Ingested fluoride, dental health and old age

dentistWhen we who are chronologically challenged get together we often discuss health – and sometimes compare notes.  But, strangely, I have never heard people discuss their dental health. Don’t know why, but I started to wonder if I was the only one with my particular problem.

These days I seem to visit my dentist quite often – but current tooth decay is never the problem. Its more likely to be tooth fracture – bits of teeth breaking away or chipping off. So I asked a couple of dentists if I was unusual – or is tooth fracture just another problem of old age.

Turns out I am quite normal, at least in this respect. Dentists do find tooth fracture is more common than tooth decay at my age.* To me this underlines an important fact – what happens in our youth can affect us for the rest of our life, and particularly in our old age.

This goes for our teeth, as well as our brain. Our teeth form and develop in our early years. So the damage we do during their development comes back to bite us, as it were, 60 or more years later. Just as child abuse or neglect can have psychological effects in old age, it can also have dental effects.

Nutritional deficiencies during these early years can increase risk of developmental defects of the teeth and dental caries throughout the rest of our lives. Because teeth development is completed by age 8 we are stuck with these defects for the rest of our lives.

Fluoride and teeth development

Fluoride deficiency can be a factor in tooth development defects. This is because it is a normal and natural part of the tooth mineral, the tooth apatite. Fluoride lowers the solubility of apatites and makes them stronger and harder. Consequently, fluoride deficiency in childhood weakens tooth enamel and can  produce a susceptibility to tooth fracture later in life.

I think it is important to realise this. Recently I heard someone claim that ingested fluoride only has an effect on developing teeth in children so was of no benefit to adults.  A very short-sighted understanding –  children turn into adults.

Another reason I think it is important to understand the importance of ingested fluoride to our teeth throughout our life is the propaganda from anti-fluoride activists claiming that ingested fluoride does not influence out teeth. They have taken on the scientific understanding of the reaction of fluoride at the tooth surface which inhibits demineralisation to argue that ingesting fluoride is like drinking sun tan lotion because the effect is, they claim, purely topical.

That is a misrepresentation – and one that causes  confusion when anti-fluoride campaigners make these claims in their submission to councils. (The Hamilton City Council even advanced this misunderstanding as accepted knowledge – see When politicians and bureaucrats decide the science).

A more balanced understanding of the science shows the beneficial effects of fluoride intake is both systemic (via ingested fluoride) and topical (via the surface reaction at the tooth surface). Incorporation of fluoride into the bioapatites forming our teeth and bones strengthens and hardens them. This occurs during tooth development. Because the tooth material is stronger and harder it is less likely to suffer from fractures, scratching and similar damage.

On the other hand, fluoride intake helps protect existing teeth from decay because of the surface reaction inhibiting demineralisation of the teeth. Just from a chemical perspective the presence of calcium, phosphate and fluoride in saliva and tooth biofilms helps prevent tooth decay resulting from acid attack and demineralisation. But from a mechanical perspective if our teeth are harder and stronger there will also be fewer physical defects providing sites for the chemical acid attack.

Fluoride benefits from ingestion and surface effects

Anti-fluoride propagandists have worked hard to deny any benefits of fluoride on dental health. Often they fall back on the argument that any benefits arise only form a “topical” effect. They usually interpret this to mean tooth brushing or dental topical applications.

However, consumption of fluoridated water and food enables transfer of fluoride to saliva and biofilms on the teeth. This fluoride, together with calcium and phosphate on the saliva, reduces acid attack on the teeth and so helps prevent tooth decay. Because fluoride concentrations in saliva decrease within an hour or so after brushing, fluoridated water complements use of  fluoridated toothpaste. We are in more regular contact with food and water than we are with toothpaste

But ingestion of fluoride in food and drink during tooth development in children also helps harden and strengthen tooth enamel. This benefits a person’s teeth throughout their life by helping prevent  and tooth fracture and physical defects. Harder tooth enamel will reduce tooth decay by preventing physical formation of sites for it to take hold, even though the acid attack is itself a chemical, surface effect.

So, even the chronologically challenged benefit from community water fluoridation. And you young ones – remember one day you are going to be old and your quality of life may well depend on the community water fluoridation you had access to as a child.


*Apparently tooth decay can still return as a major problem in old age because the withdrawal of gums from the tooth roots open new sites for decay. This is known as root caries.

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34 responses to “Ingested fluoride, dental health and old age

  1. Fluoride exposure is often quoted as being associated with more brittle teeth. Possibly less decay, but more brittleness. Certainly if there is dental fluorosis present teeth are more brittle. But I wonder if there has ever been measurement of lesser degrees of fluoride incorporation into enamel with concurrent assessment of brittleness or tendency to the chipping and cracking that Ken writes of.
    Fluoride exposure may predispose to this problem, rather than protect against it as Ken assumes.

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  2. David, it’s probably the same as bones – both being bioapatites. Increased weakness or brittleness at both low and high fluoride levels with the best strength and hardness at the optimum intake levels. A sort of “Goldilock’s zone.

    That is also consistent with the chemistry.

    But anti-fluoride propagandists often attempt to conflate the negative effects seen with excessive F intake and the beneficial effects seen at optimum intake.

    Problem with the current batch of oldies is that they did not have the advantage of community water fluoridation during the development if their teeth. Will be interesting to see if in future tooth fracture become less of a problem because of the introduction of community water fluoridation all that time ago.

    Excessive F intake has not been a problem in NZ.

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  3. Dental caries (tooth decay) continues throughout life at a rate of just under 1 new affected surface per year in the average person, irrespective of age. This means that the topical effect is just as relevant for adults of any age as it is for children. Yes, there is a detectable pre-eruptive effect, but the data suggest that the major mode of action is topical and continues as such throughout life. Check out the relevant papers by searching on Pubmed for papers from the Dunedin Study – search using the names Thomson WM (ie me) or Broadbent JM. The issue of more brittle teeth in older age is a legacy of two main phenomena: (1) the fact that those teeth are more heavily restored as a result of a lifetime’s tooth decay and treatment of its effects, and (2) the ongoing gradual decrease in pulp (“nerve”) size due to secondary dentine deposition inside the tooth.

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  4. Modern science indicates that ingesting fluoride is ineffective at reducing tooth decay, harmful to health and a waste of money http://www.FluorideAction.Net

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  5. Gee, nyscof, the “Media Relations Director” for the New York antifluoridationist faction, “Fluoride Action Network”, makes a ridiculous claim, then cites her own FAN website as “evidence” to support it. This would seem to be her claiming that “fluoride is ineffective because I say it is and if you don’t believe me then check with me”.

    Interesting, to say the least.

    Steven D. Slott, DDS

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  6. Nyscof,

    Why are you linking to a political organization to reference your sweeping claims – you have don’t seem to understand how Science works.

    Would you think that asking the NRA for advice on the psychological impact that mass gun shootings have is a good idea?

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  7. Ken, Sorry the see your teeth are falling to bits and I sincerely sympathise. That also happened to me to the extent that I had all my teeth extracted and have worn dentures since my early thirties.
    I am sure it must have been a coincidence that the problems started following a period in a country area where our GP prescribed fluoride tablets. That was in 1966 when the efficacy of fluoride was being promoted by health authorities and the dental profession with considerable vigour and bucket loads of taxpayer money. Even back then concern was being expressed about the lack of research into the long-term outcomes of the practice but those raising the issue were ostracised, marginalised and denigrated. Of course that was an era where the public generally trusted their politicians, policemen, doctors and bank managers were regarded almost on the same level as ministers of religion and scientists were seen to be leading us to the brave new world of discovery and progress.
    I suggest an increasing swathe of the public are now somewhat sceptical about politicians, doctors, policemen priests and banksters as questions are raised and dubious practises are revealed. That can only be healthy as our society expands and new norms are explored and considered. The old theories used as a foundation for society are often found wanting but linger on because of a persistent self interest or need or greed.
    I put it to you Ken that your problem could well be that your body has reached a saturation point with all the fluoride you have ingested during your long and productive life and it is now pay-back time.
    I have suffered from many chronic conditions over the past decade including joint pain, gut problems, sleep apnoea, relapsing polychondritis, fatigue to name a few. I am not claiming all these were caused by ingesting fluoride but they started to bite when I moved from a non-fluoridated community back to Hamilton. I attributed much of it to old-age, a poor diet, smoking a packet of cigs a day and too little exercise. I stopped smoking on Guy Fawkes day 2001 but many of the issues continued until I stopped ingesting fluoridated water some 18 months ago. My gut issues cleared up, I sleep soundly, my joint pains have gone and I can now enjoy exercising. My polychondritis symptoms have not recurred for 8 months and life is worth living again.
    As I say Ken I don’t know if that is attributable to avoiding fluoridation but because there is no on-going primary research into possible adverse impacts on human health I can only make assumptions based on my experience and the anecdotal evidence of people with similar stories to tell.
    I realise you are in a difficult position because of your zealous adherence to the various studies from over 50 years ago which were designed to confirm the ‘safe and beneficial’ mantra developed by the PR people in the USA during the 1950s, The same people who promoted smoking and lead in petrol.
    Until people like yourself can produce the scientific research that proves there are no adverse health effects from drinking a by-product of fertiliser manufacturing to treat the disease of tooth decay there will be people like me who will not ingest the stuff and who will continue to challenge the ‘safety and benefits’ you claim of practise that most countries have never engaged in or have soundly rejected.
    All the best!

    .

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  8. You seem to be quite the hypochondriac, design.🙂

    >

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  9. Design

    Here’s the thing. Aside from the placebo effect of your ailments having abated when you claim to have ceased drinking fluoridated water, you suffer from the same delusion as do most antifluoridationists……that because you don’t have the knowledge to understand fluoridation, you assume that all of respected science and healthcare shares your ignorance on the issue. The fact is that all of the “concerns” constantly raised by antifluoridationists have long since been considered, understood, and addressed by the appropriate regulatory agencies and healthcare personnel. There is no “new emerging science” as antifluoridationists constantly claim but fail to produce, no ongoing studies which need to be done, which have not been sufficiently addressed. Simply the addition to water of minuscule few parts per million fluoride ions identical to those which exist in water naturally, and barely detectable trace contaminants in minuscule amounts that fall so far short of maximum mandated safety levels that it is not even a surety that they aren’t those that existed in the water already.

    That you and most other antifluoridationists refuse to accept these facts is demonstration of your anti-authority ideology, not of any deficiency in knowledge or understanding of fluoridation by those in whom is entrusted the oversight of the quality of our drinking water.

    Steven D. Slott, DDS

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  10. The later the dental restorative cycle begins the better.

    Yes Jonathan, that wouldn’t surprise me, I’ve often suspected that.

    Of course, it’s all the more reason to ensure we all get the best, the hardest, the most decay resistant teeth that we possibly can, made that way by exposure to optimum levels of fluoride when our teeth develop and continuing afterwards.

    What’s Steve Slott’s view of too-early intervention, ie filling very small caries at very early stages.

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  11. You’re exactly right, Richard. Prevention is always the best treatment. That’s the message of those studies. Once invasive treatment is required, the restorations get larger each time they require replacement. The best way to avoid invasive treatment is to prevent decay from occurring in the first place. There is no more cost-effective dental decay preventive measure available to entire populations than water fluoridation. It is unconscionable to condemn children to a lifetime of the pain, debilitation, and life-threatening infection resultant of dental decay that could be prevented by this measure.

    Steven D. Slott, DDS

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  12. Thanks Steve – I am comforted by your response and I am sure my son who had all his teeth extracted by age 5 due to enamel fracturing following eruption of his first teeth will be also. I actually blame his mother who took the fluoride tablets prescribed to her by our doctor who didn’t understand there were adverse effects from fluoride. (Tablets today carry a warning that they are not to be used during pregnancy)
    Ken will also be pleased that his problem is not related to an accumulation of fluoride in his teeth because that would also indicate that he may be susceptible to his old bones and joints being compromised. Unfortunately Ken it seems that you will simply have to live with fact that you are buggered, simply because you have lived too long.

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  13. Yes, and one of the undeniable aspects of us who have “lived to long” in NZ is that we just didn’t have the advantage of a social health policy like fluoridation during our younger years when our teeth were developing.

    So it is rather silly I am being attacked on Fluoride Free Hamilton at the moment by Trev who thinks I have overdosed on fluoride!

    I think he overdosed on hubris, thinking he could throw good money, he didn’t have, after bad by taking legal action against the Hamilton City Council. Seems like the NZ Health Trust realised the action was silly and wouldn’t back him financially.

    >

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  14. Design

    The only problems you have with fluoride are your irrational obsession with it, and delusion that every possible physical ailment you have is resultant of this mineral. You need the help of a psychiatrist, not removal of fluoride.

    Steven D. Slott, DDS

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  15. Steve – you seem unable to comprehend what I have written, I clearly wrote the following:
    “I am not claiming all these were caused by ingesting fluoride but they started to bite when I moved from a non-fluoridated community back to Hamilton”.
    I have the med files that prove my conditions but have not so far been able to obtain an explanation as to what has caused them.
    Perhaps you could make a sensible suggestion instead of engaging in smart arse remarks, which seems to be your forte!

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  16. Desighna,

    If you are not claiming anything, why bring it up!

    It’s clear from the context what your implication is; to pretend otherwise and take the moral highground is simply dishonest.

    Naughty, naughty, naughty

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  17. Design.

    I comprehend exactly what you have written. As Christopher stated, your implication is clear, with your attempt to claim otherwise being transparent and entirely dishonest. You need to get your mind off of your own ailments, understand that fluoride is not the cause of them, and properly educate yourself on this issue, if you expect any credibility or respect.

    Steven D. Slott, DDS

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  18. Why hide behind a pseudonym Duhsigna?
    You sound very familiar….

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  19. Steve – I conclude from your comments that ‘properly educating myself’ means ignoring the reality that only 400 million out of 6 billion people have a fluoride compound added to their drinking water (mostly in the USA) and that the rates of decay globally in non-fluoridated areas have declined over the past 30 years at the same pace, if not quicker, than fluoridated ones.
    I should also ignore the many health professionals who have express concern about the lack of research into the issues raised around adverse health effects when water is fluoridated.
    You seem to want me to join your exclusive little mutual admiration club which, when challenged, resorts to repeating the ‘safe and beneficial’ mantra from the 1950s rather than cite the primary research from which your conclusions are drawn. I have read many ‘reviews’ on fluoridation and without exception, including the latest one, they clearly indicate a need for more research. I take from that there are areas of concern which need to be addressed or do all those experts also qualify as nutters and crackpots?
    That is not good enough and long term is detrimental to science as a profession.
    I wait with eager anticipation, but little expectation, for a positive response to my questions.
    Ken – “Seems like the NZ Health Trust realised the action was silly and wouldn’t back him financially”. That is baseless, totally irrelevant and absolutely untrue. If that is indicative of your current level of intelligence I am not surprised you conclude that a toxic by-product of fertiliser manufacturing is good for you or has your fluoride intake reached critical mass?

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  20. Well, design, perhaps you know better? Perhaps you are on the inside and know that the NZ Health Trust is still backing you? Why not come out with the evidence.

    While on this issue, I note from Hager’s book Dirty politics that Whale Oil often runs posts written by politicians, industry people and PR people under Cameron Slater’s name. The real authors then usually contribute to the comments use false on-line names. Often several at the same time.

    This seems to be a real problem on blogs – and it certainly leads me to be suspicious of anyone using a false name like “designafuture.” At the very least it indicates a lack of honestly as such behaviour is only necessary in an extremely small number of cases.

    Personally, I never take such people seriously. However, as someone here pointed out, design, sounds familiar (some might say it is another front for Trevor Crosby, or Trevor Nutter). Given the implied knowledge about the abandoned High Court case I would not be surprised.

    But is is certainly pathetic.

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  21. While discussing the NZ Health Trust the following information from their 2014 financial return is interesting.

    They received grants of $250,000. This is obviously corporate donations from the “natural” health industry.

    They dispersed $125,000 in direct grants within NZ and 140,000 in other expenses. These will no doubt include legal expenses involve in the South Taranaki case and possibly some of the early seed money for Trevor Crosby’s Hamilton case.

    There are some big money flows involved in the political and economic lobbying of this “charitable” organisation. And some at least is coming to the anti-fluoride activists and propagandist groups.

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  22. Design

    My concern for what you, or any other uninformed antifluoridationists “join” is every bit as abundant as is HFA at the tap in fluoridated water.

    Your opposition to fluoridation is not grounded in science, it is grounded in personal ideology, as it is for all antifluoridationists. Thus it matters not one iota to you as to how overwhelming is the avalanche of peer-reviewed science fully supporting the safety and effectiveness of fluoridation. As long as you can find one tiny little scrap of evidence you believe can be twisted to appear to be “scientific” support for your ideology, you will proclaim that the “science is unsettled”, “there are too many questions”, “there must be more and more and more and more testing done”, “fluoride is responsible for my joint pain, low IQ, heart problems, kidney failure, thyroid destruction, diarrhea, acne, ingrown toenail, impotence, bad haircut, and dirty windows on my car”.

    In other words, I couldn’t care less about your ridiculous “cherry-picking” of “evidence”, as I fully understand that a steam roller could not change your set-in-stone ideology.

    No, I simply post in order to correct the mounds of nonsense posted by you and all other antifluoridationists, such that any intelligent readers who may happen to read comment sections in search of accurate information on fluoridation will not mistake your unadulterated hogwash as having any semblance of credibility.

    Steven D. Slott, DDS

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  23. It is a curious state of affairs when for the most part, anti-fluoridationists often and consistently hide behind pseudonyms whilst for people supporting CWF the opposite is true.

    The ability for the internet to provide such anonymity fosters and promotes abuse but also reveals much cowardice due the absolute lack of accountability.

    This reason alone should immediately raise a bright red flag for any onlooker. For those who side with the ‘anti’ point of view – it should give pause for introspection and reason enough to question your level of personal integrity.

    If you don’t have the courage to stand by your convictions, what value do you place on those convictions?

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  24. I have carefully read your responses and they confirm my comment:
    “I wait with eager anticipation, but little expectation, for a positive response to my questions”.
    The reason I used designafuture rather than Trevor Crosbie will be obvious to anyone with a modicum of common-sense, but then you guys are obviously not particularly well served in that department, relying instead on dogma and mythology for your long winded conclusions.
    I note more communities in the US are giving fluoridation the flick instead of a tick. The wall of ignorance and deception is crumbling brick by brick.

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  25. So “designafuture” is Trevor Crosbie, sometimes calling himself Mr Nutter.

    Yes it is obvious to anyone with a “modicum of common-sense” – you have the same mentality, and dishonesty, as Cameron Slater and his mates.

    Pathetic.

    >

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  26. “It is a curious state of affairs when for the most part, anti-fluoridationists often and consistently hide behind pseudonyms whilst for people supporting CWF the opposite is true.”

    I fully agree, Christopher. I’ve probably said this a couple of times before on Ken’s site, but the reason I post my full name, of which my DDS is as much a part as are my first and last names, is not to refer to myself as being an “expert” in any sense other than any dentist would be on a dental/healthcare issue, but to make it perfectly clear who I am and what is my perspective. It’s simply a matter of honest disclosure. Some view my DDS as a plus, some as a negative, some neutral. It is of no concern to me how anyone views it. I ask people to rely on the peer-reviewed science, not my personal opinion. My signature is simply a statement that I stand fully behind all my comments, and have no problem with being held accountable to provide valid evidence of support whenever requested.

    There are those who have legitimate reasons for using pseudonyms, which I fully respect. Spineless antifluoridationists such as “designafuture” and most others who use pseudonyms to cower behind from where they throw a constant barrage of hogwash, do not qualify for such respect.

    Steven D. Slott, DDS

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  27. Design/trevor

    You are simply another in a long list of spineless antifluoridationists who cower behind, and play games with pseudonyms. If you had any confidence in the unsubstantiated hogwash you spew, you would have no need for pseudonym games. That you refer to peer-reviewed science as “dogma and mythology” further demonstrates your acute ignorance of science and healthcare.

    The latest US CDC report shows an increase in fluoridation from 73.4% in 2011 to 74.6% in 2012. That you seem to erroneously believe that fluoridation is on the decline in the US is simply due to the half-truths posted on the antifluoridationist websites from where yo lazily lap up whatever nonsense they choose to spoon-feed you.

    Steven D. Slott, DDS

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  28. Hi Steve – thanks for your latest rant. I illustrates what a closed minded zealot you are.
    Every day the newspapers carry stories of new scientific findings. There are 15 million scientists worldwide all trying to get their research published. But a disturbing fact appears if you look closely: as time goes by, many scientific findings seem to become less true than we thought. It’s called the “decline effect” – and some findings even dwindle away to zero.
    A highly influential paper by Dr John Ioannidis at Stanford University called “Why most published research findings are false” argues that fewer than half of scientific papers can be believed, and that the hotter a scientific field (with more scientific teams involved), the less likely the research findings are to be true. He even showed that of the 49 most highly cited medical papers, only 34 had been retested and of them 41 per cent had been convincingly shown to be wrong. And yet they were still being cited.
    (No wonder reasonably intelligent people are increasingly questioning the pro fluoridation mantra which is based more on marketing than on sound science.)

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  29. Trevor, perhaps I should ban this username and force you back into using your own name now it is all out in the open? J.

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  30. Design

    How’s life cowering behind the pseudonym? It appears you’ve abandoned the anecdotal nonsense about all your own ailments and have now switched to the good old antifluoridationist tactic of ………”when backed against the wall with no evidence, simply claim science to be invalid, with only antifluoridationists knowing the “real” truth.

    You guys are so predictable it’s truly comical.

    Steven D. Slott, DDS

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  31. Hi Steve – I hardly think that using a pseudonym can be seen as cowering behind anything. This site actually provides that option if one exercises their freedom of choice to use it. Perhaps you could explain the relevance of your grizzle to the debate around fluoridation?
    Strange that you seem unwilling to comment on the paper by Dr John Ioannidis at Stanford University or is he just another one of the highly educated experts you rate as a nutter because he seems to question where science is at.
    Whatever planet you people are on seems to be tracking an erratic path to an undefined and unknown destination.
    If my use of a pseudonym is an obstacle to your understanding of my questions you may call me Trevor Crosbie.

    Liked by 1 person

  32. Trevor, welcome out into the open. Scientific discussion is far more open and honest when not hiding behind pseudonyms.

    First of all, I have no idea as to what is the “grizzle” on which you ask me to comment.

    Second, I have no idea as to whom might be a “Dr. John Ioannidis at Stanford University”, or what “paper” of his on which you wish me to comment.

    Third, I have no idea as to the meaning of your bizarre comment in regard to the tracking of a planetary path, or what may possibly be the relevance of that to the issue of water fluoridation.

    Perhaps now that you have come out from behind your pseudonym, your thinking will clear somewhat and you will be able to provide at least some semblance of coherent information in regard to whatever questions you desire to be addressed.

    Steven D. Slott, DDS

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