engage the evidence… just the person… I’m intrigued that so-called objective skeptics simply believe based on faith and are unable to provide the missing evidence when requested.

    It is very telling… Objective skeptics are believers… their faith is based on consensus, not science.

    LOL… it’s been very entertaining.

  286. Ron, you are completely wrong there. Health authorities don’t hide the improvement of oral health independently of F. Why the hell should they?

    But you are aware, surely,that your use of the word parallel shows the common situation that when improvements over time are plotted together the plots for fluoridated and non-fluoridated groups are roughly parallel (limiting data to 2 points helps of course) but the fluoridated group generally have better oral health. That was certainly shown by the NZ data you tried to cherry pick from.

    OK, Ron. The thread is really useless now so I am closing it.

    Discussion can easily be transferred to one of the other suitable posts.

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