Fluoridation debate: Why I support fluoridation – 2nd reply to Connett

This is Ken Perrott’s response to Paul Connett’s second criticism of Ken’s article Fluoride Debate: Why I support fluoridation – 2nd response from Connett.

For Ken Perrott’s original article see - Fluoride debate: Why I support fluoridation.


It is a pity that Paul Connett chose to ignore the ethical question of balancing personal choice and social good because he took my comments on this as a personal criticism of him. They were not meant to be. I am happy to discuss the science but, in the end, science cannot make ethical and values decisions for us. Yes, it can, and should, inform those decisions – but pretending they are only about science does a disservice to science and to ethics.

Unfortunately science is often used in these sort of debates as a proxy for values issues. Professor Gluckman pointed that out in his statement What is in the water?  An excellent article by Tania Ritchie in Science and Society outlines the dangers of this approach (see  The fluoridation debate: why we all lose when we pretend it’s just about science). She shows how using science as a proxy backs people into pseudoscientific corners (and that is certainly an issue for these opposing fluoridation). It also places an impossible demand of certainty on science (“prove to me beyond doubt that fluoride at optimal concentrations is completely safe – if in doubt leave it out”). And concentration on the science often disguises poor ethical positions. She concludes:

“Using good science to counter bad science is productive. Using good science to tell us what will happen if we make a certain decision is also, of course, vital. But pretending science can tell us what decision we should make, or trying to counter ethical concerns with science, will never be helpful.”

Well, for the moment I guess I am opting for “using good science to counter bad science” but I hope we can return to these ethical issues at some stage.

Nature of bioapatites and systemic role for fluoride

Paul seems not to have taken on board my description of the structural role of fluoride in apatites and the recognised beneficial role of ingested fluoride. (Perhaps he considered that section was somehow a personal criticism and should be ignored.)

Mind you, I keep coming across that problem with other anti-fluoride  activists. They wish to talk only about topical application of fluoride, and ignore completely the beneficial effects of ingested fluoride. This seems to create reading, hearing and comprehension problems for them. So I get accused of advocating that suntan lotion should be drunk or similar attempts at humour!

However, it is a critical feature of this debate so I will just start this response by briefly repeating a few things.

  • Fluoride is a normal, natural component of bioapatites. In the real world these don’t exist as end-member compounds such as hydroxylapatite or fluoroapatite. They are more correctly described as hydroxyl-fluoro-carbonate-apatites.
  • Accumulation of fluoride, together with calcium and phosphate, in our bioapatites is a normal part of development. This is beneficial because it helps strength our bones and teeth, and lowers their solubility.
  • Both insufficient fluoride, or excess fluoride in our bioapatites can cause problems.
  • Excessive dietary intake can result in excessive fluoride in our bones and teeth. Insufficient intake may also cause our bioapatites to be weaker and more prone to dissolve. When dietary intake of fluoride is reduced fluoride can be lost from bones and calcified tissues.
  • The scientific literature reports that fluoride has a systemic role benefitting bones and pre-erupted teeth

Surface mechanisms for reducing tooth decay

We seem to be making a little progress here with the so-called “topical” mechanism – but only a little and very grudgingly. Paul has apologised for misrepresenting my explanation of the surface mechanism for the action of fluoridated water in countering tooth decay in existing teeth. He acknowledges that I was discussing the transfer of fluoride to saliva from water during drinking water, and not the smaller concentrations coming from the salivary glands after ingestion.

In this I was simply reporting what I have read in the scientific literature.  But Paul will still have none of that. He concedes that fluoride in saliva “may or may not do something” and presents his own “simple personal observations” to claim that there is little chance of drinking water mixing with saliva. Not the first time I have heard this argument – and it always brings a picture to mind of a committed anti-fluoride activist drinking their water through a tube down the throat. I leave it to readers to observe their own drinking behaviour and decide if drinking water has little chance of mixing with saliva – or transferring ions to saliva.

So it is one step forward and another step back. Made worse by his assertion (from personal experience) “that the fluoride ions have little opportunity to form a biofilm on any teeth other than the back of the front teeth.” Of course the fluoride does not form a biofilm. It and other ions in the water and saliva do, however, transfer to, and diffuse through, existing biofilms (plaque) on the teeth.

There are quite a few reports of the effect of regular consumption of fluoridated water increasing the F concentrations in saliva and plaque both after ingestion (eg Cury & Tenuta 2008Martínez-Mier 2012) and directly Featherston 2000Bruun & Thylstrup 1984). (Yes, I realise that the CDC sates that the ingested fluoride delivered to saliva “is not likely to affect cariogenic activity” and this is echoed by other writers. However, there still seem to be workers who argue this does contribute and I am aware of laboratory experiments showing the mechanism can work at very low fluoride concentrations. But this is a detail I will leave to the experts – it doesn’t affect the current exchange).

Loaded language and scientific knowledge

Paul again refers to advances of scientific knowledge in a sneering way. He claims that the CDC “admitted” that research indicated the prevention of dental caries by fluoride occurs by a topical mechanism in existing teeth. He also speculates that the CDC “was scrambling to salvage some kind of role for fluoridated water . . . Despite its admission of the predominance of the topical effect.” Can somebody with research experience in chemistry really see scientific progress as some sort of winning-out over a conspiracy to ignore the “truth?”

Mary Byrne, a local anti-fluoridation spokesperson, shows a similar apparent misunderstanding of the nature of scientific knowledge when she describes, disparagingly,  this progress in understanding as scientists being “wrong for fifty years.” She keeps repeating this even though her error has been explained to her.

These characterisations are like saying Newton was wrong with his laws of motion or that he was somehow hiding the truth and Einsteinian relativity  is simply a case of scientists being forced to “admit”, or “concede” they were wrong – as if they had hidden something!

Use of loaded language like this has a political purpose which interferes with proper understanding of the science.

The journal Fluoride

Paul describes my comments about the journal Fluoride, and its editors, as “derogatory,” and accuses me of “double standards.” I think that shows a sensitivity and inability to consider my comments objectively. Not surprising, as Paul has some “irons in the fire” on this issue.

I said that “if I had some credible findings in fluoride chemistry and wished to present a paper to the scientific community for their consideration Fluoride is the last journal I would choose.” This isn’t completely hypothetical because I have published a few papers on fluoride chemistry. So how do I decide where to publish my work?

Firstly, my fluoride work was relevant to pedology and soil chemistry so it was natural to consider soil science journals. This was the audience to aim for and our work was of direct relevance to readers of those journals. I doubt that many of our intended audience or their institutes subscribed to, or read, Fluoride.

But, today if I were considering a general  journal and had a look at Fluoride what would I find. First of all the website (where I would go to judge the journal’s scope, requirements and refereeing policy) – seriously, does this show a credible scientific society or editorial office?

fluoride-j

This is what greets you as the home page for the Fluoride journal (http://www.fluorideresearch.org/)

That extremely amateurish web page puts me off – perhaps there are other general journals dealing with fluoride (contrary to Paul’s claim). Let us see if Journal of Fluoride Chemistry is better? See the difference?

F-chem

Home page for the Journal of Fluorine Chemistry

Secondly, a quick skim of accepted papers in Fluoride indicates many are related to areas where fluoride toxicity is a problem because natural levels are high or excessive. The quality of many of these papers appears poor, a common problem where there are many authors whose main language is not English. It has a predominantly “third World” appearance. This would also raise a flag about possibly low standards of editorial review. Have a look at the list of contents for one of the 2007 issues.

None of these factors would attract me as a working and publishing scientist concerned at establishing a publication record in high quality and credible journals.

However, if I was a non-English speaker with routine work which I might find difficulty publishing elsewhere, and especially if that work was related to areas where natural fluoride levels were high, I would probably consider the journal. With the realisation in the back of my mind that I would probably have no luck with submission to a more reputable journal.

Now, I am not being “personal” or “derogatory” in making  that realistic evaluation. Nor do I think there are “double standards’ in choosing a good journal for publication. Good work deserves a good journal for publication.

Paul effectively concedes this in referring to attempts by Xiang et al to get their work published in a more reputable journal. He laments the fact that this journal would not include material already published in Fluoride (standard procedure in the publishing world) as amounting to Xiang’s material being “withheld from the mainstream scientific community.” (Paul obviously agrees that Fluoride does not have a good standing in the mainstream scientific community). The lesson being that Xiang should have gone for the reputable journal first time around. Why publish in a journal which does not give access to “the mainstream scientific community” if one’s work is good enough to get published in a reputable journal

That is a sensible question – not a derogatory one.

Connett’s relation with Fluoride

It is instructive to look at Paul Connett’s own publications in Fluoride. He claims to have researched the issue for 17 years and I would expect that at least some of his research papers would have ended up in this journal.

A simple search for the name Connett showed me a couple of guest editorials – often coauthored with editors of the journal (see for example Professionals moblize to end water fluroidation and Misplaced trust in official reports), a book review (coauthored with editors of the journal), reports of the International Fluoride Society (IFS – owner of Fluoride) conferences. There were abstracts of papers or posters presented at IFS conferences authored by Paul, Ellen and Michael Connett – but no sign of formal papers for these. (I hope Paul will correct me and provide links if I have missed papers with full text.)

This at least tells me that Paul is on excellent terms with those editing and running this journal. Not surprising when one looks at the names in the editorial board of the journal, the western contributors to the journal and the names on the advisory board of Paul’s activist organisation Fluoride Alert.

Another thing that stands out for me about the editorial and advisory boards is the large number of retired, former, emeritus academics (around 17 from a glance). In the past I have also noticed this about the organisations and petitions of climate change climate contrarians/deniers/pseudosceptics. As a retired scientist myself I can appreciate how such issues can become hobbies, and avenues for social involvement and personal standing for people who formerly relied on their employment and professional standing for such things. I can also appreciate that retirement often also means loss of contact with current research and findings. This increases my suspicions of the journal and organisation.

There was one normal looking journal paper by Michael Connett Vulvar paget’s disease: recovery wihtout surgery following change to very low-fluoride spring and well water.” My impression is this was simply an anecdotal history for one person – probably not normally acceptable in a scientific journal (unless at least written by the practicing medical person handling the case). A quick search of Google Scholar shows this to be Michael’s sole scientific paper – perhaps not surprising as he is not a scientist. He is the Special Projects Director for the Fluoride action network, an attorney in Philadelphia, PA, and received his law degree from Temple Law School in 2011. But now has a scientific publication record!

(Note for non-scientists wishing to show a scientific publication record. There  are plenty of anecdotal stories on the internet by people claiming sensitivity to fluoride. Hell, the other day I read the personal account of one person with skeletal fluorosis which cleared up immediately he stopped drinking tap water! You could select your own “case history,” write it up as a scientific paper and submit to Fluoride. Mind you, your paper might not be all that visible to the “mainstream scientific community”).

Looking at Fluoride, Fluoride Alert and the International Society for Fluoride Research I get a strong impression of a group who take in each other’s laundry – but at the same time give publication space for some third world scientists who may not meet the standards of more reputable journals.

Paul gave it away when he reported to us that “the US National Institute of Health (NIH) has refused to cover the contents of this journal in PubMed.” Surely that tells us something about how this journal is considered by the science community (and please – if one has to resort to conspiracy theories to explain this the argument is surely already lost.)

Bones, hip fractures and the literature

Kurt Ferre’s comment about misrepresentation of the Li et al (2001) paper referred to Paul’s note on it in Fluoride Alert (Reason 29 of 50 reasons to oppose fluoridation). Here Paul did describe the data as relating to hip fractures and not over all fractures. OK, Paul in chapter 17 of his book may have been more specific but that is not what Kurt referred to. (By the way, I am still plodding through Paul’s book – on chapter 9 at the moment).

Paul claims I “prefer” an “interpretation” of the Li et al (2001) paper that there is a “sudden” appearance of hip fracture at a higher concentration rather than a linear increase from low concentrations. He is wrong – I don’t prefer any specific interpretation. I was merely pointing out what can be drawn from the statistical analysis of the data.

One of our commenters has already noted that Paul’s argument for his own intepretation of the data here amounts to special pleading – where he has to ignore, or denigrate, the statistical analysis. He is pleading when he writes that increases “appear to be ‘real’ even though they are not statistically signficant individually.” Or that the data “appear consistent with a linear regression. Statistical significance is not the final word on whether a data point or data set is real or not.”

These were the sort of statements I would put red lines through when I was reviewing papers submitted for publication.

However, this is a digression. The interpretation of the increase at higher concentrations is not important. The fact is neither overall fractures or hip fractures showed an increase at fluoride concentrations considered optimum for oral health.

It was clear to me when I originally read and wrote about  Li et al’s (2001)  paper (see  - Is fluoride an essential dietary mineral? ) that the increased incidence of overall fractures at concentrations below optimum did not refer to hip fractures. The authors specifically brought that to readers attention - “the data show a somewhat different pattern for hip fractures in relation to the water fluoride levels. . . Instead, the prevalence of hip fractures was stable until the water concentration reached 1.45–2.19 ppm.” They qualified this with “However, it may not be appropriate to conclude that the risk of hip fracture is more sensitive to the water fluoride concentration as compared with overall fractures, because the number of hip fractures in the present study is relatively small.” And they did conclude that “our results on hip fractures support previous findings that fluoride around 1 ppm in drinking water does not increase the risk of hipfracture.”

This diagram by Ethan Seigel (which I reproduced in an article earlier this year (see Getting a grip on the science behind claims about fluoridation) was clearly taking on board Li et al’s work – when perhaps it should not have been so specific.

But of course the issue of hip fractures does not rest with the work of Li et al alone. I wrote about this specifically in Fluoridation: the hip fracture deception  where I also mentioned the recent paper of Näsman et al (2013) “Estimated Drinking Water Fluoride Exposure and Risk of Hip Fracture: A Cohort Study showing no significant correlation of hip fractures with fluoride in drinking water at the optimum concentrations.

Miscellaneous

Delivery systems: It seems I must respond to Paul’s suggestion of “an alternative delivery system for fluoridated water” – selling fluoridated bottled water. I guess that already happens in many places but I did not take his suggestion  seriously because he is offering it as a substitute for already existing social health policies. That is not my area of expertise but I can understand how fluoridated water and fluoridated salt are effective as social policies for overcoming problems where the natural fluoride levels are deficient. Surely bottled water in the corner of a “supermarket, pharmacy or clinic” hardly measures up as a social health policy? Fluoridated salt seems to me to be a more credible alternative to water fluoridation.

Having said that, bottled water is culturally preferred in some countries and is attractive to some age groups in others. There are suggestions, therefore, that fluoridation of bottled water should be encouraged. New Zealand and Australia recently brought in regulations allowing this.

Inference from high concentrations: Paul has objected to my criticism that he often relies on extrapolation from laboratory or epidemiological  studies where higher than optimum fluoride concentrations were used.  He responded by discussing Xiang et al (2003) and argued that some of  the studies covered by Choi et al  (2012) did include lower concentrations.

However, there is still a tendency to then fall back on all the studies to give extra weight to his assertions, rather than just rely on the low concentration studies. I think the image below prepared by fellow New Zealander Andrew Sparrow helps put this issue into context. High fluoride cases in Choi et al (2012) were almost all completely out of the zone for optimum fluoridation of drinking water.

Chinese IQ

Appeal to authority with declarations: This tactic is used a lot by anti-fluoride activists. The poster below is a recent example from Fluoride Free NZ. The inclusion of a citation gives it some authority – but can anyone find that paper? No one at Fluoride free could – yet they were promoting a claim using the citation!

The Journal of Dental Medicine is now defunct and I could find no abstracts or full text on the internet. However, I did find a description at http://slweb.org - a well-known anti-fluoride activist site. This claimed adverse reactions, affecting “the dermatologic, gastro-intestinal and neurological systems,” to fluoride in 1% of the group studied!  I would have liked to check out the statistical analysis used in the study as this seems a very small response. Was 1% significantly different to zero in this study?

What the hell – Fluoride Free NZ doesn’t care. They went ahead with a poster and its promotion anyway. As a political activist group they are concerned more with moulding public opinion than the facts.

Paul might argue this case is a diversion he is not responsible for. But my point is that activists do this sort of thing all the time. And Paul is no different with the way he quotes from the NRC (2006) report in his section “7. What other authorities are saying about fluoride as a neurotoxicant.”

He quotes phrases like:

  • “the results appears significant enough to warrant additional research on the effects of fluoride on intelligence.”
  • “These changes have a bearing on the possibility that fluorides act to increase the risk”
  • “More research is needed to clarify fluoride’s biochemical effects onthe brain.”
  • “studies of populations exposed to different concentrations of fluoride in drinking water should include “
  • “Studies of populations exposed to different concentrations of fluoride should be undertaken”
  • “Consideration should be given to assessing.”

The point is one can agree with all these suggestions for ongoing and future research and still accept the current assessment that fluoridation is safe. Just because there is a logical possibility of a suggested danger does not, in itself, make that danger real.

This ongoing research is happening and health authorities do monitor current research findings. In New Zealand the Ministry of Health set up  the National Fluoride Information Service to do this specific job and it regularly reports current research findings. Similarly, a report from the NZ Parliamentary health committee just the other day recommended:

“the Government work with the Ministry of Health to ensure that the addition of fluoride to the drinking water supply is backed by strong scientific evidence and that ongoing monitoring of the scientific evidence is undertaken by, or for, the Ministry of Health, and that the Director-General of Health is required to report periodically to the Minister of Health on the status of the evidence and coverage of community water fluoridation.” (see From dental neglect to child abuse?).

It is irresponsible to use such urgings to continue research as some sort of proof that there are problems sufficiently big enough to warrant abandoning a social health policy known to help people. Or to call that social health policy “reckless,” as Paul does.

Paul Connett does the same thing with the paper by Xiang et al (2003) and other Chinese work in the area of IQ. He acknowledges himself that “there are weaknesses in many of these IQ studies.” These weakness and the speculative nature of his conclusions do not stop him from seriously claiming that there is a very low limit of sensitivity to fluoride effects on IQ. I repeat my question from my last article about the huge variability in the data and how the hell one can place any confidence on the result drawn from Xiang’s figure.

“Yet Paul uses Xiang’s paper to authoritatively claim it had “found a threshold at 1.9 ppm for this effect.” (What effect he refers to is unclear.) How reliable is that figure of 1.9 ppm (actually 1.85 or 2.32 ppm F in the paper) –  considering the huge variation in the data points of the Figure 1? (Unfortunately the paper is not a lot of use in explaining that figure – reviewers should have paid more attention.)”

The final request: Paul wants me “to list the primary studies that you have read which most convinced you that fluoridation is both safe for the bottle-fed baby and for the adult over lifelong exposure.” In thinking about this I have concluded it is a strange request because I don’t think creative scientists think that mechanically.

My concepts and ideas derive from multiple sources – I never put my eggs all in one basket as it were. I can find I am impressed by something in a paper which also has something which doesn’t impress me. Consequently I take what I can from wherever I can and try to critically  understand what I read.

It’s a bit like that with people. You have to accept them warts and all and avoid the immaturity of placing anyone on a pedestal – a sure way to later find they have feet of clay.

So unfortunately I cannot satisfy Paul’s request. He will have to deal with the actual arguments I put forward.

As for the issue of bottle-fed babies – I am sure this will come up at some stage. It already has in the comments discussion.


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

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198 responses to “Fluoridation debate: Why I support fluoridation – 2nd reply to Connett

  1. Both of our debaters mistakenly take the CDC’s statement from 2001 as definitive.

    Newer statements from the CDC, including a video of ADM Bailey, head of the CDC’s oral health division, clearly state that the systemic effect of fluoridation is important. The CDC’s 2001 report was written before Singh (2004) published results of the exquisite study in Australia that quantified the PRE-eruption or systemic effect. Another proof of the systemic effect is Kumar’s 2009 paper showing fluorosis in 1st molars protects them from caries Professor Connett certainly is on record that fluorosis is a systemic effect.

    Also, the studies which show an adult effect in groups with childhood fluoride exposure are reasonable evidence – eg, Kobayashi (1992), and Neidell (2010). Other references could be listed.

    From conversations with individuals in the Oral Health Division I’ve learned that the document has not been formally withdrawn because the issue of the systemic/topical debate is a very small part of the official consensus statement from the CDC’s Fluoride Recommendations Work Group. Significant trouble and expense went into producing this document and from the larger concern of proper public health one point is a tempest in a teapot.

    It is important to read what CDC said in the 2-3 paragraphs that addressed this matter –

    see: http://www.cdc.gov/fluoridation/guidelines/index.htm

    The statement was intended to help readers understand topical benefits, not to prove there were no systemic benefits. Many studies show water fluoridation’s effectiveness. Those conclusions are not dependent on the details of the biologic mechanism causing the benefits.

    There are always good explanations why arguments like this are not reasons for opposing fluoridation. If they were valid and sufficient, scientists would abandon the practice. The overwhelming professional support fluoridation enjoys is because of the huge literature supporting.

  2. Ken, you once again demonstrate the imprudence of addressing the myriad of points made by Paul in a live, onstage debate. In such a debate it is far too easy to throw out a host of arguments, thus implanting them into the minds of listeners. Given the time and other constraints of live debates, it is impossible to adequately address each of these points. Thus listeners are left with the impression that the arguments are valid without having had the opportunity to hear why they very well may not be. Putting arguments in writing and taking the time and effort to address them fully and properly, in writing, is a far more fair, honest, and informative method to address important public health issues such as water fluoridation. Any argument that can be made in live debate can certainly be made in writing.

    Thank you, once again.

    Steven D. Slott, DDS

  3. Ken continues to use the ‘anti-fluoride activist’ moniker after a polite request from Paul early on to not use such subversive and disrespectful language

  4. Joel, go back and read Paul’s article. His request was over the word “anti-fluoridationist.” It offended him because “It makes opposition to fluoridation sound like some mental disease!”

    I find that strange but have, out of respect for a discussion partner, avoided using the word – especially when referring to him.

    Now you are objecting to the word “activist??”

    Is that really all you found to criticise in my article?

  5. Blossom, your comment is personal and unrelated to the article.

  6. Eyes Ireland – please, no vague propaganda statements. Can you make your comments relevant to the article you are commenting on. If not the comments will not be approved.

  7. Substituting “anti fluoridationist” with “Anti-fluoride activist” is hardly respectful. Typical tactic of the “anti-choice activists”…

  8. In terms of criticism, half your response was aimed at attacking Connett – even having the audacity to criticise OTHERS such as Mary Byrne in your tirade.

  9. Shocking of me, Joel, to point out where others are wrong and make mistakes. Some might even say audacious.

    Nothing of substance, then?

  10. JDR

    Can you get any more ridiculous? “Anti-fluoridationist activist” offends you? Seriously? Maybe Paul should just submit a list of adjectives to which he objects, or maybe just exactly what title he deems worthy of him. Then maybe you can actually contribute something of relevance to the discussion.

    Steven D. Slott, DDS

  11. JDR, worrying about what to call the spade is ludicrous.

    Shorter Oxford English dictionary:

    anti… prefix ‘opposite, against,….

    fluoridation the act of addition of fluoride (for example to water)

    - ergo

    fluoridation-ist – person who fluoridates, or, in common usage, who supports the practice of fluoridation

    “anti-fluoridation” against the act of fluoridation.

    anti- fluoridation-ist person who is against act of fluoridation.

    It is a perfectly respectful common-usage word.
    Deal with it.

  12. JDR, just to complete the definitions
    OED (shorter) :

    -ist suffix – forming agent nouns from verbs … In Eng the suffix is used also in a multitude of of terms having no corresponding words in -ise, -ism, which denominate the professed followers of some leader or school, the professional devotees of some principle, or the practitioners of some art….

    now quit your moaning

  13. Ken – you didn’t point out I was wrong, you just pointed out something I said. The difference between Newton being wrong and you anti-choice activists being wrong, is that Newton didn’t force his beliefs on everyone like you people want to do.

  14. Mary, I don’t think you understand the point I am making. It is really to do with the dynamic nature of scientific knowledge. We will see if Paul has any feeling on it.

  15. Dear Billy Budd

    There is nothing exquisite about the Singh paper.

    “‘There are several limitations that should be considered. The major one is that the largest group in the study was children aged 6 to 7 years, who accounted for 28.8% of the study population. The permanent first molars in these children would not have been exposed to post-eruptive fluoride for sufficient time to prevent caries. Therefore, these subjects should not have been included in the study.”

    Mascarenhas AK, Scott T. J Evid Based Dent Pract 8(1):17-8 (2008)

    How did that one slip past peer-review?

    The Neidell study is also very flawed.

    By the author’s own admission:

    “…we were assigning the probability of fluoridation exposure when in fact, an individual was either exposed to flouridation or not.”

    “The second concern is that we assigned historical fluoridation status to a respondent on the basis of the respondent’s current county of residence. Respondents, however, may not have lived in the same county for their entire lives.”

    No conclusions concerning pre-eruptive effects can be drawn from this paper.

    L

  16. Dear Ken

    It would be great if you could provide references for these statements, so that one may look it up.

    Here are a few quotes from various reviews, for you to consider:

    “Assuming that more fluoride in the enamel would provide a greater anti-caries protection, measurements of fluoride in enamel have been undertaken by many authors. However, most of these studies failed to clearly demonstrate an inverse relationship between fluoride enamel content and caries prevalence.”
    (Arends & Christoffersen 1990; Duckworth & Gilbert, 1992, Feyerskov et al, 1981)

    “No significant relationship has been demonstrated between caries experience of the individual and fluoride content of the enamel. Furthermore, the fluoride content in surface enamel between teeth developed in low and “optimal” fluoride areas is too small to explain any significant effect on dissolution rate of the enamel.” (Feyerskov et al, 1981)

    “It is concluded that even shark enamel containing 30,000 ppm F has a limited resistance against caries attacks.” (Oogard et al, 1988)

    “However, more recent studies suggest that fluoride present in the surface enamel does not significantly prevent acid production. The concentrations of fluoride present in the saliva are too low to affect bacterial metabolism.” (Rosin-Grget, 2001)

    “Nevertheless, fluoride tablets continue to be prescribed as if the action of fluoride is expressed systemically.” (Bowen, 1991)

    “Thus, efforts to increase the fluoride content of dental hard tissues
    by systemic or topical fluoride are not a logical approach to caries prevention.” (Fejerskov et al, 1981)

    “The lack of benefit of pre-eruptive systemic fluoride application has been shown by Reich et al, who performed a prospective study in newborn children. The authors demonstrated that there was no difference in caries development at the age of 5 years if fluoride was administered as tablets right after birth as opposed to an application starting in the age of seven months, i.e. with the eruption of the first decidious tooth (Reich et al, 1992)” (Zimmer et al, 2003)

    L

  17. Peter Davidson

    Ken, what comes across strongly from reading your submissions and replies is that what you are fighting to preserve in not the health, dental or otherwise, of the population, but water fluoridation. There is a huge difference.
    If your sole concern was the former, you would be delighted that most of western Europe has achieved the same improvements in dental health observed in fluoridated countries, and it has done so by some means which does not involve the massively expensive, unethical and harmful (to a degree not yet fully established of properly researched) resort to mass fluoridation of drinking water.
    Instead, you throw up some possible reasons for this, without any real interest in finding out how they achieved this amazing result.
    Your obvious priority is to explain it away, not explain it. It’s an embarrassment to you, not a source of good news.
    Similarly, your complete lack of interest in the very successful Scottish dental health program Paul reported.
    Is this really the response one expects from someone whose only concern is improved dental health, whatever it takes? Is your steadfast refusal to accept any research from anywhere in the world which points to possible, even probable harm from this measure really the behaviour of someone dedicated to preserving human health? I just can’t see it.
    Also, as a scientist, you should be horrified at the fraudulent tactics used to promote fluoridation, like the Queensland Health document referred to earlier, contrasting the worst imaginable set of teeth with a set of perfect teeth, representing the difference between fluoridated and unfluoridated water. This is mainstream, publicly-funded hype, not the work of a loose-cannon activist. It should make you squirm.
    My own dentist has a similar poster on his surgery wall, with the caption: “The fluoride difference”, presumably ADA-provided. It’s so dishonest.
    You should also be horrified by the ludicrous CDC claim that fluoridation is “one of the top ten public health achievements of the 20th century”, made in full knowledge that the same improvements attributed to fluoridation had been achieved without fluoridation throughout the developed world during the same period. (It concocted a graph to justify this statement, plotting increased levels of water fluoridation in the US against decreased levels of dental decay, carefully leaving out the confounding evidence above). Once again, mainstream hype presented as fact, and accepted without thought or question. The most obvious question being: If this is one of the “top ten health achievements of the 20th century”, why have most developed countries rejected it?
    The principal difference I see between the two sides is that those who promote fluoridation are for the most part one-string fiddles who have little or no interest in addressing the bad habits which cause tooth decay in the first place, or in promoting any of a range of intelligent measures to address the problem. It’s fluoridation or nothing. Even fluoride toothpaste is too embarrassing to talk about, with its 1000 times higher concentrations.
    On this side, we accept any intelligent, scientific approach which allows freedom of choice, and that includes fluoride toothpaste for those who choose it, and which is available at every chemist’s and supermarket in Australia. There’s nothing irrational or extreme in that.

    Peter Davidson

  18. Hi Mary

    Are you Mary Byrne of FANNZ?
    I hope so, maybe we could get some definitive answers from a representative of this website, rather than individuals’ conspiracies.

    What on earth are you talking about “anti-choice”?

    You said :“The difference between Newton being wrong and you anti-choice activists being wrong, is that Newton didn’t force his beliefs”

    Are you trying to reframe this topic as a “Anti-choice / Pro-choice” dialogue – if so people may become confused with the fluoride “debate” having something to do with the pro-life / pro-choice lobbies!!

  19. Louise, could you pleases provide full citations when you refer to an article or publication – preferably a link if you have it. For two reasons:

    1: I always like to check out originals – there has been too much selective quoting in discussions on this issue.

    2: Without details these quotes begin to look like simple copy and paste where the commenter as not even bothered to check the article themselves. Of so – why should I bother.Especially when I haveli do all the hard work of hunting it down.

    I will comment specifically on your quotes when I have time to check them out. There are some family and health priorities today.

  20. Peter, we have actually discussed salt fluoridation here. I think your bias has prevented you from recognising that, or the issues in discussion. The misinformation of fluoride apply just as much to salt or milk fluoridation as they do to water fluoridation – and these health measures are also the subject of campaigns by anti-fluoridation activists.

    There is still a need to reinforce the science and challenge the misinformation.

    I am not uninterested in the Scottish situation – having lived there at one time. The programmes Paul referred to are of course welcome (we have some similar attempts here) but fluoridation is still a hot issue in Scotland – and poor dental health is as well.

    Yes, I think the Queensland Health pamphlet was wrong and have written that in my articles. But, seeing you also are concerned could you please point me to a source of the pamphlet? It does not appear anywhere on the official web site and appears to be a one-off targeted at a few parliamentarians. It would be nice to be able to use it as an example of the sort of behaviour by health authorities that I disapprove of – without an official source I cannot do so. I suspect that the pamphlet itself is now an embarrassment to Queensland Health.

    I think the rest of your comments derive from your own bias and I cannot do much about that.

  21. Peter,
    Just for my own curiosity, what peer-reviewed, scientific evidence do you have for the causative factors of the “improvement in dental health in most of western Europe observed in fluoridated countries”? Exactly to which portions of western Europe do you refer, exactly how much of this portion of western Europe has fluoridated water either “naturally”or through fluoridation, how much receives fluoride through salt, milk, or otherwise, how many citizens of this portion of western Europe live in non-fluoridated areas yet drink fluoridated water or beverages from fluoridated areas, and how much food grown with fluoridated water is consumed by this portion of western Europe.

    As water fluoridation costs less than $1 per person per year, on what basis do you make your claim that it is “massively expensive”.

    By whose standards is it considered “unethical” to support a public health initiative which prevents development of excruciating pain, debilitation, and life-threatening infection?

    Do you not consider it unethical for those such as you to seek to deprive entire populations the proven benefits of water fluoridation based solely on your own opinions and personal ideologies?

    What peer-reviewed, scientifically acceptable proof do you have of any harmful effects of water fluoridated at 0.7 ppm?

    Are you unaware of how comical is your statement about the “fraudulent tactics used to promote fluoridation” in view of the tactics utilized by antifluoridationists?

    Exactly which nations comprise the “most developed countries” which have “rejected” fluoridation, what have been their exact reasons for their may being non-fluoridated, and what other means are they utilizing to deliver fluoride to their citizenry?

    On what do you base your opinion that those who support fluoridation have “little or no interest” in addressing the myriad of causative factors of tooth decay?

    What exactly are the “intelligent measures” to address dental decay which you deem are not being promoted?

    Why do you deem fluoridated toothpaste too “embarrassing” for you to talk about?

    Your “end” which presumably is antifluoridationists certainly does not accept “any intelligent scientific approach which allows freedom of choice”. Your “side” summarily and dogmatically rejects the most cost effective, most scientifically studied and supported, scientifically proven effective dental decay preventive measure available. Your “side” summarily and dogmatically rejects the dental decay preventive “approach” which has the consensus support of the most highly respected, worldwide body of healthcare organizations, healthcare experts, healthcare providers, U.S. Surgeons General, esteemed healthcare educators, public health experts, and respected regulatory bodies…while having not one respected science or healthcare group opposing it. Your “side” summarily and dogmatically opposes the public health initiative of water fluoridation, which has no effect on anyone’s “freedom of choice”, largely on the basis of personal ideology and little else.

    Steven D. Slott, DDS

  22. Louise,

    Without going through the entire list of studies from which you have plucked out-of-context quotes, the ones I have found fully support the concept of water fluoridation. As has been stated repeatedly, although the effect is both systemic and topical, the percentage of each is moot. The preventative benefit of fluoridation comes from the consistent exposure of the teeth to low concentrations of fluoride throughout the day. These studies you cited support this.

    “Under acidic conditions (plaque), we have, due to an influx of fluoride from the saliva or plaque as F L, an aqueous phase in the enamel supersaturated with respect to the mineral for a small distance (x*) only. Deep in the lesion the solution is undersaturated. For d x*, enamel dissolution. The surface layer thickness, about x*, depends on F L level, on pH, and on time. The results described indicate that the surface layer is formed after a considerable period if a fluoride gradient has been established in initially surface-softened enamel. The combination of this F L gradient and pH dependency of the inhibitor effectiveness results in two regions in the enamel”
    —-The Nature of Early Caries Lesions in Enamel
    J. Arends
    Dental School, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands
    J. Christoffersen
    Medicinsk-Kemisk Institut, Panum Instituttet, Blegdamsvej 3, DK 2200 Copenhagen, Denmark

    “As the major explanation for the cariostatic effect of fluoride must therefore be sought in its local effect on the oral environment, the possible effects on plaque colonization, composition and metabolic activities are discussed. The effect of even low concentrations of fluoride in the liquid phase on enamel dissolution is described, and it is concluded that the major cariostatic effect of water fluoridation, fluoride tooth paste and mouth rinses can probably be ascribed to regular increases in fluoride ion activity in the oral fluids.”
    —— Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms.
    AuthorsFejerskov O, et al. Show all Journal
    Acta Odontol Scand. 1981;39(4):241-9.

    “Based on the new findings, it appears that fluoride, either released into or present in the fluid phase bathing the hard tissue, is more important for the reduction of caries development and progression. There is convincing evidence that fluoride has a major effect on demineralization and remineralization of dental hard tissue and that it interferes with acid production from cariogenic bacteria. The provision of dissolved fluoride is the key to successful therapy.”
    —-Current Concept on the Anticaries Fluoride Mechanism of the Action
    K. Rosin-Grget and I. Linoir. 2000
    Department of Pharmacology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia

    Steven D. Slott, DDS

  23. Dear Steve

    You should pay more attention to what is being discussed before you post irrelevant quotes.

    At discussion here is the amount of fluoride in enamel and if that contributes to caries reduction.

    L

  24. Dear Ken

    ‘Louise, could you pleases provide full citations when you refer to an article or publication’

    No problem Ken.

    Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res 69:601–605 (1990)

    Bowen WH. Caries prevention–fluoride: reaction paper. Adv Dent Res 5:46-9 (1991)

    Duckworth RM, Gilbert RJ. Intra-oral models to assess cariogenicity: Evaluation of oral fluoride and pH. J Dent Res 71:934–944 (1992)

    Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)

    Reich E, Schmalz G, Bergmann RL, Bergler H Bergmann E. Caries incidence in children after varying periods of fluoride tablet application. Dtsch Zahnartz Z 47:232-234 (1992)

    Rosin-Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)

    Zimmer S, Jahn KR, Barthel CR. Recommendations for the use of fluoride in caries prevention. Oral Health Prev Dent 1(1):45-51 (2003)

    L

  25. Louise, please desist in the quote mining.
    It gets you nowhere.

  26. Dear Richard

    Do you have something worthwhile to contribute to the discussion? Perhaps a study showing how fluoride in enamel contributes in reducing caries, and to what extent? If not, why do you feel the need to insult?

    L

  27. Peter – my take on Europe

    Great Britain is currently undertaking an expansion of water fluoridation similar in scope to what has and is occurring in California.

    Removing any doubt as to European opinion, in May 2011 the European Union’s Scientific Committee on Health and Environmental Risks issued a formal report titled “Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water”.

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

    The European opinion as to water fluoridation’s safety joins those of Australia’s National Health Research Council (2007), the US National Academy of Sciences (2006), the World Health Organization (2006), Ireland’s Forum on Fluoridation (2002) and others.

    Ireland is the only European country to report fluoridated and non-fluoridated locations separately. The Ireland data nicely demonstrates benefit came to those with fluoridated water.

    Ireland WHO – web site updated 2010
    http://www.whocollab.od.mah.se/euro.html

    1984 (non fluoridated) 3.3
    1992 (non fluoridated) 2.1
    2002 (non fluoridated) 1.8

    1984 (fluoridated) 2.6
    1993 (fluoridated) 1.4
    2002 (fluoridated) 1.1

    Europe’s relationship to fluoride is complex. If anyone is interested, a very thorough and detailed analysis of fluoride in Switzerland is available.

    see: http://www.sso.ch/doc/doc_download.cfm?uuid=BFC72B80B1408D4053BBBB937D37EABD

    About half of the remarkable decline in cavities there is ascribed to fluoride.

    Roughly 80% of the children studied consume fluoridated salt. Most agree that salt fluoridation has equivalent efficacy as public water fluoridation. Also, consumption of bottled water, which in Europe is labeled as containing fluoride, is very common.

    Scandinavian Countries are culturally not diverse, have a medically compliant citizens and free medical and dental care. Public health experts have specifically warned that the Scandinavian experience should not be used to argue against fluoridation where these conditions do not exist.

    In Sweden the incidence of fluorosis at 50% exceeds that of the fluoridated United States making clear that the systemic effect of fluoride is being ensured through other methods such as using fluoridated toothpaste in infancy.

    Europe’s experience is poor reason to abandon water fluoridation. This is especially so given the compelling data on its benefits.

    For the sake of all citizen’s health, especially the children’s, hopefully New Zealand will not fall victim to bad advice from fluoridation’s opponents.

  28. Louise, going back to your previous comment. I do not know what you refer to when you ask that I provide references for statements.

    You may be referring to my brief section in the last article about the composition of bioapatites and the systemic effect of fluoride. This really goes back to a section in my previous article (look for references there) – it was only mentioned again because Paul ignored it. Presumably you will find the references you want there.

    You seem to be relying in the current understanding of the surface mechanism operating with existing teeth. This is a surface effect and relies in F in saliva and biofilms. It is the major effect for countering the acid- mineralisation reaction leading to decay.

    However, beyond that there is known to be a beneficial effect from the ingestion of F in Pre-erupted teeth. this has been shown to reduce certain types of cavity.

    There is a bait and switch deception going on here. Just because the evidence shows the predominant influence of the surface reaction with existing teeth does not remove the evidence showing a beneficial effect of ingested F on pre-erupted teeth.

    And don’t forget your bones.

  29. Louise, thank you. Yet another study you have cited which supports water fluoridation. You have become a good source of information for fluoridation advocates. Do you have more?

    “From a theoretical point of view, caries can be prevented by perfect oral hygiene and sugar abstinence. However, practice has shown that this approach is successful in individual cases only. For the whole population, effective caries prevention is still not realistic without the use of fluoride in various forms. The use of different fluoride preparations increases its efficacy. On the other hand, correct dosage is important to prevent the risk of dental fluorosis. Most of the European scientific dental associations no longer recommend the use of fluoride supplements, such as fluoride tablets or drops, as a standard procedure in caries prevention. This is due to the increasing evidence that the effect of fluoride is mainly the result of chemical reactions on the tooth surface. Therefore, fluoridated toothpastes, gels, varnishes, and rinses are more in focus. Besides this, fluoridated water and fluoridated salt are still important. Although they have a systemic effect, the efficacy of these fluoride applications results from local processes. ”

    ——Recommendations for the use of fluoride in caries prevention.

    AuthorsZimmer S, et al. Show all Journal
    Oral Health Prev Dent. 2003;1(1):45-51.
    Charité, School of Dentistry, Dept of Operative and Preventive Dentistry and Endodontics, Humboldt-University Berlin, Germany. Stefan.Zimmer@charite.de

    Steven D. Slott, DDS

  30. Louise, please desist in quote mining, it is a dishonest practice and it gets you nowhere, nor does misrepresenting my request as an insult.

  31. Louise, at issue here is the beneficial effect of the public health initiative of water fluoridation. Attempting to parse facts about enamel content of fluoride as related to decay prevention is moot when the science clearly shows fluoridation to do exactly what it’s supposed to do……reduce dental decay in entire populations.

    So, again, thank you for the supportive studies.

    Steven D. Slott, DDS

  32. Louise – Re Singh, the problem of younger children is common to all school children survey based studies. The upshot of these inclusions however is that the effect of the topical effect of fluoridation is simply masked. Data restricted to older children may well show a relatively larger topical effect but would not expunge Singh’s findings.

    Neidell’s study was based on historical residence which while clearly related to fluoride intake is not as precise as the sort of documentation being done currently in the Iowa Fluoride Study. Nonetheless, the effect of a less perfect fluoride intake estimate is to decrease the apparent cariostatic effect. It thus is really all the more remarkable that Neidell reported these findings.

    Neidell’s opinion of the systemic benefits of swallowed fluoride in childhood is made very clear in the article’s Conclusions: “This study suggests that the benefits of CWF may be larger than previously believed and that CWF has a lasting improvement in racial/ethnic and economic disparities in oral health.”

    Can I assume that you accept the Iida, Kumar paper showing that fluorosis protects teeth from cavities? Surely there is no argument that fluorosis is a systemic effect.

  33. Dear Ken

    ‘I do not know what you refer to when you ask that I provide references for statements.
    You may be referring to my brief section in the last article about the composition of bioapatites and the systemic effect of fluoride. This really goes back to a section in my previous article (look for references there) – it was only mentioned again because Paul ignored it. Presumably you will find the references you want there.’

    Yes, that was the section I was referring to. I just had a look at the previous article, but could not find supporting references there as well.

    ‘You seem to be relying in the current understanding of the surface mechanism operating with existing teeth. This is a surface effect and relies in F in saliva and biofilms. It is the major effect for countering the acid- mineralisation reaction leading to decay.’

    The current knowledge indicates that fluoride benefits, if any, are occurring once caries is already present, hence have nothing to do with ingestion of fluoride before teeth erupt. Incorporation of fluoride into sound enamel is possible only as a result of concurrent enamel dissolution (caries lesion development) (Bruun and Givskov, 1999; Feyerskov et al, 1994; Rosin-Grget, 2001; White 1990).

    Bruun C, Givskov H. Calcium fluoride formation in enamel from semi- or low-concentrated F agents in vitro. Caries Res (2):96-9 (1993)

    Fejerskov O, Larsen MJ, Richards A, Baelum V. Dental tissue effects of fluoride. Adv Dent Res. 8(1):15-31 (1994)

    Rosin-Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)

    White DJ, Nancollas GH. Physical and chemical considerations of the role of firmly and loosely bound fluoride in caries prevention. J Dent Res 69 Spec No:587-94 (1990)

    ‘However, beyond that there is known to be a beneficial effect from the ingestion of F in Pre-erupted teeth. this has been shown to reduce certain types of cavity.’

    I would like to have a look at the scientific evidence in support of this.

    I had hoped you would address the papers I had referenced above. There is ample evidence that this is not so.

    ‘There is a bait and switch deception going on here. Just because the evidence shows the predominant influence of the surface reaction with existing teeth does not remove the evidence showing a beneficial effect of ingested F on pre-erupted teeth.’

    Again – I would like to have a look at this evidence. If you could provide some studies for me to look at, that would be great.

    ‘And don’t forget your bones.’

    If you believe that fluoride is beneficial on bone, then you must also accept the mechanisms by which this is thought to be so, such as via effects on enzymes such as phosphatase, G proteins, and so on. There are several good reviews available on this subject, such as Susa, 1999 and Lau, 1998. It has very little to do with fluoride stored in bone. On the other hand, the amounts of fluoride in bone correlate directly to the three stages of skeletal fluorosis.

    Susa M. Heterotrimeric G proteins as fluoride targets in bone (review). Int J Mol Med 3(2):115-26 (1999)

    Lau KH, Baylink DJ. Molecular mechanism of action of fluoride on bone cells. JBone Miner Res 13(11):1660-7 (1998)

    L

  34. Louise – best you specifically state what is troubling you – there are a number if citations there but you must be confused about something else.

    You seem to want to interpret descriptions of the specific action of F in saliva in reducing mineralisation and encouraging remineralisation as some sort of evidence against the systemic benefits. I will just repeat Newbrun (2004) (but other commenters here have produced other references for you to check.

    “The role of systemic fluoride in caries prevention is neither “minimal” nor “of borderline significance.” On the contrary, it is a major factor in preventing pit and fissure caries, the most common site of tooth decay. Maximal caries-preventive effects of water fluoridation are achieved by exposure to optimal fluoride levels both pre- and posteruptively.”

    Fluoride is good for bones (within reason – skeletal fluorosis is a result of excess) as I have discussed in the article. It is a natural and normal constituent of bioapatites. If deficient the bones become weak and have a lower solubility. This is a basic chemical effect which I have now described several times in these articles. But it is a bit of chemistry Paul seems to want to avoid.

  35. Dear Billy Bud

    ‘Can I assume that you accept the Iida, Kumar paper showing that fluorosis protects teeth from cavities? Surely there is no argument that fluorosis is a systemic effect.’

    There is no argument that fluorosis is a systemic effect. However, fluorosis does NOT protect from cavities. It causes MORE cavities, and there many studies worldwide showing this. Below are a just a few:

    - Azpeitia-Valadez Mde L, Rodríguez-Frausto M, Sánchez-Hernández MA. Prevalence of dental fluorosis in children between 6 to 15 years old. Rev Med Inst Mex Seguro Soc 46(1):67-72 (2008)

    “Dental fluorosis is a defect in the formation of the enamel by high fluoride concentrations during tooth development. It produces hypomineralization of the enamel by increasing the porosity, thus exposing the tooth to decay….The severity was mild and very mild in 90 % of cases. Tooth decay appeared in 55 % of children with fluorosis and in 43 % of children without fluorosis….The prevalence of dental fluorosis is rapidly increasing. Tooth decay affected more often children with fluorosis.”

    Pontigo-Loyola AP, Medina-Solis CE, Borges-Yañez SA, Patiño-Marín N, Islas-Márquez A, Maupome G. Prevalence and severity of dental caries in adolescents aged 12 and 15 living in communities with various fluoride concentrations. J Public Health Dent 67(1):8-13 (2007)

    “Finally, an association of severity of dental fluorosis and caries severity was observed. While fluorosis was very common, it was often mild or very mild…The results showed that children with dental fluorosis have higher severity of caries (DMFT ≥ 4).”

    “When we compared high-severity caries group (DMFT ≥ 4 as cutoff point), we observed higher caries severity in children with fluorosis (9.6 percent in very mild/mild, and 10.6 percent in moderate/severe) than children without fluorosis (7.8 percent). Additionally, compared only DMFT=0 versus DMFT ≥ 4 similar results were observed; prevalence of DMFT ≥ 4 in fluorosis-free children was 13.5, while 15.5 and 17.1 was observed in children with very mild/mild and moderate/severe fluorosis.”

    - Bajaj M, Blah BC, Goyal M, Jain M, Joshi A, Ko HH. Prevalence of dental problems in school children – a study in a rural community in Haryana. Indian Journal of Community Medicine 14 (3): 106-09 (1989)

    “While only 54.4% of those without fluorosis had caries, 80% of those with fluorosis had caries.”

    - Budipramana ES, Hapsoro A, Irmawati ES, Kuntari S. Dental fluorosis and caries prevalence in the fluorosis endemic area of Asembagus, Indonesia. Int J Paediatr Dent 12(6):415-22 (2002)

    “In this study, DT (Decayed Permanent Teeth) increased with an increase in the fluoride content.”

    - Hoffman N, Schlittler RH, Sousa M, Cypriano S. Prevalence of enamel defects and the relationship to dental caries in deciduous and permanent dentition in Indaiatuba, Sao Paulo, Brazil. Cad. Saode Publica 23(2):435-444 (2007)

    “A positive association between dental caries and enamel defects (hypoplasia, demarcated opacity and dental fluorosis) was observed for schoolchildren aged 5…The results of this study indicated that children had increased odds of dental caries when enamel defect was present, both in deciduous and permanent dentition…”

    So much for Kumar’s theory.

    L

  36. Dear Ken

    ‘Louise – best you specifically state what is troubling you – there are a number if citations there but you must be confused about something else.’

    Why must there be something troubling me? I am not confused about anything. I have provided you with much evidence from dental publications that there are – at best – only minimal systemic beneficial effects of fluorides on caries. I have provided you with some excellent reviews on the matter. I have included studies done on children which show no -pre-eruptive benefit.

    You are citing a statement from a review by Newbrun. Would you please be so kind and provide an actual study? Please pick any study reviewed by Newbrun which you feel best provides proof for this pre-eruptive benefit.

    I already have addressed the references from other commenters.

    ‘If deficient the beans become weak and have a lower solubility.’

    Would you please provide a reference for this statement?

    L

  37. Louise, you specifically asked for references but won’t tell me what specific point you want them referring to. I think I have done my best with this. You must have made a vague comment which you now can’t back up.

    I have already been into the nature of apatites (our bones are bioapatites, as are our teeth)and the role played by F in natural apatites. You continual “please provide a reference” is an attempt to ignore what has already been put in front of you.

    Do you deny the fact that F is normally and naturally part if the apatite composition?

    Other commenters here have thrown back at you your sloppy use of references to support a belief you want to passionately hold on to.

  38. Dear Billy Bud

    ‘Louise – Re Singh, the problem of younger children is common to all school children survey based studies. The upshot of these inclusions however is that the effect of the topical effect of fluoridation is simply masked. Data restricted to older children may well show a relatively larger topical effect but would not expunge Singh’s findings.’

    How does your response here address the problems with Singh’s study?

    Once again, in Dr. Ana Mascarenhas’ words:

    “There are several limitations that should be considered.
    The major one is that the largest group in the study
    was children aged 6 to 7 years, who accounted for 28.8%
    of the study population. The permanent first molars in
    these children would not have been exposed to posteruptive
    fluoride for sufficient time to prevent caries.
    Therefore, these subjects should not have been included
    in the study. A further justification for not including these
    children, is the data in Table 2, which show that in the
    6- to 7-year age group, the DMFS6 was higher across all
    categories (II, IV, VI, VIII) with post-exposure $50%,
    when compared to the categories (I, III, V, VII) with
    post-exposure #50%; whereas, in the other age groups,
    the DMFS6 was consistently lower in categories with
    post-exposure $50%, when compared to the categorie
    with post-exposure #50%, except for groups III and IV.
    Further, as reported by the authors, the distribution of
    individuals by lifetime fluoride exposure levels was varied
    with over 75% of the children experiencing either the
    shortest level of exposure or the longest level of exposure
    (41.4% and 36.1%, respectively), and there were fewer
    than 250 subjects in 2 of the categories (III, VI), making
    results from analyses in the smaller populations more
    unstable, which is pertinent to the multivariate analyses
    in Table 3. Category VI had the strongest caries-preventive
    effect (RR = 0.52), but also had the lowest number of
    individuals (182). Additionally, the authors report that
    there were low caries levels in the proximal and smooth
    surfaces; therefore, these results apply to pit and fissure
    surfaces. The authors do not report excluding the
    proximal and smooth surfaces from the study to keep
    the analysis clean. Taken together, the above limitations
    could have resulted in the effects seen.”

    Mascarenhas AK, Scott T. Does exposure to fluoridated water during the crown completion and maturation phases of permanent first molars decrease pit and fissure caries? J Evid Based Dent Pract 8(1):17-8 (2008)

    Secondly, regarding the Neidell paper:

    ‘Neidell’s opinion of the systemic benefits of swallowed fluoride in childhood is made very clear in the article’s Conclusions’

    The conclusions are an opinion, as you state, they are not based on accurate science. You can’t just “assign the probability of fluoridation exposure when in fact, an individual was either exposed to fluoridation or not.”

    There is still more wrong with this paper, including that no attempts whatsoever were made to adjust for the known 8 predictors for tooth loss. For a comparison as how to how this study should have been conducted, see Jiang’s paper from 2013.

    Jiang Y, Okoro CA, Oh J, Fuller DL. Sociodemographic and health-related risk factors associated with tooth loss among adults in Rhode Island. Prev Chronic Dis. 2013 Mar;10:E45. doi: 10.5888/pcd10.110285.

    I already addressed the Kumar/fluorosis matter in a separate post.

    L

  39. Louise – I apologize for the length of this reply . . re the references you gave – they are all save Zimmer written prior to the CDC’s statement in 2001. I’ve previously noted how the CDC has changed their position based on new research.

    Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res 69:601–605 (1990)
    This paper presents the author’s views of cariogenesis and contains no primary data. It is relatively old and like the CDC’s 2001 often quoted statement must be interpreted with more recent clinical human studies showing important cavity prevention from swallowed fluoride in childhood.

    Bowen WH. Caries prevent ion –- fluoride: reaction paper. Adv Dent Res 5:46-9 (1991)
    Similar to Arends (1990) this is a review and reflects the greater understanding of the importance of the topical effect. Of importance to the larger debate is the abstract’s first sentence: “Although the prevalence of caries has declined in young persons in developed countries, there is still a need for water fluoridation.”

    Duckworth RM, Gilbert RJ. Intra-oral models to assess cariogenicity: Evaluation of oral fluoride and pH. J Dent Res 71:934–944 (1992)

    While this paper reviewed methodologies for enamel biopsy, as near as I can determine it did not report any data comparing caries with actual enamel fluoride concentration measurements.

    Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)
    ditto Arends.

    Reich E, Schmalz G, Bergmann RL, Bergler H Bergmann E. Caries incidence in children after varying periods of fluoride tablet application. Dtsch Zahnartz Z 47:232-234 (1992)

    This paper is not indexed in PubMed. I’m sorry but that is the cut criteria I use to identify sufficient scientific quality and peer review to make it worth my while to read.

    Rosin-Grget K, Lincir I. Current concept on the anti caries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)
    This paper, from Croatia, in the conclusion argues only that the topical effect is “more” important, not that the systemic effect is unimportant. It is very common for fluoridation opponents to jump from a reasonable statement that the topical effect is predominant to the political position that the systemic effect is unimportant.

    Zimmer S, Jahn KR, Barthel CR. Recommendations for the use of fluoride in caries prevention. Oral Health Prev Dent 1(1):45-51 (2003)
    Again, there are no primary data. Although this author believes the efficacy of fluoride is from “local processes” he states: “Besides this, fluoridated water and fluoridated salt are still important. Although they have a systemic effect, the efficacy of these fluoride applications results from local processes.” This underscores the most important point which is that the benefit of fluoridation has been demonstrated epidemiologically and that fact stands regardless of the underlying mechanism.

    I don’t think the experience of a species (shark) not even in human’s taxonomic class has any relevance to setting public health policy. BTW, Whales have spectacular bone fluoride apparently without causing arthritis or osteogenic sarcoma.

    Some of the known benefits of water fluoridation are possible only when fluoride is swallowed during tooth development. While the topical effect may be predominant, there is good evidence to support the importance of cariostatic systemic effects.

    Epidemiological studies show fluoridation decreases grinding injury for both adults and children

    Br Dent J. 2004 Oct 9;197(7):413-6; Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: The relationship with water fluoridation and social deprivation. Bardsley PF, Taylor S, Milosevic A.

    This confirms experimental literature showing that fluoride swallowed during tooth development has a number of effects on tooth structure including harder enamel and dentin. Clearly only a systemic effect can create harder, more wear resistant teeth.

    Br Dent J. 1994 May 7;176(9):346-8. Comparison of the effect of fluoride and non-fluoride toothpaste on tooth wear in vitro and the influence of enamel fluoride concentration and hardness of enamel. Bartlett DW, Smith BG, Wilson RF.

    J Dent Res. 2005 Oct;84(10):951-7. How does fluoride affect dentin microhardness and mineralization? Vieira A, Hancock R, Dumitriu M, Schwartz M, Limeback H, Grynpas M.

    On the Nov 17 Open Parachute debate document I’ve previously referred to Groeneveld (1990), Singh (2004), Kobayashi (1992), Iida and Kumar (2009) and Neidell (2010). Janet had some minor criticisms of Singh and Neidell which to me and apparently the peer review editors were not sufficient to change the conclusions.

    Kumar’s analysis of the largest data set ever collected of cavities in the adult teeth of school children found that fluorosis protects teeth from cavities. This is proof positive of a systemic effect benefit. He was able to quantify the protection and found:

    “..the effect of the lower caries experience observed among teeth with mild fluorosis on overall health care cost savings could be substantial. According to these data, fluorosis in just four or five permanent first molars in a population may be associated with an average of approximately one fewer DMFS in that population. To produce the
    same effect, one would have to seal, and maintain sealants on, four to 15 permanent first molars, a process that would cost a great deal more. Therefore, anyone formulating guidance regarding the reduction of fluoride exposures must take into consideration the protection associated with the milder forms of enamel fluorosis.”

  40. Dear Billy Bud,

    My references were specifically given in relation to Ken’s statements about fluoride in bioapatite.

    For example, Ken wrote:

    ‘Accumulation of fluoride, together with calcium and phosphate, in our bioapatites is a normal part of development. This is beneficial because it helps strength our bones and teeth, and lowers their solubility.
    Both insufficient fluoride, or excess fluoride in our bioapatites can cause problems.
    Excessive dietary intake can result in excessive fluoride in our bones and teeth. Insufficient intake may also cause our bioapatites to be weaker and more prone to dissolve. When dietary intake of fluoride is reduced fluoride can be lost from bones and calcified tissues.
    The scientific literature reports that fluoride has a systemic role benefitting bones and pre-erupted teeth.’

    All my references were related to this issue – nothing else. Not fluoride effects on tooth structure and teeth grinding.

    Now you are supplying me with first sentences of abstracts as “scientific” evidence?

    Your ignorant statement about sharks’ teeth shows how little you know about fluorapatite and its solubility.

    Regarding the Reich and Bergmann paper:

    ‘This paper is not indexed in PubMed. I’m sorry but that is the cut criteria I use to identify sufficient scientific quality and peer review to make it worth my while to read.’

    You must live in the US?

    I find it quite telling that once again, you give me the Kumar material, but neglect to address the studies I had just provided you with, showing that dental fluorosis – even very mild DF – INCREASES caries. Now why is that? Certainly they must be on PubMed?

    L

  41. Let’s see if we can get this straight, Louise.

    You say that you are concerned with my statement on the natural involvement of F in bioapatites. Sepcifically you quote:

  42. ‘Fluoride is a normal, natural component of bioapatites. In the real world these don’t exist as end-member compounds such as hydroxylapatite or fluoroapatite. They are more correctly described as hydroxyl-fluoro-carbonate-apatites.
  43. Accumulation of fluoride, together with calcium and phosphate, in our bioapatites is a normal part of development. This is beneficial because it helps strength our bones and teeth, and lowers their solubility.
  44. Both insufficient fluoride, or excess fluoride in our bioapatites can cause problems.
  45. Excessive dietary intake can result in excessive fluoride in our bones and teeth. Insufficient intake may also cause our bioapatites to be weaker and more prone to dissolve. When dietary intake of fluoride is reduced fluoride can be lost from bones and calcified tissues.
  46. The scientific literature reports that fluoride has a systemic role benefitting bones and pre-erupted teeth’
  47. Now that is a brief statement, intentionally without references, because Paul Connett had ignored the section of my previous article, Apatites contain structural fluoride, dealing with this issue. I was bringing it back to his attent6ion. It is clear one needs to refer back if one has not read the previous article.

    You seem to want to reject this chemical point, Louise, and nothing will deter you from that path. Yet it is a basic issue.

    I realise that anti-fluoridation activists work hard to deny a systemic role for ingested fluoride. They also work hard to try and convince us the surface mechanism operating on existing teeth amounts to “topical application” and therefore deny a role for fluoridated water.

    However, if you want to go along that path then you will need to produce evidence that the chemical understanding of apatites is incorrect. And, please, don’t rely on referring to the high concentration regions where we all know the situation is different (this is waht is happening when one drags in marked dental fluorosis).

    Please correct me on my chemistry if I am wrong.

  48. Luouise – could you please stop being agressive. Referring to the honest input of other commentors as “ignorant” is not acceptable.

    I will keep you under moderation and try to stop future comments which are like this.

  49. Dear Ken,

    You’ve been keeping numerous of my comments under moderation and disallowing, although there is nothing aggressive about them.

    I refer to comment 47746, for example, still under moderation. It is becoming apparent that you cannot provide a reference for your “deficiency” claim.

    You refer to “high concentration” regions. FYI – DF occurs at fluoride plasma levels of 0.2 mumol/L and above. And at what levels does fluoride inhibit caries?

    If you are not interested in addressing this issue honestly and with integrity, then I am no longer interested in participating on this blog.

    L

  50. * Correction – that should be 2 mumol/L.

  51. Louise – see my previous comment – I am keeping you under moderation because of aggression. I think I have cleared everything I intend to now. And I have provided references in my articles for the points made, Enough of attempts at confusions.

    Yes, there is a lot of sneaky behaviour by anti-fluoridation activists on dental fluorosis – another bait and switch – a very wide defintion to get the large figures and then pull up reports of negative effects which occur in severe cases only.

  52. Dear Ken,

    ‘Yes, there is a lot of sneaky behaviour by anti-fluoridation activists on dental fluorosis – another bait and switch – a very wide defintion to get the large figures and then pull up reports of negative effects which occur in severe cases only.’

    In post 47741 I have provided evidence from just a few studies showing that very mild to mild DF cause an increase in caries. How can you possibly refer to this as “severe cases” only? This shows that DF certainly is not of “cosmetic concern” only.

    http://tinyurl.com/k5qcbaw

    I have asked you for one reference for your deficiency claim, and you are continuing to evade this issue.

    I am no longer interested in participating.

    L

  53. Louise, I think your anger is getting you confused. Your arguments over fluorosis and decay at high concentrations was with Billy, I think. But a look at the references and quotes (unfortunately it would be impossible for me to hunt down those journals to check them out – what about providing links to full text) does sort of suggest the association is with the more serious form of dental fluorosis. I would have to read the papers to make a more definite conclusion.

    I asked you specific questions about the chemistry of apatites. After all, you had quoted my summary.

    Do you disagree that F is a natural and normal component of the bioapatite structure?

    Do you disagree that F in the apatite structure strengthens it and lowers the solubility of the apatite? (No I am not talking about excessive amounts of F).

    This demanding from me of references is confusing. What specific “deficiency claim” are you referring to?

    And please don’t put your confusion back on me. I not evading anything – I am trying to understand what you want.

  54. Let’s get this clear, we get all sorts of poison claims from most anti-fluoridationists. That we expect.

    But Louise is telling us that optimally fluoridated water actually makes the teeth more susceptible to decay.

    Dentists and world health organisations world-wide are not only putting rat poison in our water, but they are also making tooth decay worse.

  55. Hi Louise,

    You said…

    “…I have provided you with much evidence from dental publications that there are – at best – only minimal systemic beneficial effects of fluorides on caries”

    Forgive my ignorance but you agree there are systemic benefits to fluoridated water? – albeit in a minimal way?

    I am confused, you appeared so anti…

  56. Lousie is confused.
    Quote-mining is a bad idea. It might work with stupid people but it’s a stock standard trick that we’ve seen too often around here. Science deniers do it all the time. Pick a paper (or get one picked for you by a denier website) and then go searching for a nugget (or get one ready-mined for you).
    Stupid.
    Stupid and annoying and predictable.
    Strangely, the conclusions of the paper never get quoted.
    Just bits.
    Or one tiny bit.
    Richard rightly called her out on her little game and she got quite huffy and puffy.

    Louise?
    The best response to accusations of quote-mining is to quote the conclusions of the paper itself. In context. In detail.
    Works like a charm every time.
    Oh yes. And it’s your resposiblity to make it really easy for people to check that you have actually quoted in context. Give a….link….to the paper. This is the age of the internet, yeah?
    Getting the reader to “Go Fish” is a a piss poor way of doing things.
    Link.
    It’s not that hard.
    (And no, that’s not an invitation to do a mass link dump or endless cutting-and-pasting. Yes, I’m looking at you Trevor Nutter.)

    Flouncing off just exposes you as a lying tool.
    It’s put up or shut up around here.

    You’ve been keeping numerous of my comments under moderation and disallowing…

    Always a bad sign. It takes a lot to get Ken to moderate comments.
    The man has the patience of a Dawkins.

  57. Ken, why do you allow this slagging post by Cedric to stand, when he adds nothing new to the debate and calls people names like “lying tool”? Yet I have seen respectful and useful posts (that disagree with Ken) disappear minutes or hours after being posted. Ken, I don’t think it is right that you remove posts that challenge your use of science, but let worse posts that support you stand.
    Something may be going very wrong with the moderation of this debate. I wish I had made screen capture records of posts that Ken has removed, but I never expected him to behave in this way.

  58. David, it would be more sensible for you to contribute to the discussion instead of bitching about moderation.

    As a moderator I know I can’t please everyone – and don’t intend to. My purpose is to stop discussion descending into hateful exchanges which is the usual story for Internet discussions. Paul was also concerned about that and I welcomed the opportunity to try a stronger moderation because I have actually had complaints by some commenters who were put off by all the animosity.

    (I had not seen Cedric”a “lying tool” – so Cedric – could you please avoid such aggressive language in future?)

    David, I assure you I do not hold back comments challenging the science – those are the very comments we want. But I do stop aggressive and labelling comments, trolling videos, etc.

    Personally I think this policy has helped make the discussion so good – that and the high calibre of people participating.

    If you are spending your time just making screenshots in an attempt to find whose comment has been held back then your contributions are really pointless, and will not be posted in future. But I do pick up that you have some irons in the fire on this issue so why not contribute your ideas to the discussion?

  59. Hi David,
    Despite Cedric’s single inappropriate sentence his comment is helpful overall and it does add to the discussion. It offered Louise an acceptable alternative methodology.
    As a long-term reader of this blog I attest to viewing trolling behaviour that you would almost not believe in regard to subjects that attract science deniers (climate change, evolution, etc – and now fluoridation),
    In their arguments and approach to science and debate, those who deny the consensual outcomes of the modern scientific method and international scientific community, use uncannily similar poor methodology and dishonest tactics – it can be very tiresome.
    When these tricks crop up in the course of discussion they I believe should be exposed for what they are. Not every reader is aware of the tactics used. Sometimes there is no nice way to do it.
    Quote mining is cheap.

  60. (I had not seen Cedric”a “lying tool” – so Cedric – could you please avoid such aggressive language in future?)

    Sorry Ken. Didn’t mean to cross a line.
    I should have called Louise a plain old fashioned quote-mining liar instead.
    Quote-mining is just a sleazy way of lying and people need to be called out on it bold and clear.
    Those papers don’t say what she was implying.
    I understand that people don’t like to be called liars either but…it’s a fair comment.
    Liars do exist and liars really hate being called liars.
    Too bad for them.

    Either someone is lying or they are not.
    Spades and all that.

    Of course, David is welcome to follow my helpful and very reasonable methodology and demonstrate that Louise wasn’t a quote-mining liar at all.
    That would be impressive.
    Deeply impressive.
    (I’d ask Louise herself but, sadly, she’s already done a flounce.)
    So if David’s up to it, I will cheerfully withdraw my claim that Louise is a quote-mining liar….and make a full apology.
    That’s a promise.
    Heck, I’ll even throw in a guarantee.

    (..drum roll please…)

    If David (or anyone else) can demonstate that Louise was not at all quote-mining and ….I DON’T apologise(!!) ….then I’ll ban myself from ever taking part in any discussion ever on this or any other blog.
    Cedric Katesby will simply vanish forever from the internet.
    I’ll let Ken be the arbiter as to whether David (or someone else) has made sufficient demonstration and I promise to abide by any decision Ken might make.
    His word is final.
    That way nobody can accuse me of shifting the goal posts or welching on the deal.
    I can’t be fairer than that.

    Calling someone a tool is much more subjective and possibly inflammatory, so for the sake of this flouride discussion, I’ll avoid such language in future.
    No doubt that will assague David’s delicate sensibilites.

    So let’s see if David (or somebody, anybody but especially David) has the energy to not only bitch about moderation but also to publically look into Louise being a quote-mining liar.
    Who knows?
    This could be the end of Cedric Katesby.
    Or not.
    (….waits patiently…)

  61. Louise – re your post which ends with “So much for Kumar’s theory.”

    That fluorosis prevents cavities is not a theory, but rather the result of clinical examinations in a data set which included over 39,000 US school children. Those data included tooth level observations by calibrated examiners. Nearly 17,000 subjects with complete residence histories formed the basis of Iida and Kumar’s statistical analysis. Focusing on the first molar, these data showed that fluorosis prevents cavities.

    I note that none of the articles with appropriate publishing dates were of sufficient quality to be included in the exhaustive review published by the National Academy of Sciences in 2006. An entire chapter was devoted to enamel fluorosis. The bibliography upon which the report was based was a monumental accomplishment. One can be confident that your references would have been included if they deserved to be.

    The paper by Pontigo-Loyola AP et al., (J Public Health Dent 67(1):8-13, 2007) well illustrates why these smaller and less well designed studies are not applicable in the US.

    The subjects lived an altitude above >6,560 ft and drank water that exceeded 1.38 ppm. Their state is included in Mexico’s fluoridated domestic salt program. Over 80% had fluorosis which was moderate or severe in about a third. Because every child was exposed to fluoride and there was such a high level of advanced fluorosis and every child it is difficult to assess the relationship between fluorosis and caries. Dental work to improve appearance is likely common making it difficult to know if the “fillings” observation was due to cavities or cosmetic dentistry.

    Factors such as age, gender, dental visit, socioeconomic status and locale had an effect on the study’s cavity measurements in the bivariate analysis. Therefore those factors must be controlled for to accurately measure an association between fluorosis and cavities

    Compared to Iida and Kumar’s, this study is small, the population and fluoride exposure is not comparable to the US, observations of the filling component are not clear, and the analytical method lacks sophistication.

    Adding more small poorly designed studies will not overturn the observations from a very large nation-wide US well designed study based on calibrated observations.

    Lastly, I can only restate the fact that the observational science upon which community water fluoridation’s (CWF) benefits have been demonstrated is not dependent on the mechanistic explanation for effectiveness.

    CWF simply prevents cavities. Preschoolers have fewer operations for mouth fulls of rotten teeth, adult teeth have fewer cavities, restorations last longer and there are fewer cavities on the exposed root surfaces of elderly people.

  62. Dr. Johnny Johnson

    Louise,

    The references you make regarding fluorosis and caries are not from studies done in the United States, nor Canada. Perhaps your position would be better supported if you provided peer reviewed literature from the US or Canada that’s more applicable to the United States.

    As Billy points out, studies must pass the critical review process that credible scientific journals require. That includes sample size, control of confounding factors (to the best that they can be), and a representative sampling of the population.

    Taking literature that meets one’s own position is easy to do. I’m just as guilty of this bias as the next person. However, my bias is based on the literature that has appeared in refereed peer reviewed scientific journals worldwide. This literature is weighed by the experts in this particular field and debated in expert panels like the 2006 NRC Review of EPA standards, and the U.S. Community Preventive Services Task Force. These folks are tasked with reviewing volumes of literature and arriving at a consensus opinion. It is those experts that I rely on, not a handful of studies done somewhere, anywhere, that happens to support my position.

    The science is crystal clear. Community water fluoridation is effective and safe. That’s the consensus opinion of our experts at this time. And it has been that same consensus for the past 68 years. When, and if that were to ever change, Ken would be one of the first to broadcast it, right after the CDC and other credible scientific groups have yelled it from the highest mountain.

    Johnny Johnson, Jr., DMD, MS
    Pediatric Dentist

  63. These folks are tasked with reviewing volumes of literature and arriving at a consensus opinion. It is those experts that I rely on, not a handful of studies done somewhere, anywhere, that happens to support my position.

    The science is crystal clear. Community water fluoridation is effective and safe. That’s the consensus opinion of our experts at this time. And it has been that same consensus for the past 68 years. When, and if that were to ever change, Ken would be one of the first to broadcast it, right after the CDC and other credible scientific groups have yelled it from the highest mountain.

    That sums it up nicely.
    It would work for all scientific fields that science deniers of all stripes bitch and moan and wail at.

    A scientific consensus doesn’t happen by magic. It’s doesn’t just pop up out of thin air. “They” are not meeting in smoke-filled rooms to cook up some dodgy agreement.
    The deniers need to abandon the conspiracy mongering.

    Science deniers find nothing.
    They go all “OMG! OMG!! OMG!!!” over some isolated study that someone shoved under their nose. Yet they never really register that if they have found something shock-gasp-amazing then….how come the relevent scientific authorities aren’t going OMG?

    You found evidence that the moon landings didn’t happen?
    Really?
    Ok….but…what about the scientific community? How come they don’t see what you see as clear as a bell from that blog you found?
    There has to be a mechanism.
    If you can’t provide one then you paddling up a creek without a paddle.

    You found evidence that evolution is a lie?
    Really?
    Ok….but…what about the scientific community? How come they don’t see what you see as clear as a bell from that blog you found….

    You found evidence that climate change is a lie?
    Really?
    Ok….but…what about the scientific community? How come they don’t….

    You found evidence that HIV is a lie?
    Really?

    No. Not really.
    You’ve discovered bugger all. You’re not going to shake the scientific community to the core. You’re just another gullible soul on the internet embracing conspiracy theories with delusions of grandeur.
    Your methodology sucks and it’s making you look very silly to the rest of us.
    Dunning Kurger Effect.

    illusion of superiority

  64. jj – your comment is flippant and contributes nothing. You are welocme to comment seriously on the discussion here and the articles. But to prevent the discussion being undermined or diverted I am holding back comments like this.

  65. Dr. Johnny Johnson

    Ken,
    Apologies, my friend. Certainly didn’t mean to appear flippant or distracting from the great work you are doing here. Thanks for interacting with Paul Connett and allowing us to participate. It benefits everyone.

    Johnny

  66. In COMMENT 47831 Billy Budd writes:

    BUDD: “That fluorosis prevents cavities is not a theory, but rather the result of clinical examinations in a data set which included over 39,000 US school children. Those data included tooth level observations by calibrated examiners. Nearly 17,000 subjects with complete residence histories formed the basis of Iida and Kumar’s statistical analysis. Focusing on the first molar, these data showed that fluorosis prevents cavities.

    I note that none of the articles with appropriate publishing dates were of sufficient quality to be included in the exhaustive review published by the National Academy of Sciences in 2006. An entire chapter was devoted to enamel fluorosis. The bibliography upon which the report was based was a monumental accomplishment. One can be confident that your references would have been included if they deserved to be.”

    PM Response: Stop deflecting. That the older studies were not included in some review by the NRC does in no way diminish the quality or the findings by the researchers. We’re not here to discuss inclusion criteria by the NRC.

    BUDD: “The paper by Pontigo-Loyola AP et al., (J Public Health Dent 67(1):8-13, 2007) well illustrates why these smaller and less well designed studies are not applicable in the US.

    The subjects lived an altitude above >6,560 ft and drank water that exceeded 1.38 ppm. Their state is included in Mexico’s fluoridated domestic salt program. Over 80% had fluorosis which was moderate or severe in about a third. Because every child was exposed to fluoride and there was such a high level of advanced fluorosis and every child it is difficult to assess the relationship between fluorosis and caries. “

    PM Response: This sounds like you’re grasping for straws. Dental fluorosis is caused by excessive fluoride intake. As you stated to Louise – “Surely there is no argument that fluorosis is a systemic effect”. Surely you’re not going to dispute that now? HOW the dental fluorosis was caused has no relevance on the findings that children with dental fluorosis – even very mild to mild forms – had an increase in caries AND caries severity.

    BUDD: “Dental work to improve appearance is likely common making it difficult to know if the ”fillings” observation was due to cavities or cosmetic dentistry.

    Factors such as age, gender, dental visit, socioeconomic status and locale had an effect on the study’s cavity measurements in the bivariate analysis. Therefore those factors must be controlled for to accurately measure an association between fluorosis and cavities.”

    PM Response: Again – you’re grasping at straws. What is there to control for here? Let me know.

    The researchers came to their conclusions when they investigated WHAT was causing an increase in caries. When they did account for established confounding variables as best as possible, they found that an increase in SES, dental fluorosis, increase in dental visits, etc.. were associated with an INCREASE in caries. Not exactly what you would expect, is it?

    The authors discuss these factors at length. Perhaps have a look at table 3 and the discussion?

    And – yes indeed – confounding factors are also VERY important when investigating studies claiming that water fluoridation causes a decrease in caries, as there are many other factors which can lead to a reduction of caries incidence.

    Can you provide ONE study which has adjusted for established confounding factors such as race, gender, age, total intake, tooth eruption, brushing and other oral hygiene factors, SES – that can show a decrease in caries in fluoridated areas as compared to non-fluoridated ones? Certainly – this study must exist SOMEWHERE? Your friend Johnny Johnson could not find one. Slott couldn’t find one either, but pretended he had ”countless”.

    BUDD: “Compared to Iida and Kumars, this study is small, the population and fluoride exposure is not comparable to the US, observations of the filling component are not clear, and the analytical method lacks sophistication.”

    PM Response: Once again – fluoride exposure and how the dental fluorosis was caused has NO bearing what-so-ever on the findings here. 41% of 12 to 15 year old children in the US have dental fluorosis – certainly, that is applicable?

    Compared to Kumar, this study dealt with such 12 to 15 year old children. A total of 1,538 adolescents (representing 86.9 percent of the population) were included. Any factors and shortcoming concerning this study group are discussed by the authors.

    If you have trouble with the analytical methods employed feel free to explain their shortcomings and “lack of sophistication”.

    BUDD: “Adding more small poorly designed studies will not overturn the observations from a very large nation-wide US well designed study based on calibrated observations.”

    PM Response: There are at least 30 studies which show that dental fluorosis increases caries. That is not a “small body of poorly designed” studies. Up to now, it has been thought an increase was only observable at TF score 3. That even very mild to mild DE can cause an increase in caries AND caries intensity, is a relatively new discovery. I notice you did not address the other papers.

    BUDD:“Lastly, I can only restate the fact that the observational science upon which community water fluoridation’s (CWF) benefits have been demonstrated is not dependent on the mechanistic explanation for effectiveness.

    CWF simply prevents cavities. Preschoolers have fewer operations for mouth fulls of rotten teeth, adult teeth have fewer cavities, restorations last longer and there are fewer cavities on the exposed root surfaces of elderly people.”

    PM response: “Simply prevents cavities?” You’re simply stating nonsense. If there is real evidence – show it to me. Not a line from some CDC or ADA statement. Real evidence.

    I will ask once again – please provide ONE study capable of demonstrating this preventative effect of CWF that has accounted for established confounding factors such as race, gender, age, total intake, tooth eruption, brushing and other oral hygiene factors, SES.

    A copy of this comment will be posted at:
    http://fluoridedentalexperts.com/html/budd_melters_1.html

    Paul Melters

  67. In COMMENT 47834, Johnny Johnson writes:

    JOHNSON:“The references you make regarding fluorosis and caries are not from studies done in the United States, nor Canada. Perhaps your position would be better supported if you provided peer reviewed literature from the US or Canada that’s more applicable to the United States.”

    PM Response: The two most important and most recent references were from studies done in Mexico. Last time I checked, Mexico was right next to the USA. I understand that there is also a very large hispanic population in the US (53 million).

    JOHNSON:“As Billy points out, studies must pass the critical review process that credible scientific journals require. That includes sample size, control of confounding factors (to the best that they can be), and a representative sampling of the population.”

    PM Response: Both studies were published in peer-reviewed, credible scientific journals.

    1) Azpeitia-Valadez et al: (2008)
    http://www.ncbi.nlm.nih.gov/pubmed/18647575

    Sample: 6 to 15 years old children. 456 children was evaluated. 270 children presented fluorosis (59.2 %). Sample size, representation of population, and method of investigation are discussed.

    2) Pontigo-Loyola et al (2007)
    http://www.ncbi.nlm.nih.gov/pubmed/17436973

    Sample size – Pontigo-Loyola: 12 to 15 year old children. A total of 1,538 adolescents (representing 86.9 percent of the population) were included.

    Confounding factors: As already mentioned in the post to Billy Budd, any “control of confounding factors” here really is irrelevant. Have a look at the Pontigo-Loyola paper and tell me what variables should have been controlled for, and weren’t. And, as you’re stressing the importance of controlling factors – please answer the question at the bottom of this post. You’ve been avoiding it for months now.

    JOHNSON: “Taking literature that meets one’s own position is easy to do. I am just as guilty of this bias as the next person. However, my bias is based on the literature that has appeared in refereed peer reviewed scientific journals worldwide. This literature is weighed by the experts in this particular field and debated in expert panels like the 2006 NRC Review of EPA standards, and the U.S. Community Preventive Services Task Force. These folks are tasked with reviewing volumes of literature and arriving at a consensus opinion. It is those experts that I rely on, not a handful of studies done somewhere, anywhere, that happens to support my position.”

    PM Response: See above. These papers are recent publication (2007, 2008), published AFTER the 2006 NRC review.

    JOHNSON: “The science is crystal clear. Community water fluoridation is effective and safe. That’s the consensus opinion of our experts at this time. And it has been that same consensus for the past 68 years. When, and if that were to ever change, Ken would be one of the first to broadcast it, right after the CDC and other credible scientific groups have yelled it from the highest mountain.”

    PM Response: The science is NOT crystal clear. If it were, why have you NOT been able to provide ONE scientific study showing this – as has been asked from you now many, many times? Where I live, caries DECREASED once fluoridation stopped.

    Maupomé G, Clark DC, Levy SM, Berkowitz J. Patterns of dental caries following the cessation of water fluoridation. Community Dent Oral Epidemiol. 2001 Feb;29(1):37-47.
    http://www.ncbi.nlm.nih.gov/pubmed/11153562

    I will ask once again – please provide ONE study capable of demonstrating this “effective and safe” effect of CWF that has accounted for established confounding factors such as race, gender, age, total intake, tooth eruption, brushing and other oral hygiene factors, SES.

    Reference:___________________________________________________________

    This comment will also be posted at:
    http://fluoridedentalexperts.com/html/johnson_-_melters.html

    Paul Melters

  68. In COMMENT 47890 Cedric Katesby writes:

    CEDRIC: “Quote-mining is just a sleazy way of lying and people need to be called out on it bold and clear.
    Those papers don’t say what she was implying.
    I understand that people don’t like to be called liars either but…it’s a fair comment.
    Liars do exist and liars really hate being called liars.
    Too bad for them.

    Either someone is lying or they are not.
    Spades and all that.”

    PM Response: Okay Cedric – I believe you’re right – either people are lying or they’re not.

    I presume that you calling Louise a liar means that you have evidence that she lied? You didn’t provide any, so I am wondering – what is your accusation is based on?

    CEDRIC: “These papers don’t say what she was implying.”

    PM Response: What specific paper(s) are you referring to?

    CEDRIC: “If David (or anyone else) can demonstate that Louise was not at all quote-mining and – I DON’T apologise(!!) – then I’ll ban myself from ever taking part in any discussion ever on this or any other blog.”

    PM Response: That would be very welcome indeed. Let’s have a look at the quotes then, to find out if she was lying and “quote-mining”:

    1) Regarding the Singh and Neidell papers;

    In COMMENT 47704, Louise questions the validity of Billy Budd’s claims about those papers (see Budd’sCOMMENT 47653).

    She quotes Mascarenhas (2008):

    Louise: “There are several limitations that should be considered. The major one is that the largest group in the study was children aged 6 to 7 years, who accounted for 28.8% of the study population. The permanent first molars in these children would not have been exposed to post-eruptive fluoride for sufficient time to prevent caries. Therefore, these subjects should not have been included in the study.”

    Mascarenhas AK, Scott T. J Evid Based Dent Pract 8(1):17-8 (2008)

    She later quotes almost the entire conclusion of Mascarenhas – see COMMENT 47747.

    That’s exactly what the paper says – so – no lying here.

    Mascarenhas AK, Scott T. Does exposure to fluoridated water during the crown completion and maturation phases of permanent first molars decrease pit and fissure caries? J Evid Based Dent Pract 8(1):17-8 (2008)
    http://www.jebdp.com/article/S1532-3382(07)00201-1/abstract

    SCORE: Louise 1 – Cedric 0

    She further quotes from the Neidell paper:

    LOUISE: By the author’s own admission:

    “we were assigning the probability of fluoridation exposure when in fact, an individual was either exposed to flouridation or not.”

    “The second concern is that we assigned historical fluoridation status to a respondent on the basis of the respondent’s current county of residence. Respondents, however, may not have lived in the same county for their entire lives”.

    She obviously has the full paper, otherwise she wouldn’t be able to quote this – it’s not in the abstract.

    Neidell M, Herzog K, Glied S. The association between community water fluoridation and adult tooth loss. Am J Public Health. 2010 Oct;100(10):1980-5. doi: 10.2105/AJPH.2009.189555. Epub 2010 Aug 19. PubMed PMID: 20724674; PubMed Central PMCID: PMC2936985.
    http://www.ncbi.nlm.nih.gov/pubmed/20724674

    The actual paper states exactly as she quoted, so again – no lying.

    She later, in COMMENT 47747, addresses further shortcomings in the Neidell paper such as the total lack of accounting for the 8 predictors of tooth loss. She knows her stuff. (NOTE: No further response from Billy Budd on this…)

    SCORE: Louise 2 – Cedric 0

    2) The quotes from reviews about fluoride in enamel and the effects thereof on caries.

    In COMMENT 44705, Louise had asked Ken for references for his comments in his 2nd reply to Paul Connett – and asked Ken to consider several quotes from various reviews on the matter. (Ken later asked for complete citations which Louise immediately provided in COMMENT 47724). (NOTE: Although Slott and Budd try to make it into something else, Louise – in FOUR different posts – specified that the issue at hand is fluoride in enamel and what that means to caries reduction. See: COMMENT 47723, COMMENT 47727, COMMENT 47739, COMMENT 47751 )

    LOUISE: “Assuming that more fluoride in the enamel would provide a greater anti-caries protection, measurements of fluoride in enamel have been undertaken by many authors. However, most of these studies failed to clearly demonstrate an inverse relationship between fluoride enamel content and caries prevalence.”
    (Arends & Christoffersen 1990; Duckworth & Gilbert, 1992, Feyerskov et al, 1981)

    All three papers report exactly as stated by Louise:

    Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res 69:601-605 (1990)
    http://www.ncbi.nlm.nih.gov/pubmed/2179320

    Duckworth RM, Gilbert RJ. Intra-oral models to assess cariogenicity: Evaluation of oral fluoride and pH. J Dent Res 71:934-944 (1992)
    http://www.ncbi.nlm.nih.gov/pubmed/1592990

    Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)
    http://www.ncbi.nlm.nih.gov/pubmed/7034449

    Score: Louise 3 – Cedric 0

    LOUISE: “No significant relationship has been demonstrated between caries experience of the individual and fluoride content of the enamel. Furthermore, the fluoride content in surface enamel between teeth developed in low and “optimal” fluoride areas is too small to explain any significant effect on dissolution rate of the enamel.”(Feyerskov et al, 1981)

    That’s what Feyerskov et al report. Also discussed in many other reviews since then, including Zimmer (2003) and Resin (2001) – which apparently have “Slott Approval”.

    Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)
    http://www.ncbi.nlm.nih.gov/pubmed/7034449

    Score: Louise 4 – Cedric 0

    Louise: “It is concluded that even shark enamel containing 30,000 ppm F has a limited resistance against caries attacks.” (Oogard et al, 1988)

    Again, exactly as reported, and discussed in many other reviews.

    Ogaard B, Rölla G, Ruben J, Dijkman T, Arends J. Microradiographic study of demineralization of shark enamel in a human caries model. Scand J Dent Res. 1988 Jun;96(3):209-11. PubMed PMID: 2839893.http://www.ncbi.nlm.nih.gov/pubmed/2839893

    Score: Louise 5 – Cedric 0

    Louise: “However, more recent studies suggest that fluoride present in the surface enamel does not significantly prevent acid production. The concentrations of fluoride present in the saliva are too low to affect bacterial metabolism.”(Rosin-Grget, 2001)

    Again, exactly as cited, in proper context.

    Rosin-Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)
    http://www.ncbi.nlm.nih.gov/pubmed/11811302

    Score: Louise 6 – Cedric 0

    “Nevertheless, fluoride tablets continue to be prescribed as if the action of fluoride is expressed systemically.” (Bowen, 1991)

    Appropriately cited.

    Bowen WH. Caries prevention-fluoride: reaction paper. Adv Dent Res 5:46-9 (1991)
    http://www.ncbi.nlm.nih.gov/pubmed/1819282

    Score: Louise 7 – Cedric 0

    Louise: “Thus, efforts to increase the fluoride content of dental hard tissues by systemic or topical fluoride are not a logical approach to caries prevention.” (Fejerskov et al, 1981)

    Appropriately cited.

    Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)
    http://www.ncbi.nlm.nih.gov/pubmed/7034449

    Score: Louise 8 – Cedric 0

    Louise: “The lack of benefit of pre-eruptive systemic fluoride application has been shown by Reich et al, who performed a prospective study in newborn children. The authors demonstrated that there was no difference in caries development at the age of 5 years if fluoride was administered as tablets right after birth as opposed to an application starting in the age of seven months, i.e. with the eruption of the first decidious tooth (Reich et al, 1992)”(Zimmer et al, 2003)

    I don’t have Reich, but Louise actually quotes Zimmer (2003).

    Again – cited appropriately.

    Zimmer S, Jahn KR, Barthel CR. Recommendations for the use of fluoride in caries prevention. Oral Health Prev Dent 1(1):45-51 (2003)
    http://www.ncbi.nlm.nih.gov/pubmed/15643748

    Score: Louise 9 – Cedric 0

    3) Papers on Dental Fluorosis causing caries

    In COMMENT 47741, Louise quotes from 5 papers documenting that dental fluorosis causes an increase in caries.

    re: Azpeitia-Valadez et al.

    Louise: “Dental fluorosis is a defect in the formation of the enamel by high fluoride concentrations during tooth development. It produces hypomineralization of the enamel by increasing the porosity, thus exposing the tooth to decay…The severity was mild and very mild in 90 % of cases. Tooth decay appeared in 55 % of children with fluorosis and in 43 % of children without fluorosis….The prevalence of dental fluorosis is rapidly increasing. Tooth decay affected more often children with fluorosis.”

    I found abstract on PubMed, and original paper on-line. I don’t read Spanish as I presume Mantella does, but English summary reports as stated.

    Azpeitia-Valadez Mde L, Rodríguez-Frausto M, Sánchez-Hernández MA. Prevalence of dental fluorosis in children between 6 to 15 years old. Rev Med Inst Mex Seguro Soc 46(1):67-72 (2008)
    http://www.ncbi.nlm.nih.gov/pubmed/18647575
    http://edumed.imss.gob.mx/edumed/rev_med/pdf/gra_art/A11.pdf

    Score: Louise 10 – Cedric 0

    re: Pontigo-Loyola et al.

    Louise: “Finally, an association of severity of dental fluorosis and caries severity was observed. While fluorosis was very common, it was often mild or very mild. The results showed that children with dental fluorosis have higher severity of caries (DMFT ≥ 4).”

    “When we compared high-severity caries group (DMFT ≥4 as cutoff point), we observed higher caries severity in children with fluorosis (9.6 percent in very mild/mild, and 10.6 percent in moderate/severe) than children without fluorosis (7.8 percent). Additionally, compared only DMFT=0 versus DMFT ≥4 similar results were observed; prevalence of DMFT ≥4 in fluorosis-free children was 13.5, while 15.5 and 17.1 was observed in children with very mild/mild and moderate/severe fluorosis.”

    No lying there either. Exactly as stated.

    Pontigo-Loyola AP, Medina-Solis CE, Borges-Yañez SA, Patiño-Marín N,
    Islas-Márquez A, Maupome G. Prevalence and severity of dental caries in
    adolescents aged 12 and 15 living in communities with various fluoride
    concentrations. J Public Health Dent. 2007 Winter;67(1):8-13. PubMed PMID:17436973.
    http://www.ncbi.nlm.nih.gov/pubmed/17436973.
    http://www.uaeh.edu.mx/investigacion/icsa/LI_EnferAlter/Paty_Pont/34CARIESADOLESCENTESHGO.pdf

    Score: Louise 11 – Cedric 0

    re: Bajaj et al.

    Louise: “While only 54.4% of those without fluorosis had caries, 80% of those with fluorosis had caries.”

    I can’t find the full paper, but found the study listed in MedIND, so I presume it’s legit.

    Bajaj M, Blah BC, Goyal M, Jain M, Joshi A, Ko HH. Prevalence of dental problems in school children – a study in a rural community in Haryana. Indian Journal of Community Medicine 14 (3): 106-09 (1989)
    http://www.ijcm.org.in/article.asp?issn=0970-0218;year=1989;volume=14;issue=3;spage=106;epage=109;aulast=Bajaj;type=0
    http://medind.nic.in/imvw/imvw20076.html

    Considering that Louise has cited everything else appropriately, and that other studies in India have reported similar findings, I believe that the paper has been cited appropriately.

    Score: Louise 12 – Cedric 0

    Re: Budipramana et al.

    Louise: ““In this study, DT (Decayed Permanent Teeth) increased with an increase in the fluoride content.”

    Cited appropriately.

    Budipramana ES, Hapsoro A, Irmawati ES, Kuntari S. Dental fluorosis and caries prevalence in the fluorosis endemic area of Asembagus, Indonesia. Int J Paediatr Dent 12(6):415-22 (2002)
    http://www.ncbi.nlm.nih.gov/pubmed/12452983

    Score: Louise 13 – Cedric 0

    Re: Hoffmann et al.

    Louise: “A positive association between dental caries and enamel defects (hypoplasia, demarcated opacity and dental fluorosis) was observed for schoolchildren aged 5…The results of this study indicated that children had increased odds of dental caries when enamel defect was present, both in deciduous and permanent dentition…”

    Cited appropriately.

    Hoffman N, Schlittler RH, Sousa M, Cypriano S. Prevalence of enamel defects and the relationship to dental caries in deciduous and permanent dentition in Indaiatuba, Sao Paulo, Brazil. Cad. Saode Publica 23(2):435-444 (2007)
    http://www.ncbi.nlm.nih.gov/pubmed/17221093

    Score: Louise 14 – Cedric 0

    CEDRIC: “If David (or anyone else) can demonstate that Louise was not at all quote-mining and – I DON’T apologise(!!) – then I’ll ban myself from ever taking part in any discussion ever on this or any other blog. Cedric Katesby will simply vanish forever from the internet.”

    PM Response: Good Riddance!!

    A copy of this comment will be posted at:
    http://fluoridedentalexperts.com/html/cedric_-_melters.html

    Paul Melters

  69. As did Steve Slott earler, I have gone over these abstracts.

    Mantella’s quote dump was obviously designed to use selective quotes to suggest low or negative efficacy of fluoride for caries prevention .

    Here are but three examples from the list illustrating how her implication distorted the original sources.

    Current concept on the anticaries fluoride mechanism of the action.
    Rosin-Grget K, Lincir I.

    Based on the new findings, it appears that fluoride, either released into or present in the fluid phase bathing the hard tissue, is more important for the reduction of caries development and progression.

    clearly indicating fluoridation has role in reducing caries development and progression

    Caries prevention–fluoride: reaction paper.
    Bowen WH.

    The effectiveness of fluoride is dependent on the ambient levels of fluoride in the oral cavity. Fluoride appears to exert the bulk of its protective effect locally by promoting remineralization of early carious lesions. Nevertheless, fluoride tablets continue to be prescribed as if the action of fluoride is expressed systemically. There is an urgent need to explore the clearance of fluoride from the mouth and to develop methods to ensure constant levels of fluoride in the oral cavity, thereby reducing both the need for frequent exposure and the amount necessary for clinical effect.

    Louise selective quote clearly made to imply no systemic effect. No effect is not what the absract claims.

    Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms.
    Fejerskov O, Thylstrup A, Larsen MJ.

    it is concluded that the major cariostatic effect of water fluoridation, fluoride tooth paste and mouth rinses can probably be ascribed to regular increases in fluoride ion activity in the oral fluids

    Paul,

    Quote mining is not excused by using a letter-for-letter, word-for-word accurately pasted/copied quote.
    It is about use of the quote and spinning it to distort the source’s position.

    It is dishonest and made worse when no easy means of checking the quotes is supplied.

    Thank you Paul for the links that expose such a sordid little episode.

  70. Dr. Johnny Johnson

    Paul,

    Billy Budd is a troll. I admonish him for using segments of a posting of mine from another blog. My disappointment is that he did not credit the material to its rightful author.

    To clarify some of the information that I read on publications that were from Mexican studies, as have been referenced here and elsewhere, I turned to a colleague of mine. We exchanged emails, and I will quote his entire email below.

    Dr. Jayanth Kumar, a member of the 2006 NRC Panel which reviewed the U.S. EPA’s MCL for natural fluoride levels in drinking water,
    “Fluoride in Drinking Water: A Scientific Review of
    EPA’s Standards”, and an internationally renowned dental & fluoride researcher, wrote the following when I asked him about the statements that were being made from the referenced studies conducted in Mexico:

    “The NRC report reviewed most of the cited studies in the email and found several limitations. These studies didn’t take into account other factors when assessing the relationship between dental fluorosis and caries. In addition, these studies are based on small number of children drawn from areas where the fluoride content is much higher than that compared to the US. Furthermore, the analysis is either conducted at the population level or child level but not at the tooth level. To address these deficiencies, we analyzed a national survey data that included a large number of children (n=16,873) with known fluoride history. We derived population estimates (weighted) at the child level and tooth level using methods appropriate for complex survey data. We confirmed the findings using multivariate methods.

    I am citing the paper by Pontigo-Loyola AP et al., (J Public Health Dent 67(1):8-13, 2007) to illustrate why the findings from these types of studies are not applicable to the population exposed to fluoridation in the US. This was a study of children living at high altitude (>6,560 ft) exposed to fluoride in drinking water that exceeded 1.38 mg/L (most children) in Hidalgo state, one of the many states included in the nationwide fluoridated domestic salt program. The authors point out that “in general, a high prevalence of fluorosis was observed in all three communities (>80 percent), with almost a third of the overall study population having moderate to severe fluorosis”. If the population has this high level of moderate to severe fluorosis and every child was exposed to fluoride, it becomes difficult to assess the relationship between fluorosis and caries. Also, it is difficult to ascertain if the “Filled” component of DMFT is the result of caries or to improve esthetics.

    With respect to SES and caries relationship, the authors reported that – “we observed the opposite trend: the better the socioeconomic position, the higher the prevalence of caries”. The authors state that they found factors such as age, gender, dental visit, SES and locale had an effect on DMFT in the bivariate analysis. If this is the case, then one has to control for these factors in a multivariate analysis if one wants to examine the association between fluorosis and caries. In summary, the population is not comparable to the US, ascertainment of the filling component is not clear, the analytical method lacks sophistication, and therefore the interpretation is questionable.”

    This is why I stated what I did in my earlier post that reviews of literature, by expert groups like the NRC Panel, are so very important in determining the scientific value and contribution that any published literature will make to the body of evidence on a topic.

  71. Peter Davidson

    Interesting discussion here about bending evidence to fit a pre-ordained conclusion.
    A series of similar crimes once led investigators to suspicions that a single individual was responsible. Police soon had two prime suspects.
    Suspect A was found on investigation to have been nowhere near the scene of the crime in nearly every instance, and was logically eliminated from any possible complicity.
    Suspect B was found to have been in the area of every crime at the time it occurred and, with ruthless logic, charged and found guilty.

    In a similar series of events, a large number of decayed teeth disappeared over a long period of time in numerous developed countries, and it was believed a single causative factor must be involved. The obvious causes of better diet, better oral hygiene and intelligent dental care were immediately ruled out as being too far-fetched, and the case was handed to the American Centers for Disease Control and Prevention (CDC) for investigation.

    Fluoride was instantly placed under investigation because, as we all know, you can’t possibly have good teeth without shoving this stuff in your mouth.
    But, once again, there were two suspects.

    Suspect A, Fluoride Toothpaste, was found to have been present and widely used in every country where dramatic reductions in tooth decay were observed and, furthermore, exposed teeth to levels of this magical substance a thousand of more parts per million, and was applied intelligently with a vigorous brushing action, itself essential in removing decaying agents from the teeth. Much of its residue, for what it is worth, would also have been ingested.
    It was consequently ruled out of any possible involvement.

    Suspect B, Water Fluoridation, however, was only in use in a small number of countries where this dramatic improvement in dental health took place, and only exposed teeth to less than one part per million of fluoride, most of which immediatelly bypassed the teeth on its way to the stomach. The effect of flushing the toilet, washing the car and watering the garden with this chemical could not be discounted as having some as yet not fully scientifically explained effect on the teeth.

    The brightest and best minds at the CDC (at least, a few operatives in its small Dental Health division) reached the only possible conclusion their reasoning powers allowed, and declared water fluoridation “one of the top ten public health achievements of the 20th century”, and this is the mantra repeated endlessly by health bodies and fluoridation lobbyists around the world, almost as if it has some basis in fact. Fluoride toothpaste? Forget it!

    The capacity of the human mind for wilful self-delusion is sometimes more wondrous than its ability for honest, logical reasoning.

  72. Peter Davidson, that’s about the dumbest (non)argument so far.

    Simply declaration that “brightest and best minds” got it wrong when reviewing the state of the scientific research based on your say so, in turn based on the insignificant amount of data and trite mechanisms that you have personally considered.

    Dumb, dumb, dumb.

    On par in the dumb stakes with the climate change deniers who claim the planet is cooling because they happen to have a record breaking blizzard outside their window.

  73. for Peter

    Common sense is useless in science.

  74. Peter Davidson

    Nice yarn. Irrelevant and ridiculous, but typical of antifluoridationist arguments, and entertaining all the same.

    Steven D. Slott, DDS

  75. The brightest and best minds at the CDC (at least, a few operatives in its small Dental Health division) reached the only possible conclusion….

    I like that.

    “…a few operatives…”.

    How do a “few operatives” in a “small” division do diddly?
    Do they have a magic wand or something?
    Global scientific conspiracy theories are dumb.
    They don’t work.
    There’s no mechanism. It’s simply physically impossible to put it together.

    Today it’s fluoride. Tomorrow it’s vaccines. The day after that? HIV. Then evolution, the moon landings, tobacco, DDT, and all the rest of the Internet krazy.
    Only the labels are different.

  76. Peter Peter Peter

    You said;

    “The capacity of the human mind for wilful self-delusion is sometimes more wondrous than its ability for honest, logical reasoning.”

    How so very very right you are

  77. In COMMENT 47955, Richard Christie writes:

    RICHARD: “As did Steve Slott earler (sic), I have gone over these abstracts.

    Mantella’s quote dump was obviously designed to use selective quotes to suggest low or negative efficacy of fluoride for caries prevention .”

    PM Response: Just as with Slott and Billy Budd before you, your ploy here is not going to work.

    Mantella specified the context 4 times – including in a comment directly to you (47727): whether fluoride in enamel had any beneficial effect on caries reduction.

    Read my post again, and go back to her comments. To make it easy for you, my comment is also posted here, with hyperlinks, to make verifying the evidence easier:
    http://fluoridedentalexperts.com/html/cedric_-_melters.html

    Do you still have trouble understanding the context?

    If there is something wrong with any one of her quotes/comments – provide the evidence. Stop making it into something else. You’re just going to end up looking very foolish.

    RICHARD: “Quote mining is not excused by using a letter-for-letter, word-for-word accurately pasted/copied quote.
    It is about use of the quote and spinning it to distort the source’s position.

    It is dishonest and made worse when no easy means of checking the quotes is supplied.”

    PM Response: Mantella did supply full citations.

    Every single quote has been addressed in my comment above (47953).

    Name one that is out of context, and used inappropriately.

    It is YOU who is using Mantella’s quotes and spinning them to distort her position. Again – that ploy is not going to be successful.

    RICHARD: “Thank you Paul for the links that expose such a sordid little episode.”

    PM Response: I look forward to the evidence that you surely will bring forward any time now?

    There are 14 quotes. Have your pick. Where is the “quote mining”?

    A copy of this comment will also be posted at:
    http://fluoridedentalexperts.com/html/richard_-_melters.html

    Paul Melters

  78. Stuart Mathieson

    It’s good to see ridiculous polite posturing dispensed with and a few home truths being sheeted home to the “artful dodgers”. Otherwise we suffer the spectacle of learned scholars debating minutiae (how many angels on a pin head?) or a committee dispatched to rearrange the poop chairs on the Titanic. Sock it to them comrades!

  79. Ah, Paul M., I have a “ploy”? And it didn’t work? Man, that’s a bummer. I’ll have to work on my ploying…….

    Steven D. Slott, DDS

  80. I presume that you calling Louise a liar means that you have evidence that she lied?

    That’s not the way it works.
    It’s ok to call someone a liar. Louise is going “Oogity-Boogity”. I don’t need to lift a finger to clean up her slop.
    “There’s a dragon in my garage”.
    “You’re lying”

    Simple, yeah? It saves a lot of time. I don’t suffer fools gladly. Life is too short. It’s a little something called the burden of proof. You are trying to shift it. Won’t work.
    “There’s a dragon in my garage”.
    “You’re lying”
    “OH, YEAH??. Provide evidence that I’m lying”

    See? It’s not my job to clean up that slop. The burden of proof will not shift.
    Hitchen’s razor is applicable here.
    “What can be asserted without evidence can be dismissed without evidence.”

    What specific paper(s) are you referring to?

    I wasn’t.
    Others were. They pointed out that those papers were not saying what she was saying. It was an Ooogity-Boogity fail from Louise.
    Dear Steve, You should pay more attention to what is being discussed before you post irrelevant quotes. At discussion here is the amount of fluoride in enamel and if that contributes to caries reduction.

    That was Louise getting all huffy and puffy about her quote mining.
    Steve Slott spotted her little game straight out of the gate and she didn’t like it. Didn’t like it at all.
    Others noticed too.
    I just chimed in and called a spade a spade.
    She later quotes almost the entire conclusion of Mascarenhas – see COMMENT 47747.
    Comment 47747? Huh?

    She obviously has the full paper…
    So? I can have the full copy of Darwin’s Book “On the origin of species”. Doesn’t prevent me from quote-mining it.
    Think.
    The actual paper states exactly as she quoted, so again – no lying.
    You don’t seem to understand this quote-mining business.
    Quote-mining doesn’t work unless you state a quote exactly from the actual paper. If you change the words then…it’s a misquote.
    A misquote is not the same as a quote-mine, though they can be combined.
    All three papers report exactly as…
    Same diff’.
    That’s what Feyerskov et al report.
    You’re not getting this. Focus. Quote mining, hello?
    Again, exactly as reported, and…
    Same diff’. This is very silly of you.
    Again, exactly as cited, in proper context.
    Thanks for the empty reassurances. A little engagement with reality would be better appreciated, though.
    Appropriately cited.
    Who gives a dry turd? Quote-mining. How many times do I have to say it?
    Quote mining.
    I’m not calling her a lying citer. I’m calling her a lying quote-miner.
    Remember?
    Appropriately cited blah, blah, Again – cited appropriately.

    (…shakes head sadly…)

    I found abstract on PubMed, and original paper on-line. I don’t read Spanish as I presume Mantella does, but English summary reports as stated.
    There are no words to describe how stupid this is. What were you thinking?
    No lying there either. Exactly as stated.
    Quote-mining. It’s about quote-mining. As in, lying by quote-mining.
    Hello?
    I can’t find the full paper, but found the study listed in MedIND, so I presume it’s legit.
    Sure. It’s entirely possible that most or all of the papers she quoted are legit.
    But…
    People don’t normally quote-mine dodgy papers. Not much point.
    They quote mine real work to shore up their own position, much to the horror and disgust of the original authors. Happens all the time with science deniers. It’s a favourite tactic. Climate deniers do it. Creationist do it. Anti-vaxxers do it. They all do it. It’s sleazy.
    Quote-mining. Look it up on the internet.
    It’s a real thing.
    I believe that the paper has been cited appropriately.
    May your “beliefs” bring you comfort.
    (…awkward silence…)
    Next!
    Cited appropriately, blah, blah, cited appropriately
    Seek help.
    Maybe this video can explain it to you better.

    Creationist quote mine collapse

  81. Paul Melters

    [Richard cristie] :Mantella’s quote dump was obviously designed to use selective quotes to suggest low or negative efficacy of fluoride for caries prevention .”

    PM Response: Just as with Slott and Billy Budd before you, your ploy here is not going to work.

    Well then, lets just add Mantella’s own distillation of the issue under discussion

    At discussion here is the amount of fluoride in enamel and if that contributes to caries reduction.’

    Paul, pleae be sure to post this on your tinfoil hat website.

  82. Ouch. That’s going to leave a mark.

  83. I wish, but doubt it very much.
    We are dealing with the irrational.

  84. Hahahahahahahahaha. :)
    I got edited. Evidently, Paul doesn’t trust his readership very much. He feels the need to “helpfully” interpret and carefully quote only a small segment. What a maroon.

  85. Peter Davidson

    Moderator,

    I’m just wondering why my last two posts, and no others, are still shown as “awaiting moderation”?

  86. Peter, you last comments were snarky and/or abusive. They added nothing to the discussion.

    I am holding back those sort of comments as they will just divert discussion into personal attacks and sabotage it.

    You are more than welcome to participate in a good faith discussion.

  87. Paul Melters – I have held back a few of your comments as they have been antagonistic and added nothing to the discussion. If you wish to argue the number of angels on the head of a pin or Louise’s comments then do so on your own web site (Of course you will need to allow commenting to accomadate that).

    Louise is more than welcome to rejoin the discussion and make her pwnpoints but surely doesn’t need you to act as her advocate.

  88. In response to the use of the use of Pontigo et al (2007) by “L” (#47741) and Paul Melters (#47925, 47953) one of the authors (Maupome) passes his views on to the Open Parachuge “debate.”

    Rather than paraphrase and shorten what he said, with his permission his response is here unedited. As readers will note, he believes that the “commonest finding in the literature” is that fluorosis is associated with fewer cavities.

    ——-

    I have contacted my co-authors and discussed the issues you posed. This issue of fluorosis conditions giving rise to carious lesions is really a matter of how severe the tissue changes need to be for — all other things being equal in a cariogenic environment — clinically detectable decay to be there. The time and ages for decay and fluorosis development are so different that trying to tie the 2 things together is a daunting task.
        
    Like many of these issues in the F debate, the anti-F crowd is prone to selective quoting. My thinking is because they are looking for smaller concepts and statements to support an idea they already have in their minds.
        
    It would be worthwhile noting that in the Pontigo et al., 2007 paper, in Table 3 it is reported that mild and very mild fluorosis were associated with lower caries experience. With all of these analyses being bivariate in nature, it was not feasible to adjust the model to ascertain significance of that specific difference they mentioned. This is one way of saying that they are trying to read too much into the information reported. More important to the overall issue is the fact that these communities have unusually high levels of F in the water (for the amounts found in the Americas), and are located at high altitudes above sea level (which is a factor still incompletely understood in fluorosis development).

    It is worthwhile pointing out that another paper from the same group in another location with fluoridated salt and negligible fluoride naturally available in water, Vallejos et al., we found few cases with severe fluorosis (4 cases; 0.03%). In that study the presence of fluorosis was associated with lower caries experience — which is the commonest finding in the literature. See the tables below from Vallejos et al. 
     
    . tab  fluorosis
        fluorosis |      Freq.     Percent        Cum.
    ————–+———————————–
    no  fluorosis |        661       48.14       48.14
         very mild|        603       43.92       92.06
             mild |         93        6.77       98.83
         moderate |         12        0.87       99.71
           severe |          4        0.29      100.00
    ————–+———————————–
            Total |      1,373      100.00
     
     
    . tab  fluor_or, sum( sum_DMFT)
      fluorosis |         Summary of sum_DMFT
        ordinal |        Mean   Std. Dev.       Freq.
    ————+————————————
    no fluorosis|   1.1255673   1.6799071         661
       very mild|   .71973466   1.4186906         603
    mild,mod,sev|   .57798165   1.2344858         109
    ————+————————————
          Total |   .90386016   1.5516636        1373
     
        These results are also from a unadjusted model.  
        
    I believe the largest problem we have is that the anti-F crowd assumes that all exposure to F leads to clinically detectable fluorosis, and that all fluorosis undermines the tissue structure enough to make the tooth surface more susceptible to caries. Those two are big leaps in thinking.

    The other aspect that you may want to consider is that a good chunk of the evidence for higher experience of caries being associated with dental caries seems to come from less developed countries, places in which multiple aspects of life may be associated with developmental enamel defects. One of them is malnutrition. None of these aspects have been studied appropriately, and thus we cannot grab a handful of papers with the association we are looking for, and attempt to generalize the results.

  89. One more point about Iida/Kumar (2009) vs Pontigo (2007). Not everything which appears as fluorosis on examination is fluorosis. This an important reason why the Mexican paper about fluorosis (Pontigo et al, 2007) at high elevation should not trump the very large well designed US study

    This point was well made in the 2010 EPA document Fluoride: Dose-Response Analysis For Non-cancer Effects p 10.

    The NRC (2006) also cautions that not all enamel defects are caused by fluoride. Citing Curzon and Spector (1977) and Cutress and Suckling (1990), NRC states that “Mottling unrelated to fluoride has been suggested to be due to malnutrition, metabolic disorders, exposure to certain dietary trace elements, . . . or physical trauma to the tooth.” Furthermore, there is some evidence that “hypobaric hypoxia that occurs at high altitudes is associated with bilaterally symmetrical and diffuse disturbances in enamel mineralization that may be mistaken for fluorosis.”

    Changes visually identical to fluorosis would probably injure the enamel tooth structure but would not bring fluoride’s caries protection. High elevation, potential malnutrition, and other potential causes of symmetrical white enamel abnormalities argue that the large well-designed study correctly found that in the economically advantaged world, fluorosis prevents cavities.

  90. More mistaken views from PM (#47951)

    Said PM: “Stop deflecting. That the older studies were not included in some review by the NRC does in no way diminish the quality or the findings by the researchers. We’re not here to discuss inclusion criteria by the NRC.”

    This truly cuts to the heart of much of the fluoride opposition propaganda. If there are no standards by which various items are deemed to be of sufficient scientific quality to count in the analytical review of community water fluoridation, politics, not science, will rule.

    Over the years, mere conjecture, an individual story, junk pseudo-science, political opinion, newspaper editorials and poor science from peer reviewed journals have been used, very successfully, in local political campaigns to defeat community water fluoridation.

    Merely an old publishing date is not an important matter, but the professional weight of science considerations which led to inclusion in the NRC references were most serious decisions and you are entirely mistaken to argue otherwise.

    Indeed, legitimate arguments over whether the standards used for a given systematic review are reasonable or not exist. One such professional discussion has been whether or not epidemiological studies can be of sufficient substance to reasonably base public health policy upon.

    Fluoridation opponents on the one hand demand only “gold standard randomized blinded controlled studies” yet have thousands of times over cited egregious baloney to support their arguments.

    What is politically effective is even much worse than what might be brought up in debates like this.

    It would be nice of Professor Connett would publicly agree to a list of transparently false politically effective lines we see used in local campaigns.

    As examples

    Fluoride is in Agent Orange and Sarin Gas
    People only drink .4% (or whatever it is) therefore fluoridation is wasteful
    The Nazis used it to pacify prisoners
    Fluoridation is part of a global scheme to depopulate the world
    They are dumping industrial grade chemicals in the water
    Aluminum plants are dumping their industrial waste in city water
    The Phosphate Fertilizer companies are paying off their Dental Society shills to promote this

  91. I’d also like to add Trish’s complaint (paraphrased because I can’t be bothered searching for the actual loopy quote) :
    “Drinking a glass of fluoridated water gives you headaches. I know what I know. Don’t you tell me about your fancy-smancy science.”

    It would be nice to see an anti-fluoridationist noticing that this is very silly too.

  92. My children’s pet rats drank fluoridated water and they all died.

  93. In response to the use of the use of Pontigo et al (2007) by “L” (#47741) and Paul Melters (#47925, 47953) one of the authors (Maupome) passes his views on to the Open Parachute “debate.”

    Rather than paraphrase and shorten what he said, with his permission his response is here unedited…..

    I attempted to contact Dr Zimmer but his email seems to be down.
    Glad to see you had better success.
    Thanks to you and Dr Maupome for taking the time to set the record straight.
    It’s the best way to torpedo quote-mining.
    Straight from the horse’s mouth.
    It’s a Marshall McLuhan Moment. Science deniers always fall foul of it.

    Louise and Paul owe us all an apology for their efforts to decieve.
    Shame on them.
    And a special apology is owed to the authors of those papers.

    Would an anti-fluoridationist have the integrity to contact the authors directly?
    I’m guessing…”No”.
    Yet Billy Budd did.
    Kudos.

  94. Billy said Fluoride is in Agent Orange and Sarin Gas very good 1 out of 2 not too bad for a bit of commentary
    Chemically, Agent Orange is an approximately 1:1 mixture of two phenoxyl herbicides – 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) – in iso-octyl ester form.[19]
    Though I do recognize agent orange does have a closely related family member to F ie Cl

    Sarin, or GB, is an organophosphorus compound with the formula [(CH3)2CHO]CH3PF. It is a colorless, odorless liquid, used as a chemical
    weapon owing to its extreme potency as a nerve agent. Wikipedia
    Formula: C4H10FO2P
    IUPAC ID: (RS)-propan-2-yl methylphosphonofluoridate
    Density: 1.09 g/cm³
    Boiling point: 158 °C
    Molar mass: 140.09 g/mol
    Melting point: -56 °C

    I would think the F would be fluoride

  95. Kurt Ferre DDS, Portland, OR USA

    OMG, Ian, F in Sarin??? Here’s part of a review of one of your bibles: “The Fluoride Deception:
    “.. Unfortunately, his desire to make the book more exciting leads him into
    the all-too-familiar trap of tarring with the same brush anything associated with, or even sounding like, fluoride or fluoridation. This is especially ironic after he starts the book with “notes on terminology”, saying “fluorine and fluoride should not be confused”. However, in the next section he tells us “the same potent chemical that is used to enrich uranium for nuclear weapons, to prepare sarin nerve gas… is what we give to our children”. No doubt we can expect a series of books on chlorine (“the same potent chemical used in insecticides is what we put on our children’s food”) and oxygen (“the same potent chemical used in the strongest acids is what we allow our children to breathe”). No chemist would dispute the extreme hazards of many fluorine chemicals, but to group all fluorine chemicals together as ‘bad’ is wrong. The book is peppered with similar absurdities, which will be annoying to those who know their chemistry but dangerously misleading to those who don’t.”

    James Clark is at the Clean Technology Centre,
    Department of Chemistry, University of York,
    YorkYOl05DD,UK.

    NATURE | VOL 4 34 \ 17 MARCH 2005 [ http://www.nature.com/nature

    PS: You will NOT find this review in Ian’s, Louise’s, Paul’s, or Bill’s Fluoride Action Network website

  96. Did you know that they put chlorine in the water?
    That’s right.
    THEY ARE PUTTING A CHEMICAL WEAPON IN YOUR POOL WHERE YOUR HELPLESS BABIES SWIM.
    OMG!!! OMG!!!!! OMG!!!!!!! OMG!!!!!!!

    We’re dealing with morons here. It’s an amazingly stupid argument. It’s will only work on the painfully ignorant.

  97. Wha….chlorine??? Is this even ethical? Can’t we just give those kids who want chlorine, a bottle of the stuff?

    Steven D. Slott, DDS

  98. Peter Davidson, there is not point in moaning about moderation – or in debating it. I have made my criteria clear and won’t get into debate with you about it.

    No, abuse is not the only criteria, nor is name calling, for holding back comments. But especially note, this topic does get people haated so we can accept a certian amount of name calling, abuse, etc., as long as it is accompanied by some sort of information, discussion, debate or argument. Often some of the most intelligent and imformative commensts have a bit of emotion in them.

    I suggest you take a lesson from the positive content of comments and worry less about the emotion.

  99. Kurt thanks for the credit for a website but I am not associated
    Billy was making a point it was something anti F people use to support their case and pro F say not relevant … The chemical makeup is there for all to see, it contains a F , enough said

  100. So, Ian, wow! Hydrogen is a component of both water and hydrochloric acid. Hmmm, wonder why our gastrointestinal system isn’t destroyed with every drink of water?

    Steven D. Slott, DDS

  101. [(CH3)2CHO]CH3PF

    The C in there is for carbon, enough said,

    whoops, no, wait on, there’s more,

    the O is for oxygen., enough said, except for the P which, OMG!, stands for phosphorus.

    Have we said enough?

  102. Evidenly sarcasm doesn’t seem to reach these people.
    Hmm.
    Listen up, anti-fluoridiationists.
    This particular argument is extra, super, stupid.
    No, really.
    It’s dumber than a bag of hammers.
    When you use it, we’re just going to point and laugh at you.

    If you can’t figure out why then, I dunno, talk to your old chemistry teacher from school or something. Elevate yourself.

  103. Steve you repeatedly told everybody there is no difference where the F ion comes from, suddenly it’s changed
    Funny Steve I would have thought you might know whats in your stomach but obviously it doesn’t affect teeth!!!!!!
    Richard, Cedric the old switcheroo only allowed for the protagonists not for the antagonists hahahahahaaaaaaaaaaaaaa

  104. Ian, it is fundamental chemistry that the hydrated F anion is the hydrated F anion with exactly the same properties wherever it’s origin.

    It is also a fundamental principle of chemistry that the properties of molecules are determined by the all the constituent atoms and their links. Consequently they do not have the properties of just one of their atoms.

    I am amazed that any commenter here could disagree with that.

    >

  105. Amazing is a good word for it.
    Chemistry is not their friend.
    We really are dealing with morons here.

  106. Ian

    Umm, no, Ian, the fluoride ion hasn’t suddenly changed. Still the same ole, same ole regardless of the source. Perhaps I could recommend a 10th grade chemistry text for your reading pleasure?

    Steven D. Slott, DDS

  107. Peter Davidson

    Ken,

    If this “debate” achieved anything, it was to show up the total lack of intellectual honesty of those, including yourself, who are mindlessly promoting the fluoridation religion.
    It was never your intent to have an honest debate with Paul Connett, as he evidently discovered early on, and probably suspected from the start. Your aim was to provide a forum for you and your cronies to push your ideas, insult your opponents, never answer their serious arguments, and simply censor out any comments you could not answer, as you did with mine.
    You lied shamelessly when you stated that mine were censored because they were “abusive” – they were nothing of the sort – then, to justify the tirade of abusive comments you allowed on your side of the argument, you decided abuse didn’t matter after all. (You still blocked my comments, of course). What shallow, transparent hypocrisy!
    It was perfectly legitimate for me to not merely refer to, but expect answers, to the contradiction when the extreme exposure to fluoride from toothpaste brushed directly on every surface of the teeth is ignored as irrelevant to dental health, while the effect of fluoride at one thousandth of the concentration rushing past the teeth on its way to the stomach is hailed as a near-miraculous answer to tooth decay. But it was never your intention to answer any difficult arguments. In the end, you simply handed over the forum to your cronies to say whatever they wanted to spew out, and excluded all reasonable arguments you didn’t want to hear or answer.
    You clearly have no interest whatsoever in dental health, if that were the case you would be promoting genuine, intelligent and effective methods to bring about real, not fictitious, improvements.
    You have no interest, even, in promoting fluoride in any other way than by forced medication, when there are, as I have shown, far more intelligent, ethical and scientific ways of using it.
    Don’t delude yourself, dental health is of no interest to you, merely a pretext. It is fluoridation, nothing else, that you are promoting, and there was never going to be a real debate about it.
    That was obviously your intention from the start. Shoddy, unprofessional, unscientific, dishonest.

  108. Peter, this “debate” (really a scientific exchange) is, as far as I understand, still progressing. I have contacted Paul as I had expected to get his latest contribution by now and it hasn’t arrived. Still – it is the holiday season.

    The exchange has been transparent and uncontrolled or moderated. We both agreed that the comments, though, should be moderated – and I believe this has helped contribute to the quality of the comments discussion which is much higher than normally seen in such on-line disucssions of the fluoride issue.

    Your comment on the surface mechanism of fluoride reducing mineralisation was surely answered in the exchange. Paul several times attempted to deny the mechanism and I spent some time explaining it to him. If you think I was incorrect and Paul did not adequately present his position then why don’t you have a go? But, please, deal with the science – not empty declarations of opinion.

  109. Peter Davidson

    Wow, just what is needed. Yet one more uninformed antifluoridationist who has deluded himself into thinking he is an expert on the best manner of dental decay prevention. Do yourself a favor, instead of blindly following Connett, from the filtered and edited “information” on his “fluoridealert.org” website, access accurate information from reliable, respected sources such as the CDC, the WHO, the EPA, and the ADA. You would be amazed how much more intelligently you can discuss this issue if you would properly educate yourself prior to posting meaningless rants.

    Steven D. Slott, DDS

  110. Peter Davidson

    Thank you, Ken. I note that six of my earlier comments are still “awaiting moderation”.
    Do you have what it takes to allow your readers to make their own judgment as to their content?

  111. What is past is past, Peter. Why not concentrate on current discussion – you could of course respond to Steve’s comment. I just encourage you to discuss the science and stop the whining.

  112. Peter Davidson

    Ken,

    I would suggest that a tranquillizer would be more beneficial to Steve than a response from me. First, he owes me a calm, intelligent response.
    I did quite well in maths at school, and learnt that 1000 is ten times ten times ten.
    Given that his idol, the ADA, eventually acknowledged after decades of fluoridation that fluoride’s primary action is topical, reason tells me that a topical application of fluoride at one thousand parts per million, accompanied by highly beneficial, vigorous brushing to clean the tooth’s surface at the same time, is likely to be far more beneficial than swallowing the stuff at only one part per million or less, without any accompanying removal of decay-promoting deposits from the teeth. It’s also obvious to me that a significant amount of the fluoride residue would also be swallowed following tooth-brushing. That covers all bases.
    Mathematics is a science, and common sense does not require a degree in science. Teeth get 1000 times the “optimal” exposure from toothpaste. Amazing!
    I don’t claim expertise in the precise mechanisms by which fluoride acts, and I don’t need to in order to sustain what I write here.
    The ADA says topical, not systemic. Surely Steve wouldn’t contradict them?

  113. Do you have what it takes to allow your readers to make their own judgment as to their content?

    No doubt you can look forward to more traffic on your blog as the teeming masses, hungry for the scandalous secrets kept hidden from them, read the Trooth from your blog.
    The rest of us can move on.

  114. There ought to be a variety of Godwin’s Law that states that whoever declares that those on the opposing side of an argument are indulging a religion are no longer to be taken seriously and have automatically lost the argument.

    Which is exactly my view on Peter Davidson.

  115. Peter Davidson
    “Owe” you something? Sorry, not hardly. Your accomplishment of learning the product of 10 X 10 X 10 is laudable, but irrelevant.

    Anyone who knows me would get a good laugh at your claiming the ADA to be my “idol”. That could not be any more comical. That said, however, your implication that the ADA dismisses the systemic effect of fluoridation is, of course, erroneous.

    “Systemic fluorides are those ingested into the body. During tooth formation, ingested fluorides become incorporated into tooth structures. Fluorides ingested regularly during the time when teeth are developing (preeruptively) are deposited throughout the entire tooth surface and provide longer-lasting protection than those applied topically. Systemic fluorides can also give topical protection because ingested fluoride is present in saliva, which continually bathes the teeth providing a reservoir of fluoride that can be incorporated into the tooth surface to prevent decay. Fluoride also becomes incorporated into dental plaque and facilitates further remineralization.”

    —–Fluoridation Facts
    American Dental Association
    http://www.ada.org/sections/newsAndEvents/pdfs/fluoridation_facts.pdf

    What you deem to be “more likely to be far more beneficial” in preventing dental decay is irrelevant. Similarly what you deem to be “obvious”. The consistent exposure of the tooth to low concentrations of fluoride throughout the day is a very effective means of dental decay prevention. Water fluoridation does exactly that, and at less than $1 per person year, in a far more cost-effective manner than any other method. The one time exposure of high concentration fluoride in toothpaste does provide a protective benefit, but does not offer the consistent exposure which has been shown to be very effective. These methods are not mutually exclusive, however, and are very effective when utilized together in conjunction with other dental decay preventive measures. If you are advocating swallowing fluoride in toothpaste at 1200-1500 times the concentration of that in fluoridated water as a substitute for water fluoridation, then you’d better get your liability insurance paid up in a hurry.

    As for the ADA, sure, I have no problem contradicting it. I do so constantly. In the case of water fluoridation, however, the ADA is right on target, fully reliant on peer- reviewed science, is a world recognized authority on the issue, and its recommendations completely sound. And, as stated previously, the ADA fully recognizes the systemic and topical effects of fluoridation. It fully endorses this public health initiative.

    Now, since you have made it clear that you value the opinion of the ADA, why do you then dispute a public health initiative that the ADA firmly supports as being safe and effective?

    Steven D. Slott, DDS

  116. Hi Peter,

    You seem pretty on to it when it comes to maths…10 times ten times ten and all that.

    You seem to have overlooked an important feature.

    That is to say that water fluoridation is a Public health issue as compared with the private activity of brushing teeth.

    If you have read this blog, you may have noticed that those people promoting the fluoridation of water, also promote other methods of dental care.
    This is without exception.
    I know I can only speak for myself but test this….search this entire blog for one comment that discourages brushing teeth.
    Steve, who you believe needs sedating, would agree.

    I have noticed people against water fluoridation (I often refer to them as Anti’s for brevity) set up a false dichotomy.
    They believe that because some people think water fluoridation is a good idea, it goes to follow that they think its the ONLY good idea and all others can just bugger off.

    That’s just Dumb…don’t you think?

    No, water fluoridation is one of many beneficial activities that promote oral health.

    Its not a Brushing vs Fluoridated water battle to the death, winner takes all.
    No, they can hold hands together and be friends.

    Oral health can be promoted by many methods.

    Now back to your penchant for mathematics.

    Toothpaste may contain fluoride at 10 times 10 times 10 parts per 10 times 10 times 10 times 10 times 10 times 10 parts of water.

    Considerably more than the (I will revert to shorthand) 1ppm found in fluoridated water. Yes I agree.

    BUT, considering that brushing teeth only takes approx 2 minutes twice a day, ie: 0.0027% of the available time during the day, don’t you think Oral health may be improved by having teeth bathed regularly in a low level fluoride solution?
    Especially when the science tells us that this is both safe and effective?

    One other thing that irks me when people use the “Isn’t brushing teeth sufficient?” argument.
    Consider that my calculations were based on people actually brushing teeth twice a day.

    You may do this.

    There are plenty of people in society who don’t.

    Just ask Kurt or Steve about the prevalence of rotting teeth among some children.

    Thank you.

    Also have you noticed ALL people who argue against water fluoridation have the education, knowledge and wherewithal to brush there teeth?
    Kind of selfish huh?

  117. “Their” not “there”!
    Sorry, Arse and elbow again!!!

  118. Peter Davidson

    And yet, Steve, countries which do not fluoridate their water have experienced the same, even greater, improvements in dental health when compared with those which do. So if fluoride was the explanation, it came from another source, presumably toothpaste. That means topical, not systemic. Water fluoridation totally irrelevant to outcome. Your argument falls in a heap, whatever the ADA spin.
    As for public liability insurance, don’t go to Lloyd’s of London – they won’t indemnify for “the new asbestos” – fluoride.
    Thanks, anyway, for taking the tranquiliser option. You can make a reasoned case when you try.

  119. Peter,

    “So if fluoride was the explanation, it came from another source, presumably toothpaste. That means topical, not systemic”

    This is why we should look to the data and science, to tease out confounding issues and not rely on anecdotes, silly guesses or to use your word, presumption.

  120. Peter Davidson

    It is a perfectly reasonable assumption, Christopher, not a “silly guess”, that fluoride toothpaste is the likely source of fluoride in non-fluoridated countries – if, indeed, fluoride is the key factor – since this is by far the most widely used and concentrated form available. But it makes not the slightest difference to my argument if another source of fluoride is involved, in part or in total – possibly not at all.
    What is relevant is that it wasn’t fluoridated water, and they still got good teeth. That proves there is an intelligent alternative which does not involve mass-medication (don’t squeal – that is a literally truthful description of water fluoridation). But if you can’t even provide an explanation, doesn’t that suggest that the research is not as thorough as you would have us believe?
    As for your fanciful attempt to explain away the effect of tooth-brushing which “only takes approx 2 minutes twice a day” – are you seriously suggesting that the fluoride disappears into space as soon as the brush is put away? If not, what? It’s quite possible that the action of drinking water takes even less time. And you conveniently ignore the 1000 times factor as though completely irrelevant. (Remember – ten times ten times ten?) The science of maths again.
    Just as fancuful is your idealised fantasy of children in less-privileged homes dutifully drinking doses of fluoridated water throughout the day to keep their teeth constantly “bathed” in fluoride solution. So they don’t drink Coca-Cola or sugary fruit juice? How perfectly idyllic you make it sound. What about the reality? Where is the research to back your assumption? What about the 8 to 10 hours the child is asleep each night? Your propensity for “presumption” leaves me for dead.
    You are quite right that fluoridation is a public health issue, the problem is that teeth are not public property and, as with all other health issues, nobody has the right to act as though they are.
    Informed consent is a fundamental principle of medical ethics.

  121. Peter Davidson

    Ah, yes, the simplistic statistical snapshot. Would that causation and prevention of dental decay were that simple. Take a look at a set of statistics, read what you want into them, disregard any annoying confounding factors that don’t fit with your preconceived “conclusion” and VOILA! you’ve “proven” your case. Come up with peer/reviewed scientific studies to support your claims. Statistical snapshots prove nothing.

    And, now, all of a sudden it is the “ADA spin”. So, when you were misstating the ADA position, its opinion was “proof” of your position on your inexplicable obsession with whether fluoridation works topically, systemically, or both. Now, having been shown that the ADA does not agree with your opinion, it is providing “spin”. Prime example of confirmation bias.

    Steven D. Slott, DDS

  122. Peter, here’s some advice. If all you’re going to do is post arguments you’ve read on “fluoridealert.org” or any other antifluoridationist website, you’re just wasting everyone’s time. There is nothing on those sites which hasn’t been addressed and refuted time, and time, and time again. If you have something valid from a reliable, primary source, fine, post it. But, if all you’re going to do is run back to antifluoridationist websites then I’m sure we all have far more productive things to do than rehash the same nonsense over and over again.

    Steven D. Slott, DDS

  123. There’s a strictly limited number of times one can post the “poisoned horses” story before boredom sets in.

    One easy way to spot science denial is the fact they have to recycle everything.
    Nothing is ever new.

    Actual science is constantly being refreshed and updated. New scientists spring up. New papers. There’s always that Nobel Prize up for grabs…and it gets grabbed.

    Science denial doesn’t do that.
    It’s tiny circle of contrarians never expand. They just get older and older and die off one by one. It’s possible to remember all their names by heart.
    The “emerging” science never quite leaves the nest.
    The “vindication” and “restless, hidden majority of disgruntled scientists” never quite get around to actually standing up to be counted.
    They are there somewhere out there yet never finally come in from the cold to restore “Troo Science” to the likes of NASA and the Royal Society and the CDC and the NIH. Forever hinted at in lists and polls and comments on blogs. Yet the mainstream consensus stubbornly persists from week to week, month to month, year to year.
    And the aging process is unforgiving.
    Somehow the work doesn’t appear.

    Any papers that do show up are solitary affairs that never go anywhere and quietly wither on the vine.
    Such papers (if any) are dwarfed in number to the promotional videos or the vanity press books.
    Papers do get discussed on the denier blogs but they’re mainstream papers from mainstream scientists.
    (They’re the only ones doing any actual work, you see.)
    They get “examined” as you would expect.

    Intelligent Design was my first science denial love.
    The mid-2000′s were so very fun.
    Such blogs. Such interviews on Fox. Such promotion of the emerging and exciting world of ID.
    They even managed to organise clubs on universities that spread like a rash across America and they had a blog to prove it!
    Yet one year passed on into the next…and the next…and the next.
    The rash of clubs faded like rashes eventually do.
    Even the true believers felt a little silly repeating for the umteenth time about the bacterial flagellum.
    Even now, the flagship of the ID movement still sails in it’s own little pond.
    Pandasthumb still has an endless thread devoted to distantly observing the last Echochamber.

    PRATTs become familiar with time.
    ID/Creationism debates online led eventually to TalkOrigins. All the PRATT’s are there. They even have reference numbers. It makes talking to a creationist effortless. There’s no reason to re-invent the wheel.
    As ID/Creationism gave birth to TalkOrigins, so too did climate denialism give birth to SkepticalScience.com and their “Most Used” list.
    It would not surprise me in the least to find that some enterprising soul has made a one-stop shop catalogue for all the anti-fluoride PRATT’s too.

    If all you have are recycled PRATTs from yesteryear and your “mavericks” repeatedly fail to swell their numbers with daring young tyros in the prime of their scientific careers despite “mavericking” at it for decades then…yeah…hmm.

    It’s a ritual dance.
    Science denialism live on the Internet; not in the real world where the scientific work is done.

  124. So, Cedric, does this mean that Calamine Lotion would be effective against antifluoridationists? That would be AWESOME!

  125. Peter,

    Thank you for replying to my comment.

    I will answer perhaps in parts as a long winded post is unlikely to be read
    (Take note copy and plasterers!) – and I do want to show you the courtesy of a response by addressing the points you raise. Also I am busy wrapping presents etc!

    Firstly, on your comment that water fluoridation is “Mass Medication” – no I won’t squeal, really. I will calmly repeat what much of what I have already said and has yet to be challenged.
    This is fundamental to your most of the consent/rights based arguments.

    Arguments that all anti fluoridations (so far as I have seen) including yourself hold dear.

    I will explain this (yet again) in simple and easy to understand English.

    ___________________________________________________________
    Medicine, drug, and poison are defined clearly in legislation. Water fluoridation adjusted to 0.7ppm is not considered by the law as any of these.

    See Attorney-General ex relatione Lewis and Another v Lower Hutt City – [1965] NZLR 116.
    If you disagree then SHOW ME the legal authority that says otherwise. Therefore UNDER THE LAW, water fluoridation is not considered to be a medication. FACT.

    If you don’t like this you and others are free to try and influence a change in the law. As you know there many instances where Anti’s have tried through political activism to do this…just look at Mr Professor Attorney at Law James Robert Deal in the USA…

    __________________________________________________________Now, if you insist on calling water fluoridation “Medication”, you must do so in a non legal sense.

    Is this what you are trying to do?

    OK.

    To do this consistently (we do want to be consistent here don’t we?) you must accept scientific facts. One of these fact has it that ambient levels of F in the water occur naturally at approx .2ppm (In many parts of NZ).
    In addition, F is present in the air we breathe, the food we eat.

    So. To be consistent, YOU must therefore distinguish the F found in fluoridated water from these other sources of fluoride, or accept the obvious absurdity that air and food are also medicines and thus must be regulated.

    Ahh….. but I hear you say….water is fluoridated “artificially”.

    As Ken noted so adroitly at the beginning of November…”There is absolutely no difference between the hydrated F anions from the different sources. Anyone who tells you that is being silly and just doesn’t understand basic chemistry.”

    No one in the Anti camp has addressed this.

    So…when you show me the courtesy of replying could you please be clear whether your argument(s) are legal/scientific or both?

  126. Hello Peter,

    As promised…

    You said;

    “As for your fanciful attempt to explain away the effect of tooth-brushing which “only takes approx 2 minutes twice a day” – are you seriously suggesting that the fluoride disappears into space as soon as the brush is put away?”

    I said…

    “No, water fluoridation is one of many beneficial activities that promote oral health.

    Its not a Brushing vs Fluoridated water battle to the death, winner takes all.
    No, they can hold hands together and be friends.

    Oral health can be promoted by many methods.”

    Now…between the quote marks (the funny little 66 and 99 symbols), I clearly acknowledge the usefulness of brushing teeth.
    Can you see that?
    Perhaps you didn’t actually read what I wrote.
    Please show me the courtesy of reading what I write before you reply and getting it so, so wrong.
    .
    Now watch closely for a more detailed explanation of what I thought an obvious point…

    I claimed that toothpaste when used for a very short time is effective.
    (You agree with this. I think too most other anti’s…)

    I would suggest that the concentration of fluoride would have something to do with this….

    so…concentration vs time….effectiveness….

    can you see it?

    No…toothpaste doesn’t magically disappear.
    Neither does it magically appear. Could you please comment on those sections of society that can’t/don’t use toothpaste?

    I will also answer your other points…be patient…beer….more wrapping….relatives wanting to talk about the “kids of today”

  127. Peter,

    Language is a rich, beautiful and complex method of communicating information.

    Take for example your sentence…

    “…common sense does not require a degree in science. Teeth get 1000 times the “optimal” exposure from toothpaste. Amazing!”

    This tells me so much more than the actual words you have chosen:

    -It tells me you don’t have a Science degree (but who cares!)
    -and that you value “common sense” (whatever that is)
    -and in your mind the issue of water fluoridation is simple
    -Plus, you have an unscientific concept of the word “exposure”
    -Lastly, you are making a scientific claim based on your “common sense”

    Your limited definition of the word “exposure” ignores Ken’s explanation of the structural role of fluoride in apatites and recognised beneficial role of ingested fluoride.
    I presume to calculate “exposure” you have used your keen ability in mathematics and divided the F concentration of toothpaste with that found in fluoridated water?
    Can you see the problem now?

    Secondly, this sentence explains so much…(heavy sigh)

    “I don’t claim expertise in the precise mechanisms by which fluoride acts, and I don’t need to in order to sustain what I write here”

    No Peter, you don’t need expertise.

    However you do need a rudimentary grasp of the scientific method.

    Do not be driven by “common sense”.

    It leads to dark and dumb places.

    You don’t need a degree in Science, but don’t pretend your common sense leads you to a better informed position.

    PS: I notice you make an enormous number of claims….could you show the courtesy to reference them?

    Thank you

  128. Peter Davidson

    Christopher,

    It’s a pity you felt the need to resort to sneering sarcasm in your response, particularly as I gave you no grounds to do so. I thought you might have been above those tactics, but you have proved me wrong on that point.
    I read your comments correctly the first time, and interpreted them as any reasonable person would. A second and third reading makes not the slightest difference to that interpretation.
    Read my words again, and you will see that I did not claim that you do not ” acknowledge the usefulness of brushing teeth”. It is you who are misrepresenting me, not the other way around.
    What I certainly did say, and I don’t take back a single word, is that you were attempting “to explain away the effect of tooth-brushing”.
    Why else would you say that tooth-brushing “only takes approx 2 minutes twice a day”, as compared with “having teeth bathed regularly in a low level fluoride solution”, if not to minimise the role of toothpaste, (you made no reference to “effective”, as you later claim – now you’re misquoting yourself), and exagggerate the effect of fluoridated water?
    Why else would you overlook the 1000-times multiplyer?
    Why no mention of the fact that brushing cleans the teeth (essential), whereas drinking water does not.
    The very clear implication of that statement was that there is no significant residual effect from toothpaste, and that only fluoridated water provides that.
    Can you cite any research to back your assumption here that deprived children dutifully drink water at frequent intervals throughout the day (and night), as opposed to tooth-destroying soft drinks? That would be a real killer blow to those who merely rely on their common-sense everyday observations.

    In your later post, you imply that fluoride concentration in not particularly relevant, yet all fluoridation promotion insists there is an “optimal” level of fluoride concentration in water. One tenth of that, and children have rotten teeth, we’re told. Increse it to “optimal”, and it’s all smiles. A mere factor of ten.
    Yet you scorn the idea that a factor of 1000 is highly relevant when topical application is involved.

    You stated in an earlier post:
    “I have noticed people against water fluoridation (I often refer to them as Anti’s for brevity) set up a false dichotomy.
    They believe that because some people think water fluoridation is a good idea, it goes to follow that they think its the ONLY good idea and all others can just bugger off.”
    Well, Christopher, just consider that statement from the CDC, that “water fluourdation is one of the top ten public health achievements of the 20th century”, which is repeated endlessly by fluoridation promoters around the world, as though it has some basis in scientific fact – no mention of fluoride toothpaste here, nor diet, education, better dental care, etc.
    Fluoridation wasn’t even present in the great majority of countries where the dramatic improvement in dental health took place, all the other factors were, yet fluoridation got all the credit! How does that appeal to the scientific mind in its rigorous pursuit of truth?

    You attempt to sneak out the back door of the thorny toothpaste issue by implying that opponents of fluoridation selfishly disregard the plight of children who don’t brush their teeth (who, for that reason, are doomed to have poor teeth, fluoridated water or not). Now we’re getting near the truth – the dubious benefits of fluoridation are not for everyone, just the neglected minority.
    There’s absolutely no need to force it on those who take intelligent responsibility for their own and their children’s teeth.
    It’s time to focus attention where it is needed.
    Education, not fluoridation.
    The sheep-dip approach is completely inconsistent with modern medicine and its ethical practice.

  129. Peter, you surely aren’t seriously suggesting that education is not one of the programmes used by health authorities and professionals in their attempts to improve oral health?

    What planet do you live on?

  130. Peter Davidson writes with faux umbrage

    It’s a pity you felt the need to resort to sneering sarcasm in your response, particularly as I gave you no grounds to do so.

    Reminding readers that Peter Davidson entered the discussion with
    this comment

    Ken’s question as to which planet Mr Davidson resides upon is quite appropriate.

  131. However you do need a rudimentary grasp of the scientific method.
    Do not be driven by “common sense”.
    It leads to dark and dumb places.
    You don’t need a degree in Science, but don’t pretend your common sense leads you to a better informed position.

    True is that.

    Common Sense Is Worthless in Science

  132. Peter,

    You said;

    “It’s a pity you felt the need to resort to sneering sarcasm in your response, particularly as I gave you no grounds to do so. I thought you might have been above those tactics, but you have proved me wrong on that point”

    There are many people here who have said they take ridicule as a personal affront, You appear to be one of them.
    Yet you have no compunction dishing it out as Richard easily points out.
    Some would call this hypocrisy….me I don’t give a toss. Really.
    Really
    Truly
    Cross my heart…(whoops… a bridge too far perhaps)

    Although our friend Bill disagrees (he’s off building fences with the scientific community), ridicule can be a useful tool in debate. It is often used to point out absurdity, stupidity or just plain emptiness in an oppositions argument.

    I’ve noticed several people whine and bleat about “tactics” or pretend, to be offended (yes, you heard me, pretend! can you believe that?)

    But really, when you pare away the bluster they are simply unable to respond with something clear, cogent, relevant and substantiated.

    So…go on give it go….ridicule away.

    PS: I will show you the courtesy of responding to other aspects of your comment, but at the moment family duties call…..

  133. Peter,

    You said;

    “Read my words again, and you will see that I did not claim that you do not ” acknowledge the usefulness of brushing teeth”. It is you who are misrepresenting me, not the other way around.
    What I certainly did say, and I don’t take back a single word, is that you were attempting “to explain away the effect of tooth-brushing”.

    So I acknowledge brushing teeth is good but I minimise it…WTF???
    How does that work in your head Peter?

    Then you said;

    “Why else would you say that tooth-brushing “only takes approx 2 minutes twice a day”, as compared with “having teeth bathed regularly in a low level fluoride solution”, if not to minimise the role of toothpaste, (you made no reference to “effective”, as you later claim – now you’re misquoting yourself), and exagggerate the effect of fluoridated water?
    Why else would you overlook the 1000-times multiplyer?
    Why no mention of the fact that brushing cleans the teeth (essential), whereas drinking water does not.
    The very clear implication of that statement was that there is no significant residual effect from toothpaste, and that only fluoridated water provides that.”

    Much of this is, yes… “word salad”
    I will cut to the chase with a simple analogy.

    I love coffee (with 1/2 tsp sugar)
    I love chocolate cake (with a bucket of sugar in it)
    Because I think coffee is effective at keeping me happy all day…
    Doesn’t imply that I minimise the amount of happiness Chocolate Cake gives me when I compare how much sugar is contained in each

    See…?

    No….?

    Maybe….?

    Subtitles?

    Before you reply to this…think. Please.

    PS: Again…What are your thoughts on the structural role of fluoride in apatites?

  134. Peter Davidson

    No, Ken, I am not seriously suggesting that education is not one of the programmes used by health authorities and professionals in their attempts to improve oral health. I certainly am suggesting that is where all the money and effort currently focussed on fluoridation should be re-directed.
    The Scottish program referred to earlier on this blog is a prime example of the real benefits which would follow.
    And yes, l do indeed inhabit the same planet as you.

  135. In real life all the money and effort should never be directed at just one element, Peter. Actually the Scottish programme you mention is an example of a real world approach – I will discuss it in my next article (which will probably be the final one as Paul has pulled out of the exchange) but briefly it involves more than simple education.

    Read the details and you will see that fluoride is an integral component of the Scottish programme with the aim of achieving 2 fluoride varnish treatments of toddlers teeth per year.

  136. Hi Peter,

    I am curious…You don’t appear to accept any evidence that water fluoridation has any benefits…..fine, I don’t think any evidence could convince you otherwise

    but do you think that it is the source of any harm(s)?

    You appear to have very libertarian views…again fine…

    But do you object to other publically funded health initiatives such as vaccination?

  137. Peter Davidson

    Thanks, Ken.

    I will read your article when you publish.

    Please note that I have absolutely no objection to fluoride being available and used in various forms, provided the individual is allowed free, informed consent. I believe fluoride may play a part in preventing decay, though I believe its benefits have been wildly exaggerated, certainly in regard to water fluoridation. Using it topically (and voluntarily!) is both scientific and ethical. I couldn’t possibly object to that.

  138. Remember now, Peter, reality is not about belief.

  139. Peter Davidson

    Maybe, maybe not, Ken.

    But if we stripped this whole debate of belief, your side has far more to lose.
    I keep coming back to that ludicrous CDC claim which so many believe without question, which is uttered and repeated without thought because the CDC says it is true, and the “experts” can’t be wrong. Believe them. It’s right at the heart of fluoridation promotion.
    Where is the scientific evidence to support the CDC claim?
    I believe it doesn’t exist. Prove me wrong in my belief.

  140. Of course that is a judgement which can be debated. But when a person does not accept the scientific understanding of the data and mechanisms the of course their judgments will be faulty.

  141. Peter Davidson, you be a lamb to slaughter around here, boy.

    I believe man never walked on the moon.

    I believe in bigfoot

    I believe in fairies

    I believe the govt was involved twin towers collapse 0/11

    Prove me wrong.

    Learn where the burden of proof lies.

  142. Where is the scientific evidence to support the CDC claim?
    I believe it doesn’t exist. Prove me wrong in my belief.

    (…jaw drops to the floor…)

    This is how these people “think”.
    Forget flouride for the moment.
    That’s just the topic of the moment.

    Just look at what Peter wrote. He can’t see anything wrong with making an argument like this in public.
    There’s not a trace of self-awareness or discomfort.
    And I’ll tell you something else for nothing. None of the other members of the fan club are going to see any problem either.
    All the crappy arguments they use, all of the fallacious reasoning.
    It never gets criticized by one of their own.
    They just give it a free pass.
    Morons.
    There’s no other word to describe them. How do they even tie their own shoes?

  143. I wonder if he has even started with a search of the CDC website or just expects others to do so for him.

  144. I keep coming back to that ludicrous CDC claim which so many believe without question, which is uttered and repeated without thought because the CDC says it is true, and the “experts” can’t be wrong. Believe them. It’s right at the heart of fluoridation promotion.
    Where is the scientific evidence…

    Gotta love the conspiracy thinking too.
    If Peter doesn’t accept that scientific evidence created the scientific consensus then what did?
    There has to be a mechanism.
    A scientific consensus doesn’t pop up from nowhere all by itself.

    How do you get the CDC to make a “ludicrous claim”?
    How do you get the “experts” to repeat without thought?

    Automatically, you dive into the deep end of conspiracy thinking.
    There’s no other choice.

    Say the CDC is doing something ludicrous.
    Ok.
    (Let’s not bother with the details. Just take Peter’s claim at face value with full benefit of the doubt for the sake of argument.)

    Yet no other scientific community on the planet has noticed it.
    For decades.
    Umm…
    How?
    How does that work?
    What are the nuts and bolts of the operation?

    (…awkward silence…)

    Yep. Doesn’t work. It’s daft. You’re toast the moment you try and cobble something together just as a pure hypothetical.

    That Mitchell and Webb Look – landing on the Moon

  145. Ahhh…..but NASA commissioned this comedy to reinforce the “idea” that going to the Moon was real…

    Reductio ad absurdum……

  146. Peter Davidson

    Nobel scientists and judges have expressed judgments on this issue at odds with yours, Ken.

    Burden of proof on you, not me, Richard.

    Yes, Cedric, you do love conspiracy thinking. I was already aware of that. You love to drag that word into the discussion on any pretext.

    I was never aware until now that it was the job of scientists to rank the world’s health achievements on a one-to-ten scale. That’s quite novel, and a change from their normal work. Thank you for telling me.
    Can you name the scientists involved, and where flouride toothpaste came on their scale? I’m sure somebody would have told them of its existence.

    Given that the improvements in dental health in the US attributed to fluoridation were matched, even exceeded elsewhere without fluoridation, can you explain how they overcame this unfortunate statistical hurdle thrown in their path by the World Health Organisation?

    Many thanks in advance.

  147. “Nobel scientists and judges have expressed judgments on this issue at odds with yours, Ken.”

    Yes, and with other “Nobel scientists” and judges, Peter.

    It is very childish to rely on others for one’s own opinions, even if easier to not worry about putting the old brain into gear.

  148. Hi Peter,

    You’re not talking to me anymore?

    I am curious…You don’t appear to accept any evidence that water fluoridation has any benefits…..fine, I don’t think any evidence could convince you otherwise

    but do you think that it is the source of any harm(s)?

    You appear to have very libertarian views…again fine…

    But do you object to other publically funded health initiatives such as vaccination?

  149. Peter, it seems you don’t understand that causation of dental decay is multifactorial. Taking a snapshot of a set of stats, as antifluoridationists like to do, and attempting to draw conclusions on the effectiveness of but one preventive measure, without controlling for ANY of the myriad of other factors involved, is ludicrous. The WHO stats are simply one snapshot of data, nothing more, nothing less. Were they the sole determinant of efficacy of fluoridation, as antifluoridationists so constantly attempt to portray them to be, the WHO would not fully support this public health initiative.

    Steven D. Slott, DDS

  150. Oh, and Peter, the CDC refers to Ten Great Public Health Achievements in the 20th Century…

    You said “world’s health achievements on a one-to-ten scale”

    A wee error maybe….

    So is toothpaste available to you free of charge, care of the public purse?

  151. Peter, this issue of the WHO stats and the figures from them promoted by anti-fluoridation activists was also discussed several time in the exchange between Connett and me. Connett more or less admitted the fallacious use, but I bet it won’t stop him -or you – from repeatedly using them.

    Why do you not bother to read the articles before making comments like this?

    >

  152. Why do you not bother to read the articles before making comments like this?

    Or even the CDC website with its numerous citations.

    But why bother with world health authorities and representitives of scientific research,, after a visit to fluoridefreewhatever they’re all experts.

    Lazy suckers.

  153. Mary Byrne, coordinator of Fluoride free NZ has climbed out of her tree over a comment made here by Cedric. I am currently banned from the Facebook page so can’t correct her but others here may be interested in popping along and perhaps leaving their own comments. It would actually be nice if those commenters here who oppose fluoridation corrected Mary on her claim that I have “blocked all comments opposed to fluoridation.” https://www.facebook.com/permalink.php?story_fbid=794537947229908&id=128729960477380

    These people seem to think that any criticism of their personality cult figure amounts to “bullying”!!

    >

  154. Sorry Ken, I cannot help, I’ve no facebook account as I’m allergic to facebook and to how it operates.

  155. …I really wouldn’t worry about Granny shaking her brolly about.

  156. Just left this…

    “Hi – Dr Perrot certainly hasn’t blocked comments opposed to water fluoridation…go in give it a go!”

  157. Sorry Ken, spelt your name wrong!

  158. “None of the other members of the fan club are going to see any problem either.
    All the crappy arguments they use, all of the fallacious reasoning.
    It never gets criticized by one of their own.
    They just give it a free pass.
    Morons.”

    (…time passes….)

    Yep, bugger all. Not a single one.

    Yes, Cedric, you do love conspiracy thinking. I was already aware of that. You love to drag that word into the discussion on any pretext.

    It’s an observation.
    Remember what you wrote.

    I keep coming back to that ludicrous CDC claim which so many believe without question, which is uttered and repeated without thought because the CDC says it is true, and the “experts” can’t be wrong. Believe them. It’s right at the heart of fluoridation promotion.
    Where is the scientific evidence…

    If you don’t accept that scientific evidence created the scientific consensus then what did?
    There has to be a mechanism.
    A scientific consensus doesn’t pop up from nowhere all by itself.

    How do you get the CDC to make a “ludicrous claim”?
    How do you get the “experts” to repeat without thought?

    (..cirkcets chirping…)

    But do you object to other publically funded health initiatives such as vaccination?

    Yes, Peter. You failed to answer this one last time. Now’s your chance to set the record straight.
    Science denialism is like eating peanuts.
    You just can’t stop at one.

  159. Well, I have commented on the FFNZ page & left a link to this thread. Will be interesting to see if my comment stays put.

  160. Burden of proof on you, not me, Richard.

    English comprehension is not your strong point Peter.

    I believe it [anything you care to imagine or define] doesn’t exist. Prove me wrong in my belief.

    You make the claim, it’s your belief/claim under scrutiny, not mine, therefore it is your burden of proof, not mine. (Besides that, the construct is absurd on more than one level, including that of an invitation to prove a negative).

  161. Peter Davidson

    Funny, I thought this discussion was about fluoridation, now it’s vaccination, and I am somehow compelled to express an opinion. What next – flagellation, procrastination, navigation, perspiration, inflammation…….?

    This is normally the point where conspiracy theory and daylight saving are brought in – apparently, we all think in blocks of issues, wrong on one, wrong on all. No, I won’t fall for that one.

    Christopher,
    You demand answers, but give few.

    On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate. Don’t dare read into that anything other than what those words express.

    I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice. Fluoridation fails on every test of good medical practice – no consultation, no consent sought or given, no specified dose (I said dose, not concentration), no time limit, no testing or approval of the medication, no cautionary advice of adverse effects (of which dental fluorosis is indisputably one).

    You said:
    “I am curious…You don’t appear to accept any evidence that water fluoridation has any benefits…..fine, I don’t think any evidence could convince you otherwise”

    The largest-ever US dental health survey (NIDR) was so embarrassing to fluoridation promoters that it took FOI laws to force its findings into the public domain. It found no significant difference in decay between fluoridated and unfluoridated communities. The totality of WHO data for the past half century confirms this. Who is refusing to accept the evidence here?

    “but do you think that it is the source of any harm(s)?”

    I’ll answer that this way:
    Is there a range of chemicals to which the human body is exposed which can interfere with, disrupt or harm the body’s natural development and functions, even in very small amounts (like lead, for example)?
    Indisputably, yes.

    Is fluoride, in its various compounds, one of those chemicals?
    I believe, on the evidence of eminent scientists and a considerable body of research, that the answer again is yes, and that is my right.
    You evidently believe otherwise, and that is your right.

    Either way, it comes down to believing somebody else. It’s inescapable.

  162. On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate. Don’t dare read into that anything other than what those words express.

    You are spending a lot of time trying to say as little as possible.
    Yet the question is really simple.

    But do you object to other publically funded health initiatives such as vaccination?

    Somehow, you can’t bring yourself to give a straight answer.

    …apparently, we all think in blocks of issues, wrong on one, wrong on all. No, I won’t fall for that one.

    It’s something that you can research for yourself.
    Science denial regularly comes in clusters.
    Take evolution denial, for example.
    There’s a big overlap between the creationists and the climate deniers in terms of demographics, sloganeering and methodology.

    The same thing happens with anti-fluoridationists. Even a casual look at anti-fluoride websites reveals lots of other stuff that marketed and accepted by that community that has no connection to fluoride but also goes against the scientific consensus on other issues.
    That’s not a freaky coincidence.
    The same methodology that allows someone to reject the scientific consensus on one issue allows them to reject another unrelated scientific issue.
    It’s just the way it works.
    Ever hear of someone called John Yiamouyiannis?
    You should.
    Came to a sticky end.
    Google him. I’ll wait.

    (…waits patiently…)

    I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent…

    For example?
    Chlorine?
    Hello?

    Who is refusing to accept the evidence here?

    Then can you name any scientific community on the planet that rejects the scientific consensus on fluoride?

    I keep coming back to that ludicrous CDC claim which so many believe without question, which is uttered and repeated without thought because the CDC says it is true, and the “experts” can’t be wrong. Believe them. It’s right at the heart of fluoridation promotion.
    Where is the scientific evidence…

    If you don’t accept that scientific evidence created the scientific consensus then what did?
    There has to be a mechanism.
    A scientific consensus doesn’t pop up from nowhere all by itself.

    How do you get the CDC to make a “ludicrous claim”?
    How do you get the “experts” to repeat without thought?

    (…crickets chirping…)

  163. Hi Peter,

    Thanks for your reply,

    You said;

    “Funny, I thought this discussion was about fluoridation, now it’s vaccination, and I am somehow compelled to express an opinion. What next – flagellation, procrastination, navigation, perspiration, inflammation…….?”

    Yes, this blog is about fluoridation. The reason I asked you for your thoughts on vaccination was to see whether you were consistent with your (apparent) libertarian views.

    “This is normally the point where conspiracy theory and daylight saving are brought in – apparently, we all think in blocks of issues, wrong on one, wrong on all. No, I won’t fall for that one”

    No Peter, I am not trying to trick you. There are however, strong correlations with science denial here. This is based only on my anecdotal experience, which is why I am asking your views.

    “Christopher,
    You demand answers, but give few.”

    ? I have given you quite detailed responses…

    “On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate. Don’t dare read into that anything other than what those words express.”

    I won’t read between the lines Peter…But in my opinion these parents should be charged with failing to provide the necessities of life (or other appropriate criminal charge). As a recent example (these are frightfully more common than you may think), a small boy in Auckland contracted tetanus and nearly lost his life because his parent didn’t vaccinate him.

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10855638

    How ’bout give me your opinion instead of avoid the question?

    “I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice”

    I don’t know what you mean by “good”. Anyway, some are utter crap.
    But your comment on “informed consent” tells me we have an area to explore…

    “Fluoridation fails on every test of good medical practice – no consultation, no consent sought or given, no specified dose (I said dose, not concentration), no time limit, no testing or approval of the medication, no cautionary advice of adverse effects (of which dental fluorosis is indisputably one)”

    Peter, I understand your feelings on “informed consent” however, this is premised on the idea that fluoridated water is a medicine. It is not considered to be, either in law or in the scientific community. Without this definition to cling to, your argument falls like a pack of cards.

  164. Hi Peter

    You said;

    “The largest-ever US dental health survey (NIDR) was so embarrassing to fluoridation promoters that it took FOI laws to force its findings into the public domain. It found no significant difference in decay between fluoridated and unfluoridated communities. The totality of WHO data for the past half century confirms this. Who is refusing to accept the evidence here?”

    Peter, you have made some pretty big claims here. I have politely asked you before to cite references… and while we are at it, could you explain this a little better?

    “but do you think that it is the source of any harm(s)?”
    “I’ll answer that this way:
    Is there a range of chemicals to which the human body is exposed which can interfere with, disrupt or harm the body’s natural development and functions, even in very small amounts (like lead, for example)?
    Indisputably, yes.
    Is fluoride, in its various compounds, one of those chemicals?
    I believe, on the evidence of eminent scientists and a considerable body of research, that the answer again is yes, and that is my right.
    You evidently believe otherwise, and that is your right. ”

    A simple Yes would’ve done.
    What harm(s) do you “believe” occur? Low IQ, Osteosarcoma etc etc? Please no rhetorical or evasive questions, I answer directly to your questions.

    “Either way, it comes down to believing somebody else. It’s inescapable”

    No No No. NO. I don’t believe someBODY else.
    You obviously don’t believe in the scientific consensus, so WHO do you believe?

    PS. You got me, I spelt ” publicly” incorrectly, my apologies.

  165. Peter Davidson

    You misread me, Christopher.

    I said “On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate”. (not NOT vaccinate).

  166. Peter Davidson

    Cedric,
    You said: “But do you object to other publically funded health initiatives such as vaccination?

    Somehow, you can’t bring yourself to give a straight answer.”

    It was there in front of your eyes:

    “I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice.”

    Reading lessons, Cedric?

  167. “Like eating peanuts”

    Another one for my Cedric collection. You guys are awesome!

  168. Peter, please explain just to satisfy my own curiosity if nothing else, what is the constant antifluoridationist confusion with dose and concentration? Water is fluoridated at 0.7 mg/liter. Seventy five percent of daily fluoride intake from all sources is from water and beverages. Why does this present such a challenge to antifluoridationists to figure out their daily intake, “dose”, of fluoride? Have you never had Algebra I, or something?

    “Is fluoride, in its various compounds, one of those chemicals?”
    After the countless times it has been made crystal clear that there are no “fluoride compounds” ingested as a result of fluoridation, simply fluoride ions…..do you seriously STILL not understand this elementary concept?

    After explaining these simple facts over, and over, and over again, ad nauseum, only to see antifluoridationists keep bringing up “dose” and “fluoride compounds” as if this were new, unexplored territory…..can you understand our irritation with those who either lack the intelligence to get it, or are simply ignoring the facts in intentional efforts to mislead?

    Steven D. Slott, DDS

  169. Peter

    Mild dental fluorosis, the only fluorosis to be associated in any manner with water fluoridation, is such a nearly undetectable, benign effect that it is not considered an “adverse effect” as you erroneously stated.

    Steven D. Slott, DDS

  170. WoW Peter..

    (Pausing to collect my discombobulated thoughts)

    My apologies (again)

    So, again, are you opposed vaccination?
    (straining very hard to honour your request and not read anything into your reply)

  171. Peter Davidson

    Cedric,

    It’s understandable that you put so much faith in “scientific consensus”, when the hard evidence of dental health surveys so miserably fails to give any comfort to your beliefs.

    “A scientific consensus doesn’t pop up from nowhere all by itself”, you said .

    No, it doesn’t. But here’s a clue:

    “A two-year battle against the federal government ended in victory for a scientist fired from the Environmental Protection Agency after raising health concerns about fluoride.

    Labor Secretary Robert B. Reich ordered that William L. Marcus be returned to his $ 87,000-a-year job at EPA and be paid back wages, legal costs and a $ 50,000 penalty.

    “Fighting the federal government is by no means an easy task,” Marcus said.

    Since being fired on May 13, 1992, he said, he has had to sell assets and depend on consulting work for income; one daughter had to postpone plans to go to medical school; vacations were no longer even considered and he and his wife both developed stress-related health problems.

    Reich, in an order made public Thursday, upheld an earlier decision by Administrative Law Judge David Clarke Jr., which concluded that the EPA’s charges against Marcus were only “a pretext” and that Marcus actually was fired “because he publicly questioned and opposed EPA’s fluoride policy.”
    (Associated Press, February 11, 1994).

    (EPA officials lied, fabricated evidence, shredded documents and altered time records in their failed defamatory defence).

    It’s a wonderfully simple method for achieving “scientific consensus”, Cedric, and very effective. When scientists have mortgages to pay and children to educate, what do you expect? Only on the fluoride side are there troughs of money available to pursue legal action.

    Once a government has adopted a fluoridation policy, it will naturally ensure that nobody who disagrees will ever get, or in this case keep a job in their employ. So, in health departments and research laboratories around the nation, it’s well understood what you must never risk discovering and making public. You simply toe the government line.

    Dr. Phyllis Mullenix also came to understand this when she published her research findings of fluoride’s carcinogenic effect. She was promptly fired.

    I know you like the term “conspiracy theory” to explain such happenings, most people would call it everyday, taxpayer-funded fraud.

    So, that goes a long way to answering your questions:
    “How do you get the CDC to make a “ludicrous claim”?
    How do you get the “experts” to repeat without thought?”
    It’s more a question of “how do you prevent them?” It’s the easy road to promotion.

    Refer back to that disgraceful document circulated by Queensland Health, contrasting pictures of the worst imaginable mouthfuls of rotten teeth with a set of perfect, sparkling white teeth, claiming the difference was due to “exposure to fluoridated water”. Did any heads roll over that? Did the dental associations or scientific community raise any objections? You guessed.

    And you ask how the CDC could have got their ludicrous claim past the gate guardians.

    Christopher,

    You deny that fluoridation is a “medication”, and ask for evidence.

    Here’s the Queensland Govt. position on the matter:

    2003
    Queensland Government
    Position Statement on Water Fluoridation:
    “Whilst recognising that the balance of the scientific argument favours the use of fluoride
    in the pursuit of oral health, it is a principle of ethical public health that mass, involuntary
    medication must never proceed without the express consent of the community”. (They still went ahead and did it).

    Anything else?

  172. Peter, I suggest you do some checking on you claims. For example, Mullinex’s work on Fluoride involved rats and high concentrations of F. She did not look at carcinogenic effects but behaviour.

    Just because what you read fits into your own biases does not make it correct.

  173. Hugely unimpressed Peter. You’ll have to offer more than your personal synopsis of events to make a case for your conspiracy theories.

    For example, what health concerns did Marcus raise and how did he raise them? What was the course of events and where can the judgement be read,
    People get fired for all sorts of unprofessional and substandard work and unfortunately correct employment/contractual procedures are not always followed.

    Anyway, at least your buy-in to the conspiracy theory is acknowledged.

  174. Here’s the Queensland Govt. position on the matter:

    2003
    Queensland Government
    Position Statement on Water Fluoridation:
    “Whilst recognising that the balance of the scientific argument favours the use of fluoride
    in the pursuit of oral health, it is a principle of ethical public health that mass, involuntary
    medication must never proceed without the express consent of the community”. (They still went ahead and did it).

    No, Peter. Don’t be like Louise.

    Don’t paste excerpts without a link to the full document. The next sentence may well say that the Board considers that fluoridation is not medication.

  175. Hi Peter,

    “…anything else?”

    Yes…can you show me the courtesy of replying to my questions on vaccination?
    I presume you have the integrity to voice an opinion here?

    Secondly, you have given me some text which you claim is from the Queensland Government without any citations/references. Are you trying to be provocative or downright rude? I have politely asked you many times to provide citations.

    If you wish to garner any respect here then show some respect. This is why some are, (among other things) called lazy.

    Thirdly, in making a claim related to definition, could you not “cherry pick”….this is a NZ blog, please provide some relevancy here.

    Lastly, I have replied in depth to all of your issues, I would appreciate it if you extend this courtesy to me by spending some time and effort, rather than a short sharp irrelevant, unreferenced remark.

    Or are you unable to do this?

    Thank you

  176. Peter Davidson

    Christopher,

    Don’t try your sneering, pseudo-intellectual moral blackmail with me. It doesn’t work, and says far more about you than about me.
    I have absolutely no intention of going any further down the vaccination path, and I owe you no comment on that issue, nor any explanation. You already know that.
    You dismiss one comment I made, because “this is a NZ blog”. Yet you demand comment on vaccination – on a fluoridation blog.
    You demand citations, yet give none yourself.

    So much for integrity.

  177. Peter Davidson

    Thank you for your correction, Ken.

    You are quite right – Mullenix’s experiments demonstrated fluoride’s action as a neurotoxin, not as a carcinogen. That’s still a cause for concern, and gives support to the numerous Chinese fluoride/IQ studies.

    It is standard practice to expose rats to fluoride at high levels to produce the same plasma levels found in humans at lower levels, as she explains:

    http://www.sonic.net/kryptox/medicine/mullenix2.htm

    There is no doubt Mullenix was fired as a direct result of publishing her findings.

    Your comments about bias apply equally to everyone involved in this discussion.

  178. It’s understandable that you put so much faith in “scientific consensus”…

    Peter, faith =!= science.
    There is scientific consensus on lots of things.
    Lots and lots and lots of things.
    Big things and small things.
    That scientific consensus was created the same way.
    The boring, old-fashioned way.
    Work.
    Lots of it.
    By people and scientific communities all over the world.

    From time to time, a scientific consensus gets successfully challenged too.
    Guess how.
    That’s right. Work.
    Lots and lots of work.
    Scientific work.
    Do enough work and they’ll even throw in a Nobel Prize or two.

    No, it doesn’t. But here’s a clue.

    I have a better idea. Don’t speak in riddles. Say what you mean and mean what you say. Stop being shy and coy and ever so evasive.
    Spell it out for us nice and clear.

    It’s a wonderfully simple method for achieving “scientific consensus”, Cedric, and very effective. When scientists have mortgages to pay and children to educate, what do you expect? Only on the fluoride side are there troughs of money available to pursue legal action.

    Doesn’t work.
    Let’s take your story at face value.
    It really happened. No spin. EPA evil. Marcus good. Blah, blah, blah.
    Ok.
    Only it doesn’t work.

    The court case happened in 1994.
    How do you keep people in line from…before that time?

    What about scientists that are independently wealthy?
    They exist.
    What about scientists from other countries that don’t work for the EPA?
    They exist.
    What about devotees of anti-fluoride that happen to be lawyers?
    They exist.
    What about devotees of anti-fluoride that have scads of money and would be willing to bankroll any court case or simply just hire maverick scientists and give them lab space?
    They exist.
    What about scientists that are as stubborn as mules?
    They exist.
    What about scientists that put public welfare over their own comfort?
    They exist too.

    Marcus actually was fired “because he publicly questioned and opposed EPA’s fluoride policy.”

    Further, why was Marcus only “questioning”?
    Why didn’t he just do some work and get it published?
    Or does your conspiracy thinking cover all the scientific journals too?
    Now you can go that way…only then the conspiracy gets even bigger.

    Once a government has adopted a fluoridation policy, it will naturally ensure that nobody who disagrees will ever get, or in this case keep a job in their employ.

    Doesn’t work. Governments change. Elections happen. How do “they” enforce it?
    You can fire all the people you like but…it wouldnt’ stop the truth from getting out.
    For example, Connett doesn’t work for “teh gibbiment”.
    How come he doesn’t do any work and win that Nobel Prize?
    How do “they” stop him from doing research?
    Mind control?
    Threats to his family?
    There’s no effective mechanism.

    “How do you get the CDC to make a “ludicrous claim”?
    How do you get the “experts” to repeat without thought?”
    It’s more a question of “how do you prevent them?” It’s the easy road to promotion.

    You can’t “promote” everybody at the CDC.
    It’s a big organisation.
    Plus there’s the problem of people dying over the decades or just retiring and moving on.
    How do you get the CDC to make a ludicrous claim?
    What about other scientific communities?
    What stops them from pointing out the ludicrous claim?

    Your conspiracy theory doesn’t work.
    You have the same basic logistical problems as all the other science deniers out there.

    Claim CA320:
    Scientists are pressured not to challenge the established dogma.

  179. Christopher: “You appear to have very libertarian views…again fine…
    But do you object to other publically funded health initiatives such as vaccination?”

    Peter: (….silence….)

    Christopher: “You appear to have very libertarian views…again fine…
    But do you object to other publically funded health initiatives such as vaccination?”

    Peter: (…silence…)

    Cedric: Yes, Peter. You failed to answer this one last time. Now’s your chance to set the record straight. Science denialism is like eating peanuts.
    You just can’t stop at one.

    Peter: On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate. Don’t dare read into that anything other than what those words express. I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice.

    Cedrick: You are spending a lot of time trying to say as little as possible.
    Yet the question is really simple.

    But do you object to other publically funded health initiatives such as vaccination?

    Somehow, you can’t bring yourself to give a straight answer.

    I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent…

    For example?
    Chlorine?
    Hello?

    Christopher: Yes, this blog is about fluoridation. The reason I asked you for your thoughts on vaccination was to see whether you were consistent with your (apparent) libertarian views.
    (…)
    How ’bout give me your opinion instead of avoid the question?

    Peter: It was there in front of your eyes:
    “I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice.”
    Reading lessons, Cedric?

    Christopher: So, again, are you opposed vaccination?
    (straining very hard to honour your request and not read anything into your reply)

    Peter: …anything else?

    Christopher: Yes…can you show me the courtesy of replying to my questions on vaccination? I presume you have the integrity to voice an opinion here?

    Answer the question, Peter.
    It’s not that hard.
    Evasion looks bad. You tried to evade taking responsiblity for your conspiracy theory and that didn’t work out so well.
    Do you object to other publically funded health initiatives such as vaccination?
    Either you do or you don’t.
    Which is it?
    Say what you mean and mean what you say for once in your life.

    The Pointer Sisters – He’s So Shy (1980)

  180. Peter, if you had actually read the articles in this exchange you would have seen that I debunked your claim of “standard practice.” Mullinex”s attempt to justify that in her own paper was pathetic.

    We have also discussed the Chines studies quite a bit. I find it farcical for Paul’s crowd to put so much faith in that poor quality research and shonky explanations and then demand rigid double blind replicated studies from tiers. Farcical.

    It concerns me that you are commenting here without reading the articles.

    If you have “no doubt” that Millenix publishing her sole paper on fluoride directly resulted in her being “fired” then you will provide the evidence. Otherwise you will look silly for having such confidence when you don’t have evidence. I personally doubt the story because institutions I have worked for always had a policy of approval being required before publication. Firing is never necessary. I don’t know why she lost or changed her job so I am keen to see the evidence you rely on before making up my mind.

  181. Peter, this is not a fluoridation blog at all. It is generally commenting around scientific issues. I posted a vaccination article yesterday and give you my full permission to get struck into those issues.

    Please lay of the personal argy bargy and discussion the issues.

  182. Peter Davidson

    If it’s not a fluoridation blog, Ken, despite the title “Why I support fluoridation”, then it’s not “a NZ blog” either. Please correct Christpoher on that point, too.

    Richard, if you’re the expert you purport to be, why fire all these questions at me, when you are presumably already in possession of all the evidence and already have all the answers?
    You wouldn’t surely comment on this blog on an issue about which you know absolutely nothing?

  183. Actually, it is a NZ blog – appears regularly in the NZ Blog ranks!

    Might be simpler to just participate in the discussion by answering proper questions.

  184. Mr Peter Davidson,

    Richard, if you’re the expert you purport to be, why fire all these questions at me, when you are presumably already in possession of all the evidence and already have all the answers?

    The more you paste assertions without support and the more you avoid answering questions the more you look like a dishonest fool. CGrow up and cease your wriggling.

    I’ll repeat my last comment, :

    Don’t paste excerpts without a link to the full document. The next sentence may well say that the Board considers that fluoridation is not medication.

    How about supplying a link to the Queensland Govt position statement and the judgment on the Marcus case, otherwise we might just assume you pasted the cherry-picked quote from some FAN site (or similar blog/advocacy group).

  185. Yet again, Hello Peter

    “Don’t try your sneering, pseudo-intellectual moral blackmail with me. It doesn’t work, and says far more about you than about me”

    No Peter, you just needed to stand up and say what you believed in. Or, if you were unable/unwilling to do this just put your hand up and say that you were did not want to answer my question – you didn’t. You evaded, avoided, dodged and dived…yep you, not me. Peter.
    The lengths that you went through to do this was Herculean.

    “Pseudo-intellectual”?
    Asking a question is intellectual? I suppose that would rule out all questions Peter…which would also mean that…hold on…wait…you are also a pseudo intellectual (pause for the irony!)…and Forrest Gump and….well you see my point…or maybe you don’t.

    “moral”. I think you need to look that one up in the dictionary, Peter. But while we are here, on the subject of vaccinations I think that it is morally reprehensible to hold a anti vaccination viewpoint.
    There’s my hand Peter, shooting right up to the ceiling, shouting to the world what I believe in…try it, it’s liberating!

    “Black mail” ?? Did I hold a gun at your head, threaten you, use bad language or abuse you?

    No, I didn’t Peter, as Cedric has summarized so well, I have asked you politely many many times.

    “I have absolutely no intention of going any further down the vaccination path, and I owe you no comment on that issue, nor any explanation. You already know that”

    No Peter, I don’t already know this. You never told me.
    You never had the stones.
    Again, that’s why I asked you, remember the sentences with funny question mark thingys at the end of them? Sheesh! Whoops more pseudo intellectualising again.

    “You dismiss one comment I made, because “this is a NZ blog”. Yet you demand comment on vaccination – on a fluoridation blog”

    (Sigh) Yes Peter, because you were lazy and your sentence meant nothing to me without context, you see, you didn’t cite your reference (Haven’t I said this, a Bajillion times now?)

    “You demand citations, yet give none yourself.”

    You are not serious here…really? I mean really?
    You’re having a larf…pulling my leg…havin’ a wee joke surely.

    How ’bout a wee skip down memory lane…or more precisely, a few posts ago….

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10855638

    Want some more..?

    “So much for integrity”

    I have been polite to you, and apologised when I have made mistakes. You have not.

    Yes Peter, you haven’t had the integrity to apologize once.

    Yes Peter, so much for integrity.

  186. In terms of the Queensland Australia, the following are of interest

    Policy The Use of Fluorides in Queensland March 2008

    2.1 In October 2005, the Australian Research Centre for Population Oral Health (ARCPOH) led a
    review of the use of fluorides in Australia. The review process included more than 30 experts,
    university, jurisdictional and peak-body representatives from all states and territories of
    Australia.
    2.2 This review was a short term Action of
    Australia’s National Oral Health Plan 2004–2013
    (AHMC, 2004). The review considered the nature and distribution of tooth decay and dental
    fluorosis and the nature and distribution of fluoride use (or exposure) in Australia. In
    identifying a new set of guidelines for the use of fluoride in Australia the experts considered
    both the benefit of tooth decay prevention and the risk of dental fluorosis. 2.3 The use of fluorides in Australia: guidelines
    was published in the Australian Dental Journal in
    mid 2006.
    The guidelines reflect consensus of expert opinion, and have considered previous
    Australian reports and research conducted in Australia and overseas.
    2.4 The Queensland Health, Oral Health Advisory Committee has reviewed the
    The use of
    fluorides in Australia: guidelines
    and endorses their recommendations as background for this
    policy.
    2.5 In December 2007, the Queensland Government announced the mandatory fluoridation of all
    eligible public water supplies by 2013. This includes all water treatment plants which serve
    populations greater than 1000 persons, if the natural fluoride levels are below the optimal
    fluoride levels prescribed in the Regulation.

    5.1 Water fluoridation

    5.1.1 Water fluoridation is an effective, efficient, socially equitable and safe population health
    measure for the prevention of tooth decay in Australia.
    iii
    5.1.2 The consumption of fluoridated water should be promoted to all Queenslanders and supported by all levels of government.

    http://www.health.qld.gov.au/fluoride/document/fluorides_qld_policy.pdf

    which cites

    The use of fluorides in Australia: guidelines
    Australian Research Centre for Population Oral Health, Dental School, The University of Adelaide, South Australia

    http://onlinelibrary.wiley.com/doi/10.1111/j.1834-7819.2006.tb00427.x/pdf

  187. Peter Davidson

    Ken, you’re well aware that Christopher used the term “it’s a NZ blog” to render invalid my reference to a Queensland Government position statement. You clearly don’t exclude evidence, or bloggers, from countries outside NZ. Admit it.

  188. Of course not, Peter. Why should I?

    The Queensland position currently seems to be under discussion — why don’t you join in?

    I thought the problem was you avoiding amplification of your comments on vaccination?

  189. Ah…you’re back Peter…ah sorry, I should’ve said it’s a blog based in NZ.

    Cleared up now? (That’s another one of those apology thingies – you should try it!)

    Now…..onward and upward…

  190. On closer inspection…Peter,

    I rendered your comment invalid…because…

    “(Sigh) Yes Peter, because you were lazy and your sentence meant nothing to me without context, you see, you didn’t cite your reference (Haven’t I said this, a Bajillion times now?)”

    I think that’s a Billiion and one, don’t you think?

  191. …and you reply with….

    “ah I’m sorry Christopher, I didn’t read your post properly”

    See…easy peasy

  192. As Peter Davidson refuses to support his own comments with citations I’ll do it for him.

    Here is the Qld 2003
    position statement in full.

    Mr Davidson implies (as it is becoming a pattern of his to avoid specifics) that in this statement the QLD Govt concedes that, or defines fluoridation as a medication.

    Plainly it does not, despite a reference to consent and mass medication.

    Mr Davidson’s contention can only be arrived at by rather flimsy and wishful deduction based upon the phrasing used, but understandable given his a priori bias and tendency to copypaste arguments found elsewhere on the internet.

    I believe it simply a clumsily worded documented never intended to be interpreted and used in the manner Mr Davidson and other anti-fluoridationists do.

    As the
    2008 policy statement endorses mandatory fluoridation it would automatically violate the 2003 position statement if Mr Davidson’s interpretation were correct.

    Should Mr Davidson continue in his pursuit of this argument I have no hesitation in considering him dishonest.

  193. But do you object to other publically funded health initiatives such as vaccination?

    (…waits patiently…)

  194. Peter Davidson

    Christopher,

    Here is the answer I gave you way back:

    “On vaccination, I’ll just say this: I can well understand the agony of parents whose child has died as a direct consequence of their decision to vaccinate. Don’t dare read into that anything other than what those words express.”

    “…..just say this….” (i.e., I have nothing further to say on the subject).

    That was your answer.

    You can’t compel me to express a view I may not even have, so stop acting like a jilted diva, desperate for a word from me. You only make yourself look silly.

  195. Sorry Peter,

    Should’ve read between your lines.

    “You can’t compel me to express a view I may not even have…..”

    No Peter…I can only ask…(sigh)

    If you are unable to reply then I will have to draw my own conclusions.

    I will use this as my rationale supporting my presumption that you do support vaccination…

    “I support all good publicly (not “publically”) funded health initiatives which respect the individual’s right to informed consent, which is at the heart of good ethical medical practice.”

    That wasn’t hard now was it?

  196. An Ode to poor Peter,

    (waiting…)

  197. Just some light relief while we wait with baited breath…

    Care of Peter, Paul and Mary

  198. but perhaps more appropriately..

  199. Dr. Johnny Johnson

    Cedric,

    (I omit no one else here commenting on anti-fluoridation comments purposefully. I only single out Cedric for his comment earlier)

    Cedric,

    Your comment (December 30, 2013 at 3:26 am |) above is beautifully written. I could have lived a lifetime and not have achieved such a well put together piece such as yours. You say exactly what you mean, and you echo thoughts that are rattling around in my head.

    Thank you for putting this information into words for me. If you have no objection, I’d like to be able to use your post in my defense work of fluoridation in the U.S.

    Cheers,

    Johnny

  200. Gosh.
    Um…please, by all means use it as you see fit.
    Thank you.

    (…blushes profusely…)

  201. Dr. Johnny Johnson

    Thanks Cedric.

    You folks are awesome. Thank you for fighting the good fight. You are a real shot in the arm (no reference to immunizations :), which I DO support of course) to those of us defending & implementing water fluoridation.

    And a special note of thanks to Ken, once again, for engaging Paul Connett in this forum. This has been a great opportunity to have a peak under the hood of Paul’s mind beyond the theatrics he demonstrates in person. Nothing new to any of us I’m certain. But this is the first time I’ve had a chance to see anything he’s written this in-depth, including his novel which I won’t spend a cent on.

    Happy New Year to you all,

    Johnny

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