Fluoride debate Part 1: Connett

Ken Perrott’s response to this article is at Fluoride debate Part 1: Perrott


Connett versus Perrott Internet Debate on Fluoridation.

This is part 1 of a five-part series of internet exchanges on the fluoridation debate between Paul Connett (USA) and Ken Perrott (NZ).

1. Fluoridation is a poor medical practice.

2. The evidence that swallowing fluoride reduces tooth decay is very weak. Better alternatives for fighting tooth decay

3. The large database that indicates that fluoride can impact the brain of animals and humans.

4. Other health concerns and the lack of an adequate margin of safety to protect everyone drinking fluoridated water.

5. Key moments since 1990 that should have forced an end to fluoridation.

Paul Connett is co-author of The Case Against Fluoride (Chelsea Green, 2010) and executive director of the Fluoride Action Network ( www.FluorideALERT.org ) Paul’s cv and list of publications is attached.

Part 1. Fluoridation is a poor medical practice

 

Introduction. Using the public water supply to deliver medical treatment is a very unusual practice. In fact it has only been done only once before and that was a short trial in which iodine was added to the drinking water to help fight hypothyroidism. However this was quickly abandoned when it was found that some people were being over-exposed to iodine. Since then fluoridation has been the only example. The reasons for not using the water to deliver medical treatment are fairly obvious.

1) It is impossible to control the dose people get. Once a chemical is added to the water to treat people (as opposed to treating the water to make it safe or palatable to drink) it is impossible to control the dose people get. People drink very different amounts of water. In short, engineers at the water works can control the concentration added to the water (mg/liter) but no one can control the total dose (mg/day) individuals receive.

2) It is totally indiscriminate. It goes to everyone regardless of age, regardless of health or nutritional status. Of particular concern is that it goes to people with poor kidney function who are unable to clear the fluoride from their bodies via the kidneys as effectively as others. It thus accumulates in their bones more rapidly. It also goes to people with low or borderline iodine intake, which makes them more vulnerable to fluoride’s impact on the thyroid gland. In general, according to studies done in India, people with poor diet (low protein, low calcium and low vitamin intake) are more vulnerable to fluoride’s toxic effects.

3) It violates the individual’s right to informed consent to medical treatment. This is a very important medical ethic which is fully described on the website of the American Medical Association (www.AMA.org). It is very surprising that so many medical doctors standby while the community does to everyone what they are not allowed to do to a single patient.

The above arguments would apply to any medicine added to the drinking water but there are other aspects to the fluoride ion, which makes it particularly unsuitable for addition to the drinking water.

 4) Fluoride is NOT a nutrient. There is not one single biochemical process in the body that has been shown to require fluoride for normal function (we will see later that fluoride’s predominant action on teeth is topical not systemic). However,

5) There are many biochemical processes that are harmed by fluoride (given a sufficient dose). These include the inhibition of many enzymes. This is the reason that some of the earliest opponents of fluoridation were biochemists like Professor James Sumner from Cornell University, who won the Nobel Prize for his work on enzyme chemistry. More recently fluoride has been shown to activate G-proteins and interfere with the cell’s messaging systems. It can also cause oxidative stress. An excellent summary of fluoride’s biochemistry can be found in the article “Molecular Mechanisms of Fluoride Toxicity” by Barbier et al, 2010.

6) The levels of fluoride in mothers’ milk is extremely low. This level, on average for a woman in a non-fluoridated community, is 0.004 ppm (NRC, 2006, p.40). This means that a bottle-fed baby in a fluoridated community (at 1 ppm) will get about 250 times more fluoride than a breast fed baby in a non-fluoridated community. Bearing in mind the fact that life emerged from the sea where the average level of fluoride is about 1.4 ppm, and thus there was no impediment for nature to use fluoride when developing human metabolism, her verdict appears to be that the baby a) does not need fluoride and b) that it may be harmed by fluoride. In my view, it is more likely that nature knows more about what the baby needs than a bunch of dentists from Chicago or public health officials in Washington, DC.

7) Fluoridation has always been a trade-off between lowered tooth decay and dental fluorosis but a key question was never satisfactorily answered. When the fluoridation trials began in 1945 it was known that the trade off was that approximately 10% of the children would develop dental fluorosis in its mildest form (this was a mottling or discoloration of the tooth enamel). While the mechanism whereby fluoride caused this effect was not known it was known to be a systemic effect. In other words it was caused by fluoride interfering with biochemistry during the development of the tooth cells. The question that was not answered before the US Public Health Service endorsed fluoridation in 1950, was: “What other tissues in the body may be interfered with at the same time that fluoride was interfering with the laying down of the tooth enamel?” Were the baby’s bone cells also being impacted? How about brain cells? How about the cells of the glands in the endocrine system? Sadly, very little has been done in fluoridated countries to answer these questions since fluoridated was started. However, proponents do acknowledge that the appearance of dental fluorosis means that a child was over-exposed to fluoride before the permanent teeth have erupted. Meanwhile, in 2010 the CDC reported that 41% of American children aged 12-15 have dental fluorosis, with 8.6% having the mild form (with up to 50% of the enamel impacted) and 3.6% with moderate or severe dental fluorosis (100% of the enamel impacted).  In later arguments in this debate I will be presenting evidence that fluoride is capable of harming other developing tissues.

 8) The fluoridating chemicals used to fluoridate the water supply are not the pharmaceutical grade chemicals as used in dental products. Most of the chemicals used are obtained from the phosphate fertilizer industry’s wet scrubbing systems (see Chapter 3, The Case Against Fluoride). One of the problems with this source is that it is contaminated with a number of other toxic chemicals including arsenic. Arsenic is a known human carcinogen and as such for the US Environmental Protection Agency (EPA) there is no safe level. The EPA’s maximum contaminant level goal (MCLG) for drinking water is thus set at zero. Proponents will argue that after the dilution of these bulk chemicals by about 180,000 to 1, the level of arsenic is negligible. However it is not zero and thus this practice will inevitably increase cancer rates in the population. As there are other delivery systems which are cost-effective and do not involve the use of these industrial grade chemicals, increasing the cancer rate even by a small amount is not acceptable.

9) Worldwide fluoridation is not a common practice. Proponents will often imply that fluoridating the drinking water is a common practice. It is not. Most countries do not fluoridate their water. 97% of the European population is not forced to drink fluoridated water. Four European countries have salt fluoridation (Germany, France, Switzerland and Austria), but the majority of European countries have neither fluoridated water nor fluoridated salt, yet according to World Health Organization (WHO) data available online (measured as DMFT in 12-year-olds) tooth decay rates in 12-year-olds have declined as rapidly over the period 1960 to the present in non-fluoridated countries as fluoridated ones and there is little difference in tooth decay rates today (see Cheng et al, 2007). The reasons that European spokespersons have given for not fluoridating their water are usually twofold: a) they do not want to force fluoride on people who don’t want it and b) there are still many unresolved health issues (see a list of statements by country at http://fluoridealert.org/studies/caries01 ).

10) Typically fluoridation is promoted via endorsements not via sound science. When the US Public Health Service (PHS) endorsed fluoridation in 1950, before a single trial had been completed and before any meaningful health studies had been published, it clearly was not the result of solid scientific research. However the PHS endorsement set off a flood of endorsements from other health agencies and professional bodies (see Chapters 9 and 10 in The Case Against Fluoride). Most of these came between 1950 and 1952. These endorsements were not scientific but simply reflected a subservience of public policy to the US government.  However, promoters of fluoridation for over 60 years have used these endorsements very effectively with the general public as if they were coming from scientific bodies reflecting thorough and comprehensive scientific research. Very seldom is this the case.  Hopefully, in these exchanges with Ken Perrott we will both focus on what the primary science actually says and not what some “authority” has to say about the matter.

References:

Barbier et al., 2010. Molecular Mechanisms of Fluoride Toxicity. Chem Biol Interact. 188(2):319-33 http://www.ncbi.nlm.nih.gov/pubmed/20650267

CDC, 2010.  Beltrán-Aguilar,Prevalence and Severity of Dental Fluorosis in the United States http://www.cdc.gov/nchs/data/databriefs/db53.htm

Cheng et al. 2007.  Adding fluoride to water supplies. BMJ 335:699

http://www.bmj.com/content/335/7622/699?tab=responses

Connett, P., Beck, J and Micklem HS. The Case Against Fluoride. Chelsea Green, White River Junction, Vermont,  2010.

NRC, 2006. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (2006) http://www.nap.edu/catalog.php?record_id=11571


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

13 responses to “Fluoride debate Part 1: Connett

  1. Pingback: Fluoride debate Part 1: Perrott | Open Parachute

  2. The process of supplying potable water to the community is also a public health matter. In addition, when it was realised that soft water led to lead in the water in the days of lead piping some authorities hardened the water to prevent this. From this point of view fluoridation is just a public health measure like many others.

    I see no reason to buck the consensus of medical opinion on the matter.

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  3. Peter Van Caulart

    That’s an incorrect oversimplification and assumption. Treating drinking water is a public heath measure to inhibit contaminants from being consumed. Soft water hastens lead/copper dissolution from piping and fittings, therefore increasing consumer exposure. Chemical lead/copper control inhibits metals solubility and preserves potability of treated water.

    Fluoridation chemicals degrade treated water quality and increase lead dissolution, particularly in larger cities using chloramine for secondary disinfection. Silicofluoride compounds do not treat water.

    In the former the water is treated for healthful potability, in the latter the water is used as a vehicle for medication meant to treat living beings.

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  4. It’s hard to understand why Paul would believe that such highly respected organizations as the American Dental Association, the American Medical Association, the World Health Organization, the American Academy of Family Physicians, the American Academy of Pediatrics, the Canadian Dental Association, the Canadian Medical Association, and the Institute of Medicine, just to name a few, would blindly endorse ANY healthcare initiative simply out of “subservience of public policy to the American Government”. These organizations are dependent on their credibility and reputations for honesty and integrity. They have Boards of Directors which must answer to their membership, constituencies, and the general public for the information they disseminate and the the recommendations they make. Additionally, there are legal liability considerations for these entities for the recommendations they make. There is no way that any of these organizations would publicly support any initiative, such as water fluoridation, without first being as certain of its safety and effectiveness as is possible.

    These organizations do not take their public support of ANYTHING lightly, and most certainly not as cavalierly as Paul and his followers would have the public believe. To continually attempt to trivialize the support of these organizations in such a manner is either a clear demonstration of the lack of understanding by Paul and his followers of science and healthcare, or a clear, intentional attempt to mislead………either of which does not reflect favorably on them.

    Steven D. Slott, DDS

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  5. Actually, peer-reviewed science disagrees with the opinion stated in this comment that “fluoridation chemicals degrade treated water quality, and increase lead dissolution”.

    From Urbansky:

    “Overall, we conclude that no credible evidence exists to show that water fluoridation has any quantitatable effects on the solubility, bioavailability, bio- accumulation, or reactivity of lead(0) or lead(I1) compounds. The governing factors are the concentrations of a number of other species, such as (bi)carbonate, hydroxide, or chloride, whose effects far exceed those of fluoride or fiuorosilicates under drinking water conditions.”

    —-Can Fluoridation Affect Lead (II) In Potable Water? Hexafluorosilicate and Fluoride Equilibria In Aqueous Solution
    Urbansky, E.T., Schocks, M.R.
    Intern. J . Environ. Studies, 2O00, Voi. 57. pp. 597-637

    If adverse health effects of water additives were truly the concern of fluoride opponents, it would make no difference for what purpose substances were added to water. Chlorine, at improper levels, is every bit as toxic and corrosive as is fluoride, at improper levels, if not more so. Acceptance that proper dilution of chlorine renders it safe for human consumption, while refusing to accept the same for fluoride, is yet one more clear example that ideology, not science or healthcare concerns, is the motivating factor for fluoride opponents.

    Steven D. Slott, DDS

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  6. Just to add to the information about water treatment chemicals, I did have my tap water tested for lead. We fluoridate with HFSA and I live in an old house. I conducted the test in the middle of the day (not a first draw lead sample as is typical) just to determine the worst case scenario, and mine was still very low. That said, the water company told me that they do have to treat the water with a significant amount of additional sodium hydroxide, due to the acidic nature of the fluoridating agents. So, without proper pH adjustment to balance out the HFSA, there could be more of a problem. The studies about lead and fluoridation have largely implicated systems in which chloramine (rather than chlorine) was used in combination with HFSA, especially in situations where there was a system wide switch from chlorine to chloramine. It is essential that people who are serious about this issue take the time to educate themselves on the whole process of water treatment in their district. Disinfection byproducts actually present a much greater threat than fluoride and are easily filtered with a basic carbon filter for both drinking water and showers. It’s amazing that people don’t know this, even though it is universally accepted by health agencies, and many water systems have had violations.
    At this point in my research, I oppose water fluoridation for a variety of reasons, but most importantly, it is essential that we all learn about water quality, water treatment, and the protection of our water sources. The threats are numerous and it is easy to zero in on fluoride (because it would be so easy to stop), and miss the larger issues. For more info on disinfection byproducts see:
    http://www.cdc.gov/safewater/chlorination-byproducts.html

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  7. Alison, it is normal practice to adjust the ph of finished water to prevent corrosion of pipes. This requirement is due to many factors beside fluorosilicic acid.

    I agree that chlorination is actually a bigger problem than fluoridation – the formation of toxic chloro-organics concerns me. In our city the first chlorination stage has been replaced by a more modern UV treatment which reduces the risk. I think the final disinfection using Cl2 is less problematic but understand why many people use filters to remove the taste.

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  8. Ken, it is true that pH adjustment is a normal practice independent of fluoridation, but fluoridation with HFSA does necessitate the use of significantly greater quantities. This is just a fact. I’m not saying it is necessarily a point against fluoridation, but it does have a marginal increase in the cost and complexity of the practice.
    As for disinfection, the use of chloramine to replace chlorine is controversial. Chloramines may not produce the common DBPs which are trihalomethanes and haloacetic acids, but it is thought that they may produce other carcinogenic byproducts that have not been studied as much. The reason for filtering the water is less about taste and more about removing these possible carcinogens which contribute greatly to total incidence of bladder cancer, especially in men. I cannot speak for your water system, but UV disinfection is indeed a far superior method than pre-chlorination which is being phased out in most places. Maybe New Zealand as a whole has done things to address the DBP issue since this article was published. http://europepmc.org/abstract/MED/10606403

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  9. Fluoridation is extremely cost-effective. I don’t think a little pH adjustment is going to blow the budget.

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  10. Hi All. I have a couple of comments.

    Firstly, Peer Review, does not mean it is right. Consensus is NOT Science. Show me the data, not the subjection. I want quantitative vs qualitative data.

    Secondly, all those wonderful associations, well, what are you saying? They are above reproach, are Gods, and are not above being driven by outside forces? Does a bunch of dentists equal a bunch of Toxicologists or a bunch of Epidemiologists because I would like to know which one trumps which? The bottom line here, is that just because they are Medical Doctors or Dentists, does not make them impervious to graft nor corruption, nor does it make them an expert on anything but their chosen field. Nor does it make them Industrial Hygienists, nor Toxicologists nor Epidemiologists. Quite frankly I want my expert witness coming from the latter. You can shove the Medical Doctors and Dentists under a bus in this argument. They really have no enlightenment to this issue (simply because they are or are not Dentists or Medical Doctors) and have a vested interest anyway.

    Thirdly, “The Dose Makes the Poison” [Paracelsus] so can you tell me, what dose I am getting if drink a 1 Litre Bottle of Fluoridated water from my water supply? Can you tell me if I take that dose, whether or not I am going to benefit or not benefit from it, and if so or not, what will happen when I continue the dose for 50 years? Being that my water supply, is 500 metres from my home, will my friends’ 2km’s away get the same dose as I if they drink from the same supply? What happens if my friends’ drink 2Litres per day? Well Paracelsus said “The Dose makes the Poison!”. Anybody heard of Schrodingers Cat? Well you cannot tell me my dose from a supposition that X ppm shows up in 1L of Water at its source, you simply do not know how much I will drink. Even if you knew how much I would most likely drink today, do you know what dose I am getting from that? No. You do not, because you never measured it at my personal source, you only measured a concentration at the water supply’s source. One can simply not throw a bag of stuff into a water supply and expect that everyone is going to get an equal dose, neither can you tell me that the dose is sufficient or insufficient for anyone, to do so is not science it is voodoo.

    Fourthly, what is it that you are actually throwing in the water as a fluoridating agent? A) is it Pharmaceutical Grade, B) is it Analytical Grade, C) Technical Grade or D) Didn’t Do Chemistry but it sounds and looks good after watching Breaking Bad. The point here is, who determines this? Well in my case it is the local Council. So in the absence of the local council having anyone on it, that isn’t a property developer, I am expected to believe that they can be trusted with a bunch of chemicals to throw into my water supply without any idea whether or not it is good or bad or otherwise.

    These lunatics don’t even understand what method study is and cannot even maintain a road so it doesn’t get shredded in a week, but I am supposed to have blind faith that when I feed my 18 month old daughter her daily dose of water, these clowns haven’t screwed up. Would they tell me if they did? How many bodies hit the floor if they do, before they will admit it was them? Is one Councillor, (Only asking for one) going to be tried for mass murder or gross negligence causing multiple deaths if they do screw up? Doubt it.

    How often do these people test for results at homes? None. How often do they test for results at primary schools, kindergartens, day care centers? Same. Perhaps if a few more people had an idea of what it was they are actually putting in the water, and a few less of them relied on Mrs Marsh’s “ooh it does get in, Colgate advert” then perhaps we would not be needlessly damaging the bodies of those not able to fend for themselves.

    Of course it never does well asking a question to that, you do not want to hear the answer to. (Risk Management 101) This is simply why they do not come around to your home once a decade, let alone once a year and actually do a test.

    A) They do not want to know. B) They do not care C) They do not want to be sued. Hence if you slowly after time, withdraw from actually testing, or from discussing it, the problem will eventually go away and you will have done what you wanted to do by adding it into the supply in the first place. Add a tin full of Colgate Ads over a generation, so that the next and the next, actually believe what it is you are saying with blind ignorance, and you win. You get to dump what ever it is you like into the water supply and no one (the masses) of any significance is going to protest, and for anyone who protests you just use the Delphi Technique to castigate them. So what is it they are dumping in your water supply, and what else comes with it? Is it pure? 95% 90% 1% (pick one Hydro Fluoro Silicic Acid, Sodium Hexa Fluoro Silicate, et al et al et al.
    How much Arsenic, Cadmium, Radio Isotopes, Lead, is coming with it? After seeing the results in South Australia, I’d rather feed my daughter coke a cola.

    Do not be a lemming. Which brings me back to vested interests. Shall I bring up the Mellon Institute for Industrial Research, or Edward Bernays? Don’t have time. You can do that, which is what I hope everyone will actually do apropos this issue. Here is a quick Pressure Relief Valve test….Go to (Don’t ring them) your local water authority and ask them when it was the last time they tested for Fluorides (Independently) at your home, and if they haven’t will they come and do it, because you want to make sure they have safely proportioned the concentration at your home. Bet you they do not jump out of their skins to help you. If they do(help you), I will be surprised and you can wither into the ether of religious science and I will never bother you again. If they do palm you off, I hope you start asking questions.

    Does the Medical profession have a vested interest? Yes Does the Dental Profession have a vested interest? Yes. Does the providers of this stuff to your Water Authority have a vested interest? Yes. What is the benefit? Who tests this benefit? I will leave that to you.

    Finally, I was always told to ask questions, even whilst in the military I was told to ask questions! Committing Genocide is not a Lawful General Order, anywhere! Water is H2O not H2O plus (insert a whole heap of crud that isn’t supposed to be in it) here…..

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  11. Risk,

    There is far too much unsubstantiated nonsense in your comment to even attempt to address it all. However, as far as your questions about dose, yes, it can be determined. Water is fluoridated at 0.7 mg/liter. Thus for every liter of fluoridated water you consume, you ingest 0.7 mg of fluoride. The upper limit of daily fluoride intake from all sources before adverse effects may occur, has been established by the Institute of Medicine to be 10 mg. The CDC and the IOM have estimated that 75% of daily fluoride intake from all sources, is from the water. It’s simple math to determine your daily “dose” . Before you even approach the 10 mg upper limit, water toxicity would be your problem, not fluoride.

    http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/ULs%20for%20Vitamins%20and%20Elements.pdf

    That you choose not to trust healthcare professionals for accurate information on a healthcare issue makes little sense, but to each his own.

    Steven D. Slott, DDS

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  12. Firstly, Peer Review, does not mean it is right. Consensus is NOT Science. Show me the data, not the subjection. I want quantitative vs qualitative data.

    Wait. Are you talking about fluoride or are you talking about climate change or evolution or the moon landings or vaccines or the link between HIV/AIDS or the risks of smoking?
    Hard to tell.
    Impossible, really.
    Same playbook.

    Does the Medical profession have a vested interest? Yes Does the Dental Profession have a vested interest? Yes. Does the providers of this stuff to your Water Authority have a vested interest? Yes. What is the benefit? Who tests this benefit? I will leave that to you.

    It’s a konspiracy. We know. We know.

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  13. Pingback: Fluoride debate Part 1a – response: Connett | Open Parachute

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