Fluoride debate: Why I support fluoridation

So far, our exchange has only covered some arguments against fluoridation and responses to those arguments. Some readers feel we should have started with me advancing the arguments for fluoridation. For example one commenter, Alison, said

“readers haven’t had the opportunity to see the basic arguments favoring fluoridation as you see them. . . . we are genuinely perplexed about why this practice has continued and honestly and sincerely trying to further or understanding.”

Paul Connett made a similar remark in his last article:

“promoters of fluoridation should not be surprised that some people are trying to come up with a rational explanation for why certain governments are behaving  so irrationally promoting this practice.”

I can’t understand why anyone should be perplexed or think fluoridation is irrational. But I am happy to give my reasons for supporting fluoridation – but remember it is a personal perspective as I can’t speak for everyone who supports it. My perspective derives from several issues that are important to me – the science, defence of science against anti-science elements, social concerns and the provisional nature of knowledge.

Scientific acceptance of fluoridation

We have many advantages in New Zealand, despite our social, economic and political problems. The climate, our scenery, our people (who are generally open-minded, liberal and accepting), agriculture and food. But our agriculture and food, and the rest that depends on these, has only really been possible because of the application of science to solve problems with the land we inherited.

NZ-dairy

New Zealand agriculture dependent on science and correction of deficient micro-elements. Phot credit: Farm Forestry NZ

New Zealanders accept the need to correct nutrient and micro-element deficiencies because we realise their importance to our place in the world. The correction of cobalt deficiencies in our central volcanic region of the North Island/Te Ika-a-Māui had huge economic returns. We also took steps to correct other important deficiencies like molybdenum, copper and selenium. Discovery of the role of fluoride in oral health, and that we had a deficiency which needed correction, was hardly a surprise to us. Nor did most of us find the solution unusual.

In the mid 1960s I worked at Soil Bureau, DSIR, outside Wellington, and remember some of the early discussions around fluoridation – there was some debate then about the possible role of the micro-element molybdenum, rather that fluoride, in limiting tooth decay. Later my research developed further into the nature of phosphate and it’s reactions in soil and the fluoride story really made sense. I became aware that the primary minerals of phosphate in soils were apatites which had fluoride as a natural constituent. This small amount of fluoride imparted important properties to the apatites – lowering their solubility and increasing their hardness which helped prevent weathering losses.

So it is understandable I could see how fluoride improved oral health (bones and teeth are bioapatites). In my research reading I also found many dental research papers were very useful. Looking back I can, for example, remember the discovery like of the role of fluoride in inhibiting dissolution of apatites by a surface reaction in partly acidulated rock phosphate fertilisers. This  parallels similar discoveries about the role of surface reactions of fluoride in saliva inhibiting tooth mineralisation and reducing tooth decay.

So the efficacy of fluoridation as a social health measure was a no-brainer as far as I was concerned. But about 10 years ago I had a sort of road to Damascus moment about the political issues when working on a research project involving fluorosilicic acid. My analysis of this material (the same used in New Zealand for water fluoridation) revealed the concentrations of contaminants like arsenic were very low – contrasting sharply with the claims of activists campaigning against fluoridation (whose story I had sort of accepted till then). That left me with a healthy respect for evidence, and a corresponding suspicion of ideologically motivated activists, in these sort of public debates involving scientific issues.

Defence of science

I guess most scientific researchers have, at some stage, to meet the activity of anti-science sympathisers and activists. Evolutionary  biologists have a permanent battle defending their science against creationists. There has been huge political pressure imposed on climate scientists. Surprisingly, even scientific researchers in agriculture periodically face this problem. Quacks selling snake oil seem to be able to find a market with farmers selling alternative fertilisers, etc., just as they can on health issues. Ideology also intrudes, with debates over organic farming and use of chemicals in agriculture.

Often these conflicts are not simply black and white. The last two examples are complex. There is a role for organic farming and there is certainly need to lower chemical inputs into agriculture. These issues get sensibly debated and have there own scientific support. But agricultural scientists have often had to face the problem of more highly motivated and ideologically driven detractors with more extreme views.

These anti-science people and groups can often be very effective politically and will skilfully use the mass media and the new social media – blogs, Twitter and Facebook. Very few scientists have experience with, or a liking for, this form of public relations and easily lose such media debates. Scientists don’t willingly get their hands dirty in such public relations battles. It is interesting to speculate why – but that is a subject for another time. One barrier I was aware of during my career was the limits and control placed on individual researchers by their institution. Institutional politics often over-ride the freedom of researchers to defend their work and take part in social debates about it. institutions encourage scientists to keep their heads down when attacked and not retaliate. The institutional fear of such social engagement possibly results form fears of legal action.

I am now retired and this has at least one advantage – freedom from institutional constraints. Mind you, if a retired scientist is involved with paid consulting, advocacy or lobbying, then they have another form of constraint  which is probably more direct and rigid than that imposed by a research institute. Because consulting, advocacy and lobbying usually need prior committment to an idea, product or policy  - payment is made for endorsement or justification and not research.

In my case I have not had to rely on such extra income so have had the freedom to explore my interests, and express my opinion without censorship or control. I have enjoyed the freedom to read and  research ideas and to follow my nose in a way intensive paid research does not allow because it is so focused.

Inevitably I have been attracted to some of the more controversial areas – controversial politically, not necessarily  scientifically. Such as the religion-science conflict, evolution, climate change and, more recently, fluoridation. I have participated in on-line debates on these issues, and about 7 years ago started this blog. None of this would have been possible while I was employed, or if I had got into paid consulting or advocacy during my retirement.

Despite my interest in the chemistry around the fluoridation issue I did not get involved in any public discussion until earlier this year. My city, Hamilton, held a referendum in 2006 which overwhelmingly supported fluoridation. I was aware  the issue was coming up again and assumed we would have another referendum this year. That was OK by me – but, like many Hamiltonians, I was shocked to hear in June that the local council had decided to stop fluoridation without a referendum. Yes, they held hearings beforehand and had last year reversed their decision to send the issue to referendum again – but most citizens were just not aware of this going on. Many of us felt it was done behind our backs.

In New Zealand decisions on fluoridation are left to local councils –  because they are the ones managing the treatment plants. Most councils really don’t feel they should be making those decisions – that this should be the responsibility of central government and health ministries. However, that is the way it is.

While other decisions on water treatment don’t go to referendum, or get decided by councils, fluoridation attracts controversy – there have been regular campaigns by activists opposing fluoridation. I don’t think citizens think councils should make decisions about health and science – that is not their job. Councils should instead reflect the views of the community on such issues. Personally, I think if a community opposes fluoridation that should be enough. While I accept that the person in the street does not understand the science (why should they) and may be prone to chemophobia or misinformation, if they are so inclined it should not be imposed.

In the end sensible citizens will take advice on such issues from scientific and health experts – not local council politicians.

So I guess my interest in the political issue was sparked off by what I saw as a violation of democratic rights. As I reacted and started to comment on line and write to councillors about the injustice I became more and more aware of just how badly the science around this issue was being distorted by anti-fluoride campaigners. So, we had a repeat of the evolution and climate change debates. There was a battle about the science behind fluoridation and I had to get involved.

As with these other issues a strong motivation for me is the integrity of science. The need to challenge and expose distortions about the science. But fluoridation is also an ethical and social health issue which raises a human rights motivation for me. In particular I find some of the hostility towards fluoridation repugnant because it demonstrates a complete lack of understanding of what life is like for the economically and socially disadvantaged in our society. In fact, it often demonstrates a complete lack of empathy for their situation.

Social concerns

This not the place for discussing the details (and that is very difficult anyway) but I come from a socially deprived  background and have some understanding of what it is like for people caught in such social and economic traps. I believe more people are actually in that situation than political activists, or politicians in general, realise. Partly because socially and economically disadvantaged people are usually incapable of advocating for their interests, and partly because the rest of society prefers to turn a blind eye, or to otherwise deny the problem.

But these problems exist, and they affect all of us. If a section of society cannot reach its potential for social, economic and psychological reasons that affects us all. It often means more people dependent on state social and financial help. Fewer people getting the education and becoming the experts needed to make our society better. These problems increase the health costs which end up being pad by us all through our taxes.

Social health policies, like fluoridation, are actually very cost-effective. They help reduce what the whole of society must pay in their absence. Probably more important from my perspective, they are humanitarian. They help rescue children and adults from otherwise hopeless situations.

Poor oral health is a huge burden for the individual. Toothache is unbearable for children, who do not have the power to ease their situation. In later life the inevitable cosmetic consequences affect the individual socially. Destroying their confidence, inhibiting their employment and other social opportunities.

Believe me, I am just as big an advocate for personal freedom of choice as the next person. But in the real world this needs to be balanced against social good. To dogmatically stress one at the cost of the other is just political extremism. And this is rejected by most people in today’s democratic, empathetic and pluralistic society. Most people accept that social health programmes benefit the whole of society, financially and ethically.

Provisional nature of knowledge

I have not dealt here with any of the many arguments used against fluoridation. This was meant to be a positive article, dealing with the argument for this practice. I expect it will bring out many of the arguments against fluoridation in the comments and response and I can respond to them then.

I don’t wish to ignore the criticisms of fluoridation – far from it. But I do want to make my own judgements on them intelligently and critically. I think that is the correct scientific approach. And my own experience has taught me that criticisms can be wrong, ideologically  motivated or just plain untrue. The example of the claimed contaminants in hydrofluoric acid illustrates this.

I also recognise that humans are not really a rational species, more a rationalising one. Confirmation bias is a natural result of the very human activity of pattern seeking. We are all prone to logical fallacies, selective viewing, and biased interpretation. Scientists are no exception, but at least the scientific ethos  of demanding evidence, checking ideas against reality and submitting conclusions and theories to the critique of ones peers help to to reduce (but not eliminate the problems),

Ideology and strong convictions get in the way of intelligent and critical assessments. Personally I think this problem is rife among anti-fluoride activists. They are a socially and ideologically diverse group but philosophies of alternative health, alternative medicine and treatments, opposition to establishment ideas for its own sake, conspiracy theories of one sort or another and a long-term component of extreme right-wing politics are all present. In saying that I am not denying the many honest and sensible people who may have concerns about fluoridation for one reason or another. Hopefully it is the latter group which will engage in discussion here.

I am definitely ready to honestly assess the criticisms and arguments made by opponents of fluoridation – especially if presented in good faith and a non-hostile way. One thing that a career in scientific research teaches is that we are often wrong. Discovery is about making mistakes, discovering one has been wrong, seeking further evidence and adjusting one’s ideas and theories. I can recall situations where experimental results have proven me wrong and I felt enthused because that mistake, and my discovery of it, opened things up to new discoveries. In effect, whether we personally intend it or not, scientists do experiments with the express purpose of proving themselves wrong. After all, the best experimental evidence one can offer for a dearly loved theory is one that would test it properly and show it wrong if that is the case.

That is why I have chosen the name Open Parachute (“your mind doesn’t work if it is closed”) for the blog and adopted the slogan - “if you have not changed your mind in the last few years – check your pulse, you may not be alive.”

I am certainly open to changing my mind about fluoridation. But that change will need evidence, good evidence. And honest, intelligent interpretation of that evidence.

So criticise what I have written here. Present your arguments against fluoridation. But please do so in good faith. I am not going to be convinced by name calling or hostility. Unwarranted extrapolation from studies done at high concentration are a dime a dozen and worthless in this debate. And misrepresentation of the literature is counter-productive because I do like to check. I have seen too many examples of distorted interpretation and misinformation to take such assurances on trust any more.


Anyone wanting to follow the debate and/or check back over previous articles in the debate can find the list of articles at Fluoride Debate.

See also:

Similar articles on fluoridation
Making sense of fluoride Facebook page

About these ads

139 responses to “Fluoride debate: Why I support fluoridation

  1. Ken, I’ve only read halfway through right, but will most definitely read the rest. This is very informative, with your parallel between soil and humam hard tissue very interesting. Thanks again to both you and Paul for doing this.

    Steven D. Slott, DDS

  2. You lost me when you made the claim that those who are passionate about organic farming are anti-science and put them in the same boat with climate deniers and creationists. This is really a very bad article.

  3. Skeptic – yes I think you did get lost – perhaps you should reread what I wrote:

    ” Ideology also intrudes, with debates over organic farming and use of chemicals in agriculture.

    Often these conflicts are not simply black and white. The last two examples are complex. There is a role for organic farming and there is certainly need to lower chemical inputs into agriculture. These issues get sensibly debated and have there own scientific support.”

    I even did a little bit of work myself on soils collected from organic farms.

  4. Hear hear Ken!!

  5. jwillie – I am moderating you as a well known troll on this subject. If you wish to participate in this discussion could you please relate your comments to the articles – and stop relying on bare declarations. Provide evidence.

  6. Thank you, Ken. Can you moderate him on all other sites, too, please?

    Steven D. Slott, DDS

  7. Shane you are just trolling so I am going to moderate you. Could you at least accompany videos by a description of their relevance or relate them somehow to the article you are commenting on.

    I am trying to raise the level of commenting here appropriate to the effort going in to the articles so am clamping down on thoughtless trolling.

  8. I do love the whole “you disagree with me so I’m ‘moderating’ your post schtick… China is nice this time of year

  9. Comparing soil to human tissue?

  10. JDR, you seem unaware of the purpose of discussion and moderation.

    Discussion requires participants who disagree on at least some things. Clearly we have this here – both in the discussion and in the articles. You may have failed to notice that in this series of articles on this blog there are 2 people producing the articles and they disagree on many things.

    I find it difficult to accept that you have also not noticed that the comments also disagree with each other.

    Paul and I agreed that we should use a firm moderation because this subject does tend to attract trolls, abuse, thoughtless copy and paste and the posting of irrelevant comments unrelated to the articles.

    Normally your comment would also have been moderated (and any like this will be in future because they add nothing to the discussion). However, I thought my reply to you might be of use to those who are bitching about having their comments moderated. They should consider if their comments really dealt with the article at all. Those who have just posted videos and copypasta without any contribution from themselves should perhaps consider that they do add their own thoughts next time they comment.

    >

  11. Fair enough Ken, might I point out you have already been asked to drop the “anti-science” label. You and I both know this is a subtle technique of belittling an argument – just as the terms ‘conspiracy theorist’ and ‘climate change denier’. You claim to have the evidence to back up your claims and yet continue to take these kind of cheap shots to get people on side. Well I say it is YOU who is anti-choice, anti-freedom and anti-science. The burden of proof is on you.

  12. And comparing opponents of fluoridation to creationists? C’mon mate

  13. JDR – it is disingenuous to imply I compare soil to human tissue. Clearly I don’t. But the fact is that the bioapatites in your body, teeth and bones, are the same sort of mineral that exists in geological deposits and the parent material and unweathered minerals in soils.

    Or perhaps you know differently? If so, please enlighten us.

  14. Joel, you are clearly attempting to be disruptive. Your comments are exactly the sort of things that do not contribute to good faith discussion so you will be moderated in future. Perhaps you will try and make a contribution to the exchange and discussion instead of working off your spleen. If you do then your comments will be approved.

  15. Ken you assume people opposing fluoridation are not poor or have never been poor. You have no idea. You also infer that we are doing this out of self interest – you are wrong. You say you are honest but I notice you lied about something I said they other day. I said “I bought cheap folders for the councillors” and you wrote on Making (non)Sense about fluoride that i “bought expensive folders”. You say you have an open mind, but I have told you time and again that all modern research including the CDC and our own NFIS say that fluoride incorporated into the enamel does NOT makes teeth more resistant to decay but you continue to say it does. You act as if everyone opposing fluoridation doesn’t understand the science with is amazingly arrogant and condescending as well as being downright wrong. Are you telling us that Dr Arvid Carlsson, Nobel Prize winner in Medicine in 2000 does not understand science? Or Prof Paul Connett? Or Prof Robert Mann? Or Ted Ninnes? These people are all perfectly capable of understanding the science and for you to act as if they don’t makes you look really, really bad, You come across as someone with an ideological belief in fluoridation who will never change their mind no matter what. That’s not science – it’s religion.

  16. Quick Mary, get in and edit Wikipedia, set them right too, the liars.

    http://en.wikipedia.org/wiki/Fluoridation#Mechanism

  17. Mary, do you honestly not see the hubris in asserting “but I have told you time and again” as a proof of something? You have persistently misrepresented the CDC on this issue, I have shown you the actual text which you guys carefully avoided, and yet you can say that.

    Incredible hubris.

    No one is telling you that anybody in your list specifically does not understand science (but yes, I am sure you don’t understand it from many things you say). But why select those names? There are a large number of scientists throughout the world and many have worked in this area. Why pull out just those names? Are these the only people you think understand science or fluoride? Are you, in your wisdom going to simply declare that all these experts are ignorant because they don’t agree with you? That is pretty desperate.

    As an aside, Tedd Ninnes is a sociologist, not a scientist. I don’t think he has good understanding of science – I wouldn’t expect him to because it is not his area. He certainly has got many things wrong on the fluoridation issue.

    But Mary, why contrast them to me? I have an advanced degree in science and a career in scientific research with many published research papers. Are you going to suggest that I do not understand what I have been doing all my life.? Just because you don’t like the scientific facts I tell you?

    Again, hubris.

    And no, I did not say anything about the wealth or otherwise of opponents of fluoridation – it is you who have no idea – and no excuse as my article is in front of you.

    >

  18. Barb Smith, nothing in your comment is specific either to this article or the ongoing exchange between Paul and me. Consequently I am moderating you. However, you are welcome to contribute properly to the discussion if you wish. Relevant comments will be approved.

    I am trying to keep this discussion on track and civil so strict moderation is necessary.

  19. Mary

    If I had a nickel for every time the name Aarvid Carlsson, Nobel Laureate, has been invoked by antifluoridationists, I could buy an island in the South Pacific and retire in luxury. That he is used so often by so many different people in different parts of the world is indicative of the fact that respectable scientists, worldwide, who have made negative statements about fluoridation, are so few and far between that one of them must have his name completely worn out from overuse. It is also indicative of the fact that instead of doing legitimate research on your own, from reliable, respected, and primary sources, that you rely solely on the filtered, edited “information” you copy from antifluoridationist websites. As Director of an organization which claims to know the truth about a scientific issue, you are held to a higher standard and should do due diligence in seeking out that truth. Clicking on “fluoridealert.org” and copy/pasting off of that site and others like it does not uphold your obligation.

    Steven D. Slott, DDS

  20. And comparing opponents of fluoridation to creationists? C’mon mate.

    Creationists are not unique.
    The bee in their particular bonnet is evolution.
    However, there are other scientific topics out there.
    Don’t like climate change? Or the link between smoking and cancer? Or the efficacy of vaccines? Then welcome to the wacky world of science denialism.
    Take one label or take them all. It makes no difference.
    They are all the same.
    The same excuses, the same rationalizations, the same playbook.

    Nothing new is going on. It’s a ritual dance. The moves are well-known.
    You can take an HIV denial site and compare it to an anti-vaxxer site.
    Swap the labels and it’s imposssible to tell them apart.
    The methodology is exactly the same.
    Same diff with the anti-vaxxers and the anti-fluoridationists.
    It’s never anything new.

    Science denialism is a real thing. It’s not just limited to one topic.

  21. If I had a nickel for every time the name Aarvid Carlsson, Nobel Laureate, has been invoked by antifluoridationists,…

    Case in point.
    Science deniers invoke their tiny band of “experts”.
    It’s not just the anti-fluoridationists.
    All science deniers do this.

    Dr Duesberg.
    Look him up.
    Now imagine you are an HIV denier.
    Spot the similarity.

  22. Ken, This explains why you support fluoride in general, but not why you support putting it in everyone’s water. Several other countries have fluoridated salt. Around here, they give school kids with well water fluoride tablets. Free fluoridated bottle water for low income people is another option. These options would give people a choice in whether they wanted fluoride added in their diet or not. Why do you think putting fluoride in the water is better than the other options?

  23. Mel, thanks for your question. It gives me the opportunity to expand a little.

    Of course the social health policies used will vary from country to country. All international health authorities agree on the beneficial role of F for oral health but it is up to each country whether to do anything about this, or what to do. Some countries have sufficiently high natural levels of F in their water, others use fluoridated salt or milk. Some areas have opted for school mouth rinse programmes.

    In NZ we have opted for fluoridated water. It has an overwhelming advantage for a social health policy viewpoint in being very cost effective and not requiring individual initiative. I see a big disadvantage in that while it works well for cities and larger towns many rural areas and small towns effectively get missed. Our health authorities are working hard to extend public water fluoridation to more areas but they seem to have little to offer as an alternative – probably because of funding problems.

    As for choice – none of has a choice of whether they want fluoride in their diet in that all our water, fluoridated or it, contains natural fluoride. There is no fluoride free water. All fluoridation does is top up the concentrations. I find objection to the top up, while accepting the natural levels, disingenuous.

    But because of the controversy around the issue local communities do get a choice by referendum, or decision of their local body, on whether there is any F top up. I can understand why some people may object to the practice because they don’t accept the science, suffer from chemophobia, or have ideological reasons. As a democrat I think the political decision of the people, even when misinformed, has to be respected.

    In my community there is overwhelming support for fluoridation. Therefore I think the council must approve it. If referenda showed majority opposition then the council should oppose.

    Like all such democratic decisions we have freedom of choice at two levels:

    1: we can vote for or against a policy.
    2: if the vote doesn’t go our way nothing is imposed – we have the choice of taking individual different action.

    If our referendum had gone the other way them freedom of choice means that I would have to make individual arrangements – alternative sources, mouth rinse, diet, to ensure I obtained sufficient F. (Since the council stopped fluoridation back in June I have used a mouth rinse and eaten more fish).

    As the referendum supports fluoridation then opponents have the freedom of choice to make alternative arrangements if they desire- alternative sources, filter, etc.

    In either case no one has anything forced in them. It is like our public education and hospitals. A minority of individuals object to them and refuse to use them. They make their own arrangements. They are not forced to use them.

  24. Mel also asked “Why do you think putting fluoride in the water is better than the other options?”

    I guess in NZ because the majority seem to prefer this method. It also has the advantage of being a no brainer in that it does not require individual action.

    Fluoridated salt is probably almost as good and perhaps has the advantage of reaching a higher proportion of the population. If there was sufficient public opposition to fluoridation of water I think fluoridated salt would be the way to go. But it would have to be done by mandate at a central level. It would be silly to have two separate programmes operating at the same time.

    By the way, there would still be political opposition. Overseas many anti-F people campaign against fluoridate salt and milk social health policies too.

  25. Thank you, Ken, for taking the time to outline your basic reasons for supporting fluoridation. Your basic reasoning makes sense to me and I began my research very much prepared to come down on the side of supporting fluoridation. However, what happened for me is that I tried to calculate and plan my children’s daily fluoride intake. Around the time when my son was 2 1/2, I needed to decide whether to start having him use fluoridated toothpaste, and since he, like many toddlers, is very unreliable when it comes to spitting, I looked into it a little. I imagined it should be simple enough to research an optimal and tolerable upper intake for fluoride(based on body weight), and then perform rough calculations to be sure that my children were somewhere around there.
    The EPA IRIS reference does of .06mg/kg/day (roughly .027 mg/lb/day)
    for fluoride is set to protect against severe dental fluorosis. Personally, severe dental fluorosis is much too severe for my personal preferences, but even if I were to decide that this is the only level of fluorosis I wish to avoid for my children, simple math tells me the following:

    1. That my 35 lb 3 year old should have no more than 1 mg/day. This is roughly consistent with the institute of medicine recommendation of .7mg/day for 2-3 year olds and 1mg/day for 4-8 year olds.

    2. If my 3 year old brushes twice a day with a pea-sized amount of fluoridated toothpaste (roughly .25mg per pea-sized amount), he may swallow all of it. This could potentially contribute .5mg/day to his daily fluoride intake, and that is only if I am extremely diligent about monitoring his brushing. This is a lot to expect from parents, and most authors agree that many children may swallow more fluoride from toothpaste than is recommended for an entire day.

    3. As soon as you add in water consumption at an average of just under 1 liter per day at a concentration of .8mg fluoride per liter (which is the average for my water district), he has exceeded the daily recommended dose, as well as the EPA IRIS reference dose.

    4. In the United States, grape juice is common, and it is commonly mixed with other fruit juices to form blends. I can avoid fluoride pesticides by giving him organic juice, but I cannot always control what he drinks at preschool and with his grandparents, etc. Non organic grape juice contains an average of over 2 mg/liter fluoride…

    None of this is labeled. My basic problem with fluoridation arose because I read all the recommendations and then attempted to calculate my children’s daily intake. For a parent, it is very hard to see why additional fluoride is necessary. This is precisely why the EPA decided to phaseout the use of sulfuryl fluoride as a food storage fumigant, because it was determined that some children were already being overexposed (using dental fluorosis as the indicator). It feels like I have to make a choice between fluoridated water or fluoridated toothpaste in order to stay with in the recommended daily intake. This doesn’t seem reasonable and I am quite certain that most parents are not performing this type of calculation. Further, only 50% of people in my area are on municipal water supplies. It seems that water fluoridation actually complicates the issue by making it more difficult to assess intake and exposure within the community. Why not have all the kids brush their teeth at school and thereby reach 100% of kids while teaching them good habits? I do not understand how a health measure that reaches 50% of children is worth promoting with such vigor and in spite of such opposition, especially considering the fact that where I live, many of the children most at risk live in rural areas with no fluoridation at home or school. Perhaps I would be able to look at the issue differently in an area where coverage was more universal.

  26. Alison, have you attempted similar calculations for the other range of elements? Or just F?

    >

  27. Ken – what’s the point of your question to Alison? Is it because you can’t come up with a sensible response. Also, you are the one with the hubris. You are the one implying that everyone who wants fluoridation free water is not capable of understanding the science. I mention Arvid Carlsson as he is who springs to mind but there are thousands of scientist, doctors etc who oppose fluoridation. Think about it, most of the world does not have fluoridation. And by the way Ted Ninnes is qualified in science MA Hons (First Class), University of Dundee, 1970
    Ph.D University of Edinburgh, 1979
    MSc University of Stirling 1987. Probably more qualified than you Ken.

  28. Mary, I don’t want to get into a debate about Ted – he is a personal friend of mine. A sociologist not a scientist. We usually discuss wine, not our qualifications. I don’t think he understands science in a practical way and he probably adheres to a particular minority school of sociology on this. Something we will probably discuss some time, if we ever finish with the wine.

    He certainly makes some glaring errors on the fluoride question. I am pretty sure I have pointed out to him in the past that the claims about heavy metal contamination in fluorosilicic acid are completely wrong and described my own analytical results to him. So I was rather shocked when he repeated the anti-fluoridation misinformation on this. Still, perhaps we had drunk too much wine at the time for him to remember. More than likely.:-)

    As for my question to Alison, I thought that was simple and straightforward. Can’t understand why you should intervene on that? Alison will respond in her own time (she is in the US).

  29. Alison, as has been stated ad nauseum, the only consequence of your 3 year old exceeding the upper limit of fluoride in relation to water fluoridated at 0.8 ppm is the risk of development of mild to very mild dental fluorosis, neither of which has adverse effects on cosmetics, form, function, or health of teeth. If you want to deny your child the proven dental decay resistance of water fluoridation because you are more concerned with mild dental fluorosis, so be it. But that is not reason to deny the entire population of your area of this benefit. Once again, brushing teeth one to two times per day with fluoridated toothpaste does not provide the protection of the consistent exposure ot the teeth to a low concentration of fluoride all during the day.

    You’re going around in circles, now, with nothing seeming to register with you. This is a classic sign of objections based on personal ideology, not science.

    Steven D. Slott, DDS

  30. Mary

    Aarvid Carlsson just happened to “spring to mind”? Yep, he sprung to your mind straight off of the pages of “fluoridealert.org”. Instead of continuing to provide nothing more than uninformed nonsense about water fluoridation, why don’y you at least make an attempt to support your unsubstantiated claims with valid evidence? Could it be because none exists?

    If you want to begin contributing intelligently to the discussion, you can start by providing a list of the “thousands of scientist, doctors, etc. who oppose fluoridation”? Otherwise, thank you for your comments. They present an excellent opportunity to expose the complete fallacy of yet one more little “fluoridefree” whatever, “clearwater” whatever, or whatever you call your little group.

    Steven D. Slott, DDS

  31. I found this information on dental fluorosis

    http://www.cdc.gov/fluoridation/safety/dental_fluorosis.htm

    which states

    Dental fluorosis is a change in the appearance of the tooth’s enamel. These changes can vary from barely noticeable white spots in mild forms to staining and pitting in the more severe forms. Dental fluorosis only occurs when younger children consume too much fluoride, from any source, over long periods when teeth are developing under the gums.

    and later

    Dental fluorosis is caused by taking in too much fluoride over a long period when the teeth are forming under the gums. Only children aged 8 years and younger are at risk because this is when permanent teeth are developing under the gums. The severity of the condition depends on the dose (how much), duration (how long), and timing (when consumed) of fluoride intake.

    Increases in the occurrence of mostly mild dental fluorosis were recognized as more sources of fluoride became available to prevent tooth decay. These sources include drinking water with fluoride, fluoride toothpaste—especially if swallowed by young children—and dietary prescription supplements in tablets or drops (particularly if prescribed to children already drinking fluoridated water).

    so Alison would appear to be a good parent and following health guidelines issued by (in this case, the US) government, and checking on her child’s use of toothpaste etc.

    Children, especially teenagers, are very sensitive to their appearance these days, so I don’t think we should underestimate the effect on them if they have blemishes to their teeth from whatever cause.

  32. I found this information on dental fluorosis…

    We both know that the CDC is fully in favour of water fluoridation.
    You need to stop and ask yourself what it is that you think you are doing.

    “For 65 years, community water fluoridation has been a safe and healthy way to effectively prevent tooth decay. CDC has recognized water fluoridation as one of 10 great public health achievements of the 20th century.”
    (..)
    “Water fluoridation prevents tooth decay mainly by providing teeth with frequent contact with low levels of fluoride throughout each day and throughout life. Even today, with other available sources of fluoride, studies show that water fluoridation reduces tooth decay by about 25 percent over a person’s lifetime.

    Community water fluoridation is not only safe and effective, but it is also cost-saving and the least expensive way to deliver the benefits of fluoride to all residents of a community. For larger communities of more than 20,000 people, it costs about 50 cents per person to fluoridate the water. It is also cost-effective because every $1 invested in this preventive measure yields approximately $38 savings in dental treatment costs.

    This method of fluoride delivery benefits all people―regardless of age, income, education, or socioeconomic status. A person’s income and ability to get routine dental care are not barriers since all residents of a community can enjoy fluoride’s protective benefits just by drinking tap water and consuming foods and beverages prepared with it.

    Fluoride from other sources prevents tooth decay as well, whether from toothpaste, mouth rinses, professionally applied fluoride treatments, or prescription fluoride supplements. These methods of delivering fluoride, however, are more costly than water fluoridation and require a conscious decision to use them.”

    If you’re going to quote the CDC (or any other scientific community) then do it right. Tell the full story. Don’t cherry pick.
    I’ll leave it to the discretion of the reader to see for themselves how Alison’s views match up with reality.

  33. Armed with her internet references Mary should email CDC and correct them over how fluoride works, they’ve obviously got the mechanism all wrong.
    Hop to it Mary.

  34. Janet

    Yet once again……the only dental fluorosis which may occur attributable to water fluoridated at the optimal level of 0.7 ppm, is mild to very mild. Note from your out-of-context quote from the CDC:

    “Dental fluorosis is a change in the appearance of the tooth’s enamel. These changes can vary from barely noticeable white spots in mild forms to staining and pitting in the more severe forms.”

    Note:
    BARELY NOTICEABLE WHITE SPOTS IN MILD FORMS.

    Antifluoridationists are trying their utmost to turn mild dental fluorosis into a life-threatening, face deforming, major disorder due to the fact that they have nothing else to use to attempt to stike fear about water fluoridation. It is not.

    Again, if Alison wants to deprive her child the increased resistance to dental decay rather than risk barely detectable white spots on the child’s teeth, that is entirely her prerogative. However, you and she, both, should bear in mind that black dental decay is far more detectable than mildly fluorotic white spots.

    Steven D. Slott, DDS

  35. We both know that the CDC is fully in favour of water fluoridation.
    You need to stop and ask yourself what it is that you think you are doing.

    I am reading the government advise on dental care and fluoride.
    Is this a problem for you Cedric?
    Steven Stott, how is this out of context? I took the paragraphs straight out of the page on the CDC.

  36. Janet, whether you consider it out-of-context or not is moot. Dental fluorosis related to water fluoridation is a non-issue. Again, even your CDC quote makes that clear.

    In 32 years of practicing dentistry in a fluoridated community, surrounded by fluoridated communities, I have as yet to see one case of dental fluorosis that could be in any way attributable to fluoridation, that would even be detectable outside of close examination in my dental chair. Anecdotal, sure, but anecdotal from a dental professional who treats thousands of patients per year.

    I have consumed fluoridated water for over 40 years. My 20-something kids have consumed it their entire lives. No detectable dental fluorosis. My 2 year old grandson has been ingesting fluoridated water since birth. Am I concerned for him for so doing? Of course not, that would be ridiculous. I would be concerned for his dental health were he not consuming it, however.

    Find another excuse, Janet. This one doesn’t work.

    Steven D. Slott, DDS

  37. I am reading the government advise on dental care and fluoride.
    Is this a problem for you Cedric?

    Where does the CDC advise parents to monitor fluoride intake from other sources, as you claim.

    You seem to be inventing things.

  38. Richard Christie | November 13, 2013 at 11:17 am |
    Where does the CDC advise parents to monitor fluoride intake from other sources, as you claim
    You seem to be inventing things.

    On the contrary…
    From the CDC site:

    What parents and caregivers can do to reduce the occurrence of dental fluorosis—

    Know the fluoride concentration of your drinking water

    You should know the fluoride concentration in your primary source of drinking water, especially if you have young children. This information should help with decisions about using other fluoride products, particularly fluoride tablets or drops that your physician or dentist may prescribe for your young child. Fluoride tablets or drops should not be used at all if your drinking water has the recommended fluoride concentration of 0.7 mg/L or higher.

    If you live in a state that participates in CDC’s My Water’s Fluoride, you can find out your water system’s fluoridation status online. If you are on a public water system, you can call the water utility company and request a copy of the utility’s most recent Consumer Confidence Report.

    For very young children, less than 2 years old:

    Do not use fluoride toothpaste unless advised to do so by your doctor or dentist. You should clean your child’s teeth as soon as the first tooth appears by brushing without toothpaste with a small, soft-bristled toothbrush and plain water.

    For children aged 2 to 6 years, apply no more than a pea-sized amount of fluoride toothpaste to the brush and supervise their toothbrushing, encouraging the child to spit out the toothpaste rather than swallow it. Until about age 6, children have poor control of their swallowing reflex and frequently swallow most of the toothpaste placed on their brush.

    I actually hadn’t heard of Dental Fluorosis until I read about it on this thread. So, I Googled it, found this apparently authorotative site, that was suggesting this kind of measures that parents should take to ensure that their children shouldn’t get too much Fluoride.

    I don’t have any agenda or position on this. I don’t have any children that are affected. I was just doing some reading on the topic that seemed to back up the claim that Alison was being a diligent parent by following these guidelines.

    This appears to have upset some people.
    Why is this?

    Should parents not follow guidelines from the government health agencies?

  39. This appears to have upset some people.
    Why is this?

    Perhaps because you claimed something based on a quote you provided, but it wasn’t in the quoted material.
    You pulled it pulled out of a hat later.

    Very poor form.

    Doesn’t make you come across as someone to trust in any discussion.

  40. Sure, Janet, parents should be diligent about everything their children ingest. The problem with fluoridation opponents is that they get all bent out of shape over dental fluorosis, while the extremely toxic, highly corrosive chlorine that their children ingest with every gulp of water, doesn’t seem to phase them in the least. Why? Probably because their objections really aren’t based on health concerns related to water fluoridation, but simply on personal ideologies. While this is fine for them to have, it is not fine for them to cloak these ideologies in trumped up health concerns, and attempt to use that to deprive the entire population of their area of the benefits of fluoridation.

    Steven D. Slott, DDS

  41. Perhaps because you claimed something based on a quote you provided, but it wasn’t in the quoted material.
    You pulled it pulled out of a hat later.

    Well, I am extremely sorry RIchard Christie

    Obviously, you find it politically incorrect to use information from public health websites to make informed decisions about how to manage your child’d health

    You seem to have other motives than children’s health at stake. I’m not sure what they are though

  42. Obviously, you find it politically incorrect to use information from public health websites to make informed decisions about how to manage your child’d health

    Even the most stupid reader will recognise what you are doing here.

  43. Yes, Ken, I have always been one to keep general track of basic micronutrients and trace elements necessary for good health. I became a vegan when I was 9 (although I do eat some fish) and my parents insisted that I educate myself on nutrition and have blood tests done from time to time, as they were worried I might miss something, and so I made sure that my diet included all the essential amino acids and micronutrients considered important. Also, growing up on a horse farm, we always ran soil samples, sometimes spread lime to raise the pH and increase calcium and magnesium content, as well as a variety of other things, so I’ve grown up with a keen interest and awareness of elements and the way they interact with each other, and their role in horses, people, and healthy pastures. However, most of my focus has been on things that are labeled, and I’ve normally found that I must go out of my way to include certain things such as sources of vitamin B12, omega 3 fatty acids, etc. Mostly, the beneficial elements are labeled and the amount to be found in various foods remains constant and predictable…. Undesirable elements like lead and arsenic are on my radar too, but I don’t obsess about a little bit of dietary arsenic. I’ve seen the certificates of analysis from my water company, and the arsenic content of my tap water due to HFSA is the least of my concerns. The lead content of the soil outside my house is a far bigger concern than over exposure to fluoride, and any potential lead and arsenic contamination in the HFSA does in fact pale in comparison to all our other sources of exposure. It is not a major concern for me.
    Basically, the major gripe i have with fluoridation comes from the difficulty f calculating intake within a relatively small recommended range. I can’t understand why fluoride content wouldn’t be labeled on packaging, just like most other elements that are considered “beneficial”. It shouldn’t be so complicated to figure out how much we’re getting. The use of fluoride pesticides in the United States creates unexpected fluoride concentrations in products that would normally contain negligible levels and I’m not aware of this issue with other beneficial trace elements, but I may be wrong.

  44. Alison, why are you not concerned with the exact amount of chlorine intake by you and your child? Do you calculate the exact number of mg per day of chlorine intake?

    Steven D. Slott, DDS

  45. Alison, my question related to elements, not vitamins, and the intensity of monitoring. For example do you apply the same monitoring intensity to intake of Ca, PO4, I and Se?

  46. Ken, I am most open to a chemistry lesson if there is something I’m failing to see. Your knowledge in this area is on a much different level than mine, so please understand that I’m not trying prove a point, just to explain my thinking and learn from any insight that you or others might offer. My understanding is that most of the things I mentioned are in fact elements many elements play an essential role in vitamins. Cobalt is the element which is the most important component of vitamin B12, which also contains phosphorus…
    It seems to me that all of the elements that you mention are either considered essential nutrients or essential trace elements and each correlates with one or several established deficiency diseases. It is my understanding that over exposure to iodine, phosphorus, calcium, or selenium, without the use of supplements is highly unlikely. So yes, I calculate calcium and iodine based on diet to be sure that our family gets enough, but I have rarely worried about getting too much. As for selenium and phosphorus, I think my diet would have to be pretty out of the ordinary to risk deficiency or over exposure.

  47. No, Alison, my question is more about what you are paying attention too, rather than any specific chemistry.

    I get the impression you are far more concerned with F than you are with any other element which could present problems with deficiency or excess. Personally I wouldn’t be any more concerned about F than say Se – except for the deficiency problems with both – in NZ at least. In fact here there is probably a bigger risk of excess Se because of its presence on farms and a colleague of mine who used to analyse for Se often got samples from poisoned children. That said, there is also a risk of F poisoning on farms – with animals grazing freshly fertilised pasture. Not to children.

    However, I think your attitude to the calimed contamination of fluorosilicic acid and fluorosilicates is great. Wish more people could resist the misinformation on this.

  48. Alison, I fully agree with Ken about your attitude toward HFA. It is really a breath of fresh air to see that coming from a fluoridation opponent.

    However, I still question why you don’t accord the same concern to intake of chlorine as you do to fluoride. Both are highly toxic, corrosive water additives, in their undiluted concentrations. What is your differentiation?

    Steven D. Slott, DDS

  49. “I get the impression you are far more concerned with F than you are with any other element which could present problems with deficiency or excess.”

    Ken, since the conversation is about fluoride, I may have seemed hyper-focused on fluoride. Of course my personal level of concern about deficiency and over exposure to other elements is entirely irrelevant to the question of whether or not the water should be fluoridated, but since you’re bringing it up, I am more than happy to expand on my other concerns. It seems to me that you’ve grown to expect certain behaviors from opponents of fluoridation, and thus fail to recognize that my comments and questions often don’t fit into preconceived notions. Fluoride ranks low on my list of concerns. Selenium, however, does rank lower due to the fact that soil in the Northeastern United States has generally low levels of it. The amount of time I spend thinking and talking about fluoride pales in comparison to the amount of attention I devote to lead, chlorine, disinfection byproducts, and other unregulated water contaminants. I take advantage of all the free lead dust testing kits that the CDC offers, I’ve had the soil tested in my children’s play area (it was very high), and I regularly help people analyze their own water quality reports and encourage them to test their wells (arsenic levels in Maine groundwater are very high in many places). Radon is also a concern. I test my basement every 1-2 years for radon levels in the air. There are Maine water systems which have tested quite high for radon, but this is mostly an air quality concern. 1 out of every 3 homes in Maine is thought to have elevated radon levels, but some Maine water systems do have elevated levels of radium and uranium which is definitely a concern for certain populations.

    “However, I still question why you don’t accord the same concern to intake of chlorine as you do to fluoride.”

    Steve, maybe you missed my post earlier about chlorine. You must have. You can refresh your memory by searching for the word chlorine in the comments section here. http://openparachute.wordpress.com/2013/10/30/fluoride-debate-part-1-connett/
    I use a shower filter for the purpose of filtering chlorine and disinfection byproducts. I could go on an on about this issue and anyone who knows me has heard me do so (although they may not have heard me talk about fluoride). When I can, I have tried to fit the issue into discussions about fluoride (although internet commenting on fluoride issues has been limited to this forum and one or two others), because it is a much more important issue to me. The only reason I didn’t expand upon my earlier comments is because I thought Ken might object to me talking about issues other than fluoride. But yes, it is mind-boggling and frustrating when fluoride opponents don’t take the time to educate themselves on the much more serious water quality concerns, or arsenic in apple juice, or lead baby toys. Here is part of what I posted earlier about chlorine.

    It is essential that people who are serious about this issue take the time to educate themselves on the whole process of water treatment in their district. Disinfection byproducts actually present a much greater threat than fluoride and are easily filtered with a basic carbon filter for both drinking water and showers. It’s amazing that people don’t know this, even though it is universally accepted by health agencies, and many water systems have had violations. At this point in my research, I oppose water fluoridation for a variety of reasons, but most importantly, it is essential that we all learn about water quality, water treatment, and the protection of our water sources. The threats are numerous and it is easy to zero in on fluoride (because it would be so easy to stop), and miss the larger issues. For more info on disinfection byproducts see:
    http://www.cdc.gov/safewater/chlorination-byproducts.html

    This report here is what everyone should read if you live in the United States (and probably elsewhere too) and actually are sincere in your concern about drinking water quality. http://static.ewg.org/reports/2013/water_filters/2012_tap_water_report_8b.pdf

  50. Alison, I stand corrected. I now remember that you did indeed post that comment about other water additives. Fair enough.

    My personal opinion is that you are way over the top in obsessing about all of these things. However, that’s just my opinion and I respect your efforts to do what you deem best for yourself and your family.

    Steven D. Slott, DDS

  51. Steve, I wouldn’t say that I’m obsessed, just interested. In the Northeast, there are many old houses and lead exposure is still a significant issue.
    As for disinfection byproducts, a shower filter is inexpensive and I find it quite exciting that this small change will reduce my husband’s risk of bladder cancer, among other things. It also makes my hair a little softer without having to use so much conditioner.
    If you don’t find anything I mentioned to be worth worrying about, I certainly wouldn’t expect you to be concerned about fluoride, but now you are the one deviating from established scientific consensus.
    I prefer to stay ahead of the government regulations when it comes to chemical exposure. For example, I won’t wait for the FDA to get around to regulating BPA before I choose to exercise caution.
    The lag time between scientific understanding and public health policy is too slow for me.
    Even with fluoridation, It took the CDC more than 50 years to figure out that people in the north don’t necessarily drink less water than people in the south, and thus, we don’t need to have nearly 2X as much fluoride added to our water.
    I like my teeth with no spots on them and I can’t remember ever seeing a toothpaste ad featuring someone with dental fluorosis. It is noticeable.

  52. Alison, no, mild dental fluorosis is not noticeable at normal speaking distance under normal lighting. It can only affect teeth during their development, which occurs between the ages of 0-8 years, thus, you have no risk of developing spots on your own teeth as a result of fluoridation. Too, it generally disappears with age such that by late teens, early adulthood, these discolorations are gone. There are multiple factors that can cause white spots or other discolorations on teeth. If you are noticing these spots on people’s teeth then you are either specifically looking closely for them, or they are attributable to factors other than water fluoridated at 0.7 ppm.

    Again, I respect whatever are your efforts you deem to be in the best interests of you and your family.

    Steven D. Slott, DDS

  53. Thanks, Steve. I do sincerely appreciate your willingness to engage and respond. We have a different philosophy, but it is obvious to me that you are sincere in your motives and your commitment to dental health. I have become somewhat hyper focused on water treatment, not only because I find it fascinating, but also because it is so often taken for granted. I can see that you are perhaps similar in your passion for dental health… there is plenty of room for champions of all sorts of causes, so long as it is done in good faith. Fluoridation bothers me, in part, because it is often seen as a last resort; a safety net for those who don’t know any better or who can’t be trusted to brush their kids teeth, but as teacher of both high school and elementary school, I have more faith in the power of education than the power of a health practices. I personally think we should put all our effort towards teaching young children good habits and the basic science of tooth decay, in a way that prepares them to take responsibility for their health, whether they find themselves living in a fluoridated part of the world or not. Water fluoridation can never reach everyone, so why not put our effort toward strategies that can truly be adopted universally?
    Anyway, I have learned a lot from reading your comments. When I have time, I enjoy participating in the debate, not so much as a personal crusade, but as an opportunity for continuing my own education. Keep in mind that most people my age do not have a rigid perspective on this issue. In no way am I predisposed to believing that fluoride lowers IQ or anything like that. I guzzled fluoridated, unfiltered tap water throughout both my pregnancies and used it exclusively until quite recently. My 3 year old does have very mild dental fluorosis (according to the pediatrician) although he was always breastfed (although it took me asking for her to notice it, and she didn’t seem particularly confidant or any more informed than I am). If I can get him to smile long enough for a close up, maybe you can tell me what you think. I have started using reverse osmosis with an alkalizer only recently (in large part because of my increased awareness about the lead pipes in my home, the slight acidity of our water source, and the limited water testing done in my district). My kids don’t always follow the water company’s recommendation to flush the pipes before drinking, and a $200 investment puts my mind at ease. But, I am in no way looking to confirm a bias toward fluoridation. Quite the opposite is true.
    It is entirely possible that I am misdiagnosing dental fluorosis that is in fact something else. I’ll post some pictures when I get a chance and perhaps you can explain what you think.
    By the way, you should really start a blog or something so you don’t have to keep typing the same thing over and over again! I sincerely hope that you have some sort of system that allows you to spend all this time responding, so that you can still use your time and energy to help those in need of dental care.

  54. Peter Daniel – you comment really contributed nothing and was pesonally abusive. I have put you into moderation and future comments like that will be deleted.

    You are welocme to comment but please adhere to reasonable standards and contribute to the discussion, not try to destroy it.

  55. Robert Brentwood

    Steve, as you well know, chlorine is added to drinking water to make it safe to drink, fluoride is added to drinking water to treat those drinking it.

    Alison, you might be interested in this – http://www.npwa.org.uk/wp-content/uploads/2008/06/cathys_horses_feb07.pdf

    Robert

  56. Groan, not the horses again.
    Robert, you are late to this party and it shows.

  57. PRATT’s never die. They just get repeated……………………………………………………………………again and again and again and again and again and again and again and again and again and again and again and again and again and again and again and again and again and again.

    What is wrong with these people?

  58. I was in two minds about approving Robert’s last comment. It could be that Steve can usefully correct him on his naive comments comparing F and Cl. But I am getting pissed off with people who cynically use a discussion like this to advertise and proselytise via posting naive videos. They aren’t contributing anything, not commenting in good faith and just opportunistically using this discussion as a platform for their propaganda.

    >

  59. Robert, if ANY additive to water caused the myriad of problems that antifluoridationists so desperately seek to attach to fluoride at 0.7 ppm, we would all be screaming about it, regardless of the purpose for its being added. We would boil our water, if necessary rather than consume such a toxic substance as chlorine if we didn’t fully understand that in the right concentration chlorine is entirely safe to ingest. That you and all other antifluoridationists are not screaming about chlorine, belies your “concerns” about the safety of fluoride at the concentration at which it is used in water. This clearly demonstrates that you understand the safety of these substances at the right concentration. Therein is the hypocrisy of the entire antifluoridationist argument.

    As for the horse tale, yes, I am familiar with it. It is actually the best example of confirmation bias of which I’m aware. After having been told by 6 veterinarians, at least one of whom was affiliated with a university, who had examined her horses pre and post mortem, that the sickness and death was not fluoride poisoning, Justus finally found one who seemed to confirm what she had talked herself into believing through her own “research”. Relaying what she interpreted as having been the symptoms of her animals to this veterinarian, she was apparently told by him that these symptoms could be indicative of fluoride poisoning. That’s all she needed. Do I really need to expound any further on the absurdity of that story?

    Steven D. Slott, DDS

  60. ……..and again, and again, and again, and again, and again….ad nauseum.

    Steven d. Slott, DDS

  61. I fully share your pissed offedness, Ken. However, you’ve done an excellent job of keeping it at a minimum. Most other fluoride sites are complete cesspools of utter nonsense.

    Steven D. Slott, DDS

  62. Richard, I’ll get Robert a piece of cake, if any is left, if you’ll get him a drink. Maybe we can get him up to speed.

    Steven D. Slott, DDS

  63. I did see part of the horse thing, and it seemed quite hard to believe. I think the effects on horses would be worth investigating, as horses drink lots of water, but as someone who has spent a good part of my life training horses in different parts of the country, there almost definitely had to be something else going on with this woman’s animals. Fluoride may have exacerbated some severe nutrient deficiency, or maybe there was some other water quality concern, but people really pay attention to their horses, and if changing a horse’s stabling to a facility with fluoridated water really had such deleterious effects, I think more people would be talking about it. I’ve spent plenty of time with horses competing at the top levels of dressage, drinking both fluoridated and non-fluoridated water and have never seen anything like that. That said, my analysis is anecdotal and I have not researched the effects of fluoride on horses at all. The thing that seemed most implausible was the number of animals effected at her farm. I would be willing to entertain the idea of extreme fluoride sensitivity in a small portion of the population but such extreme reactions seem outlandish for such a large percentage of the animals. Again though, this response is just a gut reaction, but I’ve spent my whole life with horses.

  64. Alison, you continue to have my respect. This story has so many holes in it, that it’s difficult to believe anyone would accord it any credibility. The fact that it only seems to exist on antifluoridationist websites speaks volumes.

    Steven D. Slott, DDS

  65. The fact that it only seems to exist on antifluoridationist websites speaks volumes.

    It gets repeated by anti-fluoridationists endlessly. It’s a classic PRATT. One that will never, ever die. This is them. This is how they think. It should tell you something significant about the quality of those websites and their “scienciness”.

  66. Cedric, what is a PRATT?

  67. Got it. In other words, like 99% of Connett’s arguments.

    Steven D. Slott, DDS

  68. Here’s an interesting aside about Connett’s arguments. Recently in Brooksville, Florida, Connett was allowed an hour and a half uniterrupted presentation to the City Council there. The Council was considering reinstating fluoridation after having quietly ceased it two years ago, with no significant prior warning. . This time, however, the Council members had been presented accurate facts with valid scientific support. In spite of Connett’s show, the council voted 4-1 to reinstate, the sole vote against being that of the antifluoridationist mayor who had been responsible for the quiet cessation, and who fought as hard as she could to keep it from being reinstated.

    In Clarksburg, West Virginia, this past week, the City Council heard a presentation by staunch fluoride opponent and close Connett affiliate, attorney Robert Deal. Deal has a website with the not-so-subtle name of

    http://www.fluoride-class-action.com/

    on which he attempts to promote lawsuits against fluoridation. After his presentation to the Council, a very knowledgeable pediatric dentist, fluoridation advocate, refuted each and every one of Deal’s arguments. After this, the Council voted to table the fluoride issue, a victory for fluoridation in this town.

    When Connett’s arguments are met head on, in a rational, controlled manner, such as in this online debate and in the two cases I just described, they do not hold up and are easily shredded with the facts. In all liklihood, this is why Connett has not published any peer-reviewed literature on fluoridation, why he chose to put his opinions in a non peer-reviewed book form rather than do as do legitimate scientists and researchers, and submit them for proper peer-review, and why he constantly seeks live debates in which he can gloss over, with rhetoric, the major deficiencies in his arguments.

    Steven D. Slott, DDS

  69. ….and why he constantly seeks live debates in which he can gloss over, with rhetoric, the major deficiencies in his arguments.

    Ah, the famous Gish Gallop.
    Beloved by science deniers of all stripes.
    People try it too with online debates and sometimes they get away with it, which is why directly quoting original statements in full is so very important.

    In the scientific arena, where any debate is conducted within peer-reviewed literature, the Gish Gallop is dead in the water.

    Jonathan M vs. PZ Myers

  70. At the end of the day, it is the same script. If you don’t agree with the “consensus”, you are “anti-science” and are compared with a creationist.

    Some people might have valid reasons for not wanting to have fluoride in their water, perhaps?

    We haven’t really heard from them.

  71. Janet, have you not noticed that this series is an exchange of articles between me and Paul Connett. Paul is considered the ultimate spokesperson for people opposed to fluoridation.

    So how can you say “we haven’t heard from them yet?” Half the articles are by him.

  72. I did notice the series of exchanges.
    I referring to follow ups in the comments.
    There seems to be very little constructive dialog in the comments after each article, other than to bag Dr Connett and call him names

  73. I would be a little uncomfortable about having a “spokesman” for the people who didn’t want chemicals put in their water.

    Why do these people need a “spokesman”

    Like, how hard is it to say “we don’t want your chemicals” already?

  74. Whether you are uncomfortable or not Janet the fact remains that Paul Connett is head of fluoride alert in the USA which masterminds much of the anti-fluoride activity around the world. It provides resources to opponents of fluoridation. Connett himself makes regular speaking tours and will be in NZ next February – he seems to be here annually. On these visits he is promoted heavily by the anti-fluoride groups. He often participates in person or by Skype in local council hearings.

    I have found the discussion in the comments section very helpful. Picked up some new information. And I look forward to further discussion. I think it would help if Connett himself entered the discussion in the comments – but that is up to him.

    What “names” has Connett been called?

    There have been a few supporters of Connett. They haven’t had many good arguments.

    As for comments I have held back for rudeness and irrelevance – many of them have been anti-fluoride. Some have been very nasty. The rest have been the regular trolls which have in the past taken advantage of my lack of moderation. It is good to be free of them.

    There is actually concurrent discussion of these articles occurring on a few Facebook pages (Fluoride Free and Making Sense of fluoride pages). I can’t control these but I assure you I am being called some horrible names, and horrible things are being said about me and my articles. Most of these people seem quite unwilling to enter discussion here, though. Perhaps they have nothing of substance to say.

    I think it is naive to say “we don’t want chemicals in our water” – who is going to agree with that. We rely on these chemicals to protect us from water borne diseases and to improve the quality of our water.

    Anyway, water itself is a chemical.

  75. At the end of the day, it is the same script. If you don’t agree with the “consensus”, you are “anti-science” and are compared with a creationist.

    Methodology.
    There’s a scientific consensus on a whole lot of things.
    Evolution is just one of them.
    Creationists reject that consensus. They reject it in a certain way. There’s a pattern in the way they promote their ideas and the way they argue.

    Same deal with the HIV deniers. They reject the scientific consensus too.
    They reject it in a certain way. There’s a pattern in the way they promote their ideas and the way they argue.

    It’s fair and reasonable to take those two groups and contrast and compare them.
    The methodology is identical.
    The creationists and the HIV deniers are mimicing each other. They are following certain patterns of behaviour.
    Those patterns are not restricted to just them.
    There are others. Lots of others.

    If you reject the scientific consensus on “X” and you fit the pattern, then whatever it is that you think you are doing…well…you’re doing it wrong.

    On the other hand, it’s possible to reject the scientific consensus using a different approach. One that is a universe away from the nutters out there.
    That way leads to being awarded a Nobel Prize.

    Don’t want to be put in the same box as the creationists?
    Don’t do what they do.
    Easy fix.

  76. Hang on Cedric.
    You are comparing those who do not Fluoridate their water with HIV deniers, anti-vaxxers and creationists.

    So this includes the entire population of Scotland, for example, in this category.

    seems a bit of a sweeping generalization to me

  77. No, Janet, you have things garbled, as usual. The citizens of Scotland are victims of members of Parliament who listened to antifluoridationists who behave in the same manner as HIV deniers, anti-vaxxers, and creationists. They all have in common that they deny science, in favor of personal ideology………and “the entire population” of Scotland suffers as a result.

    Steven D. Slott, DDS

  78. You are comparing those who do not Fluoridate…

    Gee, Janet. You seem to be making a real effort to not understand.

    Read simple English. Stop acting stupid.
    Methodology.
    Look it up.

    Let me say it again.
    Methodology.

    The creationists and the HIV deniers are mimicing each other.
    It’s fair and reasonable to take those two groups and contrast and compare them.
    The methodology is identical.
    Creationists reject that consensus. They reject it in a certain way. There’s a pattern in the way they promote their ideas and the way they argue.
    Same diff for HIV deniers.
    They are following certain patterns of behaviour.
    Those patterns are not restricted to just them.
    There are others. Lots of others.

    I can’t make it any clearer for you without using a blackboard and coloured chalk.
    Don’t create strawmen. It only makes you look weak.
    (It’s a favourite with science deniers.)
    “Entire population of Scotland”, indeed.

    The “Straw Man” Fallacy

  79. As I’ve explained, I’m not as concerned about the myriad of health effects that other fluoridation opponents cite. There are other water quality concerns that present well documented risks. What does bother me are the significant changes in the scientific rationale for fluoridation since it began, and the failure of health professionals to educate themselves and the populations they serve regarding these changes. In my community, this is the ad that ran in 1968 promoting fluoridation.
    https://goo.gl/h5kzAI
    Today, the argument in favor of water fluoridation does not include claims of decreased bone fracture or reduced hardening of major arteries, but this was a major part of what convinced communities to support fluoridation, and in my community, the vote was still incredibly close. From my research into the old newspaper articles, it is clear that many of the things that convinced people to favor fluoridation turned out not to be true. People were told that fluorosis WOULD NOT OCCUR. This is what doctors and dentists said in newspaper editorials. Today, we can argue about whether dental fluorosis is a problem or not, but the fact remains that there is a measurable difference between what was promoted and the current reality.

  80. I don’t know about the hardening arteries claim but the bone fracture claim still has validity. See Ken’s post today and much earlier posts

  81. Alison, the link you provided was to a newspaper ad in1968. What healthcare practices do you know that have NOT significantly changed in 45 years? The remarkable thing about this ad is that it demonstrates how LITTLE facts and opinions on water fluoridation have changed in 45 years, not how much. Of the three listed benefits in the ad, the one claiming less hardening of the arteries is the only questionable one. The other two are still valid today. Forty five years ago, the opinions on decreasing hardening of the arteries may very have been valid, given the information they had available on this particular claim. Studies at that time did show a 65% decrease in decay. At that time, it was much easier to segregate fluoridated groups from non-fluoridated, for the purpose of study, than it is today, and the studies were showing that much decrease in dental decay. There still may be that level of decay decrease, it is just too difficult to assess as accurately now as it was then.

    As can be noted in Ken’s latest post of today, bone fracture does indeed appear to be less at the fluoride level utilized in water.

    Now, contrast the claims made in this ad to those made by antifluoridationists. The one questionable claim about arteries, which I honestly have not looked enough at to have an opinion on, with mounds and mounds of false and misleading information that has been put out by antifluoridationist for decades, and which continues today unabated. Look at the claims of osteosarcoma, thyroid, kidney, IQ, etc, that antifluoridationists have been making for decades. None of them have been proven in any manner to be valid, in the entire 68 year history. If you want to indict anyone for their facts and opinions having been shown to be invalid, antifluoridationists are the ones at whom you should be looking, not healthcare personnel.

    If you want to cite proof for your claims in this comment, I’ll be glad to look at them, but the ad you provided from 1968 pretty well debunks your theory about the public having been misled about benefits.

    Steven D. Slott, DDS

  82. Just a general point Alison about your concern with the “changes in the scientific rationale.” Frankly I would be concerned of scientific rationale did not change. The thing about science is that knowledge is dynamic. Provisional and dependent on verification and new evidence. So,we always expect scientific knowledge to change, in most cases improve, over time.

    I think this is the case with our understanding of the role of fluoride. And probably true of just about anything in health. The only way to get “knowledge” that is absolute and doesn’t change is via religion. But such absolute “knowledge” does not help us health wise.

    >

  83. What does bother me are the significant changes in the scientific rationale for fluoridation since it began….

    Wonderful example.
    The arguments don’t change; just the labels.
    I wonder if the creationists use this argument too?
    Why yes. Yes, they do.
    Gosh, what were the chances of that happening?

    Claim CA250:
    Scientific theories are always changing. You cannot trust what scientists say, since it may be different tomorrow.
    Source:
    Egilson, G. H. 2003. For creation. Post on talk.origins, 23 Oct
    Matthews, Michael. 2003. A century of fraud. http://www.answersingenesis website.

  84. Robert Brentwood

    Alison

    I had to laugh when Steve above said you still had his respect as if that was why you entered this discussion. What you are dealing with here is a ‘mutual self-comfirmatory cabal’.

    The simplest arguments against fluoridation are:
    1) Fluoride is not essential for dental or general health
    2) As presented (as having the properties to prevent tooth decay) adding fluoride to drinking water is obviously medication without individual, informed consent and is therefore fundamentally wrong
    3) If there is a benefit from adding fluoride to drinking water to justify ignoring 1) and overriding 2) then it would have to be supported evidence of the highest quality – Randomized Controlled Trials. There are none. A pile of poor studies on fluoridation high enough to reach the moon will always be poor studies carrying a high risk of bias

    Alison, here’s the story of a senior NZ fluoridationist changing his mind to become an opponent of the practice – http://tinyurl.com/ojk9ot7 (if it gets past Ken’s moderation).

    Let the apoplexy begin.

    Robert

  85. Robert Brentwood

    Cedric

    Thank you for highlighting the ‘HIV’ denialist issue. What’s the reference for the isolation of ‘HIV’?

    Steve, you and the rest of your gang bring me up to speed? Hee, hee. Baked chocolate cheesecake (without an biscuit base!), plum compote and a nice cup of tea, mmmh, yes please!

    Robert

  86. Robert

    Seriously? The same, stale, unsubstantiated antifluorifationist “arguments”? The “forced medication” gambit has been repeatedly tried and failed in US courts. It has no merit. Informed consent for a mineral which has been ingested by humans in water since the beginning of time? That argument is so absurd that it bears no further comment.

    The old “randomized controlled trials” copy/paste from antifluoridationist websites? Your unqualified opinion on the quality of peer-reviewed scientific studies is irrelevant. It appears we have far more work to do to bring you up to speed than previously thought. The very first thing you need to do is to stop relying solely on misinformation spoon fed to you by antifluoridationist websites, access accurate information from reliable, and respected primary sources, and try to begin using your own brain. Only then may you possibly begin to contribute anything of intelligence to this discussion.

    Steven D. Slott, DDS

  87. Robert Brentwood

    Steve

    Those were pathetic responses.

    Without RCTs, fluoridation is unsubstantiated and that is after nearly seventy years!

    Cedric tries to lump those opposed to mass-medication in with creationists et cetera but the belief in fluoridation is just like the belief in creation by an entity commonly referred to as God – there is no proof! I also disagree with those who say there isn’t a god. How can they know?

    Perhaps you would like to try again. Where’s my cake??? I want cake!

    Robert

  88. Read my previous comment, Robert It’s self-explanatory. Begin using your own brain and properly educate yourself. Otherwise you’re just a waste of time.

    Steven D. Slott, DDS

  89. Robert Brentwood

    Steve

    You have no response to my basic points. I’m not trying to mass-medicate anyone or defend the obscene practice of fluoridation. You are the one who should “Begin using your own brain and properly educate yourself”.

    No cake then?

    Robert

  90. Robert. If you’re still parrotting RCT’s, first of all, do you even know what a double blind, randomized, controlled trial is? Second, do you even have a basic understanding of how public health initiatives are evaluated? Third, state specific points in specific studies that you deem make them “poor”.

    Steven D. Slott, DDS

  91. Steve, I see no value in contrasting the claims of anti fluoridationists against the claims of promoters of fluoridation. This is a logical fallacy. The strength of the pro-fluoridation rationale is unaffected by the quality interest arguments opposing it. Public standards for the quality of information coming from public health officials, and financed by tax payer money, will always be much higher than standards for those who start their own Internet websites with private money. The fact that opponents sometimes exaggerate the risks is entirely irrelevant as to whether or not the benefits have been exaggerated.
    When it comes to an ad in the paper from public health representatives, 1 questionable claim is ONE TOO MANY. It played on fears of the “tragedy of arteriosclerosis” and “broken bones of skiiers and football players”. How about telling people that “some fluoridated towns never see hip fractures”?
    Yes, at low levels there is evidence of possible benefit, but total fluoride accumulation over a lifetime exceeds that range easily, especially for people in the north who have been fluoridated at 1.2-1.6 for the past 50 years.

  92. Alison, you’re grasping at straws here. Again, there has been no misleading of the public as to the benefits of fluoridation by public health or any other responsible, respected groups or organizations. The claim of benefit to reducing athlerosclorosis was the belief in 1968, and may very well be true, I honestly don’t know. But if you’re going to try to make an issue out of that then you are behaving as does any antifluoridationist, not as the responsible fluoridation opponent I’ve come to believe you to be.

    Public health intiatives are evaluated on the basis of effect on entire populations which are exposed to that initiative. There are countless peer-reviewed studies, some of which I’ve cited in these comments, which clearly demonstrate the effectiveness of water fluoridation in reducing dental decay of exposed populations. There have been NO proven adverse effects in its entire history. Those are the relevant points. If you want to attempt to argue against fluoridation because a newspaper ad in 1968 cited a benefit in reducing athleroscloris, feel free, but if so, that is clear demonstration that you are seeking to find anything, no matter how irrelevant in order to further your argument. That’s not arguing science. It’s arguing personal ideology.

    Steven D. Slott, DDS

  93. Thank you for highlighting the ‘HIV’ denialist issue. What’s the reference for the isolation of ‘HIV’?

    More overlap? Colour me unsurprised.
    What next?
    Will the moon landing deniers come out of the woodwork?

    Steve :Mounds and mounds of false and misleading information that has been put out by climate deniers for decades, and which continues today unabated. Look at the claims of no global warming, 70′s Ice Age, Urban Heat Island, , that climate deniers have been making for decades. None of the PRATT’s have been proven in any manner to be valid, in the entire climate denier history. If you want to indict anyone for their facts and opinions having been shown to be invalid, climate deniers are the ones at whom you should be looking, not healthcare personnel.

    Alison: Steve, I see no value in contrasting the claims of climate deniers against the claims of NASA and every single scientific community on the planet. This is a logical fallacy. The strength of NASA and every single scientific communities rationale is unaffected by the quality interest arguments opposing it. Public standards for the quality of information coming from scientific communities, and financed by tax payer money, will always be much higher than standards for those who start their own Internet websites with private money. The fact that opponents sometimes have false and misleading information is entirely irrelevant as to whether or not climate change has been exaggerated by some ad I found in a newspaper from 1968.

    Methodology, Alison.
    It’s the same.
    You’re doing it wrong.

  94. I’m saying that fluoridation would never have passed here in Camden if not for that ad. People felt there were better means of getting fluoride to our population than putting it in half the town’s water, and the town had voted it down twice before. Fluoridation has not improved our hip fracture rates or the rate of cardiovascular disease, and there was never good evidence to show that it would. Still, most doctors in town had no problem signing an ad telling everyone it would do just that. They had the best of intentions, but it turned out not to be true.

  95. Also Steve, don’t interpret everything I say as an attempt to reveal some smoking gun that shows fluoridation is wrong. I bring things up mostly because I find them interesting and worth talking about. Fluoridation may make more sense for certain communities than others. I think the quality of information all around is too low. That isn’t a point against fluoridation or for it. I don’t think it’s killing anyone, but there may be much more effective ways of improving dental health AND communicating information to the public.

  96. Alison, in all likelihood, the reason that your ad may have been instrumental in passing fluoridation, if indeed it was, was due to the lengthy list of respected supporters who signed onto it, not because of any claims of reducing atherosclerosis. If you differ with this, then please cite proof that this ad was the reason it passed.

    As far as hip fracture claims:

    “Estimated individual drinking water fluoride exposure was stratified into 4 categories: very low, < 0.3 mg/L; low, 0.3 to 0.69 mg/L; medium, 0.7 to 1.49 mg/L; and high, ≥ 1.5 mg/L. Overall, we found no association between chronic fluoride exposure and the occurrence of hip fracture. The risk estimates did not change in analyses restricted to only low-trauma osteoporotic hip fractures. Chronic fluoride exposure from drinking water does not seem to have any important effects on the risk of hip fracture, in the investigated exposure range."

    Estimated Drinking Water Fluoride Exposure and Risk of Hip Fracture
    A Cohort Study, P. Näsman, J. Ekstrand, F. Granath, A. Ekbom, C.M. Fored
    Journal of Dental Research

    Steven D. Slott, DDS

  97. Also Steve, don’t interpret everything I say as an attempt to reveal some smoking gun that shows evolution is wrong. I bring things up mostly because I find them interesting and worth talking about. Evolution may make more sense for certain adaptations than others. I think the quality of information all around is too low. That isn’t a point against evolution or for it. I don’t think it’s killing anyone, but there may be much more effective ways of improving biology AND communicating information to the public.

    (Alison goes off hunting for more trash from Answersingenesis)

    Actions speak louder than words.

    They had the best of intentions, but it turned out not to be true.

    If that’s true….so what?
    Why the obsession with a newspaper ad from 1968? What a bizarre way of doing things. You really are scraping the bottom of the barrel here.

    Whatever next? Are you going to focus on a 70′s cover story from Newsweek to take a pot shot at climate change?
    There’s one available.
    (….rumages through collection…)
    Ah, here we go.

    Methodology.
    It all comes back to methodology.

  98. Alison, your opinion that there may be much more effective ways to improve dental health is true. Providing free, comprehensive, regular dental treatment to the entire populace, along with a massive, worldwide, constant educational program with no financial limitations would probably be more effective. As this will not happen, the overwhelming consensus of leading healthcare experts in the world is that water fluoridation provides a significant tool in the prevention of dental decay. It is not a cure-all for dental disease, nor was it ever purported to be by any respected healthcare entities or individuals. As a tool, there is no more cost effective manner of obtaining the level of dental decay prevention than water fluoridation.

    Steven D. Slott, DDS

  99. Robert, silly name calling is no contribution. I have put you into moderation to see if we can control such behaviour.

    As always, constructive contributions to discussion will be arrived. But not the abusiveness stuff.

  100. It would be helpful, also, for those who choose to use opposing talking points, for them to at least understand the science and methodology, as applicable, behind these points. I don’t agree with the stated need by opponents for RCTs, but I respect those who do understand what they are talking about in this regard and can make intelligent, thought provoking arguments. That type of discussion is useful. When those who have no understanding of the science, rationale, and methodology simply repeat what they glean off of third party websites, with no understanding of it, whatsoever, they simply waste time and space.

    Steven Slott, DDS

  101. Read the history of fluorspar in award winning British journalist Christopher Bryson’s book The Fluoride Deception and you will never love fluoride or fluoridation again. The arguments will be all over. We have been totally deceived and conned and made to look absolutely stupid by America’s best spin doctors!

  102. Peter, I have approved your comment but will moderate you and not approve such comments in future as they really add nothing to the discussion being basically a book promotion and a political put down. I have read Bryson’s book, which is basically about industrial pollution, and it just didn’t have the effect on me you suggested. I really can’t see why anti-fluoridation activists rave on about it.

    Please feel free to join in the discussion here with something of value.

  103. Here’s a better idea for intelligent people who truly seek reliable information on water fluoridation. Instead of reading a non peer-reviewed, insignificant book written by an investigative reporter, why not access accurate information from reliable, respected, and knowledgeable sources? The websites of the EPA, the CDC, the NSF, the ADA, the WHO, among many others, have a wealth of accurate information on water fluoridation readily available to anyone who so desires.

    Steven D. Slott, DDS

  104. “Read the history of the moon landings in Bill Kaysing’s book We Never Went to the Moon: America’s Thirty Billion Dollar Swindle and you will never accept the Apollo Missions hoax again. The arguments will be all over. We have been totally deceived and conned and made to look absolutely stupid by America’s best spin doctors!”

    “Read the history of vaccines in Andrew Wakefield’s book Callous Disregard and you will never accept Big Pharma again. The arguments will be all over. We have been totally deceived and conned and made to look absolutely stupid by America’s best spin doctors!”

    “Read the history of climate change in Stanley Feldman’s book Global Warming and other Bollocks and you will never accept Obamaism again. The arguments will be all over. We have been totally deceived and conned and made to look absolutely stupid by America’s best spin doctors!”

    “Read the history of evolution…”

    “Read the history of HIV…”

    Read the etc, etc, etc, etc,…..

    Methodology. It all comes back to methodology.

    Skewed views of science Theory or Guess_ – YouTube.FLV

  105. Andrew Stratford – your comment is personal and irrelevant.

  106. When I read the above I think
    1/There is sufficient emotion in this argument.
    2/ All of you are married to an idea on the basis of fairly low quality studies and will be immovable even in the face of new evidence.
    3/ fluoridationists need to respect that they are married to an idea, that has been at least historically subject to political manipulation, antifluoridationists need to respect that they too are married to an idea and it just so happens that the media and govt are opposed to this.

    You can continue these arguments but they will simply fuel the fire further, you are better to work on producing more high quality research or finding better alternatives.

    4/ The only way forward in terms of discussion is for both parties to have sufficient empathy for each others position, this takes time, effort and maturity. I don’t see that in the above discussion and it saddens me to see people of such supposed stature not able to achieve this.

  107. Hi Derek –

    I think you have been in touch with your feelings so long you have either forgotten or misunderstand what science is.

    I think your 4th point say’s it all.

    If only the Fluoride ion could decide whether is was a good ion and prevent tooth decay or a bad bad toxic poison that causes dumb kids, cancer, skeletal fluorosis and bad hair…

  108. in before Cedric ;-)

    3/ The worlds medical community needs to respect that they are married to an idea that HIV causes AIDS, that has been at least historically subject to political manipulation, HIV denierss need to respect that they too are married to an idea and it just so happens that the media and govt are opposed to this.

    3/ The biological sciences need to respect that they is married to the idea of evolution, that has been at least historically subject to political manipulation, creationists need to respect that they too are married to an idea and it just so happens that the media and govt are opposed to this.

    3/ Medical science need to respect that they are married to an idea that vaccinations save millions of lives, that has been at least historically subject to political manipulation, ant vaccinationists need to respect that they too are married to an idea and it just so happens that the media and govt are opposed to this.

    The only way forward in terms of discussion is for both parties to have sufficient empathy for each others position,

    No, that won’t do, empathy means squat all.

    Only the work in the scientific arena counts.

    (How did I do, C?)

  109. You are stealing my material, you magnificent bastard you!
    Well done. :)
    Go forth, grasshopper, and spread this techinque far and wide.
    There is nothing more for me to teach you.
    The student has become the master.

    No, that won’t do, empathy means squat all.

    Yep.
    In science, nobody cares about your feelings about the scientific consensus. Keep them to yourself.
    In science, the work talks and the bullshit walks.

    26 — Science vs. the Feelies

  110. In COMMENT 48068, Cedric Katesby wrote:

    CEDRIC: “In science, the work talks and the bullshit walks.”

    PM Response: When are you going to start walking?

    Or have you forgotten your wonderful promise already?

    http://openparachute.wordpress.com/2013/11/25/fluoridation-debate-why-i-support-fluoridation-2nd-reply-to-connett/#comment-47953

    As you said – “it’s put up or shut up around here.”

    Paul Melters

  111. Paul, read simple English.
    Click your own link.
    I replied to you yesterday. Do try to keep up.

  112. Focusing on the question of effectiveness of fluoride (including its mode of action and cost-effectiveness) provides the best objective evidence.

    1.) Topical Application vs. Systemic Ingestion:

    “The level of fluoride incorporated into dental mineral by systemic ingestion is insufficient to play a significant role in caries prevention. The effect of systemically ingested fluoride on caries is minimal.” Featherstone JDB (1999) Prevention and reversal of dental caries: role of low level fluoride. Community Dent Oral Epidemiol 27 (quoted text from abstract, discussion at pp. 31-40).

    Pubmed link: http://www.ncbi.nlm.nih.gov/pubmed/10086924

    This study has not been contradicted or called in to question. The recognition that fluoride is not effective through systemic ingestion has been noted in other studies:

    “For the past 50 years community water fluoridation has been considered the milestone of caries prevention and as one of the major public health measures of the 20th century. However, it is now accepted that the primary cariostatic action of fluoride occurs after tooth eruption.” Pizzo et al. (2007) Community water fluoridation and caries prevention: a critical review. Clin Oral Investig. 2007 Sep;11(3):189-93. Epub 2007 Feb 27.

    However, proponents have cited a 2009 JADA study to say that there is some benefit from ingestion of fluoride:

    The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren, Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH, JADA July, 2009 140(7):855-862

    JADA link: http://jada.ada.org/content/140/7/855.long

    I only have access to the abstract of the JADA study- the full text is behind a wall. However, I note that it “examined the association between enamel fluorosis and caries” and concluded only that “[t]his study’s findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis.” The authors intentionally used the word “suggest.”

    Perhaps this is related to their overlapping 95% confidence intervals- “0.71 (95 percent confidence interval [CI], 0.56–0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74–1.06) in communities with water at or above optimal fluoridation levels.” I’d love to read the entire study, but based on the information given, it does not substantially contradict Featherstone JDB (1999) for the proposition that systemic ingestion of fluoride is not significantly beneficial to caries prevention. Steven D. Slott apparently has access to the entire study, but has not shared its essential characteristics, such as sample size and identification of the cohorts.

    2.) Effectiveness Generally:

    A large Australian study from this year found a 10-11% decrease in DMFT’s attributable to water fluoridation.

    G.D. Slade, et al., Effects of Fluoridated Drinking Water on Dental Caries in Australian Adults, Journal of Dental Research, revised March 18, 2013.

    ADA link to .pdf version of study: http://www.ada.org.au/app_cmslib/media/lib/1303/m537918_v1_nsaoh%20fluoridation%20paper.pdf

    JDR link to online version: http://jdr.sagepub.com/content/92/4/376

    As recognized, studies comparing fluoridated vs. non-fluoridated communities within the U.S. are virtually impossible today due to the “halo effect.” Presumably, Australia, with its mix of fluoridation policies, presents a similar quandary.

    However, the Australian study used a different comparison- people born before 1960 vs. those born between 1960 and 1990- to reach the conclusion that “In fully adjusted models, > 75% of lifetime exposure to fluoridation relative to < 25% of lifetime exposure was associated with 11% and 10% fewer DMF-Teeth in the pre-1960 (p < .0001) and 1960–1990 cohorts (p = .018), respectively." Thus, the study found that the 10-11% reduction in DMFT's due to water fluoridation remained constant over time (ie. before and after introduction of fluoride-based topical applications.) The study does not directly address cost-effectiveness, but keep in mind the 10-11% figure.

    3.) Example of Typical Cost-Effectiveness Study:

    A 2005 study found that "Colorado would save an additional $46.6 million (credible range, $36.0 to $58.6 million) annually if [water fluoridation programs] were implemented in the 52 water systems without such programs and for which fluoridation is recommended."

    Brunson et al., Costs and Savings Associated With Community Water Fluoridation Programs in Colorado, Prev Chronic Dis. 2005 November; 2(Spec No): A06.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459459/

    First, it is a fair observation to make that the authors of this study state the purpose of the study is "…for health policy makers, health education specialists, health care providers, and the news media to have state-specific quantitative information on the impact of oral disease prevention strategies to MAINTAIN SUPPORT for existing programs and PROMOTE implementation of new programs." (emphasis mine). This purpose is at odds with the scientific method, and undermines their credibility. To be fair, the authors also discuss at some length the weaknesses of their method in their Discussion section.

    Second, substantively, the authors use a 25% estimated reduction in DMFT's that was found by Griffin, et al. Setting aside whether raw percentages should be the basis for cost-effectiveness analysis at all, why would they choose this figure? Why don't they include costs associated with fluorosis? ("mild" fluorosis means that white spots cover between 25% and 50% of the tooth surface- it does not mean that it looks mild) How do they include "lost productivity" in their equations with a straight face? The point is- any cost-effectiveness study needs to be closely examined rather than taken at face value, particularly when the authors admit their goal is providing "quantitative information… to maintain support for existing programs."

    Thanks,
    Joseph

  113. Brunson et al., Costs and Savings Associated With Community Water Fluoridation Programs in Colorado, Prev Chronic Dis. 2005 November; 2(Spec No): A06.

    write:

    It is important for health policy makers, health education specialists, health care providers, and the news media to have state-specific quantitative information on the impact of oral disease prevention strategies to maintain support for existing programs and promote implementation of new programs.

    Joseph writes

    it is a fair observation to make that the authors of this study state the purpose of the study is “…for health policy makers, health education specialists, health care providers, and the news media to have state-specific quantitative information on the impact of oral disease prevention strategies to MAINTAIN SUPPORT for existing programs and PROMOTE implementation of new programs.”

    followed by

    This purpose is at odds with the scientific method, and undermines their credibility.

    See what he did there?

  114. Yes.
    Creepy.
    What is wrong with these people?

  115. “It is important for” is not meaningfully different than “the purpose of this study is for.”

    Brunson et al. (2005) give another formulation of the same purpose:

    “In 2005, Colorado met the Healthy People 2010 objective of 75% or more of people using optimally fluoridated water through community water systems. The actual percentage in Colorado, however, was just above 75%. Because communities with CWFPs face challenges in retaining water fluoridation programs, and communities without programs require information to make implementation decisions, it is important that data on CWFP costs and treatment savings be available at the state level.” (internal references deleted).

    To paraphrase this second statement of intent: “In 2005, Colorado met our Healthy People 2010 objective of 75% fluoridation, but we only barely exceeded it. Because communities with water fluoridation programs face challenges in retaining those programs, it is important they have information to help them make the correct implementation decisions.”

  116. Don’t feel bad, Joseph. Out-of-context quoting is perfectly permissible by any antifluoridationist standards.

    Steven D. Slott, DDS

  117. Joseph,

    You supplied the link to the papers…
    - that was helpful.

    Creatively interpreting them for us…
    - not so helpful.

  118. It makes you look bad, Joseph. It unacceptable. We don’t do it to you so you shouldn’t do it to us.
    Want to quote something? Then quote it.
    In full. In context. No changes. No cute re-wording.
    The link was nice, though.
    Certain people don’t do that.
    (Yes, Louise. I’m looking you. This is the internet, remember?)

  119. In the Discussion section of Brunson et al. (2005), they repeat the purpose of their study for a third time:

    “Traditional messages on fluoridation have been, “it prevents caries,” “it saves money,” and “it’s cost-effective.” The model used in this analysis provides Colorado-specific estimates of CWFP savings and may be replicated for other states. Such information may be used by public health practitioners and policy makers at all levels to promote continued support for existing CWFPs and implementation of new programs.”

    The “creepy” comment seems off-topic.

  120. No, it doesn’t. Deal with it.
    If you want to quote somebody then then quote them.
    Do it right.
    In full. In context. No changes. No cute re-wording.
    Anything else is unacceptable.

    To paraphrase this second…

    No.
    Keep that to yourself. We’ll stick to reality.

    Creationist quote mine collapse

  121. In the Discussion section of Brunson et al. (2005), they repeat the purpose of their study for a third time..

    No Joseph.
    You are still creatively interpreting.

    i read it as the authors are suggesting possible uses for the information given the clear outcomes of the study. They are implying, perhaps with overconfidence (but then again perhaps not), that similar results may be replicated in other states.

    Thank you for your creative efforts, but I will use my own judgment.

  122. Here is the link to the full text of Iida et al., The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren, JADA July, 2009 140(7):855-862:

    http://www.fairbanksalaska.us/wp-content/uploads/2011/07/20090707Iida-Kumar-Fluorosis-and-Caries-JADA-855-862.pdf

    The study concluded that “The results of this study suggest that teeth with fluorosis were more resistant to caries in U.S. schoolchildren than were teeth without fluorosis. Our results highlight the need for those considering policies regarding reduction of fluoride exposure to take into consideration the caries-preventative benefits associated with milder forms of enamel fluorosis.” (Conclusion, p. 862).

    In addition to my previous observation about the study’s overlapping 95% confidence intervals and ultimate “suggestion,” I add the following brief comments:

    1.) The study limited its examination to permanent maxillary right first molars- tooth number 3.

    “To analyze the association between enamel fluorosis and dental caries at the tooth level, we focused our analysis on the permanent maxillary right first molar (tooth no. 3) as a response variable.” (Iida et al. at 857).

    2.) The study inexplicably used DMFS’s instead of DMFT’s for their analysis.

    “At the tooth level, we performed bivariate analysis relating mean DMFS (hereafter referred to as “mean DMFS^3,” to indicate the DMFS of tooth no. 3) and caries prevalence in the index tooth (refers to percentage with DMFS^3 > 0) to enamel fluorosis and potential covariates such as age, sex, race or ethnicity, water fluoride content, metropolitan status, school region and sealant status.” (Id.).

    3.) The study used an adjusted odds ratio instead of a risk ratio, despite the “rare disease assumption” being questionably applicable. (See Id., Table 3 at pg. 860).

    4.) Most importantly, the study found this:

    “In communities with fluoridated water ([at or above] 0.7 ppm), the protective effect of enamel fluorosis was observable, but the statistical significance was borderline. This could be explained partly by the pre-eruptive and posteruptive protective effect of community-water fluoride on molars without fluorosis as well. Another issue is that the diagnosis of enamel fluorosis is subject to misclassification error. In such a case, the association between enamel fluorosis is attenuated if it is assumed that such a misclassification is nondifferential.” (Iida et al. at 861)(internal citations omitted).

    7,086 molars in the total sample size of 16,873 molars were from communities with 0.7 ppm or above water fluoridation. This subset is comprised of 6,350 molars from communities with between 0.7 ppm and 1.2 ppm and 736 molars from communities above 1.2 ppm. (Iida et al. Table 1 at pg. 858).

    The authors do not provide an separate statistical analysis of communities with optimal water fluoridation other than to say that the relationship between fluorosis and dental caries in these communities is observable and of borderline statistical significance. It is difficult to explain how, given this finding specific to water fluoridated communities, the authors nevertheless conclude that fluorosis is statistically associated with caries prevention overall. The logical inference is that fluorosis is significantly associated with caries prevention in non-optimally-fluoridated communities to a degree that overcomes the lack of association in optimally fluoridated communities sufficient to make the overall association “suggestive.”

    *Note on ad hominem comments- there were comments that I am “creepy,” “creative,” and “feel bad,” and that I am one of “those people” and an “anti-fluoridationist.” These comments are more or less inaccurate, and not probative of the questions under discussion.

  123. EDIT (math)-

    7,990 molars in the total sample size of 16,873 molars were from communities with 0.7 ppm or above water fluoridation. This subset is comprised of 7,177 molars from communities with between 0.7 ppm and 1.2 ppm and 813 molars from communities above 1.2 ppm. (Iida et al. Table 1 at pg. 858).

  124. Note on ad hominem comments….

    Someone’s going retro.
    (sigh)
    What ad hominem?
    Here’s a clue. Find out what it means.
    There’s this thing called google. You can just type in “ad hominem” and find out what it means as opposed to what you think it means.
    Once more around on the merry-go-round.
    Is there some training camp where people go where they teach them to you invoke the same stupid cliches???
    Look it up.

  125. Ah, screw it. Let’s just move this along, shall we?
    Your next move is to ignore my advice and assert that you already know what an ad hominem really is and to keep bitching about it.

    Then my next move is , with great weariness, to post a video that shows in simple English what an ad hominem actually means.

    From there you will do one of three things:

    1) Ignore everything that happened and keep bitching.
    2) Ignore everything and act like you never brought up accusations of ad hominem in the first place
    3) In a surly way, acknowledge that you were kinda-sorta mistaken but (goshdarnitt!!!) it doesn’t matter any way, so there.

    So what’s it going to be then?

  126. I don’t know if you are a creative person or not, Joseph.
    Certainly. it wasn’t ad hominem to call your embellishments creative.
    The words didn’t appear in the quote, you created them. Easy to avoid the charge, next time just quote in full and argue the point, don’t append your interpretation to a quote. Simple.

  127. It is difficult to explain how, given this finding specific to water fluoridated communities, the authors nevertheless conclude that fluorosis is statistically associated with caries prevention overall.

    You could ask them if it bothers you so much.
    Try it before creating a reason.

  128. I retract my note about “ad hominem comments”- it incorrectly implied that the speaker or speakers were attempting to refute an argument, when in fact most of the comments were merely gratuitous (or, in the case of the re-posted Youtube clip, related to creationism). Regretfully, my note opened the door to more gleeful distraction from those tedious statistics surrounding community water fluoridation policies.

  129. Ken-

    You may have noticed that there have been several unrelated (yet entertaining) Youtube clips posted in the comments here, but a grand total of 0 (zero) citations to peer-reviewed studies in the support of community water fluoridation. In an attempt to cut through the clutter, I’d ask you for a couple studies you examined that support your conclusion that water fluoridation is cost effective. This may further the conversation.

    Thanks,
    Joseph

  130. I retract my note about “ad hominem comments”-

    Gosh. You did the right thing.
    Hmm.
    Well, thank you then.
    One point to you in the credibility box.

    …it incorrectly implied that the speaker or speakers were attempting to refute an argument, when in fact….

    Don’t spoil it. Just retract and move on with your life.
    Otherwise, it becomes a notpology.

    …from those tedious statistics….

    I’ve never felt that giving tedious statistics was a good move.
    Most people find them tedious.
    If even YOU find them tedious then they’re unlikey to send a thrill up anybody else’s leg.

    (or, in the case of the re-posted Youtube clip, related to creationism).

    If you don’t like being compared to creationists, then don’t behave like them.
    Adopt a different methodology.
    You can start by pulling your socks up on quoting people.
    Avoid “creative embellishment”.
    Kill it stone cold dead.
    Let the quote accurately represent the original writer.
    Is it really that much to ask? Surely not.
    If you feel you have to put it your “little bit extra” then maybe you should ask yourself how much you value your personal integrity.
    If you have to stoop that low, then give it up.

    It is difficult to explain how, given this finding specific to water fluoridated communities, the authors nevertheless conclude…

    Why share your feeling on authors? There doesn’t seem to be any reason for us to care. JAQ’ing off is not acceptable around these here parts.
    We see it all too often and we can recognise it a mile off.
    It gets old very fast.

    If you want to make a claim, then do so.
    Don’t allude.
    Don’t hint.
    Don’t suggest.
    Don’t act all confused and querulous.
    Just spit it out.
    Say what you mean and mean what you say.

  131. Joseph

    You asked for peer-reviewed citations in support of fluoridation. How many would you like? Here are a few:

    1). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925001/

    Results
    Children from every age group had greater caries prevalence and more caries experience in areas with negligible fluoride concentrations in the water (<0.3 parts per million [ppm]) than in optimally fluoridated areas (≥0.7 ppm). Controlling for child age, residential location, and SES, deciduous and permanent caries experience was 28.7% and 31.6% higher, respectively, in low-fluoride areas compared with optimally fluoridated areas. The odds ratios for higher caries prevalence in areas with negligible fluoride compared with optimal fluoride were 1.34 (95% confidence interval [CI] 1.29, 1.39) and 1.24 (95% CI 1.21, 1.28) in the deciduous and permanent dentitions, respectively.

    ——Community Effectiveness of Public Water Fluoridation in Reducing Children's Dental Disease
    Jason Mathew Armfield, PhD

    2) http://www.ncbi.nlm.nih.gov/pubmed/23550501

    CONCLUSIONS:
    Children with severe dental caries had statistically significantly lower numbers of lesions if they lived in a fluoridated area. The lower treatment need in such high-risk children has important implications for publicly-funded dental care.

    ——Community Dent Health. 2013 Mar;30(1):15-8.
    Fluoridation and dental caries severity in young children treated under general anaesthesia: an analysis of treatment records in a 10-year case series.
    Kamel MS, Thomson WM, Drummond BK.
    Source
    Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand.

    3). http://www.ncbi.nlm.nih.gov/pubmed/23488212

    CONCLUSIONS:
    The survey provides further evidence of the effectiveness in reducing dental caries experience up to 16 years of age. The extra intricacies involved in using the Percentage Lifetime Exposure method did not provide much more information when compared to the simpler Estimated Fluoridation Status method.

    —–Community Dent Health. 2012 Dec;29(4):293-6.
    Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland.
    Mullen J, McGaffin J, Farvardin N, Brightman S, Haire C, Freeman R.
    Source
    Health Service Executive, Sligo, Republic of Ireland. joej.mullen@hse.ie

    4) http://www.ncbi.nlm.nih.gov/pubmed/8500120

    Abstract
    The effectiveness of fluoridation has been documented by observational and interventional studies for over 50 years. Data are available from 113 studies in 23 countries. The modal reduction in DMFT values for primary teeth was 40-49% and 50-59% for permanent teeth. The pattern of caries now occurring in fluoride and low-fluoride areas in 15- to 16-year-old children illustrates the impact of water fluoridation on first and second molars.

    —-Caries Res. 1993;27 Suppl 1:2-8.
    Efficacy of preventive agents for dental caries. Systemic fluorides: water fluoridation.
    Murray JJ.
    Source
    Department of Child Dental Health, Dental School, University of Newcastle upon Tyne, UK.

    5). http://www.ncbi.nlm.nih.gov/pubmed/23252588

    CONCLUSIONS:
    Data showed a significant decrease in dental caries across the entire country, with an average reduction of 25% occurring every 5 years. General trends indicated that a reduction in DMFT index values occurred over time, that a further reduction in DMFT index values occurred when a municipality fluoridated its water supply, and mean DMFT index values were lower in larger than in smaller municipalities.

    —-Int Dent J. 2012 Dec;62(6):308-14. doi: 10.1111/j.1875-595x.2012.00124.x.
    Decline in dental caries among 12-year-old children in Brazil, 1980-2005.
    Lauris JR, da Silva Bastos R, de Magalhaes Bastos JR.
    Source
    Department of Paediatric Dentistry, University of São Paulo, Bauru, São Paulo, Brazil. jrlauris@fob.usp.br

    Steven D.Slott, DDS

  132. Joseph, in regard to your “analysis” of the Kumar study

    http://jada.ada.org/content/140/7/855.long
    The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren
    Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH

    Here is a response from Dr. Kumar:

    “My impression is that these comments are superficial and not based on a thorough understanding of the study design or oral epidemiology.

    4. I see that the main criticism is this –The logical inference is that fluorosis is significantly associated with caries prevention in non-optimally-fluoridated communities to a degree that overcomes the lack of association in optimally fluoridated communities sufficient to make the overall association “suggestive.”

    Our response –We performed a stratified analysis because all children are exposed to fluoride in communities with optimal water fluoridation (Table 3 & 4). If one wants to assess the association between smoking and lung cancer, it will not be possible to detect the true association if all are smokers! Similarly, if one wants to understand the true association between enamel fluorosis and caries one should look at the relationship in a non-fluoridated area where there are sufficient number of teeth with fluorosis (Table 3).

    1. The study limited its examination to permanent maxillary right first molars- tooth number 3.

    We provide a detailed explanation about why we chose this tooth as an index tooth for this publication (2nd & 3rd paragraphs on page 857)- “all four permanent first molars presented similar patterns of caries experience and enamel fluorosis, according to our preliminary analysis;”

    2. The study inexplicably used DMFS’s instead of DMFT’s for their analysis.

    It’s always preferable to use DMFS over DMFT. We charge patients by the number of surfaces affected, therefore it is important to know how many surfaces are affected.

    3.) The study used an adjusted odds ratio instead of a risk ratio, despite the “rare disease assumption” being questionably applicable. (See Id., Table 3 at pg. 860).

    Our goal was to assess if there is an association. The study design is cross sectional and the odds ratio is the appropriate measure of association directly estimated from a logistic regression model. If I had used the risk ratio in this case, the reviewers would have summarily rejected our paper!”

    Steven D. Slott, DDS

  133. You could ask them if it bothers you so much.
    Try it before creating a reason.

    I’m willing to bet it never occured to you.

    Here is a response from Dr. Kumar:

    “My impression is that these comments are superficial and not based on a thorough understanding of the study design or oral epidemiology.

    That’s right. Dr Kumar is a real person.
    Has he done something to displease you? Well, you could always complain directly to him.
    That would be wonderful fun.

    (…grabs popcorn…)

  134. Steven D. Slott-

    Thank you for correcting the tone in this comment section. Dr. Kumar’s response does clarify and justify the choices made in the design of the study.

    However, my main criticisms were not addressed:

    First, the strength of the conclusion the study draws. As I put it- their widely overlapping 95% confidence intervals- “0.71 (95 percent confidence interval [CI], 0.56–0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74–1.06) in communities with water at or above optimal fluoridation levels.”

    Was this finding not strong enough to conclude that there is a correlation (rather than association) between fluorosis and caries prevention, or does Dr. Kumar use the terms interchangeably?

    More to the point, you cited this study for the proposition that there is a SIGNIFICANT effect on caries prevention from systemic ingestion of fluoride (not fluorosis). Does Dr. Kumar agree with this characterization of his study? And is it his opinion that his study significantly contradicts Featherstone JDB (1999).

  135. Does Dr. Kumar agree with this….

    This whole “ask him yourself” concept seems a bit beyond you.

    However, my main criticisms were not addressed.

    Did you notice Dr Kumar mentioning “…comments are superficial and not based on a thorough understanding of the study design or oral epidemiology”?
    That would make a normal person slow down a bit.
    You, on the other hand, just keep digging.
    Hmm.

  136. Thank you for correcting the tone in this comment section.

    It’s never easy being caught out under the spotlight.

  137. Joseph

    Dr. Kumar’s response stands very well on its own merit. Readers can assess for themselves the validity of your comments.

    “Significant” is a subjective term. Even so, I have not quantified systemic or topical effect. Dental fluorosis is a systemic effect on developing teeth from the ingestion of fluoride. Therefore, there is a systemic effect. What I have said, however, is that it is moot what percentage is topical and what percentage is systemic. Water fluoridation is a public health initiative the success of which is gauged by effect on an entire population. Countless peer-reviewed scientific studies have demonstrated its effectiveness.

    Steven D. Slott, DDS

  138. “You could ask them if it bothers you so much.

    Try it before creating a reason.
    I’m willing to bet it never occured to you.”

    Cedric you are, not surprisingly, right on target yet once again.

    Steven D. Slott, DDS

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s