Fluoridation – the violation of rights argument.

Fluoride_YourNotGoingToPoisonOf all the arguments anti-fluoridationists advance this is the one I have the most sympathy for. The idea that such matters should be left to personal responsibility and not imposed on everyone.

Partly because I see it as the most honest argument – it is specifically appealing to values and political viewpoint and, presumably, should be argued out in that arena. People  have different reactions to the argument and, being a political question, is should properly be decided democratically.

But also because it, in effect, puts aside the controversy generated by pseudo-scientific claims. It faces up to the real underlying political problem and gets away from the use of a manufactured scientific controversy as a proxy for the political and values judgements that Sir Peter Gluckman referred to in this comment (see What is in the water? for full text):

“The misuse or inappropriate and alarmist use of science is a classic example of science being a proxy for values debates.” (See Poisoning the well with a caricature of science).

In effect the Fluoride Action Alert NZ group (FANNZ) used this argument in the last of their 7 objections to fluoridation (see 7. Fluoridation is enforced medication without your consent). Although their description of fluoridation as “medication” is aimed at getting a certain emotional reaction. In reality fluoridation corrects for a natural deficiency – fluoride is usually considered a beneficial (for bone and oral health) trace element and not a “medicine.”

The libertarian argument

Brian Edwards used this rights argument in a radio discussion on Monday afternoon (listen to the audio at The Panel with Dr Brian Edwards and Michelle Boag (part 1) ). He wasn’t interested in the scientific claims, believed he had a right to “fluoride free water” and objected to fluoridated water being imposed. If someone wanted added F they have the responsibility to fluoridate their own water or find other treatments. It is the classic libertarian argument with which some people agree, or are tempted to agree.

But libertarianism can be taken to a ridiculous extremes – most practical libertarians will resist that and take a more moderate position. Consider these points Brian:

  • Do you also believe you should not have chlorinated or deflocculated water imposed on you? Do you think such treaments should be left to the individual?
  • Fluoride-free water is just not a possibility – we live in a soup of chemicals and nothing is completely free of such elements. For example, the Waikato River water used in Hamilton naturally contains around 0.3 or 0.4 ppm F. Sometimes peaking around 0.6 ppm F. Fluoridation simply supplemented this to achieve levels of 0.7 – 1.0 ppm – considered the safe and beneficial level by health authorities.
  • So what do you want Brian? That Hamiltonians receive the Waikato river water exactly as it comes (not F-free and, if he objects to chlorination and flocullation, with its normal load of harmful organisms and colloids)? Or does he insist that the water be treated to remove these low natural levels of F (and presumably the colloids and harmful organisms)?
  • And imagine this scenario – if the local geology was such that the natural water supplies had excessive levels of F ( say above 1 – 4 ppm – it happens) would you insist that it not be treated to remove such high levels? That such treatment would be an unjustified imposition violating your rights? And if it were to be treated to remove excessive amounts of F, will you demand that the level be dropped to exactly zero (the impossible F-free level) or would you accept dropping it to say 0.7 ppm F?

Very often the libertarian ideal is just not possible, Brian. And that is only considering the factual information science provides. There is still the overriding issue for libertarians of personal vs social responsiblity. The fact that it is the socially and economically disadvantaged section of society that benefits most from fluoridation. Libertarians usually argue these people should fend for themselves – remember the discussion on school meals?

In the end, while science can inform us about the reality of fluoridation, it can’t decide our values for us. That is best done by the democratic process and quite rightly the personal vs social responsibility views will drive that debate and influence the final decision.

Genuine concern or fear

Realistically I accept that some people take up positions on these sorts of issues out of genuine concern, or even fear. Consider the opposition to cell phone towers near schools and homes. Despite the best arguments of radiation specialists and the phone companies residents are often still concerned, or even afraid. Should authorities go ahead and impose towers on these people regardless (because after all the science supports them)? Or should the issue be decided democratically?

I think the latter for two reasons.:

  1. Even where the science says things are safe the fear or concern people have is real. It may arise out of ignorance or being misinformed (that’s going on a lot in the fluoridation debate). It might be concern that there are effects science is so far unaware of. Or it might just be the understandable fear of the new.
  2. Whatever the source of the concern or fear we have to recognise that it is, in psychological terms, a real effect. I understood this several years ago when I was considering a surgical procedure. My surgeon dealt with all the usual concerns, showed me why each one was not valid and that the procedure was safe. But I still had some concerns about possible unknown effects. His advice was that my residual fears were really psychological, but real. I should therefore not go ahead.

So, I think that on issues like cell phone towers, WiFi and fluoridation, if a majority of the people involved have real concerns or fears they need to be listened to. Even if those fears are groundless or misinformed authorities should not go ahead with their plans just because they “know better.” They must recognise the reality of the psychological effect.

The need for good information

This approach raises questions of the responsibility of authorities, experts and scientists to communicate with the public – especially when new treatments or equipment are being planned. The reality is that we are all naturally somewhat conservative and suspicious of new things. There are also a number of politically or ideologically motivated groups who cultivate people’s fears and promote a anti-science or pseudo-science approaches.

The fluoridation issue illustrates just how widespread anti-science and pseudoscience thinking is these days. Google “fluoridation” and you find that most hits seeking to give information are from groups like Fluoride Alert – anti-fluoridation activists. Very few are reliable scientific sources. It’s just so easy for the innocent layperson to be misinformed.

Recent polling in New Zealand still show many more people support fluoridation than oppose it – which I guess says something for the common sense of New Zealanders. Perhaps we are developing the ability to recognise the snake oil salespeople on the internet.

Scientists can do a lot to encourage this sort of commonsense by participating in the public debate on these issue and helping to inform it. Despite the fact that, as Gluckman says, “The misuse or inappropriate and alarmist use of science is a . . .  proxy for values debates” that distortion and misinformation can have an effect. Where possible scientists and other experts in these areas should be helping to expose it.


NOTE: The fluoridation issue this time around was sparked by the recent decision of the Hamilton City Council to stop fluoridating Hamilton’s water supply. Hamiltonians reacted with concern and a petition calling for a Citizen’s Initiated referendum on the issue has obtained 1000 more signatures than required. So it looks like Hamilton will get its public debate on fluoridation (again) and a democratic decision – most likely at the next local body elections (see Fluoride referendum petition gains numbers).

See also:

Fluoridation
Poisoning the well with a caricature of science
Fluoridation petition – for Hamilton citizens

Getting a grip on the science behind claims about fluoridation
Is fluoride an essential dietary mineral?
Fluoridation – are we dumping toxic metals into our water supplies?
Tactics and common arguments of the anti-fluoridationists
Hamilton City Council reverses referendum fluoridation decision
Scientists, political activism and the scientific ethos

30 responses to “Fluoridation – the violation of rights argument.

  1. Pingback: Colin's Folly

  2. ANOTHER RESPONSE TO FLOURIDATION – THE PROMOTION OF CHILDREN’S RIGHTS FOR GOOD DENTAL CARE.

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  3. Frank, I think promotion of children’s rights to care and good health should be happening all the time. It doesn’t really have anything to do with fluoridation which is about correcting a deficiency.

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  4. Excellent post. Well done!

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  5. If water has a fluoride deficiency then it is deficient in dozens of elements.
    The deficiency claim is probably one of the wackiest I’ve heard. Just more pseudoscience.

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  6. Hmm, surely you aren’t that thick, Gus. Deficiency refers to intake – not water. It’s just that for F, and for most people, water provides the majority of the intake of F. If it is below 0.7ppm consumers are likely to be getting insufficient F for the bone and oral health. In NZ this is the case, but not in all countries. Excess can also be a problem.

    That is what the science indicates.

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  7. So, Ken, in that case you’ll be advocating the addition of selenium and iodine, to name two essential nutrients that are deficient in New Zealand… fluoride is not a recognised essential nutrient.

    Ken, you beginning to sound like the cheer leader for the dietary supplement industry… mandatory supplementation is an interesting concept.

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  8. You really are at a loss, Ron. Trying to pick a fight with your own straw men. Pathetic!
    Now, I didn’t call F an essential element, although that is debatable as definitions are a bit hazy. Here is actually what I said – and really I shouldn’t have to repeat it:
    “In reality fluoridation corrects for a natural deficiency – fluoride is usually considered a beneficial (for bone and oral health) trace element and not a “medicine.”
    Notice that the word “essential” is not present. Your speed reading is letting you down again.
    The question of use of Cl2 is not a wild diversion. Plenty if people use filters precisely to remove the taste of Cl2. As a chemist I personally see more danger (although small) from products of oxidation of organic matter by Cl2 than I do from the very low levels of F. I would prefer if UV or H2O2 were used. These methods have replaced Cl2 in a number of industries.
    Nor is the question of removing high levels of F – it has to be done by some authorities overseas to keep the public water supply within the standards. If the fertiliser companies do add the HFSA back into their fertiliser in large amounts I could imagine it eventually happening here.
    These are real questions for libertarians.
    But of course, in the end democratic decisions hopefully prevail and libertarians are only one of the groups with an input.

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  9. Ken, I didn’t say you said it was essential… what I said was that if you see a benefit for making addition of fluoride mandatory then surely you’d see a benefit for adding essential nutrients that are deficient such as selenium and iodine.

    It’s simple really… you’re advocating mass mandatory dietary supplementation… via the water supply. Go Ken!

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  10. No, Ron, you are fighting with the straw man you created.

    It is a pathetic sight.

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  11. So why do you advocate supplementing our drinking water with fluoride but not selenium?

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  12. Ron is going to run out of hay at this rate.

    The “Straw Man” Fallacy

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  13. Cedric, are you denying that Ken is advocating mass dietary supplementation via the water supply?

    If so, I presume you believe it is mass medication.

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  14. I see at least one of the underemployed has surfaced this afternoon.

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  15. Hi Ken. Enjoy your nap?🙂

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  16. Never presume. The best way to find out what Ken is advocating to to quote the man himself.
    Quote him in context. Quote him in detail.
    Stop being a dick.
    Simple really.

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  17. Haaaa Haaaa! People are fluoride deficient! Incredible. First they say NZ waters are deficient and when challenged now you say people are deficient. Ken I nearly doubled over in laughter. I’m in stitches Your’e trapped in your fluoride philosophy. Thanks for the mirth – it really feels good!

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  18. You seem confused, Gus?

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  19. OK Ken – how much water must I drink to get the right amount of fluoride?

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  20. Gus, the recommended range for water supply is calculated so that one would have to drink unreasonably large amounts to get close to the maximum recommended intake of F. Amd that includes large safety factors. Considering that the water supply will be around 0.7 ppm and your toothpaste 1500 ppm or more you would be silly to worry about he water.

    But the concept of a “right amount of F” is probably silly. Do you worry about getting the “right amount” of I? Se?, H2O?, P? S?

    It’s a silly question.

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  21. Plenty people get too much fluoride like tea drinkers and bottle fed babies and those people with fluorosis. So now you want to give them even more. This is why many doctors are now speaking out against fluoridation.

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  22. Yes, high F intake can cause fluorosis, particularly when taken young. It is a problem in some parts of China and the US because of naturally high levels in diets. Fluorosis occurs in unfluoridated areas as well as fluoridated ones – but that associated with fluoridation is extremely mild, probably only recognised by a dentist.

    My reading suggests that it is the alternative sources of F intake, rather than fluoridated water, which is causing some problems. The assessment still seems to be that fluoridation of water supplies is still the best and safest approach in many, not all, areas. But there is some concern about how to ensure other methods like topical application dental procedures, fluoridated salt and sweets, etc, can be managed to limit excessive intake. Personally I can see a future in NZ where our dietary F increases sufficiently that fluoridation of water my no longer be required. But are the current activists going to be happy this is caused by the practice of fertiliser companies adding the HFSA back into their products?

    Regarding bottle fed babies. this is only a problem when bottle feeding is 100% of their intake. In such situations other elements in our water supply could also be a problem and I can understand recommendation to use bottled or filtered water for preparation. Such assessments are based on a recommended maximum intake (and for other elements as well) calculated using large safety factors. The recommendations for F would not be exceeded where bottle feeding only supplemented breast feeding.

    Some doctors and dentists do speak out – but only sme, the majority support fluoridation. This means you should critically assess who is speaking and what they say and not be dazzled by the title. An example is Anna Goodwin, who speaks for the anti-F activists locally and nationally. She is an oncology trained doctor (not a full oncologist I think). Her chemistry is naive to say the least – recommending that CaF2 is a safe chemical – 2 gm is harmless, whereas HFSA is corrosive, etc. she doesn’t seem to understand that the F in our water supply is present as F anion, not HFSA. She also claims the HFSA is loaded with toxic elements which is just not true. Finally she claims to have had her road to Damascus conversion to anti-F beliefs in the last few months.

    Now why should you be impressed by her just because she has a doctorate in a completely unconnected subject.

    By he way, she also promotes the lie that the Nazis invented fluoridation for subduing inmates if their camps and the US government uses it to create a docile population.

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  23. Ken – one of your best comments. I’m really concerned about bottle fed babies. Plenty of parents of bottle fed babies don’t know and cannot afford to buy water. These babies are our future. Let’s play it safe and stop adding fluoride to the public water supply.

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  24. Actually, just buying bottled water is not necessarily the solution because it may have higher concentrations of F and other elements than tap water anyway. Don’t forget public water supplies are treated and adjusted to meet health standards – spring waters, etc., are not. This is not a problem for occasional use but could be if it were a major component of a families H2O intake..

    I noticed that Belgium health authorities are expressing concern on this because to legislate to control standards for bottled water could destroy the special quality of that water.

    These babies are our future and that is one good reason that F deficiencies shouldn’t interfere with their health. I know from experience what heel bad teeth are for children – you probably cannot comprehend the suffering. The effects last on in life.

    I personally don’t see any real problem with bottle fed babies because the standards here are so low and there are large safety margins. But any concerned parents probably already use bottled or filtered water anyway.

    But here’s a thought. What are all those activists Hamiltonians doing with their water filters/ion exchangers now? Have they thrown them away because no more F is being added? Or do they still want to ensure removal of the natural F? Or do they have wider reasons for treating their water, such as taste and other elements?

    I rather suspect those who use such filters will continue to do so. I certainly would.

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  25. Ken, even the MOH advised the HCC about concerns with babies… the margins of safety are not huge at all…

    By the way, I gather, in the interests of public health safety, you’ll be advocating for the prohibition of red meat sales in our food stores.

    http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=10894919

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  26. Ken, did you note this in the NZHerald article you referred to,..

    “The other issue was babies,” Hardaker says. “Advice from the Ministry of Health was that children under 3 should not ingest fluoride and that babies under 6 months should not be exposed to fluoride via bottle-fed formula.”

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10895050

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  27. By the way, I gather, in the interests of public health safety, you’ll be..

    Never presume. Never “gather”.
    The best way to find out what Ken is advocating is to quote the man himself.
    Quote him in context. Quote him in detail.
    Stop being a dick.
    Simple really.

    The “Straw Man” Fallacy

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  28. Pingback: Fluoridation and conspiracy theories | Open Parachute

  29. Pingback: Fluoridation – topical confusion | Open Parachute

  30. Pingback: Hamilton gets its fluoridation referendum | Open Parachute

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