Category Archives: Health and Medicine

Declan Waugh continues his distortion of Finnish fluoride research

In my last post (Another fluoridation whopper from Declan Waugh) I described how Declan Waugh (a self-professed “scientist and fluoride researcher”) badly misrepresented data from a Finnish study which had concluded the prevalence of ailments attributed to fluoridation were “likely connected with psychological rather than physical effects of being exposed to fluoridated water.”

However, he has continued with his distortion and misrepresentation of the data in this study.  On Monday he claimed:

“The study into health effects of cessation in artificial fluoridation in Finland published in 1997 reported that within THREE WEEKS of stopping fluoridation and without the public being aware it had ended, respiratory ailments reduced by 31 per cent in adults.”

On Tuesday he presented another of his infamous bar graphs (see below) derived from manipulating data in the paper.

Declan2

Here are my comments about this latest distortion.

1: The groups for the time when the drinking water was fluoridated and the time when it wasn’t (but people believed it was) were separate samples so any differences could simply reflect that fact. The authors noted people in the original fluoridated group “reported being slightly healthier than those in the” unfluoridated but unaware group. “Thus the smaller number of symptoms in the” later group “probably was not caused by cessation of fluoridation.”

“Taken altogether, two-thirds of the recorded symptoms were slightly more rare in [the unfluoridated but unaware group] than in [the fluoridated group]. For one-third of the symptoms, the situation was the opposite. However, the difference was statistically highly significant for only one symptom, “other skin rash”, which appeared more often in [the fluoridated group]  than in [the unfluoridated but unaware group].”

One reason for the differences in the reported health of the two samples (fluoridated and unfluoridated but unknown) could be beliefs about fluoridation. The table below shows that fewer people in the fluoridated group believed fluoridation beneficial. The authors point out that “In both groups the mean number of symptoms was lower among those who considered fluoridation to be good than among those who thought it was bad or who had no opinion.”

2: Again, Waugh has taken a “percentage of a percentage” in his recalculations. In the process converting statistically insignificant differences into what seem like very large effects. In the table below I have shown how ridiculous this is for the ‘urticaria’ symptom. This had a prevalence of 1.3% in the fluoridated group, 0.5% in the unfluoridated but unknown group and 1.5% in the last known unfluoridated  group. These differences have no statistical significance but Waugh’s graph shows a huge 62% difference!

3: Waugh also grossly distorted the numbers claiming “more than 2 thirds of people actually felt better after fluoridation was stopped and they didn’t know it had.” But the Finnish authors described the incidence of symptoms in the unflouridated group as only “slightly more rare” with only one difference being statistically signficant. In fact, the better health of the unfluoridated but unknown group is really limited to the fact that 65.5% reported no ailments compared with 63.5% of the  fluoridated group (see table below) – a mere 2%, not two-thirds!

Fluoridated (%) Stopped-Unknown (%) Stopped – known (%)
Beliefs about fluoridation
Good 39 45
Bad 20 15
No opinion 41 40
Ailments
Nettle rash (urticaria) 1.3 0.5 1.5
Other skin rash (eczema) 10.6 4.3 4.9
Insomnia 8.1 11.5 5.6
None of the  symptoms 36.5 34.5 50.1

Although Declan Waugh’s graphical presentation grossly distorts the true data in the paper I have expanded it in the figure below to include all the ailments. Waugh had deleted the data for one-third of the ailments – presumably because their negative “percentage reduction” would have interfered with the misrepresentation he wished to convey.

Declan4

Actually, I cannot leave this with Waugh’s distortion of the data producing such high figures. Here is a more realistic presentation of the difference in percentage of reported ailments. Please note, Lamberg et al (1997) report that only significant difference is for “other skin rash” which the authors commented on – “this group of people should be studied further.” All other differences are in the -4 to +4% range.

Declan5

Finally, a comment on an old study constantly being used by anti-fluoridation propagandists to “prove” claims of fluoride sensitivity. Waugh comments on the Lamberg et al (2007) study saying:

“Regretfully, the authors of this study did not refer to one of the only double blind clinical studies on fluoride every undertaken, and published, which also demonstrated similar outcomes from exposure to fluoride.”

He refers to the paper:

Feltman, Rueben; Kosel, G. (1961). Prenatal and postnatal ingestion of fluorides – fourteen years of investigation – final report. Journal of Dental Medicine, 16(4), 190–198.

Feltman & Kosel (1961) did state they observed possible side effects of the fluoride treatment (use of fluoride tablets):

“One percent of our cases presented evidence of undesirable side effects from fluoride therapy. It is pointed out that if a patient is affected by the fluoride, by this method, the allergen or intoxicant  can be removed readily from the diet by discontinuace of the dietary supoplement.”

However, the paper did not present any data for side effects to support the statement. It is impossible to judge the validity of their conclusion. And Waugh is not able to produce a fancy but misleading bar graph from Feltman & Kosel (1961) as there isn’t any data to work with.

Conclusion

Again, Declan Waugh has been caught out distorting data to produce a completely unwarranted conclusion. In the process he has produced fancy-looking bar graphs which are misleading. This is not valid scientific evidence. It is dishonest distortion

However, this won’t stop Declan Waugh and other anti-fluoride propagandists presenting his claims and bar graphs to gullible city councillors. They will no doubt accompany these distortions with citation of Feltman & Kosel (1961) and Lamberg et al (2007) to make their submissions look sciency and “authoritative.”

It’s about time we exposed these frauds.


Note: I sent Declan Waugh a message bringing his attention to my earlier article (Another fluoridation whopper from Declan Waugh) but got no response. So I repeat my offer to Waugh that he debate his claim here. I am happy to give space for him to argue his case so that a proper scientific exchange can occur.

See alsoFluoride sensitivity – all in the mind?

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Another fluoridation whopper from Declan Waugh

Declan Waugh is a self-proclaimed “scientist and fluoride researcher” who seems to spend all his time misrepresenting and distorting  scientific literature and health data to promote his anti-fluoride cause. Waugh has an avid following, among fellow anti-fluoride activists and propagandists. The sad thing is that he “reports” do manage to fool some gullible people. The Hamilton City Council staff listed one of his reports at the top of the “list of scientific information” they relied on when they stopped fluoridation last year (see When politicians and bureaucrats decide the science). And the “Physicians and Scientists for Global responsibility, NZ” also relied heavily on this report in their anti-fluoridation submission to councils.

But Declan Waugh’s latest “scientific” gem is a real whopper. He has extracted data from a 1997 Finnish paper to produce “evidence” fluoridation causes all a sorts of ailments. In the process he surely can’t have missed the fact the authors found the same level of expressed symptoms from people who were drinking unfluoridated water but believed it was fluoridated. That is, the symptoms seem to have a psychological cause, the belief threat drinking water was fluoridated, and not a physical cause – fluoride in the water.

The paper is Lamberg, M., Hausen, H., & Vartiainen, T. (1997). Symptoms experienced during periods of actual and supposed water fluoridation. Community Dentistry and Oral Epidemiology, 25(4), 291–5. Or see the full text.

Here is the image Waugh is promoting, and which is being repeated by anti-fluoride propagandist. For example fluoride Girl tweeted this:

@FluorideGirl: In Finland they Removed #fluoride in the tap water…Look at the reductions in diseases in just 3 months or 12 weeks! http://t.co/Lofb16ucnC

And this links to Waugh’s Facebook image:

Seriously? Waugh’s bar graph will be interpreted by many as evidence 72% or more of people drinking fluoridated water report “nausea and vomiting” which disappear when fluoridation is stopped!

Intentionally dishonest!

Trouble is, that image is extremely dishonest and intentionally so. Waugh could not have extracted that data from the paper without seeing and understanding the data alongside it for people who were not drinking fluoridated water but believed they were. He has made 3 outrageous distortions to produce his data:

  1. He has ignored that actual data (in the same table) for % reduction of reported symptoms for both the group that had originally drunk fluoridated water, and the group who had originally drunk unfluoridated water in the mistaken belief it was fluoridated.
  2. He took his data from the information for all respondents, combining both groups in the final survey but ignored the column for people drinking unfluoridated water but believing it was fluoridated.
  3. He then took a “percentage of a percentage” so that, for example, although the percentage of respondents reported “Nausea and vomiting” when drinking fluoridated water was 3.8% (and 2.3% for the group who wrongly assumed they were drinking fluoridated water)  had dropped to 1.1% when knowingly drinking  unfluoridated water (a decline of 2.7% which was not statistically significant) his calculation produced a decline of 72%!

What a whopper!

An honest depiction of the data would have included both sets as below:

Waughs-cockup

Very different to his figure.

Lamberg et al (1997) concluded:

“Since the occurrence and mean number of symptoms were fairly similar during actual and supposed fluoridation, the results do not support the theory that the symptoms considered in this study are caused by the physical effect of fluoridated water. On the other hand, the significant reduction in the number of symptoms only after the respondents had become aware of the discontinuation of fluoridation reveals that fluoridation may have psychological effects which present as perceived symptoms.”

The authors did toss a small glimmer of hope the hypochondriacs who claim fluoride sensitivity is real. The differences in reported decline in incidence of ailments between the fluoridated and supposed fluoridated groups are statistically insignificant for almost all the tested ailments. The exception was for “skin rashes” and the authors say:

“However, the significant decrease in the number of other skin rashes leaves room for speculation, seeming to favor the view that a small segment of the population may have some kind of intolerance to fluoride. This group of people should be studied further.”

The again, it is not uncommon to get a false positive when considering a large number of ailments in the same study.

“Tasting fluoride” in water

Nearly 10% of the respondent in the Finnish study claimed they could taste the fluoride in fluoridated water – which is known to be impossible for humans.

“However, the respondents made this claim equally often during actual and supposed fluoridation. As expected, the percentage reporting this “fluoride taste” dropped to nearly zero during known discontinuation of fluoridation in March. The psychological aspect is further confirmed by the fact that the illusory tasters seemed to be predisposed to perceived symptoms, as were also those who regarded fluoridation as a bad practice in general.”

No wonder the authors concluded:

“it seems likely that the prevalence of the symptoms
considered in the current study is connected with the psychological rather than with the physical effects of being exposed to fluoridated water.”

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I am still waiting for my cheque

LiarI have often said I wonder how some of the anti-science propagandists sleep straight in their beds at night. Lately this refers to various members of the local anti-fluoridation movement and their claims.

Pity I am not the litigious sort – there could be a bit of money in a recent claim because it slanders me, and a fellow SciBlogger, personally

Lynn Jordan, the Wellington representative of Fluoride Free NZ recently declared (under her on-line pseudonym “Penelope Paisley”) on Fluoride Free Hamilton NZ:

Penelope Paisley Peter- you asked what Debz and Ken get out of it. Ken and Alison are getting paid to blog about fluoridation. “

As I said, I am still waiting for my cheque.

Apparently Lynn’s “evidence” for this is the fact that this blog, and Alison’s Bioblog, are both syndicated on the NZ SciBlog platform as Open Parachute and  BioBlog.

I certainly appreciate my association with NZ SciBlogs, and I am sure Alison does to. But neither of us expect payment – nor is SciBlogs in a position to pay its syndicated bloggers or its full bloggers (of which there are now quite a few  –  check them out).

Lyn may not like the fact that Alison and I have blogged about the scientific aspects of fluoridation, and in the process revealed the misinformation and distortion promoted by Lynn and her fellow activists, but that does not provide a basis for her claim. She is simply telling porkies in an attempt to shoot the messengers and avoid the message.

Why is “Penelope” telling porkies?

At this stage I have no interest in making an income, either through blogging or anything else. It feels good as a retiree not to feel obliged to support, or suffer the control of, an employer. Of course, it may well be different for Lynn. In my post The irony of some peer-review and citation complaints I wrote this about her:

“Penelope” is the on-line name used by Lynn Jordan – the  Fluoride Free NZ Committee member for Wellington. She also practices as a  cranio-sacral therapist in Wellington. Cranial-sacral therapy is an alternative or “natural” therapy which Edzard Ernst  described as more or less bogus (see Up the garden path: craniosacral therapy).

Obviously she has ideological and financial committment to the “natural” health business. She relies on it for her income. If you were spiteful you might even think  she is paid to advance propaganda and to attack those who support an evidence based approach to health. But I wouldn’t possibly make that claim.

By the way, in the best tradition of astroturfing, Lynn  often sends submissions to councils opposing fluoridation under the name of an organisation NZ Health Professionals Opposing Fluoridation. What the hell is a “cranial-sacral therapist doing representing health professionals? I leave that to your imagination but it hardly adds credibility, does it?

Mind you, many councillors seem to be gullible. They certainly were in Hamilton last year.

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An answer to the anti-fluoride critics – in one image

Undeserved-Reputations-Fluoride-724x1024

Click image to enlarge. 

The chemical website Compound Interest, is producing a series of infograms to communicate some chemistry.  Here is an excellent one they produced on fluoride. I think it would make a great poster.

It is accompanied by some straightforward text describing the science behind fluoridation and countering a lot of the misinformation anti-fluoride propagandists promote.

Worth reading. See Fluoride & Water Fluoridation – An Undeserved Reputation?

The chemically minded may also be interested is some of their other infograms –  here are just a few examples:

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Elected officials must ignore activists and listen to own voters

Seel

Karen Williams Seel, a member of the county board of commissioners in Pinellas County, Fla.

A recent US blog article made some very pertinent points about the role of elected officials, such a local body councillors, on important social health issues like fluoridation.  These officials have a responsibilty to avoid pressure from misinfomred activists and must instead  listen to their constituents.

Karen Williams Seel, who wrote the article Fluoridation: Elected officials have a critical duty is a member of the county board of commissioners in Pinellas County, Fla., USA. Three years ago, the board voted 4-3 to stop fluoridating its water supply but reversed that decision in 2012 after voters defeated two incumbent commissioners who had voted against fluoridation. In both instances, Seel voted in favor of fluoridation.

She wrote:

“As Americans increasingly seek health information online, elected officials and other policymakers need to recognize that anti-fluoride activists have created a web-based panoply of false fears. For many fluoride critics, these online messages are the source of their concerns. This spring, for instance, a New York resident wrote a letter to his local newspaper, saying he “was surfing the Web and came across information on water fluoridation and the dangers that lie within this practice.”

And

“Public officials have a responsibility to listen to their constituents. We also have a duty to not allow false fear to drive public health decisions. We should direct our constituents to reputable websites like these sites. We shouldn’t let “guess what I read on the internet” be the reason that we abandon a proven, safe practice like water fluoridation.”

Rotorua District Councillors should take Seel’s points on board as they confront their own decisions about Rotorua’s fluoridation and how to consult citizens on it (see Council votes for referendum on fluoridation).

They should also beware of the”Tribunal” trap the Hamilton City Council fell into which effectively led to them being captured by politically and ideologically motivated anti-fluoridation activists, ignoring the information from scientific and health professionals, and ignoring the views of voters. A mistake which eventually led to pressure for another referendum and a reversal of the council’s faulty decision.

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The irony of some peer-review and citation complaints

peer_review

Anti-fluoridation propagandists and other promoters of pseudoscience have a sort of “love-hate” attitude towards science and the scientific literature.

On the one hand they love to cite scientific papers they claim support their message. Very often the citation is completely unwarranted, misrepresents the paper or even distorts the findings reported. Declan Waugh stands out as a repeat offender of such misrepresentation and distortion of the literature on the fluoride issue.

But, on the other hand they sort of recognise that they cannot rely on support from the scientific literature so will often denigrate the scientific process. Sort of having a bob each way.

A sordid affair

“Penelope Paisley” at Fluoride Free Hamilton NZ  is indulging in the latter by posting a link to a news report about exposure of a “peer review  and citation ring” at the Journal of Vibration and Control (JVC). This was reported at Retraction Watch in its article SAGE Publications busts “peer review and citation ring,” 60 papers retracted.

Besides retraction of the 60 papers this exposure led to the editor in chief of the journal resigning and a  professor in Taiwan who was responsible for the ring resigning from his employment.

A sordid affair which unfortunately does happen from time to time in the scientific community. We are, after all, human.

But it is ironic for local anti-fluoride propagandists to “point the finger” at this case. Periodically they promote “their own” peer-reviewed paper from a journal with a somewhat similar scandal. I wrote about this in Peer review, shonky journals and misrepresenting fluoride science.

The hypocrisy of the complaint

The paper is Peckham & Awofeso (2014), Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention, The Scientific World Journal Volume 2014 (2014). It has been heavily promoted in the anti-fluoride social media –  “natural” health web sites, blogs, Facebook pages and Twitter.

However, The Scientific World Journal was described as a” bottom feeding” journal because of its approach to peer review and citation.  It relies on author fees, and not subscriptions, and is therefore open to the charge that it provides an easy way for unscrupulous authors to buy space for their articles. It was banned from lists of impact ratings because it allowed the unethical practice of self-citation.

So there is one irony in anti-fluoride propagandists’ exposure of  a shoddy incident in science publishing – they happy to use it to attack the scientific publishing process in general while on the other hand giving support to a similar shoddy case because it supports their word-view.

But there is another irony. “Penelope” is the on-line name used by Lynn Jordan – the  Fluoride Free NZ Committee member for Wellington. She also practices as a  cranio-sacral therapist in Wellington. Cranial-sacral therapy is an alternative or “natural” therapy which Edzard Ernst  described as more or less bogus (see Up the garden path: craniosacral therapy). I imagine that “Penelope” consults very few peer-reviewed scientific journals as part of her job. More likely she relies on “natural” health and pseudoscientific publications and on-line sites.

The irony here is that the “natural” health and pseudoscience publication industry will never have a scandal involving peer review and citation. Peer review and responsible citation is completely outside the ethos that guides them.

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“Creative” reporting of fluoridation science

duane

I am all for genuine creativity in science, and elsewhere. But some people seem to think anything goes when the are promoting their ideology or political views.

Again and again I come across campaigners , especially in areas like “natural” health, climate change denial and promotion of creationism, who seem to think “creative embellishment – or outright distortion – is OK when claim that science is “on their side.”

Here’s a typical example from Fluoride Free NZ (FFNZ) who are attempting to deny the science indicating that fluorosilicates used for fluoridation of water supplies decompose to form the fluoride anion. They are desperate to assert that fluorosilicate species remain and these “might” be toxic.

FFNZ cites the National Toxicology Program (NTP), part of the US Department of Health and Human Services. But puts words into their mouths to create exactly the opposite conclusion to tat which should be taken from that web site.

According to FFNZ:

the NTP “says the assumption that fluoridation chemicals disassociate into free fluoride ions is not supported by experimental evidence. This is good to remember when the fluoridationists claim that fluoride, is fluoride is fluoride. They are operating on belief rather than scientific fact.”

But the NTP says nothing of the sort. The page simply lists a 1999 nomination, from a “private individual”, for research to consider possible toxicity. Yes, the “private individual” gives as grounds “lack of toxicity information; assumed complete dissociation to free fluoride under normal conditions of use not supported by experimental evidence.” But that is the view of the nominator – not of NTP.

In fact, the NTP has a statement making clear that selection of an agent for study does not imply support for the nominators views:

” Selection of an agent for a study does not imply that the agent is hazardous or a potential carcinogen in laboratory animals; likewise, an agent not selected for toxicologic study by the Program should not be taken to mean that the agent is not potentially hazardous or potentially carcinogenic in laboratory rodents.”

Interestingly the cited web page includes “The following information related to “fluorosilicates  “including history from earlier or later nominations for this same agent.” Specifically  Nomination Background a pdf document “Review of Toxicological Literature.” It is a comprehensive review, but on page 4 it says:

“In water, fluorosilicic acid readily hydrolyzes to hydrofluoric acid and various forms of amorphous and hydrated silica. At the concentration usually used for water fluoridation, 99% hydrolysis occurs and the pH drops to 4.2. As pH increases, hydrolysis increases. At the pH of drinking water, the degree of hydrolysis is “essentially 100%” (Crosby, 1969; Urbansky and Schock, 2000).

H2SiF6(aq) + 4 H2O    →    6 HF(aq) + Si(OH)4(aq)”

Exactly the opposite of what FFNZ assert!

Now who is ” operating on belief rather than scientific fact.”

A clear example of extreme confirmation bias amounting to complete distortion.

For more information on the science of the decomposition of fluorosilicates in water have a read of Declan Waugh’s misinformation on fluorosilicic acid and An open letter to Declan Waugh – new mechanism for fluoride toxicity?

Credit: Thanks to Duane for the image.

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What happens when fluoridation is stopped?

Tooth fluoride protection icon isolated

When fluoride becomes incorporated in teeth, it makes the enamel more resistant to demineralization, preventing the decay process. Illustration: TuftsNow.

Anti-fluoride propagandists continually assert that fluoride is not effective in reducing tooth decay. One piece of “evidence” they rely on for this is a claim that when fluoridation is stopped dental health does not decline, But is this claim true? Does the scientific literature really show tooth decay doesn’t rise when fluoridation is stopped?

Connett misrepresents the science again

Well, here is what Paul Connett – the self-described world expert on fluoridation – claimed in our exchange (see Fluoride debate: Response to Paul’s 6th article. December 9, 2013):

“modern studies have not found tooth decay when fluoridation has been stopped in various communities.”

In chapter 5 of his book The Case Against Fluoride he provided more detail:

“there is no evidence that where fluoridation has been started and stopped in Europe there has been a rise in tooth decay. Indeed, two studies published in 2000, from Finland and the former East Germany, show that tooth decay continued to decline after fluoridation was halted.11,12 There have been similar reports from Cuba13 and Canada’s British Columbia.14

Pretty definite claim isn’t it? “No evidence” of the expected increase in tooth decay after fluoridation is stopped. And he cites scientific reports to “prove” his claim. But what do those four scientific reports actually say? Let’s look at each one in order and, unlike Connett, I will quote from the papers.

11. L. Seppä, S. Kärkkäinen, and H. Hausen,Caries Trends 1992–1998 in Two Low-Fluoride Finnish Towns Formerly with and without Fluoridation.” Caries Research 34, no. 6 (2000): 462–68. I can’t find the full text, or even an abstract, for this paper but the authors commented on this research in Seppa et al (2002). They found their “longitudinal approach did not reveal a lower caries occurrence in the fluoridated than in the low-fluoride reference community.” But commented:

“The main reason for the modest effect of water fluoridation in Finnish circumstances is probably the widespread use of other measures for caries prevention. The children have been exposed to such intense efforts to increase tooth resistance that the effect of water fluoridation does not show up any more. The results must not be extrapolated to countries with less intensive preventive dental care.”

12. W. Künzel, T. Fischer, R. Lorenz, and S. Brühmann,Decline of caries prevalence after the cessation of water fluoridation in the former East Germany Community Dentistry and Oral Epidemiology 28, no. 5 (2000): 382–89. These authors found no increase of caries in two German cities after fluoridation of water was stopped. But again the authors suggest why:

“The causes for the changed caries trend were seen on the one hand in improvements in attitudes towards oral health behaviour and, on the other hand, to the broader availability and application of preventive measures (F-salt, F-toothpastes, fissure sealants etc.).”

13. W. Künzel and T. Fischer,Caries Prevalence after Cessation of Water Fluoridation in La Salud, Cuba.  Caries Research 34, no. 1 (2000): 20–25. Again this study found no increase in caries after stopping fluoridation but the authors suggested why:

“A possible explanation for this unexpected finding and for the good oral health status of the children in La Salud is the effect of the school mouthrinsing programme, which has involved fortnightly mouthrinses with 0.2% NaF solutions (i.e. 15 times/year) since 1990.”

14. G. Maupomé, D. C. Clark, S. M. Levy, and J. Berkowitz,Patterns of dental caries following the cessation of water fluoridation.” Community Dentistry and Oral Epidemiology 29, no. 1 (2001): 37–47. The authors reported “Caries incidence . . .  was not different between the still-fluoridating and fluoridation-ended communities.” However, they considered other factors and limitations in their own study and concluded this issue was complex:

“Our results suggest a complicated pattern of disease following cessation of fluoridation. Multiple sources of fluoride besides water fluoridation have made it more difficult to detect changes in the epidemiological profile of a population with generally low caries experience, and living in an affluent setting with widely accessible dental services. There are, however, subtle differences in caries and caries treatment experience between children living in fluoridated and fluoridation-ended areas.”

So when we actually read these cherry-picked reports we find that, while no increases in tooth decay were found after fluoridation stopped, in all 4 cases this was attributed to the existence of other sources of fluoride and fluoride dental treatments. This is a similar situation to that I reported about one of Colquhoun’s papers in my recent article Fluoridation: what about reports it is ineffective? In that case all children from non-fluoridated areas had been given six-monthly dental fluoride treatments whereas most children from fluoridated areas had not. So the lack of an effect due to fluoridation is hardly surprising.

Read scientific literature critically and intelligently

This underlines the need to always read the scientific literature critically and intelligently, doing our best to avoid confirmation bias and cherry-picking. Perhaps that was Connett’s mistake – he was just selecting reports supporting his bias without being aware of these details. However, in his book he says:

“The ADA claims that in cases where fluoridation has been halted and no increase in tooth decay observed, other steps have been taken to fight tooth decay.”

So these details had been brought to his attention. But it did not stop him misrepresenting the scientific reports he cited. Nor has it stopped him continuing this misrepresentation, even today. All he has done is to attempt a diversion when these details arise:

“Whether or not that is the explanation, European countries have clearly demonstrated that there are other ways of reducing tooth decay without forcing everyone to take a medicine in their drinking water.”

He had the same response in our exchange when I pointed to the role of other fluoride treatments in these studies. Connett attempts to avoid the issue of his misrepresentation of the published science to support his claim that fluoride does not help prevent tooth decay – by acknowledging fluoride can be beneficial but pretending the argument was about the mode of delivery when it wasn’t!

Connett’s reference to ADA is actually to their booklet Fluoridation Facts. It appears the he has read page 15 – What happens if water fluoridation is discontinued. He has taken the 4 citations he uses from that page. But tellingly he ignores completely another 5 citations reporting deterioration of oral health when fluoridation was stopped. He cannot have missed those citations – in this case his cherry-picking amounts to dishonesty.

Studies do show increase in tooth decay when fluoridation stopped

The ADA booklet referred to above answers its question about the consequences of discontinuing fluoridation this way:

“Over time, dental decay can be expected to increase if water fluoridation in a community is discontinued, even if topical products such as fluoride toothpaste and fluoride rinses are widely used.”

In Fluoride debate: Ken Perrott’s closing response to Paul Connett? I discussed one of the ADA cited papers which did show an increase in tooth decay –  Attwood and Blinkhorn (1991),“Dental health in schoolchildren 5 years after water fluoridation ceased in South-west Scotland.”  They measured dmft and DMFT – decayed, missing and filled teeth in primary and permanent teeth respectively.

The figures below illustrate the data from this paper which compared changes in oral health of two Scottish towns  in both 1980 and 1988. One town, Annan, had never had fluoridated water while the other, Stranraer, had it until 1983. This enabled the effects of both cessation of fluoridation and the generally observed improvement in oral health due to other factors to be compared and considered. The graphics show the results for 5 year old and 10 year old children.

Decayed missing and filled deciduous teeth for 5 year olds. Stranraer fluoridated until 1983. Annan not fluoridated.

Decayed missing and filled teeth for 10 year olds. Stranraer fluoridated until 1983. Annan not fluoridated.

The plots indicate aspects of the complexity of these sort of studies. Because 2 different towns were compared it was possible to measure the decline in oral health after discontinuation of fluoridation against a background of the general improvement in oral health, even in a non-fluoridated situation.

The moral here is don’t accept at face value the claims made by anti-fluoridation propagandists – even if they, or their supporters, insist the propagandist is “the world expert on fluoridation.”

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Controversial IQ study hammered in The Lancet

I have discussed the paper by Grandjean & Landrigan (2014) before in the article Repeating bad science on fluoride. So have other bloggers and commenters. On the other hand anti-fluoride propagandists are still promoting it heavily in social media and “natural” health web sites.

But the cogs of science publishing have ground slowly on and the scientific critiques are starting to appear. The last issue of The Lancet (which published the original paper) has several articles in the correspondence section critical of the paper (see Neurodevelopmental toxicity: still more questions than answers). Two of these related to claims made about fluoride.

Unsubstantiated claims, misquoted studies

Virginia Feldman wrote that the authors:

“make unsubstantiated claims and misquote previous studies to pull together heterogeneous elements and drugs into a group of substances termed neurotoxicants.

The investigators’ claim of new data is undermined by 24 of the cited references being their own previous, mostly review articles . . . . . . Their “strong evidence” for adding fluoride was a finding from Grandjean’s own review of older Chinese studies. Contrary to their statement—“Confounding from other substances seemed unlikely in most of these studies”—findings from many previous meta-analyses have shown the faults of using intelligence quotient (IQ) data from countries with highly polluted air and water; non-validated IQ tests; poor controls for parent IQ, socioeconomics, and other variables; and studying mega-doses in animals and in human beings. By contrast with this review of Chinese studies, all of problematic methodological robustness, more than 3000 studies of the safety of water fluoridation stretch over 65 years. During this time, as fluoridation increased from 0% to 72% of US households, average US IQs have not decreased, but have instead increased by 15 points.”

She also directs the authors’ attention to a paper by one of their frequent co-authors, David Bellinger, about determining IQ points lost (Grandjean & Landrigan 2014 claimed fluoride can cause a 7 point drop in IQ). Bellinger specifically says the meta-analyses of the sort used by Grandjean & Landrigan (2014) are just not suitable for calculating IQ points lost.

Unacknowledged research

Julianna Gelinas and Myron Allukian were also concerned about the authors’ reliance on very flimsy evidence. The “claim that fluoride might cause neurodevelopmental harm” is “based on only one paper, of which Grandjean is a coauthor.” Further describing the limitations of that study they say “it contains several flaws that undermine its credibility and calls into question its applicability to the community water fluoridation programme in the USA.”

“The study is a meta-analysis of 27 cross-sectional studies done in poor, rural communities in China, Mongolia, and Iran, countries where the drinking water contains high levels of naturally occurring fluoride. The 27 original studies did not adequately control for a variety of intervening and confounding variables that could have affected intelligence quotient (IQ) scores, such as parents’ education and socioeconomic status and air and water pollution. It is unfortunate that Grandjean and Landrigan did not mention these limitations.

Additionally, they did not clearly state that the reference groups in their article use water fluoridated at about the recommended level. Thus, another interpretation of their analysis could be that communities fluoridated at the recommended level have a higher IQ.”

Nor did Grandjean and Landrigan acknowledge research showing fluoride was not harmful:

“No credible scientific studies show a relation between fluoride consumption and IQ levels; however, several have shown that fluoride ingested at recommended levels is not harmful. Grandjean and Landrigan did not acknowledge the animal study that showed no evidence of a neurotoxic effect of fluoride, even at levels up to 230 times the recommended concentration; an earlier study showing that fluoride causes no harm to children; two formal reviews that delineate weaknesses in the Chinese fluoride and IQ studies; and the conclusion by one of these sets of investigators that biological plausibility for a link between fluoridated water and IQ has not been established.”

Request for statement on fluoridation

They are also concerned at the way the original paper is being used by anti-fluoride propagandists:

Unfortunately, Grandjean and Landrigan’s Review has been aggressively and improperly used by antifluoridationists to frighten the public about the effects of fluoridation, a well-established public health measure that has been shown to be cost-effective and safe. As a result, the public’s oral health, especially that of the most vulnerable people, is put in jeopardy. . . .

A statement from Grandjean and Landrigan clearly stating that their addition of fluoride to their list of neurotoxins does not apply to fluoridation at the recommended levels of 0·7—1·2 ppm would clarify our concerns on the misuse and misinterpretation of their paper.”

The authors’ response to these criticisms was brief and rather flippant.  They claim other reviewers of their meta-analysis were “without access to important background information” – without providing information on this. They dismissed Feldman’s reference to the increase in population mean IQ as a “serious error” – again without justification or explanation.

The remained silent about the way they had relied on very few sources, often their own, in their review.

So some important criticisms of the original paper and ones that the authors did not respond to properly. But will this stop anti-fluoride propagandists relying on this paper – one that very few of them have bothered reading?

I doubt it.

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New group challenging the anti-science brigade

Here’s a recent press release from a new group, The Society for Science Based Healthcare, which is having some successes in challenging anti-scientific advertising.


ASA2s

Controversial Church Caught Red Handed

The Advertising Standards Authority (ASA) upheld three complaints from the newly formed Society for Science Based Healthcare today regarding misleading health claims.

The Universal Church of the Kingdom of God, DailyDo and Pure Wellbeing have all been asked by the ASA to remove adverts that make misleading health claims.

The Universal Church of the Kingdom of God, which was recently embroiled in controversy regarding claims that its holy oil could heal a variety of serious health problems, has had a second complaint upheld against it. Bishop Victor Silva, when responding to a previous successful ASA complaint, had promised that:

“When we come to hold another similar event, we will take external advice as to the content of any promotional material to doubly ensure that it is fully compliant with all regulation and that there is no chance of another complaint of this nature.”

Despite these assurances, within 3 weeks of this promise the church sent out another advertisement for a “chain of prayer” series of events. This advert claimed that “IT WORKS!” and that a “HEALING” session covered cases such as “When doctors & medicines are not enough” and “incurable diseases”. A majority of the complaints board agreed that “the Advertiser had presented their religious beliefs in evangelical healing as an absolute fact, rather than opinion, and may mislead and deceive vulnerable people who may be suffering from any of the illnesses listed in the advertisement”. The board ruled to uphold the complaint.

DailyDo, a daily deals website, advertised amber teething necklaces with phrases such as “Traditional homeopathic treatment for teething babies, designed to help provide relief”. As the advertiser was unable to provide any evidence to support their claims, the ASA ruled that “the advertisement was misleading and had not been prepared with the high standard of social responsibility required for products with intended therapeutic use”.

This is the latest in a long series of successful complaints regarding misleading health claims about amber beads, which resulted in a new ANZA guideline being written. In response to the complaint, the ASA has sent a copy of this guideline to other “one day deal” sites.

A number of advertisers of these products, such as Baa Baa Beads, have had complaints upheld against them but have refused to remove their misleading claims. Now that the Fair Trading Act has been recently updated to prohibit unsubstantiated claims in trade, the Society for Science Based Healthcare hopes that the Commerce Commission will step in to put a stop to claims such as these. The Society intends to file a complaint with the Commerce Commission against companies that continue to make these misleading claims.

The Pure Wellbeing website advertised Detox Foot Patches, claiming that they could remove “toxins” and heavy metals “By stimulating the reflexology points and the blood circulation”. Because the advertiser failed to provide any evidence that the claims they were making were true, the complaints board ruled that the advertisement was misleading and must therefore be removed, upholding the complaint made against it.

There were also two settled complaints from the Society for Science Based Healthcare, against a homeopathy advert by Ngaio Health and a colour therapy advert by Colour Therapy Manukau. Both companies had claimed that they were able to treat serious health conditions such as cancer, but did not substantiate these claims. In both cases the company agreed to remove the claims.

The Society for Science Based Healthcare welcomes these decisions, and hopes that the advertisers involved will take them to heart and refrain from making misleading health claims in the future. These are the latest in a long line of complaints about misinformation regarding healthcare, and as there is still plenty of misinformation out there you can expect to hear more from the Society in the future.


About the Society for Science Based Healthcare

The Society for Science Based Healthcare is a newly formed consumer advocacy group that aims to protect consumers’ rights to make informed healthcare decisions. Although the society itself is new, over the past 2 years its founders have lodged over 50 successful complaints with the ASA regarding misleading health claims, dealing with products and services ranging from chiropractic and acupuncture to magnetic mattress underlays and a quantum magnetic health analyser.

Mission statement

“We believe that a strong basis in rigorous science is a necessary prerequisite for providing safe and effective healthcare. Decisions regarding public funding of healthcare in New Zealand should therefore be science based. We support public health measures that have a clear basis in science and evidence, and oppose those that do not.
We will work to counter misinformation about health issues propagated by individuals and organisations in New Zealand.
Consumers have the right to make an informed decision about their healthcare, and should not have to worry about being misled by unsubstantiated claims.”

Relevant links

Society for Science Based Healthcare – http://sbh.org.nz
Advertising Standards Authority – http://www.asa.co.nz
Universal Church of the Kingdom of God – http://www.uckg.co.nz/
DailyDo – http://www.dailydo.co.nz/
Pure Wellbeing – http://www.purewellbeing.co.nz/

Upheld Complaints:
http://asa.co.nz/display.php?ascb_number=14219
http://asa.co.nz/display.php?ascb_number=14205
http://asa.co.nz/display.php?ascb_number=14250

Settled Complaints:
http://asa.co.nz/display.php?ascb_number=14266
http://asa.co.nz/display.php?ascb_number=14290

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