Fluoride debate: Ken Perrott’s closing response to Paul Connett?

This is Ken Perrott’s response to Paul Connett’s last article Fluoride debate: Arguments Against Fluoridation Thread. Part 8. Paul.

For Paul Connett’s original article see – Fluoride debate Part 1: Connett.

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This exchange is now winding down – despite the fact we have not dealt properly with all the items on Paul’s original list. The exchange has become repetitive and personal. I think readers are becoming bored with this and would have preferred us to work through each item in turn and move on. Paul’s declaration he “will end my participation in this exchange forthwith” – unless  I specifically respond to his vague 4 point challenge (with 3 qualifying points) – makes an early conclusion inevitable.

As this is my last article in the exchange I want to deal with the nature of Paul’s activist organisation – the Fluoride Action Network. This is scientifically relevant because it raises questions about how science should be done and communicated. I will precede that with another look at some of the scientific issues Paul disputes and briefly respond to a number of points he persistently raises.

But first I will respond to Paul’s use of certain “debate tactics” and his criticisms of the comment discussion that has accompanied these articles.

A scientific exchange or a “debate?”

Many readers are familiar with the debating tactics used by the Christian apologist William Lane Craig. He is always promoting himself by challenging others to “debate” him on his own choice of topic. Undoubtedly he is skilled in formal debate procedure and understandably he wants to choose his own “weapons.” But, formal combative debates are more a sport than a way of resolving issues (that is why we never use formal debates in science), more about egos than reality. The objectionable part of Craig’s approach is his use of the debate format as his way of attempting to control discussion. He tries to determine what subjects are covered and demand discussion centre around his own arguments. Intrinsic to his approach is to continuously pass judgment on his discussion partners – declaring they have not dealt with his argument, have failed to counter them, etc. Acting as the de facto debate judge he attempts to center discussion around his own arguments and will inevitably declare his opponents have lost the debate. This judgement is of course faithfully reported by his followers – to hell with the content of the discussion.

Do readers recognise the similarity to Paul’s approach, or should I spell it out? No, I think it is clear.

Right from the beginning I insisted this exchange not be a debate in the gladiatorial sense (even though we have tended to use the term loosely in titles, etc). I rejected Paul’s request the discussion be restricted to his own book insisting we each have our own data and arguments and we should be free to choose and advance our own points. I know Paul did not want this but what could he do?

I think that is the normal mature way to approach scientific exchanges. It should not be about ego but for drawing out the existing evidence and enabling discussion partners to perhaps see things in a light they have not considered. It is not about winners and losers but about attempting to get a clearer picture of reality.

Moderating comments

Paul criticised my moderation of the discussion accompanying this exchange. He is upset that I did not prevent what he sees as personal attacks on him in comments being “part of the visible record on is matter.”

I recognised in undertaking to moderate discussion (a new thing for my blog but something I had been considering) that criticism was inevitable and my moderation would be used as an “excuse” when commenters were not effective. It has certainly been used as an excuse by a number of local anti-fluoridation activists for not participating in the discussion (but this has not stopped a lot of bad mouthing in the background on other forums like Facebook).

My approach to moderation was to hold back comments that were:

• Clearly spam (such as posting videos without accompanying comment),
• Extensive copy and paste without personal input (I personally feel insulted when commenters will copy and paste several pages from a book or web site, without any formatting to remove page numbers or add links),
• Simply abusive without contributing to the discussion or providing information (No, I did not stop comments which were abusive or angry when they did have something of value in their arguments or information).

By repeating Steve Slott’s comment in the body of his article Paul has ensured his readers and supporters will now have Steve’s succinct criticisms and characterisations of Paul in front of them. Paul has extracted a single comment from almost 2000 and ensured it will be part of the public record by placing it in the body of his article. Presumably Steve will by chuffed that his comment was not lost to such readers by being buried in the comments section. Perhaps Paul would have been wiser to leave things as they were.

But perhaps Paul is suing this comment as a diversion – or an excuse to accuse me of some sort of unethical behaviour. Or maybe this just results from his regular email contact with New Zealand anti-fluoride activists who are currently doing the same and discussing their “distaste” for me with them.

Correcting some misrepresentations

Sorry about the brevity and large number of these responses – a bit of responsive “Gish galloping” on my part!

Paul claims I argue “that water fluoridation is the only way to go as far as fighting tooth decay is concerned” yet I have never argued that at all. Several times I have pointed out that other countries use different social policies like fluoridated salt, fluoridated milk, school mouth rinse programmes etc. I would be perfectly happy to see New Zealand switch to fluoridated salt, for example, if fluoridated water proved unacceptable to the majority of the population. In some ways fluoridated salt may work better than water because it would not be under the control of local councils vulnerable to being “picked off” by activist groups. And sometimes I question the technical possibility of reaching the more than 70% coverage through community water fluoridation required to reach the whole population.  Salt fluoridation was discussed quite a lot in the comments discussion.

He claims I have a “distaste for opponents of fluoridation in NZ.” He is wrong (I have friends and family members I love who disagree with me on this question). But yes I do have a distaste for the tactics used by some of the activists. I also object strongly to the arrogant misrepresentation of the science commonly advanced by these activists. I find the fact Paul is in email contact with local activists and discussing their “distaste” for me unpleasant. I can imagine how nasty that discussion gets, but does he think that sort of bad mouthing advances anyone’s case? And has he responded to their bitching by urging them to participate in discussions here (as I have), or did he warn them to keep away?

He accuses me of not acknowledging there could be a problem for some individuals with increased sensitivity to fluoride and that I attack studies and “numerous anecdotal reports that have waved “red flags” on this issue.” Did he miss my comments in my last article that “I am happy to concede there may be a small number of people like this – as for other common chemicals in the environment?” Perhaps he chooses to ignore my conclusion “Maybe the most empathetic solution is that society as a whole compensate this small number of people in some way to aid them with their predicament.”

Paul has several times argued for a “weight of evidence approach” to the literature on fluoride. I will discuss this in greater depth in the section on the Fluoride Action Network. In principle this is exactly the same as my insistence that we should be approaching the literature in an intelligent and critical way. We should be considering all the literature, assessing quality, understanding flaws and strengths, considering the possible role of confounding factors and drawing interim conclusions from this overview. I think examples in this exchange show Paul often does not do that. Instead he often relies on cherry picked papers of poor quality. He even argues the lack of higher quality papers is a point in favour of the poor quality ones, when it may simply indicate other researchers don’t see the effect he wants. And he often claims studies support his conclusions when they don’t.

Paul criticises public funding of an information service in New Zealand set up specifically to facilitate a “weighted evidence approach” towards fluoridation research. Perhaps this shows his hypocrisy in the use of the term. However, Paul is thoroughly confused on this so a little information is required (readers can also refer to my article Anti-fluoridationist astro-turfing and media manipulation).

The NZ Fluoridation Information Service (NZFIS) is not publicly funded as Paul claims. It is an astroturf organisation set up by FANNZ, part of Paul’s International Fluoride Action Network (see Anti-fluoridationist astro-turfing and media manipulation). The astroturfing is so clumsy they use the same contact address as FANNZ! Mary Byrne and Mark Atkin, activists for FANNZ, often act as spokespersons for NZFIS, using the organisation to give an air of credibility to their press releases. This astroturf organisation was also used to provide false credibility to Mark Atkin in an an exchange of opinion article written for the Journal of Primary Healthcare. It is sometimes used to disseminate propaganda for Paul’s FAN organisation using local press releases.

This aura of “credibility” rests on the confusion of the similarity of it’s name to the NZ National Fluoridation Information Service (NFIS). This is publicly funded and part of its role is to monitor the research literature and make summaries available. It is an information and advisory service supporting District Health Boards and Territorial Local Authorities by providing robust and independent scientific and technical information, advice and critical commentary around water fluoridation. It is the organisation that takes a “weighted evidence approach.”

Unfortunately the ploy of using similar names does confuse the news media at times. (The NFIS periodically has to set the media straight.) Apparently it even confuses Paul – and I have seen similar confusion from local anti-fluoridation activists.

Paul is still confused about the graphic I introduced early in this exchange showing data for fluoridated and unfluoridated areas of the Irish Republic. He insists it is a comparison of data for the Irish Republic and Northern Ireland. It is not. How many times must I repeat this?

He again avoids the importance of including social good in ethical considerations of social health policies like fluoridation. This time he does so by pretending that social benefits just don’t exist. And yet he seriously proposes alternatives such as the Scottish ChildSmile programme and the programmes used in other European countries. Fluoride treatments are an integral part of the Childsmile programmes and fluoridated salt and milk is part of the programmes used in many European countries. What this boils down to is his insistence on individual choice as his over-riding concern and his absolute rejection of any concept of balancing this against social benefits. His insistence that fluoride has no beneficial effects and concern for harmful effects is merely an excuse for his concentration on individual choice.

Paul’s emotional (or political) obsession with individual choice often comes though in the most unlikely places. Why should he use the term “forced fluoridation” in a polite scientific exchange? It is equivalent to a politician referring to public education as “forced secular education,” or our public health system as “forced free hospital care.” No one has secular education, free hospital care or fluoridation forced on them. There is always a choice for those prepared to make the effort to satisfy their convictions.

Paul claims I know “full well” he has disowned claims that “Hitler used fluoride to control prisoners.”  No, I didn’t (still haven’t reached  pages 256-258 of his book), but I am very pleased he has repeated his statements here. Let’s disseminate these points far and wide:

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Paul Connett rejects the arguments of some of his fellow fluoridation opponents that fluoride has been used “as a method of mind control.” He also rejects speculations that fluoridation is a “sinister plot to ‘dumb down’ the population” or “part of some world wide plan to reduce the size of the global population.”

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I hope his fellow anti-fluoridation activists in New Zealand read this and take it on board. I hope they publicise Paul’s comments. I hope spokespersons for the local organisations reprimand any of the supporters who make these claims (far more of them do than Paul seems to think).

And I hope that Paul himself will repeat these assurances during his upcoming speaking tour of New Zealand – and particularly take to task supporters (like local spokesperson Dr Anna Goodwin) who repeat such rubbish. From my perspective he needs to push that message home loudly and often.

So thanks for that Paul – but why did he ignore my similar request?:

“I have yet to see him condemn the atrocious propaganda, lies and personal attacks of propagandists like Alex Jones and Vinny Eastwood. It is not enough to say he doesn’t necessarily support all their positions. The fact that he uses their services, and they use his, makes such weak dissociation disingenuous.”

Is his refusal to condemn  such “atrocious propaganda, lies and personal attacks of propagandists like Alex Jones and Vinny Eastwood” an indication of his support for them?

He claims I wish to “avoid” education on oral health issues. That is just silly and he has no justification for the claim. Proponents of fluoridated water supplies, fluoridated milk, fluoridated salt, fluoride dental treatments, etc., just do not see the world is such a naive black and white way. Fluoridation in any form is not a substitute for good oral hygiene. Health authorities will often operate campaigns of all sorts aimed at fighting tooth decay and education about oral hygiene is very common. We do in New Zealand and Paul has several times referred to such programmes in Scotland.

Paul’s attempts to deny the scientific consensus about the contribution of fluoride in drinking water to increasing concentrations in saliva and tooth surface biofilms has become desperate and farcical. I can only conclude this is because he has been promoting the mantra of “topical application” as a way of hiding the “surface mechanism” message.

He insists I have ignored his claims on margin of safety asking where my comments on this are. Yet, several times he has ignored my request for him to justify the low safety of margin he derives from the paper of Xiang et al (2003). I find it hard to believe he has not seen my requests (although that would be possible if he has not been reading my articles seriously). However, this could just be a cynical ploy as part of his campaign to pretend I am avoiding issues. I mentioned this above in my comment on debating tactics.

Briefly on the pineal gland and calcification (although not as briefly as Paul’s Gish galloping reference to it). It is a favoured subject of many anti-fluoride propagandists and they often give it mystical overtones with reference to a third eye, etc. Calcification is not caused by fluoride – it is caused by calcium, phosphate and old age. Because the bioapatites in calcified tissues are actively undergoing mineralisation and remineralisation they easily incorporate fluoride into their structure and this leads to higher concentration of fluoride in calcified tissues than in bones generally.

A similar situation occurs with calcium rich plaque deposits in cardiac arteries. Li et al (2011) suggested that fluoride incorporated into such deposits could be used to identify their occurrence by measurement of  F-18 using positron emission tomography. They were describing a diagnostic method and yet Declan Waugh and other activists disingenuously use this paper as some sort of “proof” that fluoride increases the risk of heart attacks!

I am surprised Paul has taken the approach of blaming practically every illness or change on fluoride. Arthritis, early onset of menstruation, all the symptoms attributed to “fluoride sensitivity,” osteosarcoma and other cancers, hypothyroidism, and so on. It is a common tactics of the non-scientific, even anti-scientific, rank and file anti-fluoridation activists to blame all the ills of the world on fluoridation – but one expects more from a trained scientist.

Some of the ills fluoride gets blamed for.

Despite the many advantages of modern society we do appear to face an increase in some health problems. Obesity has become far more common, for example. Surely the scientific approach is to attempt to identify the real causes properly. To start by blaming fluoride (or any other chemical) without evidence, is misleading. It is even worse to insist on attributing this as a cause to the exclusion of all else and to demand research only into such a dogmatic hypothesis – as Paul does. This ideologically driven labelling is not only dishonest. It is dangerous as it diverts efforts away from proper objective research and serious investigation of the problems. It inhibits proper identification of causes.

Paul insists on using the authority fallacy – out of context quotations from authoritative figures. An example in his last article was that by David Locker. Perhaps he is not aware he is doing this – it seems to be an instinctive reaction for anti-fluoridation activists. He should appreciate that the world is never as simple as implied by such quotes. I see his resort to such fallacies as a weakness, not a strength.

The Hastings experiment

Paul’s description of the Hastings experiment is biased and reeks of conspiracy theory. He has since included the same information in an internationally distributed newsletter entitled “New Zealand Fluoridation Fraud.” This is being disseminated in New Zealand and, I suspect, Paul will push this story during his upcoming speaking tour here. I always consider allegations of scientific fraud  to be very serious. Usually a researcher’s whole career is at stake as it is one the most serious allegations that can be made.

Typically, Paul’s bias means he relies on a single source for his story. He writes that he “would be anxious to see if Ken can throw a different light on this matter.” While this is not the place to give a full and more balanced history of the Hastings experiment (and I haven’t done the research for this) I will make just a few comments to expose Paul’s bias.

Paul quotes John Colquhoun:

“The school dentists in the area of the experiment were instructed to change their method of diagnosing tooth decay, so that they recorded much less decay after fluoridation began.”

This just shows how simple facts can be distorted to fit a conspiracy theory. My own family remembers this change in dental technique by the school dental service because it was country-wide – not restricted to Hastings as Colquhoun, and Paul, imply. There goes the conspiracy theory and Paul’s claim of a scientific fraud.

Akers (2008) agrees these changes confounded the experiment:

“The changing of NZSDS [NZ School Dental Service] diagnostic criteria for caries and the cessation of the NZSDS nurses’ practice of prophylactic restoration of fissures further confused interpretations. While later antifluoridationists justifiably claimed that the changed diagnostic criteria contributed to the fall in caries (Colquhoun, 1999), their “science or swindle” questioning of methodology and findings (Colquhoun and Mann, 1986; Colquhoun, 1998; Colquhoun and Wilson, 1999) simplified confounding variables and dismissed international evidence supporting community water fluoridation as one factor in declining community caries incidence (de Liefde, 1998).”

So science, probably bad science, but not the “swindle” Paul wants to believe – and wants us to accept. As an aside, I think changes in dental practice like this will have also contributed to the graphs Paul and other anti-fluoride activists love to use to prove improvement of oral health in the absence of fluoridation – yet they never discuss that sort of detail. It is a potential problem with any longitudinal study and Colquhon was criticised for ignoring it in his own presentation of New Zealand data.

Akers also refers to the problem with using Napier as a control city:

“The abandonment of the control city (Napier) because it had a lower initial caries rate than that of Hastings (Ludwig, 1958) implicated soil science as a confounding factor in New Zealand cariology (Ludwig and Healey, 1962; Ludwig, 1963).”

I referred to my memories of this discussion about the role of other trace elements in dental health in a previous article (see Why I support fluoridation).

Yet, how does Paul express this: “after about two years the control city of Napier was dropped for bogus reasons.” So Paul considers the fact it was not suitable as a control to be bogus?

The Hastings experiment (or “project” or “demonstration”) was also confounded by political changes, birth of the anti-fluoridation activity in New Zealand, loss of support from the Hastings City Council, and so on.

That is the problem with conspiracy theories – they paint the world black and white which is very unrealistic. I expected far more professionalism from Paul than this.

The Scottish ChildSmile programme

Paul returns to this through quoting material from Bruce Spittle. What I find a little weird is that his original reference to this programme was as an argument for an alternative to fluoridation. But he seems oblivious that Bruce’s note reveals that use of fluoride varnishes is an integral part of the programme.

In fact the programme includes this target:

“At least 60% of 3 and 4 year old children in each SIMD quintile to receive at least two applications of fluoride varnish per year by March 2014.”

It is an excellent programme but only Paul seems to see it as an alternative to use of fluoride. Here is a quote from the ChildSmile programme:

“The Scottish Dental Clinical Effectiveness Programme (SDCEP) Prevention and Management of Dental Caries in Children guidance outlined that the benefits of fluoride varnishing should be extended to all children. They recommend fluoride varnishing twice a year to all children over two years of age.

Even at very low levels, fluoride in the plaque and saliva is able to alter the balance between demineralisation and remineralisation, favouring the remineralisation process. As the remineralisation happens in the presence of fluoride, the new mineral crystals are stronger and less susceptible to acid attack.

When fluoride is present in the saliva, the fluoride ions become concentrated in the plaque. When sugars then enter the plaque, the presence of fluoride reduces the conversion of dietary sugars into acid by plaque bacteria with less acid produced.

How fluoride varnish works:

• it slows down the development of decay by stopping demineralisation
• it makes the enamel more resistant to acid attack (from plaque bacteria), and speeds up remineralisation (remineralising the tooth with fluoride ions, making the tooth surface stronger and less soluble)
• it can stop bacterial metabolism (at high concentrations) to produce less acid.

Fluoride varnish leads to heavy remineralisation of the enamel surface, and subsequent acid attacks will allow fluoride ions to penetrate more deeply into the tooth structure. Varnishes like Duraphat® are useful because they stay on the tooth surface for some hours, allowing slow release of the fluoride ion.”

Improving oral health and effects of stopping fluoridation

Despite our discussion of the errors in drawing the conclusions he does from declining tooth decay in European countries he continues to naively present that as “proof” fluoride plays no role in oral health. And he is still completely confused about the Irish data I presented – this was for one country, Ireland. I was not comparing Northern Ireland and Ireland in any way. His claims that oral health shows no decline when fluoridation is stopped involves a similar misrepresentation of the evidence.

I am glad he acknowledges the protective role of other fluoride treatments after fluoridation was stopped in La Salud, Cuba, and the former DDR. But seriously, did he not know that already? Had he not checked out the studies which activists rely in to make these claims? And will he now stop using those examples in future presentations and discussions? I suspect not.

This shows all the earmarks of cherry picking studies to confirm his bias and basing arguments on studies he has not bothered checking. He attempts to deflect criticism by saying “It is not clear if Ken believes that alternative methods were applied to explain the results in Finland and British Columbia.” Well, perhaps I should spell it out – I don’t have a “belief” about those studies because I have not checked them out. But I suspect they do not support Paul’s arguments against fluoridation any more than the Cuban and German studies do. (After all I am sure Paul would be describing the details by know if they did). He has already lost that argument and he is desperately clutching at his remaining straws while the rest of us have moved in to the next issue wishing to spend our valuable time on more important things.

Once again I can illustrate some of the problems with his cherry picking and simple interpretations by comparing the changes in oral health of two Scottish communities described in a study by Attwood and Blinkhorn (1991), “Dental health in schoolchildren 5 years after water fluoridation ceased in South-west Scotland.”

This compared caries prevalence in two towns in both 1980 and 1988. One town, Annan, had never had fluoridated water while the other, Stranraer, had it until 1983. 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.

Paul might want to seize on the Annan results to argue that fluoridation has no effect on oral health as they show the same pattern as the European data he loves to present. But in this case we see that stopping fluoridation did have a significant negative effect on caries prevalence for Stranraer – even though oral health of these children in the two towns was similar in 1988.

I fully accept this is just one study, and by itself is not conclusive (I don’t claim it is). Nor have confounding factors been considered. Paul can claim I have “cherry picked” it. All perfectly valid criticisms – but that only describes the process used by Paul and his fellow activists. They have chosen papers they think supports their case. That is not good science. We should be basing our conclusions on on a proper critical and intelligent review of all the studies – not selecting ones which suit us.

Even with the study of Attwood and Blinkton described above activists from either side of the fluoridation debate can select or cherry pick “evidence” to fit their predetermined case. To argue either that it “proves” fluoride is not effective for oral health as shown in Annan where tooth decay declined despite there being no fluoridation. Or to argue that it “proves” fluoride is effective because oral health declined after fluoridation in Stranraer was stopped.

Nature of Fluoride Action Network

Ii is important this exchange not finish without considering the nature and role of Paul’s activist organisation, the Fluoride Action Network (FAN). I commented in previous articles about the problems of scientists becoming involved in activism. FAN illustrates those problems of cherry picking, confirmation bias and group thinking. Here I will comment on some of the specific ways these are manifested in FAN and it’s international role in the anti-fluoridation movement.

Martin (1991) and Newbrun (1996, 1999) described the social base of anti-fluoride activism as a weird mixture of fundamental greenies, misguided environmentalists, food faddists, anti-science “naturalists,” chiropractors and right-wing extremists. I guess readers could add more to this list but anyone who has watched the videos of the submissions made by anti-fluoridation activists to the Hamilton City Council hearings this year will recognise all these elements. They are all ideologically driven, illustrate characteristics of cherry picking, confirmation bias and group thinking, and make extensive use of the services FAN provides.

These social groups, and their associated businesses, also provide an organisational and financial backing to FAN and it’s regional organisations like the Fluoride Action Network of NZ (FANNZ). One current example is the NZ Health Trust which attempted to get a judicial review of South Taranaki’s decisions on fluoridation in the High Court.

FAN works hard to select scientific literature which can be interpreted, or reinterpreted, to support the anti-fluoridation case. They have accumulated a large database of such literature – a useful resource for the naive internet commenter wishing to “prove” fluoridation is evil. This database, and its extensive internet use by activists, has produced high Google search rankings for articles promoting an anti-fluoride case – frustrating for the honest Google user attempting to find more objective material.

The organisation certainly searches far and wide for any scientific report or paper which can be used to further their cause. Apparently the normally accessible scientific literature has not been fruitful enough for this purpose so they are making more use of obscure foreign sources. They have put a lot of effort into translation of Chinese publications and recently put out a request for people to translate foreign material in other languages.

Clearly FAN is searching for anything that can be used as “evidence” for negative effects of fluoride in human and animal health. This is not a critical or intelligent approach to the literature. I am all for the possibility of finding interesting ideas in foreign untranslated and obscure papers – I have done so myself. But the FAN motives are all wrong. They are uncritical, unintelligent and selective in their search. The quality of the research they use is their last concern – which is hypocritical considering the frequent demands for proponents of fluoridation to produce replicated double-blind studies.

The FAN database gets a lot of unintelligent use by fluoride activists throughout the world. Naive quoting and citing is very common in social media like Twitter and Facebook. Commenters in blogs will often simply post a quote or even just a link – drive by trolls. People who commonly read and use the scientific literature properly shudder to see such unintelligent use as it downgrades the idea of scientific knowledge.

FAN also makes videos available for similar use.

In effect FAN heads an international network. There are “action networks” and “fluoride free” organisations in many countries and regions where fluoridation is an issue. In New Zealand there is FANNZ, as well as regional Fluoride Free structures and Facebook pages. Mary Byrne, National coordinator of FANNZ is also a Advisory Board member on Paul Connett’s FAN organisation.

These international links are apparent in the way that media is manipulated by planting propaganda material. FAN will issue press releases which get faithfully transmitted by the alternative media connected with conspiracy theorists, natural and alternative medicine and practitioners, food faddists, some environmental groups, etc. These press releases also get planted locally by groups like FANNZ, sometimes using its astroturf group, the NZFIS. They also get picked up and reproduced by bloggers. Links and simple, very often misleading, one liners get transmitted ad nauseam by Twitter and Facebook.

Sometimes the normal mass media will reprint a press release, or pick up an article from elsewhere giving it a prominence it doesn’t deserve. And of course, these are immediately promoted on Facebook and Twitter as if they were independently sourced stories.

Example of Israel and it’s decision to regulate on the mandatory stays of fluoridation.

Whether intentionally, or just because of human foibles, part of international promotion is the use of personality cult. We can see this in New Zealand with Paul’s upcoming speaking tour. Locally he is being promoted and advertised  as the “World Fluoridation Expert” – despite the fact that he has no research papers to his name on the issue. In a previous article I referred to his claimed 18 years research into fluoride and his self promotion as an expert:

“with such a reputation it is reasonable to expect a body of publications in reputable peer-reviewed scientific journals. My simple searching does not show any, although he does list 2 which I could not find on-line in a recent CV. Could Paul give us a relevant publication list? And links to the papers.”

Significantly, this is another of my questions Paul has chosen to ignore.

Local Facebook advertisement for Paul’s NZ tour.

Paul also has remained silent on my critique of the Fluoride journal and his relationship to it. His organisation FAN is currently campaigning to win respectability for that journal in the wider scientific community. I can understand FAN’s motives for this – but the tactics? Promotion of a journal by an activist organisation which often attacks science and scientists would normally be considered the kiss of death.

Concluding comments.

This is the last article in my exchange with Paul Connett. Although, if he insists, I will not deny him the right of reply.

I have enjoyed the exchange. It has been useful for me to get my ideas into some sort of order and to get a measure of the arguments used by opponents of fluoridation. In that respect I am conscious that Paul does not adhere to some of the common arguments used. I am glad he dissociates himself from some of the extreme right-wing propaganda in the anti-fluoridation movement claiming an Agenda 21 conspiracy to control population and keep us dumb. Nor does he promote the silly arguments claiming fluoridation was used for this purpose by Nazis in the concentration camps. The negative side is that we did not get to see those arguments presented properly and I did not get to look at them more critically.

There have been a large number of comments on these articles and I believe they are of higher quality than we commonly see in discussions of fluoride. Many commenters have presented useful arguments and information with many useful citations. I have found these valuable and urge readers to go back and browse comments for them.

The links to all the articles in the exchange are listed by date on the Fluoride Debate page. In the new Year I will put the articles together in a PDF document (and maybe an eBook format) so readers can download and consult at their leisure. Maybe we could even use Paul Connett’s speaking tour of New Zealand early in the year to encourage people to read the exchange.

Finally thanks to Paul Connett for agreeing to this exchange (it was actually his idea to try it as an on-line exercise) and to all the people who participated in the comments discussion.