I am always amazed at how some people will crudely misrepresent the scientific literature in their efforts to pretend their particular political agenda is scientifically valid. The way they will dredge the scientific literature searching for studies they can quote and misrepresent seems an extreme form of cherry picking and confirmation bias. Surely those indulging in such crude literature dredging are fully aware of what they are doing.
Here is an example of literature dredging I picked up recently. The offender is Michael Connett, Special Projects Director for Paul Connett’s Fluoride Action network (yes – a bit of nepotism there. Son Michael and Wife Ellen are on the payroll). Michael has a legal qualification, but no scientific qualification. Nevertheless, one of his special projects is a litrerature database anti-fluoride activists can use in their propaganda.
Any and every scientific publication that can be quoted, misquoted or misrepresented in arguments against fluoridation.
Here are a couple of slides from Michael’s talk at recent anti-fluoride get-together organised by the Connetts. It’s about “Fluoride and IQ Studies” and the section was meant to show that recent research confirms community water fluoridation is bad for our brain. So he found 4 studies from on rats from 2014.
I have extracted from each cited paper details from the conclusions and the fluoride concentrations of the drinking water given to the rats.
Keep in mind that in New Zealand the recommended optimum concentration for community fluoridated water is 0.7 – 1.0 mg/L.
“We found that NaF treatment-impaired learning and memory in these rats.” The NaF treatments were 25, 50 and 100 mg/L!
“these results indicated that long-term fluoride administration can enhance the excitement of male mice, impair recognition memory, . . ” The NaF treatments were 25, 50 and 100 mg/L!
“exploration preference in the novel object recognition test was significantly altered in mice treated with 5 and 10 mg/L NaF compared with the water-treated control animals.”
“These data indicate that fluoride and arsenic, either alone or combined, can decrease learning and memory ability in rats.” “The rats in the F, As, and F+As groups had access to drinking water with a 120 mg/L NaF solution, 70 mg/L NaAsO2 solution, and combined 120 mg/ L NaF and 70 mg/L NaAsO2 solution for 3 months, respectively.
It’s the old story. Find evidence for adverse effects at concentration much higher the optimum and pretend the results apply to the optimum.
Beware of political activists who claim their agenda has scientific support. There is a good chance they are manipulating the science.
Update
Surpise, suprise. FAN has used young Michael’s talk at their get-together to launch a press release –Fluoride’s Brain Damage Studies Mounting. This will be sent through their usual social media merry-go-round in the hope that the MSM picks it up somehwere.
Just what one expects from a political activist organisation.
It takes a scorecard to try to keep up with the science the Connetts have garbled, twisted, quoted out-of-context, and misrepresented to appear to support their personal ideology against fluoridation.
Ken,
I’m surprised you would stoop lower than such crude smearing.
Did you attend the Fluoride Conference and listen to Michael Connett? I didn’t see you there. If you had, you would know you have cherry picked four of his slides and completely distorted them.
Rats and mice do not have the same toxicological reaction to toxins such as fluoride as humans, about seven fold. The value of animal studies is to understand the potential for harm in humans. Those studies demonstrate too much fluoride does indeed cause neurological harm.
What you failed to consider and evaded are the many human studies finding significant harm with lower IQ from fluoride exposure similar to the fluoride exposure of many in the USA. This is confirmed by estimates of total exposure and urine and serum fluoride concentrations.
Remember, water is not the only source of fluoride. Toothpaste for some can be an even larger source of fluoride exposure. Quality studies include measurements and avoid estimates of assumptions which the American Dental Association and the US Centers for Disease Control rely on.
Yes, I am not surprised you were at the Connett get together Bill. You are, after all, on the team.
Yes the 4 slides are selected (from 27 slides) – by Michael – to show studies from 2014 he claims shows water fluoridation damages our brains. I was simply providing some information from the papers (and please note this is in the form of quotes) showing that the studies are not relevant to community water fluoridation. They are just examples of crude dredging of the literature.
Useful information for readers that Michael certainly didn’t include on his slides. did he actually point out the limitations of what he was doing in his talk, Bill?
Yes. I am aware that some claim that one needs to use higher concentrations with rates and mice to make this equivalent to human situation. But that is controversial and really amounts to special pleading. When researcher use concentrations of 100 ppm and more where a proportion of the rats actually die it is dishonest to pretend the results are relevant to community water fluoridation.
The crass violation of scientific ethos involved in this literature dredging is disgusting and you should be ashamed to be openly supporting it.
So when you scratch the surface, Why would a lawyer work for a group like Fluoride action network? the money must be good to support all the hangers on, and you cant tell me they are there for their health,and the list of lost court cases must cost a lot. Someone is funding it ,and I bet the Natural Health Industry has its hand in the pocket And if you look at the local group they are always after money as well
So really it is not about the fluoride, it is about any way to fund the family business, and fluoride is a convenient scapegoat
You are the one who did the crude dredging of scientific literature and now you are starting to back peddle. Pathetic, unprofessional, and quackery at its extreme.
The research on animals speaks for itself and you distorted and crudely dredged his presentation to fit your agenda. Michael did not present the animal studies with a claim those studies demonstrated harm to human brains. The studies you presented were animal studies, not human studies.
Ken, your crude cherry picking of Michael’s presentation is a mockery of science. You failed to mention that eight of the studies referenced by Choi et al in their Harvard meta analysis had subjects drinking less than 3 ppm fluoride in the water and the average IQ drop was 8 IQ points.
Ken, think “total exposure” of fluoride rather than simply water concentration of fluoride. The subjects in the 8 studies used almost no fluoride toothpaste which can often provide more fluoride than fluoridated water. Therefore, many in the USA are drinking more water than “average”, swallowing toothpaste, receiving fluoride varnish and fluoride medications which make their “total exposure” very similar to the 8 studies with fluoride concentrations lower than the Maximum Contaminant Level Goal (MCLG) set out by the US EPA of 4 ppm.
The excess fluoride exposure is confirmed when fluoride urine and serum concentrations are compared.
The question is not whether fluoride causes neurological harm, rather at what dosage and age is the harm taking place.
Bill, I realise that as you are the West Coast Spokesman for the Connetts’ Fluoride Action Network you have irons in the fire and a point of view to promote. But you are being ridiculous.
Michael was the one who did the literature dredging. I simply checked out the papers he dredged up. That is the normal response of an intelligent researcher. And isn’t literature dredging one of Michael’s “special projects?” Isn’t that how he builds up the database for anti-fluoride propagandists to use?
The fact is that again and again the Connett’s and their off-siders use the tactic of quoting literature where much higher concentrations are used to claim that there is a problem with fluoridation – or at least a possible problem is indicated. But in the thinking of the political activists a possible indication quickly becomes a fact and is perceived as a fact. It’s a simple political tactic. But it is dishonest.
Of course the animal studies speak for themselves but the dishonest presenter can easily take them out of their proper context, not communicate the actual details of the study and use them to promote misinformation.
Isn’t that exactly what Connett’s outfit does again and again?
My article purely presented a neat little example of literature dredging. As for the Choi paper I have written several times on it and will be doing so again when I review the document you guys produced to attack the NZ Royal Society Review. Why don’t you check back and get stuck into my comments on them in one of those articles. It is silly to claim there is something. Wrong for me not to have included it is this article. Silly.
You are into special pleading in your homilies on “total exposure” – partly for the very reason that most of the studies in Choi’s paper are so weak you cannot find information on “total exposure” Your are forced to assume or speculate.
As for your claim of neurological harm – come off it? Where is the established mechanism? Why do you rely on such poor studies? And why do you ignore the role that severe dental fluorosis will have on children’s learning? You are so busy trying to invent a neurological mechanism you may be blind to what sticks out like a sore thumb. To my mind if tooth decay can cause learning difficulties then surely so also can severe dental fluorosis. And these studies comes from an area of the world where fluorosis is endemic. Unlike NZ and USA.
Even the authors of Choi’s review have stated it is not relevant to community water fluoridation.
“The crass violation of scientific ethos involved in this literature dredging is disgusting and you should be ashamed to be openly supporting it.” Pot kettle and black Ken with regards to your support of the Gluckman/Skegg review. That report is one of the best examples of cherry picking you could ever find. It’s more a political than scientific report. Reminiscent of tobacco science and lead. With lead top scientists insisted that the low levels of weren’t toxic.We already know that fluoride levels found in fluoridated water affect some people adversely.
Really? We know that fluoridated water (ie with concentrations of 0.7-1ppm) adversely affects people? Remarkable. Would you care to share the studies which demonstrate this?
I mean, call me a skeptic, but if we have evidence of harm to people at those concentrations, then what the heck is Connett doing wasting everybody’s time with studies on rats at fluoride concentrations which are orders of magnitude higher?
It is always facinating to see you, Connett and other antifluoridationists constantly attempting to use the 27 studies dug out of obscure Chinese journals and reviewed by Choi and Grandjean, as the basis for your IQ nonsense. These studies were so ridiculously flawed and irrelevant that it is a marvel that any intelligent person would embarrass him/her self by putting them forth as evidence of anything, other than a prime example of the flimsy base on which antifluoridationists rest their constant attempts to deprive entire populations of the benefits of water fluoridation. It is not a certainty that these studies were even peer-reviewed.
You hypocritically rely on these 27 “studies” to justify neurotoxicity claims against CWF, claims grounded in the paranoid fear of “mind control” which pervaded antifluoridationist ideology from the very beginning of the initiative, while attacking Broadbent, a properly peer-reviewed study published in a highly respected journal. Broadbent is a study of the effects of exposure to CWF not of exposure to high fluoride levels, is not missing key information, does not have missing pages, and did not employ questionable methodologies.
The following are examples of the flaws pointed out by Grandjean and Choi, themselves, in the “infamous 27” upon which you rely:
From:
——Developmental Fluoride Neurotoxicity: A Systematic
Review and Meta-Analysis
Anna L. Choi, Guifan Sun, Ying Zhang, Philippe Grandjean
Page 4 Conclusion:
“The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.”
Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 9
“Six of the 34 studies identified were excluded due to missing information on the number of subjects or the mean and variance of the outcome (see Figure 1 for a study selection flow chart and Supplemental Material, Table S1 for additional information on studies that were excluded from the analysis). ”
Page 13
“Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.”
Once again, note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration, exactly in the r. ange of the control groups in this study.
Page 13-14
“While most reports were fairly brief and complete information on covariates was not available, the results tended to support the potential for fluoride-mediated developmental neurotoxicity at relatively high levels of exposure in some studies.”
Incomplete information on covariates (controls). Relatively HIGH levels of fluoride. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 15
“The present study cannot be used to derive an exposure limit, as the actual exposures of the individual children are not known. Misclassification of children in both high- and low-exposure groups may have occurred if the children were drinking water from other sources (e.g., at school or in the field).”
Page 15-16
“Still, each of the articles reviewed had deficiencies, in some cases rather serious, which limit the conclusions that can be drawn. However, most deficiencies relate to the reporting, where key information was missing. The fact that some aspects of the study were not reported limits the extent to which the available reports allow a firm conclusion. Some methodological
limitations were also noted. Most studies were cross-sectional, but this study design would seem appropriate in a stable population where water supplies and fluoride concentrations have remained unchanged for many years. The current water-fluoride level likely also reflects past developmental exposures. In regard to the outcomes, the inverse association persisted between studies using different intelligence tests, although most studies did not report age adjustment of the cognitive test scores.”
As I’ve said, the 27 Chinese studies were so flawed as to have no value, whatsoever, in evaluating water fluoridated at 0.7 ppm in the U.S.
Chris, you obviously do not understand antifluoridationist code. Let me explain.
“We” is defined as: uninformed antifluoridationists.
“Know” is defined as: speculate, argue, put forth, desperately wish to be true, and that for which “we” can provide anecdotes of our own ailments and those of horses, as proof.
You “shoot the messenger” when he/she alters the ‘message” to fit his/ her personal ideology.
How about if you show us your science on fluoride and neurological risks, remaining relevant to fluoride at the optimal level. You’re the one making unsubstantiated claims, not I. It is not encumbent on me, or anyone else, to disprove such claims.
You don’t like Choi et al. Then perhaps you would be kind enough to provide a prospective randomized controlled trial on benefits or risks of fluoridation.
You assume “low” fluoride is 0.7 ppm. Low fluoride is mother’s milk with most samples measuring no detectable fluoride and mean of 0.004 ppm. What you consider to be “low” at 0.7 ppm is 175 times more concentrated than mother’s milk. The terms in the study “high” and “low” were not equating “safe” and “harm.” The low fluoride cohorts were the comparison. One study had low of 0.88 ppm finding harm, 8 studies had water fluoride concentrations under 3 ppm and the average IQ drop was 8 IQ points. Don’t forget the US EPA says 4 ppm is safe. Yet 8 studies are lower than 3 ppm.
You assume the only fluoride exposure is from water. Total exposure in the “high” cohorts is similar to what many are ingesting in the USA.
A lower limit cannot be determined from the studies because that was not the purpose of those studies. The kind of study you are suggesting is not ethically possible and I don’t think would be permitted by human study review boards. Nuremburg Trials and Tuskegee study etc. have shut down the experimentation on humans of toxic substances to expected harmful concentrations.
QUESTIONS:
Have you actually read the studies? Have you read Tang’s review of the fluoride neurological studies? What dosage of fluoride do you think is safe and effective?
What is the maximum fluoride concentration in urine and serum which you feel is safe and effective? The intent of artificial fluoridation is not to treat water, but to treat people. When we treat people, we dispense an amount to achieve a result in the person. What is safe and effective in the person?
What concentration of fluoride in dentin and enamel prevents or mitigates tooth decay?
You talk about “high” vs “low”. Please explain in ppm or mg/L and also mg/Kg/day BW what you mean by “low” and “high” fluoride exposure.
Please provide the criteria of a quality study on humans which would be accepted by a human study review board that you would also accept. Do you really think a human study review board would accept giving fluoride to cohorts and measuring the dosage when they would have neurological harm? Therefore, we are left with low quality studies. Fortunately we have numerous studies and they are all finding consistent results.
The question is not whether fluoride causes neurological harm but at what dosage.
Until a dosage is determined, the safe dosage for infants would be the same as mother’s milk, less than 0.001 mg/Kg/day.
Steve,
Artificial fluoridation is the act of using police powers to force a person to ingest fluoride. Almost impossible to avoid because it is in processed foods, etc.
Freedom to chose medications is a fundamental right and should be protected.
As a public health professional, I agree with courts that public health should have police powers and the courts are clear, those powers can only be used for highly contagious diseases. Tooth decay is not highly contagious.
When governments remove my freedom to choose substances intended to prevent disease (drugs, medications), governments must have clear and strong scientific evidence of safety and efficacy and provide me with appropriate label and doctor’s supervision. None of that is happening with water fluoridation.
Israel stopped artificial water fluoridation. Why?
Most of Europe has stopped or never started fluoridation of public water and most salt does not have fluoride.
Why are you opposed to letting me have freedom?
Question: What concentration of fluoride in the dentin and enamel body has been shown to be “optimal” for the prevention of dental caries?
“Artificial fluoridation” is a misnomer used by antifluoridationists to mislead the public into believing that the fluoride added to water systems is somehow “man-made” and not the “natural fluoride” provided by CaF. You should know, as well as I do, that the HFA utilized to fluoridate the majority of systems, is derived from phosphorite rock as a co-product of the process utilized to derive phosphoric acid. You should also know that the fluoride ions released by HFA are identical to those released by CaF, NaF, or any other compound. Please don’t waste my time or yours by attempting the argument about heavy metal contaminants. If you have the need, complete information on these contaminants is found on the National Sanitary Foundation website.
No one is forced to anything in regard to fluoridation. People are entirely free to consume it or not. No one will tie them down and force fluoridated water down their throats. Inconvenience, regardless the degree, does not equate with “force”. The “forced medication” argument is nothing but an unconscionable attempt to invoke emotion by exploitation of the sufferings of those unfortunate ones throughout history who truly have been subjected to forced medication. “Forced medication” has been repeatedly attempted in US courts through the decades. It has been rejected each and every time by those same courts. You are certainly free to try it yet again, but I don’t much like your chances with that.
Water fluoridation in no manner interferes with anyone’s “freedom to chose [sic] medications. Local governments and/or water boards are entirely free and authorized to determine the content of their local water supply in compliance with all applicable laws and regulations.
Israel ceased fluoridation due entirely to the unilateral action of one person, their Minister of Health, who deemed her personal ideology to be more important than the best interests of the citizens of Israel. Over the vehement objections of the respected healthcare community of Israel, this Minister had made it her mission, since taking office last year, to impose her antifluoridationist ideology onto the entire Israeli citizenry, as she had years before in the community over which she presided as mayor. Unfortunately, the Israeli system of government allowed her the authority to do so. Given the staunch opposition by the Israeli healthcare community, and even the Prime Minister himself, to this grievous action by the Health Minister, I, personally, would not like to have her prospects for job security.
The reasons that European countries may or may not fluoridate their water systems are myriad, few, if any, related to effectiveness or health concerns of optimal level fluoride. They are also irrelevant to that which is done by New Zealand, the US, or any other countries, in the best interests of their respective citizenries.
I am not opposed to letting you have freedom. That, however, is irrelevant to water fluoridation.
As you well know, Warren and Levy attempted to ascertain if there could be determined an optimal level of fluoride which would provide a caries-free dentition, with no adverse effects. As you also well know, due to halo effects and other variables, they were unable to do so to any degree improved over that which is currently utilized as the optimal level. This in no manner negates the decay preventive benefit of the current optimal level of 0.7 ppm to 1.2 ppm. It simply means that they were unable to improve upon this determination. Given the countless, peer-reviewed studies clearly demonstrating the effectiveness of fluoridation, coupled with the lack of any proven adverse effects of fluoride at this level, the validity of the current optimal level has been borne out over the 69 year history of this initiative.
You asked me to show you my “science on fluoride and neurological risks”. You are the one claiming neurological risks, not I. Once again, it is not encumbent on me, or anyone else, to disprove your unsubstantiated claims. It is of no concern to me what you present here. I am simply exposing the fact that your claims are unsubstantiated.
The Times of India
High fluoride content in drinking water major public health risk
Syed Intishab Ali,TNN | Sep 15, 2014, 10.02 AM IST
JAIPUR: High content of fluorides in drinking water are not only causing skeletal damages but it is also causing non-skeletal damages including infertility and mental disorders.
In the state, a total of 2,749 samples (up to August 2014) was taken from different sources of water in 18 different districts and found that 1,717 of them contain 1ppm to 3 ppm of fluoride, while 314 contain 3ppm-5ppm and 99 of them contain more than 5 ppm of fluoride.
According to health experts, 1ppm to 1.5ppm concentration of fluoride in water is the standard and recommended upper limit.
Water with high fluoride content put people at risk of getting affected with gastric problems, mental retardation, paraplegia and burning sensation during urination.
Health officers checked the content of fluoride in urines and they found that out of 7,649 samples, 5,869 have fluoride more than 1 ppm, which is above the permissible level.
“Fluorosis is a public health problem resulting in major health disorders like dental fluorosis, skeletal fluorosis and non-skeletal fluorosis besides inducing ageing. There are cases of infertility, mental disorders and others which we have found during the survey in areas with high fluoride contents in drinking water,” Dr Ramavatar Jaiswal, state nodal officer for fluorosis said.
He said the harmful effects are permanent and irreversible in nature.
A health department’s physical report on fluorosis releasing figures up to August 2014, shows that there are 4,850 suspected cases of non-skeletal fluorosis including cases of suspected cases of infertility due to fluorosis in different districts.
In the survey, the health department conducted tests on more than 2,76 lakh people and found that 90,122 were suspected cases of dental fluorosis and 17,160 persons were suspected cases of skeletal fluorosis but it came as a shock for the health authorities when they found that there are cases of 4,850 suspected non-skeletal cases.
Dr Jaiswal said they do not have separate figures of cases of infertility linked to fluorosis as they are included in suspected non-skeletal cases. The other non-skeletal cases are persons suffering from swollen joints, muscular tenderness and systematic rigidity.
The survey was conducted in 18 districts of the state. The highest number of non-skeletal cases were found in Jodhpur (2,262), Churu (1,325) and Jaipur (1,068).
Rajasthan is one of the states with the best National Programme for Prevention and Control of Fluorosis (NPPCF) and the director general of the Union ministry of health is expected to visit the state soon.
ASWLA comment: Funny how those that have no knowledge of the ‘debate’ on this blog, are doing their best to remove fluoride from causing suffering to people via drinking water supplies; whilst those supporting fluoride on this blog, do their best to inflict it on everyone without any concern for suffering people might have. Interesting ethics Ken, don’t you think?!
If a person drinks more than one litre of water a day, they are getting more than the ‘recommended’ dose of 1mg a day. The same as those poor people mentioned in The Times of India, who have to deal with calcium fluoride – not the industrial waste fluorosilicic acid muck forced into Australian, American, UK or Irish water!
ASWLA……….Seriously? High fluoride intake and skeletal fluorosis in India? You really have no clue as to the irrelevance of this to water fluoridation in NZ or the US have you?
Here’s another toxic poison about which we need to enlighten the unwitting public. Think maybe you could form a group and a website to oppose the forced medication of us all with this noxious substance?
Maybe name it “Water Free Australia”, or something, with websites such as “wateralert.org”, “waterresearch.org”, “waterfacts.com”…….or something?
Maybe have a blog of “the things your corrupt government doesn’t want you to know about water”, have an investigative arm to find out how pro-water lobbyists are paid by the corporate water industry.
Demand absolute, irrefutable proof that water does not cause cancer, and that the moon is not made of green cheese, before any more of this toxic waste is allowed into our public utility systems…..
Sloth, ASWLA knows EXACTLY the relevance. But the point of putting up that article being, other people in the world know how TOXIC fluoride is to the human system. You Sloth – and your kin – arrogantly believe that people are only their teeth; and we can ingest industrial waste without any problems, no matter age, health, or even, need (what if you don’t have your teeth anymore Sloth – you don’t need to ingest anything, eh!); and you continue to ignore any relevance to any other studies, results or problems other people are dealing with in the world that state a different tale to your agenda – that of selling fluoride as a magic cure-all for too much sugar, poor diet and chemical imbalances, that will not be fixed by snake oil sales of an outdated mode of ingesting a corrosive acid. Your kin like to impinge your will on all of us, with a very very narrow focus – teeth. Grow up. The world is awake these days, to this aluminium waste product you call ‘fluoride’. One day you will see, people don’t want to drink, ingest or have forced upon them, the will of the industrial merchants peddling their waste products or those wearing white coats and touting ‘safe and effective’ as a mantra. NZ and Australia have high rates of arthritis, thyroid, kidney, heart and fluorosis. And the skeleton is the final resting place of these chemicals that destroy the softer tissue health first. No matter what you bluster on about, India is leading the way. And whether you like it or not Sloth, the world has cottoned on to the scam perpetuated for way too long – the scam that industrial waste is somehow, ‘good for us’, ‘safe’, and ‘effective’. Show us the long term safety date of ingesting this stuff – you still have not coughed it up Sloth. ASWLA has asked you more than a dozen times now, on different blogs. But, you never produce the hard evidence of safety – as there is none. You just go silent, and move on the peddle more of your opinions, caring not one iota for the welfare of those who don’t want or need this stuff; and suffer because they cannot avoid it – tap water is in everything processed. Meanwhile, India is doing its best to remove natural forms of fluoride, to look after its people.
Pray tell dear Sloth, all who deem you the God of fluoride chemistry and who knows what is the ‘safe’ dosage for all – with a one size fits all approach that water fluoridation demands: What dose is recommended by you, oh mighty doctor of all babies, elderly, indigenous, kidney diseased, heart diseased, thyroid diseased or other? And how does one measure a daily dose from all sources of water fluoridated foods and beverages; and pay tell, please, if you KNOW, tell us all what that recommended daily dose is, for each of us, regardless of our need or health status? If 1ppm is deemed ‘safe’ per day, how does one measure that dose in all sources?
Where IS that safety data for long term ingestion? Hmmm…. doesn’t seem to be any, does there. We’ve asked so many times for it. Never materialises, does it Sloth. You’ve still avoided producing it. If fluoride is so safe, then cough up the evidence please. We’re all still waiting. ASWLA has better things to do than waste time on this little blog. Time to leave. If you do happen to find that evidence of perfect safety for long term ingestion, please do us all a favour – we’ll go away permanently then – and provide it for us. Even the Australian TGA cannot provide such evidence. We rest our case. Cheers! ASWLA now has more important things to do, than prop up the egos in this mighty sad ‘debate’. For fluoride as a ‘safe and effective’ solution to too much sugar, is just like this blogs name – an open parachute – falling, falling, falling down. Ciou!
I see not one scrap of valid evidence to support these ridiculous claims you make. Please provide such, keeping relevant to fluoride at the optimal level, and bearing in mind that your personal opinion, and/or links to “fluoridealert” do not constitute evidence of anything.
As for my going “silent” when challenged by you, and other antifluoridationists, to disprove the constant barrage of unsubstantiated claims you make….far from it. Each and every time you attempt that nonsensical tactic, I remind you that it is not a responsibility of mine, or anyone else, to disprove your unsubstantiated claims. It is when I ask you for valid evidence that a problem exists in relation to water fluoridated at the optimal level, that occurs the silence you have observed.
Ah yes, ASWLA, in predictable manner, you disappear when challenged to provide valid evidence of any problem with water fluoridated at the optimal level. Comical.
Wow! Please let me know who are all these people who deem me to be a “God” so I may thank them! Think maybe I could be deemed the “Premier International Authority on Fluoride”? Oh wait….somebody has already anointed himself with that moniker…oh well.
As far as daily recommended “dose” and other diatribe in your comment, this information is readily to anyone, even you, who put forth a bit more effort than is required for the lazy copy/pasting of nonsense spoon-fed to them from “fluoridealert”.
But, alas, since the reality is that you will never exert such an additional effort, I will explain this to you…..
Simply put, water is fluoridated at 0.7 mg/liter (ppm=mg/liter). Thus, for every liter of fluoridated water consumed, the “dose” of fluoride intake is 0.7 mg. The average daily water consumption by an adult is 2-3 liters per day. So, let’s go to an extreme and double that to an excessive 6 liters of fluoridated water consumption per day. This translates to 4.2 mg “dose” of fluoride intake per day from the water. The CDC estimates that of the total daily intake, or “dose”, of fluoride from all sources including dental products, 75% is from the water. Thus as 4.2 mg is 75% if the total daily intake from all sources, the total daily intake, or “dose” from all sources would be 5.6 mg for an individual who consumed an excessive 6 liters of fluoridated water per day.
The Institute of Medicine has established that the daily upper limit for fluoride intake from all sources, for adults, before adverse effects will occur, short or long term, is 10 mg. Thus, even the excessive 6 liter per day consumer of water will still only take in a daily “dose” of fluoride that is slightly more than half the upper limit before adverse effects.
The range of safety between the miniscule few parts per million fluoride that are added to existing fluoride levels in your water, is so wide that “dose” is not an issue. Before the UL of 10 mg could be reached, water toxicity would be the concern, not fluoride.
Sorry, Chris, it looks like ASWLA has disappeared like a wisp of smoke in the wind. Seems he has more “important” things to do than hang around us rude people with the gall to hold him accountable.
Bill’s special pleading over the a Choi et al review is typical of the arguments being used currently by anti-fluoride propagandists because of the directions coming from Connett’s organisation at the moment.
Bill says “One study had low of 0.88 ppm finding harm.” Of course if this was at all convincing. he would have gone into details but he chooses not to (not part of the direction). He is referring to the report of Lin et al. This is 1 and 1/2 pages long and omits important details. No information on the range of F concentrations in drinking water – just a bald mean for 2 of the areas. No details about level of dental fluorosis found, just a bald percentage. I could go on.
But the significant feature Connett et al always cover up is this was a study of subclinical cretinism basically due to I deficiency. The comparison was of the I deficient areas with a control area given I supplementation. 14% of the studied children were mentally retarded, and 69% of these exhibited subclinical cretinism.
The study showed a significant difference between the I deficient and supplemented areas. Differences between the two I deficient areas were far less convincing. However, the straw clutching and special pleading required to claim this study is at all relevant the CWF where I is not deficient is extreme.
I have my health and my families health and our freedom at stake.
You distorted and put words in Michael’s mouth which he did not use or say. You did not attend the convention. You intentionally misrepresented the research to fit your agenda. Michael did not say or imply what you wrote.
You accuse Michael of “crudely misrepresenting” the scientific data. He did not.
You Ken.
You Ken, crudely misrepresented Michael’s references to animal data.
Steve, you asked me to provide research on risks at the “optimal” level of fluoride intake.
Sure. Lets first define “optimal.” Use science, not religion.
What is optimal? Mother’s milk. Most samples have no detectible fluoride. That is optimal.
All studies on fluoridation are weak. Not a single prospective randomized controlled trial. And only 8 human studies with fluoride concentrations less than 3 ppm.
And based on the lack of scientific evidence, you support forcing me to consume more fluoride without my consent.
The problem Ken and Steve is judgment. Stand back for a moment and consider.
1. Poor quality studies on efficacy and safety:
• A. Not one Study corrects for Unknown Confounding Factors
• B. Not one Prospective Randomized Controlled Trial
• C. Socioeconomic status usually not controlled
• D. Inadequate size
• E. Difficulty in diagnosing decay
• F. Delay in tooth eruption not controlled
• G. Diet: Vitamin D, calcium, strontium, sugar, fresh and frozen year around vegetables and fruit consumption not controlled.
• H. Total exposure of Fluoride not determined
• I. Oral hygiene not determined
• J. Not evaluating Life time benefit
• K. Estimating or assuming subject actually drinks the fluoridated water.
• L. Dental treatment expenses not considered
• M. Breast feeding and infant formula excluded
• N. Fraud, gross errors, and bias not corrected.
• O. Genetics not considered
2. Mother’s milk 0.004 ppm
3. No known optimal tooth fluoride concentration.
4. Recommended serum fluoride concentration less than 0.02 ppm and many have higher.
5. Fluoridation cessation studies finding no increase in caries.
6. Animal studies finding harm.
7. Human studies finding harm
8. Fluoride given without consent.
9. Defined by law as a poison, legal to dispense under pesticide laws or drug laws. Approved by the FDA CDER for topical use only. “DO NOT SWALLOW”. The FDA CDER warning is for the same amount of fluoride as one glass of water.
10. Many studies finding no benefit with the ingestion of fluoride.
11. No margin of safety.
12. No enzymatic or neurological safety studies
13. Not approved by the drug regulatory agency.
14. Most developed countries not fluoridating and reducing dental caries to the same as those fluoridating.
Again. Stand back and look at the big picture. With so much uncertainty both on safety and efficacy why refuse to give people the freedom to choose?
I repeat, Bill, is the new fact-free emotional comment a response to my comment on the problems with the Lin et al study? You were the one that brought up the study – I would think you would want to discuss it.
By the way I don’t support forcing anyone to adjust their dietary intake. No-one. But again this is an emotional response, isn’t it?
“I have my health, my families health and our freedom at stake”
Oh, for gosh sakes, Bill, save the drama for Broadway. I doubt that your whining about your “freedom” would garner much sympathy from anyone whose freedom had ever truly been at stake. Get over yourself.
The “optimal level of fluoride” is a term used to identify that level established by the US Department of Health and Human Services at which maximum dental decay prevention will occur with no adverse effects. The current optimal level is a range of 0.7 ppm to 1.2 ppm. Although this is a recommended level which has no legal mandate, public water systems generally abide by this recommendation when fluoridating.
Your personal opinion as to what is the optimal level of fluoride is meaningless. You and Connett are the ones using religion, not I. For some inexplicable reason you both seem to think you have a special pipeline to the Almighty, such that you, and you alone know what He has intended in terms of how much fluoride is “safe” for infants. Human breast milk is deficient in iron and Vitamin D. Please ask the Almighty next time you and Connett meet with Him, if He intended for infants to be anemic and develop Ricketts.
Once again, you are the one making unsubstantiated claims about “neurological risks” of fluoride. I couldn’t care less what you post, but if you expect credence for these claims then provide valid, peer-reviewed scientific evidence of support, relevant to fluoride at the optimal level.
“The problem Ken and Steve is judgment. Stand back for a moment and consider.”
1.Humans have been ingesting this identical fluoride ion in water since the beginning of time
2. Sixty nine years of fluoridation, hundreds of millions having chronically ingested it.
3. Fluoridation being the most most discussed, tested, poked, prodded, twisted, and squeezed to find any adverse effect that could conceivably, in any possible manner, be attributed to it….than any other public health initiative in history.
4. Countless peer-reviewed scientific studies clearly demonstrate the effectiveness of fluoridation.
5. No proven adverse effects
Seems the one with the judgment problem is you, Bill.
What government agency determined “optimal?” What was the scientific evidence and what was the date and mg/Kg/day?
Most important, who is reviewing the total exposure people are ingesting from all sources today?
The ever increasing biomarker of excess fluoride ingestion, dental fluorosis, continues to increase, now at 41%. HHS 3 years ago asked for input on making 0.7 ppm maximum giving 90 days because they were going to make a decision within 6 months. Still no response.
EPA in their Dose Response Analysis admits about a third of children will ingest too much fluoride even when they ignore infants and the 10% of the population drinking the most water and claiming fluoride is now safer by 33%. This in direct contradiction to the NRC 2006 report that EPA’s MCLG of 4 ppm is not protective.
Steve, you are trusting the American Government to determine “optimal” and the US Government is not doing what you (or I or Congress and the law) expect and require.
With fluoridation, the US Government cannot be trusted.
Ken,
Thank you for your response that you do not think anyone should be forced to change their dietary habits. I agree. Freedom of choice for food and drugs is a fundamental right.
Now lets talk about fluoride which is not a dietary nutrient.
Fluoride is not a food. No physiological function requires fluoride. The absence of fluoride does not cause any disease.
Mother’s milk does not contain fluoride in most samples.
Fluoride is not exempt from toxic poison laws as a food, only as a drug or pesticide.
The FDA has repeatedly stated that fluoride is a drug.
Toothpaste labels with fluoride say “drug facts” and “do not swallow.”
When fluoridation started, researchers were confident fluoridated water would not increase dental fluorosis. Other sources of fluoride were started, such as fluoride toothpaste, mouthwashes, fluoride medications, teflon pots and pans, and much more.
No one is seriously monitoring total exposure of fluoride.
Few US studies include serum or urine fluoride concentrations.
And dental fluorosis has increased to 41%. A clear sign that many are ingesting too much fluoride. While those promoting the “optimal” fluoride concentration in water, few are seriously considering the total fluoride intake.
Instead of carefully considering the law or science, public health policy simply promotes tradition.
With so many ingesting excess fluoride and increasing amounts of fluoride being ingested, at what point should total fluoride be reduced? And what should be reduced?
Pesticides? We gain quality produce with fluoride pesticides.
Toothpaste? Topical fluoride is FDA approved to help prevent dental caries.
Medications? Lives are saved with fluoride medications.
Fluoridated water serves no additional intent, is done without consent of the patient, is the contaminated waste product of industry, increases lead blood levels, etc.
To reduce the excess fluoride consumption of the public, the most reasonable exposure to reduce is water fluoridation. All other sources have good reasons to use them.
I agree the fluoride ion is the same regardless of source. However, NaF and hydrofluorosilicic acid readily give F ions whereas the CaF does not dissolve as readily and is far less toxic. Natural fluoride is usually found in calcium rich water, hard water, and is less toxic.
And fluoridated water is not by choice. How do you know your processed foods have or do not have fluoridated water? We don’t know. The “halo” effect is without label.
Many are ingesting too much fluoride. Give people freedom.
Bill, you seem to take my agreement that no-one should have dietary requirements forced on them to apply to you but not to me. You wish to force on me the requirement of a fluoride-free diet, despite my rejection of your misinformation and assessment fluoride deficiency is bad for my oral health.
The simple fact is that no-one has the right to demand society be organised purely according to their own beliefs and hang ups. For the last year I was in the situation where our city council provided water deficient in F. I opposed this because it was against the declared request of the majority of voters â not because of my particular beliefs. If voters had supported the council I would have accepted this and taken my own steps to overcome the problem. Fortunately public pressure has forced our council to listen to the majority and reverse their mistake.
I think that is the responsible approach and just wish those people whining about fluoridation would be as responsible. If the community wants it then they should have it. Those among the minority who donât want it should take steps to accommodate their own hang ups â not demand others be forced to do something they have clearly said they donât want to.
You have many alternatives for choosing alternative water supplies or filtering your water. If yore community chooses to fluoridate the water then your responsible action is surely clear â stop your whining and misinformation. Take steps to get what you want without denying the benefits to others.
If you want to swallow fluoride, swallow a small pea size of toothpaste which contains 0.25mg of fluoride. Fluoride is easy to find and ingest. And the dosage can be controlled.
Avoiding fluoride is complex because we don’t know which foods have had it added.
we cant have that Ken, the family business would be out of work ,and out of income, it does not matter what is right or wrong , the bottom line is the money, And Mercola would stop paying
Bill, my logic makes perfect sense to me. And as the majority of my community has finally got their democratic rights accepted on the matter I am happy – even though all this whining is going on. It can be amusing though.
Your insistence in avoiding F is your hang up. It is not rational but you are welcome to it. Don’t expect me to have to suffer or lose my freedoms because of it. Especially as democracy and science has spoken in the matter.
Community water fluoridation is well established as beneficial and safe. Much more so than swallowing toothpaste. What a stupid suggestion.
If the input was in a properly controlled situation like Community Fluoridated Water at .7-1PPM ,A person would be very sick from water ingestion before any fluoride damage at that level, is that not a better control situation, than telling the public to use this amount of fluoride toothpaste that can contain fluoride at 1000-1500PPM, And leaving the amount they use up to them, and to cover your arse putting a warning label on the tube.
You make a big thing about the damage caused by high fluoride levels and then promote the source of fluoride that carries the highest dosage
You dont need a warning label on the tap
“Steve, you are trusting the American Government to determine “optimal” and the US Government is not doing what you (or I or Congress and the law) expect and require.
With fluoridation, the US Government cannot be trusted.”
Thank you, but I’m fine with trusting the US Centers for Disease Control, the US Environmental Protection Agency, the US Department of Health and Human Services, the United States Public Health Service, the United States Institute of Medicine, and the past 5 US Surgeons General……..as opposed to trusting the “Fluoride Action Network”, Declan Waugh, non peer-reviewed books by a retired chemist/activist and an “investigative reporter”, filtered and edited “information” posted on activist websites and blogs, out-of-context quotes, half-truths, and misinformation.
Once again, the optimal level of fluoride is that level, established by the US Department of Health and Human Services, which provides maximum dental decay prevention with no adverse effects. As I provided previously, Warren and Levy attempted to ascertain whether an even more precise optimal level could be determined which would provide caries-free dentition, with no adverse effect. They concluded that it could not be done. Given the volume of peer- reviewed science clearly demonstrating effectiveness of fluoridation, and the lack of any proven adverse effects of fluoridation since its beginning 69 years ago, the DHHS recommended optimal level has been borne out to be valid. If you have a problem with this recommended level, you are certainly free to contact DHHS with your complaint.
The US Department of Health and Human Services oversees the US water fluoridation initiative.
The US EPA oversees and regulates all additives to drinking water. This includes fluoride. In order to monitor the effectiveness of its guidelines and mandates, in accordance with requirements of the Safe Drinking Water Act, the EPA periodically requests the National Research Council to review all pertinent fluoride literature to determine the adequacy of the EPA primary and secondary MCLs for fluoride, 4.0 ppm and 2.0 ppm respectively, to protect the public against adverse effects. The past two such reviews were in 1993 and 2006.
The “41%” of dental fluorosis to which you refer comes from a 2010 CDC study by Beltran-Aguilar in which researchers found that 41% of adolescents whom they examined, showed signs of dental fluorosis. This 41% was composed of 37.1% mild to very mild dental fluorosis and 3.8% moderate dental fluorosis. Pendry concluded in 2004, that moderate dental fluorosis is resultant of improper ingestion of toothpaste, improper prescription of fluoride supplements, use of fluoridated water to reconstitute powdered infant formula, and/ or exposure to high levels of environmental or well-water fluoride, in relation to children during the tooth developing years. The mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse.
The optimal level of fluoride was originally set by the USPHS service as a range of 0.7 ppm to 1.2 ppm. It was set as a range to allow for differing levels of water consumption in different climates. Recent studies have shown that, due to air-conditioning and other modern amenities, a significant discrepancy in water consumption between climates no longer exists. In recognition of this finding and of the greater availability of fluoride now than when the optimal was originally set, the CDC, in 2011, recommended that the optimal level be reset to simply the lower end of the current range, 0.7 ppm. Although the DHHS has as yet to officially adopt this recommendations, most public water systems are utilizing this recommended optimal of 0.7 ppm. when setting the fluoride level.
Yes the 2006 NRC Committee on Fluoride in Drinking Water deemed the EPA primary MCL “to not be protective”. The other half of this truth is that it only deemed it not protective against severe dental fluorosis, skeletal fluorosis, and bone fracture when water with a fluoride content of 4.0 ppm or greater is chronically ingested. No other concerns were stated in regard to fluoride at or below 4.0 ppm. The Committee made no recommendation to lower the secondary MCL of 2.0 ppm. As water is fluoridated at 0.7 ppm, one third the level the 2006 NRC Committee made no recommendation to lower, the final recommendation of this Committee has no bearing on water fluoridation.
“I agree the fluoride ion is the same regardless of source. However, NaF and hydrofluorosilicic acid readily give F ions whereas the CaF does not dissolve as readily and is far less toxic. Natural fluoride is usually found in calcium rich water, hard water, and is less toxic.”
One fluoride ion is no more toxic than another, regardless the source compound. If there was an uncontrolled amount of HFA being added to water supplies your solubility argument might have some merit. However, there is not. HFA is carefully diluted to a 23 % aqueous solution which is then added to drinking water only in the amount which will raise the existing fluoride level up to the optimal. It, thus makes no difference as to differences in solubility rates between HFA and CaF. We are only concerned with the fluoride ions which they actually release into the water.
Ken,
I understand you to suggest that it is OK to dispense fluoride to each other if the majority of the voters vote in favor. In other words, those with the most money to advertise convincing the most people win. Most European nations have rejected fluoridation because it does not give freedom of choice.
The suggestion that fluoridation is safe and effective is held by several english speaking countries, but not most developed countries. Unfortunately science does not support either effective or safe.
If fluoridation were effective we would see lower rates of dental caries in fluoridated countries, states, counties, and cities. Not true. Same caries rates where socioeconomics is similar. Dental expenses would be lower and fewer dentists would be found and when fluoridation stopped, dental caries would increase. None of those indications have been found.
Please provide at least one prospective randomized controlled trial of fluoridation’s effectiveness. Or do you rely on junk science?
Please provide at least one prospective randomized on fluoridation’s safety.
The claim of efficacy and safety are based on tradition and myth in English speaking countries.
Look up the toxicity of ingesting hydrofluorosilicic and sodium fluorides. My memory is about 5 mg/kg/day BW. And compare that with CaF, again my memory is over 600 mg/kg/day BW. My understanding is the difference is due to the free ions. One of the reasons CaF is not used to fluoridate water is because it clogs the equipment, does not dissolve well.
Steve,
You wrote, “Thank you, but I’m fine with trusting the US Centers for Disease Control, the US Environmental Protection Agency, the US Department of Health and Human Services, the United States Public Health Service, the United States Institute of Medicine, and the past 5 US Surgeons General……..”
So did I for 25 years of dental practice and then I looked at the law and science. None of those government agencies determine the safety or efficacy of any chemicals, drugs, or substances. You could have listed the department of highways, school boards, or a long list of other government agencies. They do not have jurisdiction over substances used with the intent to prevent disease. Even the EPA does not approve substances added to public water. Sorry. You are trusting agencies with no jurisdiction.
The government agency set up by Congress to determine the safety and efficacy of substances used with the intent to prevent disease is the Food and Drug Administration Center for Drug Evaluation and Research by the Food, Drug and Cosmetic Act.
The FDA has testified in Congress and in FOIA documents that fluoride when used with the intent to prevent disease is a drug. The FDA CDER has approved fluoride as a drug to be used in toothpaste with the appropriate label. The FDA CDER has publicly stated they are deferring regulatory action on fluoridated water. The FDA regulates drugs by having the manufacturer go to the FDA for approval. Applications for fluoride supplements have repeatedly been rejected because of lack of scientific evidence of efficacy.
The FDA CDER says unapproved drugs are illegal. The marketing of any product at any concentration, even a placebo, must be FDA CDER approved or it is missbranded and illegal.
“Look up the toxicity of ingesting hydrofluorosilicic and sodium fluorides. My memory is about 5 mg/kg/day BW. And compare that with CaF, again my memory is over 600 mg/kg/day BW.”
HFA is not ingested in fluoridated water. It immediately and completely hydrolyzes, once added to drinking water, into fluoride ions and trace contaminants. HFA no longer exists in that water after this point. It does not reach the tap. It is not ingested. That to which is commonly referred as “Naturally occurring fluoride” is simply those fluoride ions released into water by CaF. It makes no difference how quickly they are released, it is simply a measure of those which are released. The fluoride ions released by HFA are identical to those released by CaF. Only that amount of HFA is added to water which, when taking into account the existing fluoride ions from CaF, will raise the level of fluoride ions in that water, to the optimal level.
“So did I for 25 years of dental practice and then I looked at the law and science. None of those government agencies determine the safety…..”
The EPA has full jurisdiction and regulatory authority over all additives to drinking water. This includes optimal level fluoride. You are certainly free to argue your personal interpretation of the law in court, but I don’t much like your chances.
Your “interpretations”, are precisely why I trust the US regulatory system over the “information” provided by “FAN” and other such antifluoridationists groups.
‘The FDA CDER says unapproved drugs are illegal. The marketing of any product at any concentration, even a placebo, must be FDA CDER approved or it is missbranded and illegal.”
No matter how many times you express your personal opinion, no matter how desperately you seek to impose your own “interpretation” of the law unto society, the facts will remain the same. Fluoride added to water at the optimal level is not a “drug”. It is simply a mineral identical to that which has existed in water since the beginning of time. As the EPA has full jurisdiction and regulatory authority over all such water additives, there is no requirement, nor any need, for FDA approval.
You accuse me of a political agenda and then you reference politics (EPA, CDC et al) instead of science. Did it ever dawn on you that you are relying on politics instead of science?
You have (and so did I) serious misunderstandings of jurisdiction. EPA under the Clean Water Act, has jurisdiction over naturally occurring contaminants, not substances added to water. If water has too much, for example, arsenic or fluoride, then EPA has MCL and MCLG maximums.
However, the scientists of the EPA did speak out through their Union. These are the scientists who evaluate the toxicological effects of the contaminants. They said,
“”In summary, we hold that fluoridation is an unreasonable risk. That is, the toxicity of fluoride is so great and the purported benefits associated with it are so small – if there are any at all – that requiring every man, woman and child in America to ingest it borders on criminal behavior on the part of governments.”
Dr. J. William Hirzy, Senior Vice-President, Headquarters Union,
US Environmental Protection Agency, March 26, 2001″
A very strong statement from the scientists you are relying on. They are not saying fluoridation is safe or effective.
Please provide law or statements from the EPA which give you the evidence to rely on the EPA that the addition of fluoride to public water is safe and effective.
“The recommended optimal fluoride intake for children to maximize caries prevention and minimize the occurrence of dental fluorosis is often stated as being 0.05-0.07 mg/kg/day (Levy 1994; Heller et al. 1999, 2000).
On page 68 of the 2006 NRC report on fluoride, it states, “Burt (1992) attempted to track down the origin of the estimate of 0.05-0.07 mg/kg/day as an optimum intake of fluoride but was unable to find it.” NRC 2006 p 68.
The amount of fluoride dispensed in water is not controlled and concentration is not dosage.
“Some subpopulations consume much greater quantities of water than the 2 L per day that EPA assumes for adults, including outdoor workers, athletes, and people with certain medical conditions, such as diabetes insipidus.” NRC 2006 P 23
The 90th percentile consume 2 L/day and the 99th percentile 5L/day and there are reports of 13 L/day. Also remember, some don’t drink water. The amount of fluoride ingested from water fluoridation varies from 0 to over 10 mg/day.
Of most concern is when we consider dosage, mg/kgBW/day. A 5 Kg infant with 1L of formula made from fluoridated water will consume 1 mg of fluoride or about 0.2mg/Kg/day of fluoride, much more than mother’s milk at 0.004 mg/Kg/day or 0.05mg/Kg/day the theoretical political “optimal”.
The highest risk of excess fluoride exposure are the fetus, infant, and young children.
The question is not whether fluoride causes brain damage, the question is at what age and what dosage. The MCLG must be zero to protect subpopulations.
“For ages 1.5-9 months, approximately 40% of the infants exceeded a mass-normalized intake level for fluoride of 0.07 mg/kg/day;
for ages 12-36 months, about 10-17% exceeded that level (Levy et al. 2001b).” NRC 2006.
Remember, fluoridation is targeting 100% of the population. Those with or without teeth, everyone.
“. . . fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children…”
CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of
Drinking Water to Prevent Dental Caries. MMWR, 48(41); 933-940, October 22.
Toothpaste at about 1,000 to 1,500 ppm is FDA CDER approved, apparently showing some benefit if not swallowed.
Fluoride varnish in some studies shows some benefit at 22,500 ppm
Contact time for water and concentration at 1 ppm means the topical effect from drinking artificially fluoridated water shows no topical benefit.
Most people looking at the EPA’s lack of jurisdiction will try to hide under the umbrella of the CDC. Doesn’t work.
CDC: “Ingestion of fluoride is not likely to reduce tooth decay.” CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. MMWR, 48(41); 933-940, October 22
MANY HAVE EXCESS FLUORIED IN SERUM
CDC: “Normal serum fluoride levels are <20 mcg/L (0.02 ppm) but varies substantially. . . .”http://www.bt.cdc.gov/agent/sulfurylfluoride/casedef.asp
Taves (‘66) normal <0.013 ppm
Sowers controls 0.05 ppm (4th quartile)
Sandhu controls 0.042 ppm and tumors at 0.072 ppm (Xiang 0.064 ppm)
Zang controls 0.04 ppm and 8 IQ loss 0.08 ppm
Rathe controls 0.025 ppm and stones at 0.12 ppm
Hossney (2003) Mother’s Milk most samples – none detected
What is your fluoride serum concentration? What is the mean fluoride serum concentration in your community, city, country?
Washington Board of Pharmacy: “Fluoride is a legend drug regulated under chapter 69.41 RCW.
Idaho Board of Pharmacy confirmed fluoride is a drug.
FOIA sent to me from the FDA
FDA “A search of the Drugs@FDA database . . . of approved drug products and the Electronic Orange Book. . . does not indicate that sodium fluoride, silicofluoride, or hydrofluorosilicic acid has been approved under a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA) for ingestion for the prevention or mitigation of dental decay. . . . At the present time, the FDA is deferring any regulatory action on sodium fluoride products. . .”[1] Email from the FDA (7-22-09)
Please provide your evidence fluoride when ingested with the intent to prevent disease is not a drug.
For heavens sake, read the fluoridated toothpaste label. “DRUG FACTS.”
ORS 453.005 (8) “Highly toxic” means any substance that falls within any of the following categories:
(a) Produces death within 14 days in one-half or more of a group of 10 or more laboratory white rats each weighing between 200 and 300 grams, at a single dose of 50 milligrams or less per kilogram of body weight, when orally administered;”
About 5 mg/Kg of body weight of NaF is considered lethal for an adult.
Bill,
“You accuse me of a political agenda and then you reference politics (EPA, CDC et al) instead of science. Did it ever dawn on you that you are relying on politics instead of science?”
No, I have not accused you of any “political agenda”. I guess that’s just one more figment of your very active imagination. Your distrust of government and respected government regulatory agencies such as the CDC and the EPA is unfortunate for you, but of no concern to me and irrelevant to water fluoridation.
The EPA has jurisdiction over additives to public drinking water supplies. This includes fluoride at the optimal level. That is a simple fact. Whether you choose to believe it or not is of no concern to me. Take your arguments to court and see how far you get.
The EPA union to which you refer was simply a small union of 1200 or so EPA employees led by the current paid lobbyist for the New York antifluoridationist faction, “FAN”, William Hirzy. Nearly a decade and a half ago, a small group of executive committee members of this union voted to support the antifluoridationist activities of leader Hirzy, as he had requested of them. This action did not represent the EPA in any manner, it was simply that of this small union. Shortly after this action, this union went defunk and was usurped by the much larger EPA Union.
In regard to Hirzy, in 2013, he petitioned the EPA to recommend cessation of use of HFA to fluoridate water systems due to what he claimed were abnormally high costs of cancer cases related to HFA use. Hirzy based his petition on data from a recent study that he and fellow antifluoridationist Robert Carton had completed. When EPA officials reviewed Hirzy’s petition, they discovered that Hirzy had made a basic miscalculation in his data which resulted in a 70-fold error in his conclusions. When the reviewers corrected this error, they found that Hirzy’s and Carton’s data actually demonstrated the opposite of what Hirzy had concluded. Needless to say, Hirzy’s petition was rejected. When notified of this error and rejection, Hirzy stated that he was “embarrassed”, as well he should have been.
So, given the choice between placing my trust in a now defunk small employee union which voted to support the dubious activities of its biased, incompetent leader who is now a paid lobbyist for an antifluoridationist faction…….and placing my trust in the US CDC, the US EPA, the US Institute of Medicine, the past 5 US Surgeons General, the ADA, the WHO, the American Academy of Pediatrics……….I’ll take the latter option.
“Predominantly” does not equate to “completely”. The actions of of fluoride are both systemic and topical. The mild to very mild dental fluorosis which antifluoridationists constantly attempt to pump into being a major disorder, is clear evidence of the systemic benefit of fluoride. Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, a definite benefit. Mild dental fluorosis can only occur systemically.
Additionally, the systemic incorporation of fluoride into saliva results in the the consistent bathing of the dentition in a low concentration of fluoride throughout the day, an effective means of decay prevention.
“Fluoride works to control early dental caries in several ways. Fluoride concentrated in plaque and saliva inhibits the demineralization of sound enamel and enhances the remineralization (i.e., recovery) of demineralized enamel (12,13). As cariogenic bacteria metabolize carbohydrates and produce acid, fluoride is released from dental plaque in response to lowered pH at the tooth-plaque interface (14). The released fluoride and the fluoride present in saliva are then taken up, along with calcium and phosphate, by de-mineralized enamel to establish an improved enamel crystal structure. This improved structure is more acid resistant and contains more fluoride and less carbonate (12,15–19) (Figure 1). Fluoride is more readily taken up by demineralized enamel than by sound enamel (20). Cycles of demineralization and remineralization continue throughout the lifetime of the tooth.”
“You persist in suggesting fluoride is not a drug. Both Federal and State laws define drugs the same way:”
I am not “suggesting” anything. I am stating a fact. Fluoride at the optimal level is simply a mineral identical to that which has existed in water since the beginning of time. Fluoride is in the water already. Fluoridation is nothing but the increasing of these ions up to the optimal level where they will provide the maximum of what has been noted to be a benefit of this mineral, dental decay reduction. For those systems whose existing fluoride content is found to be already at or above the optimal level, fluoridation is not necessary and is not done.
You are free to take your “forced medication” argument to court, however, given that the US courts have rejected this nonsense each and every time antifluoridationists have wasted court time and resources with it, I don’t much like your chances.
“Liquid H2O is the sine qua non of life. Making up about 66 percent of the human body, water runs through the blood, inhabits the cells, and lurks in the spaces between. At every moment water escapes the body through sweat, urination, defecation or exhaled breath, among other routes. Replacing these lost stores is essential but rehydration can be overdone. There is such a thing as a fatal water overdose”.
If you eliminate every substance that is toxic with no consideration of concentration use level, you can ingest absolutely nothing and will be dead within a week.
If you care to present valid evidence of toxicity to humans of water fluoridated at the optimal level, then do so.
I catch up with Ken’s blog over breakfast most days, so I’ve just read your Gish Gallop and gradual shifting of the goalposts in a single go.
I’m aware of the literature over community water fluoridation, and most of the stuff you’ve cherry picked does not say what you appear to think it says. It’s annoying errors and behaviours like this from the anti-fluoridationists that are turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.
I suggest that you read what you have written in this blog and then consider it. There are many places where you have directly contradicted yourself because you haven’t reviewed what you have previously said, or at least if you have reviewed it you haven’t cared that you contradict yourself. A single example will suffice (paraphrasing):
You want evidence from Steve that CWF works; you say it doesn’t in spite of all of the evidence it does (“If fluoridation were effective we would see lower rates of dental caries in fluoridated countries, states, counties, and cities. Not true.”) You then define fluoride as a drug (using a non-standard definition) because it’s being used to prevent disease in the form of dental caries. Well, if fluoride doesn’t work, then it does not meet your definition of a drug. Does fluoride work to prevent/reduce caries, or not? You can’t have it both ways.
I’d like to point out that another halogen, chlorine, is also added to community water supplies to prevent disease (eg gastroenteritis). Chlorine has all the same dose related health problems that fluorine has, and the salt used in community water supplies also tends to be prepared as an industrial poison. When are you going to start campaigning against water chlorination? If not, why not? Again, you can’t have it both ways.
I would like to second Stuart’s comment about behaviour like Bill’s being responsible for”turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.”
My experience is similar. I accepted the simple science of the beneficial role of F in apatites in a “ho hum” way while at the same time sort of accepting some of the environmental claims of the anti-fluoride people. However, just over 10 years ago I analysed a sample of fluorosilicic acid we we using for researching its use for removing heavy metals from biosolids wastes and was shocked to discover that contamination in the fluorosilicic acid was extremely low. This made me realise I should not trust the claims io political activists and since then I have checked many if their other claims out and found them to be false.
So I find the sort of misinformation and distortions presented in rants like those of Bill rather silly. He should realise such misinformation is counterproductive if and when readers actually are exposed to more factual material. It turns them against the political activists.
Of course, many readers really just don’t bother looking at these rants anyway. For them such behaviour is counterproductive from the start.
I do have other things to do than try to explain the most fundamentals of drug laws and science to blind believers. Sort of like trying to change the mind of ISIS believers.
Instead of providing good evidence, you attack the messenger.
Contaminants in HFS? I did not bring up the issue. You are changing the subject because you have no laws or science to counter the lack of efficacy or safety of fluoridation. Your support is little more than religious belief.
Why not read the assay of the manufacturer? Yes, very small amounts of contaminants, but there is some in many samples. And most samples are not tested as NSF claims. How much lead and arsenic do you want added to your body?
You suggest I’m ranting by posting laws? Talk to those who made the laws.
More important, provide your laws you rely on to support fluoridation.
Slow down and read what I posted again. No contradictions. A drug is defined by intent of use or listed in the US Pharmacopeia.
INTENT OF USE.
Read that again. If the intent is to prevent or treat disease, then it is a drug. Makes no difference if it works, simply intent of use.
So lets look at a “Guidance Document” from the FDA.
“The legal difference between a cosmetic and a drug is determined by a product’s intended use. . .
The FD&C Act defines drugs, in part, by their intended use, as ‘articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease’ and ‘articles (other than food) intended to affect the structure or any function of the body of man or other animals’ [FD&C Act, sec. 201(g)(1)]. . . .
“Intended use may be established in a number of ways. Among them are:
Claims stated on the product labeling, in advertising, on the Internet, or in other promotional materials. . . .”
“The legal difference between a cosmetic and a drug is determined by a product’s intended use. . .
The FD&C Act defines drugs, in part, by their intended use, as ‘articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease’ and ‘articles (other than food) intended to affect the structure or any function of the body of man or other animals’ [FD&C Act, sec. 201(g)(1)]. . . .
“Consumer perception, which may be established through the product’s reputation. This means asking why the consumer is buying it and what the consumer expects it to do.”
“Ingredients that may cause a product to be considered a drug because they have a well known (to the public and industry) therapeutic use. An example is fluoride in toothpaste.” FDA GUIDANCE DOCUMENT
“INTENT OF USE” IS KEY.
Not dilution or even placebo exempts the substance.
The FDA CDER (not the voters, you, me, CDC, EPA, ADA, et al) have the experts and policy to weigh the benefits and risks of a substance, determine a label, dosage, cautions, and supervision.
Drugs are defined as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” [FD&C Act, sec. 201(g)(1)].
Bill, there is plenty of evidence in my article here – and you attacked me for it instead of engaging. Attacking the messenger is what you guys do all the time.
You are just Gish Galloping – in an extreme way. Flitting from one attack to another, one extreme claim to another.
Even my personal reflection of discovering the misinformation about fluorislicic acid seems to have gone above your head. It was a warning to you of how counterproductive such propaganda and distortions are – not an invitation for you to present more misinformation.
You are ranting.
If instead, you had dealt with the details of the above post instead of attacking me for showing how young Michael was literature dredging then we could have had a reasonable discussion. But I really don’t think you know how.
You are correct, water can be lethal. We have the choice to drink too much. We do not have the individual choice to drink fluoridated water unless it is labeled and an alternative source is available.
Laws define fluoride as a poison and highly toxic, similar to arsenic.
The FDA CDER has the experts to determine whether fluoride at 1 ppm or 0.004 ppm is safe. No doubt they would provide some cautions not to drink too much if they approved artificial fluoridation of water.
Mother’s milk contains no detectible fluoride in most samples.
Fluoridated water is 175 to 250 times more concentrated than the mean fluoride concentration of those samples which had some detectible fluoride.
Steven, “Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth”
I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis. If I took my key and scratched your car, would you call that “no damage.” Cosmetic damage is damage. 41% now have dental fluorosis. Up from 10%. In your opinion, what percentage of the population should have dental fluorosis? Should it increase to 100%?
And only the most blinded faithful fluoridationsits would claim a biomarker of excess fluoride exposure only affects teeth and has no affect on any other structures.
What is the optimal fluoride concentration of tooth structure? NO ONE has responded to that question.
Lab research finds teeth with more fluoride to be harder, more brittle and fracture more. Preliminary research in humans finds this might be true. What research evaluates increased fracture rate with more fluoride exposure? Harder teeth, more brittle, more complete cusp fractures.
“An NDA (New Drug Application) is the vehicle through which drug sponsors formally propose that FDA approve a new pharmaceutical for sale and marketing in the U.S. FDA only approves an NDA after determining, for example, that the data are adequate to show the drug’s safety and effectiveness for its proposed use and that its benefits outweigh the risks. . . .”
“A note on “new drugs”: Despite the word “new,” a “new drug” may have been in use for many years. If a product is intended for use as a drug, no matter how ancient or “traditional” its use. . .”
If you have an issue stick with it, provide the citations and stop darting off to other things.
As I have tried to warn you, such Gish galloping is counterproductive for your side. It reinforces the view that you avoid proper discussion. It turns readers off and just clutters up the comments with irrational raving.
“You are correct, water can be lethal. We have the choice to drink too much. We do not have the individual choice to drink fluoridated water unless it is labeled and an alternative source is available”
Note, your statement that ‘we do not have the choice unless……’.
“Forced” means that there is no choice. “Unless” means there is a choice.
Yes, fluoride at improper levels is toxic…..as is every other substance known to man. Your point?
“No doubt they would provide some cautions..”, another example of antifluoridationist “evidence”. What you deem to not be doubtful is meaningless.
“Mother’s milk” is deficient in iron and vitamin D. Have you and Connett yet asked the Almighty if He meant for infants to be anemic and develop Ricketts?
“I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis.”
To “treat” what level of dental fluorosis? If you and other dentists are doing “many thousands of dollars of cosmetics” to “treat” mild to very mild dental fluorosis, someone needs to report this to your state dental board immediately.
If you took a key and scratched my car down to the metal, this would be permanent damage requiring expensive repair, analogous to severe dental fluorosis. If you took a key and scratched my car to a noticeable level, but not down to the metal, this would be damage requiring cosmetic repair, but not nearly as expensive as the first scratch. This would be analogous to moderate dental fluorosis. If you took your key, covered it in felt, and “scratched” my car to no degree that was even noticeable outside of close examination under a magnifying glass and strong light, this would be analogous to mild to very mild dental fluorosis. If this last key “scratch” rendered my car more resistant to dents and corrosive rust…..then you could scratch my car in such a manner with my full blessing.
What you personally deem that a “biomarker of excess fluoride exposure” affects, is meaningless in the absence of valid evidence.
I have repeatedly responded to your questions regarding the optimal level of fluoride at which maximum dental decay protection occurs with no adverse effects, which is the purpose of water fluoridation. If you have an overwhelming desire to know the “optimal fluoride concentration of tooth structure” then do the research to find out.
Properly cite whatever “lab research” and “preliminary research in humans” to which you refer, if you desire any credence for whatever claim you are attempting to make.
The New Zealand legal definition of a drug is different to that in the USA. OK, it may be splitting hairs, but this is a New Zealand blog and fluoride does not meet the definition of a drug in New Zealand. That’s why I supplemented my earlier comment.
My understanding is that many court cases both in the USA and other countries have established that fluoride as used for CWF is not a drug.
The chemical used for CWF is not listed in the US pharmacopeia as a drug. It’s not listed in the British National Formulary, by New Zealand’s PHARMAC, or the Australian Pharmaceutical Formulary and Handbook. I don’t have any formularies from other countries to hand.
That’s why I referred to your personal definition of a drug, and noted that chlorine as used in water chlorination also meets your definition.
Are you now going to object to community water chlorination as well as to community water fluoridation?
“I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis.”
If you are allowed to use anecdotes…
I’m not a dentist, but I have to examine the mouths of many people. In more than two decades of practice in a fluoridated area, I can’t recall a single case of fluorosis.
Obviously, the problems with the literature dredging by Little Connett, and the other tactics used by antifluoridationists, emanate, in large part, from Connett. In the interactions I’ve had with him, and certainly as Ken exposed in his online debate with him, Connett has seemed surprisingly uninformed, given his educational level. The use of out-of-context information, flawed studies, misrepresented study conclusions, half-truths, misunderstanding of the science, etc. etc. seem to be, to him, valid evidence. His belief in these tactics and his seeming ignorance on basic facts of fluoridation travel down through the ranks of FAN, and are disseminated via his “fluoridealert”. When you have someone such as this at the top, seemingly well educated, who garners fierce loyalty amongst his followers, it creates problems in properly educating citizens and community leaders.
Those such as Bill are insiduous. While Connett seems to truly believe in his tactics, not understanding any better, those such as Bill, do know better. One has only to look at his comments in this section to see examples of most of the standard tactics used by antifluoridationists. The half-truths, out-of-context information, references to properties of high level fluoride, gish-gallop, and posting of misinformation…… are all here. When there are such individuals who do understand the fallacy of these tactics, who do understand the deceptive nature of them, but intentionally continue to use them anyway, the problem is exacerbated. It is difficult to battle with truth and accuracy, against those who have no regard for such and who do not, in any manner, limit themselves to operating within these tenets.
I certainly don’t know the answer to these people, other than to keep doing as is Ken….educate, educate, educate. That has worked well in the US, where fluoridation has increased, and also seems to be making a difference in NZ through the efforts of Ken and the rest of the marvelous folks who have been working so hard and so effectively to combat the Connett puppet FANNZ and its zealous leaders.
No Federal Court has rejected artificial fluoridation as a drug in any country that I know.
You suggest chlorine fits in the definition of a drug, but that is not true. The intent of chlorine and the other chemicals added to water have the intent to treat water, to make water safer to drink. Artificial fluoridation has no intent to make water safer to drink, but rather the intent is the prevention of dental caries. (Mitigation is a more accurate term.)
You don’t remember seeing dental fluorosis and neither did I because I was not looking for dental fluorosis. If you know what you are looking for and look for it. I diagnose it in about half of children on artificial fluoridation and about a third of children on fluoride free water.
“You don’t remember seeing dental fluorosis and neither did I because I was not looking for dental fluorosis.”
Growing up, and practicing for 32 years, in a fluoridated community surrounded by fluoridated communities, I have most certainly known what I was looking for, and have indeed looked for it. Once again, in my entire 32 year career, I have as yet to see one single case of dental fluorosis in any manner attributable to water fluoridation, that would even be detectable outside of my dental chair.
Of the cases of mild dental fluorosis I have seen which could be attributable to fluoridated water, there are none that required any treatment, most certainly not “many thousands of dollars worth” as you have stated that you have done.
“Answer my simple questions above. Stick to the subject rather than attacking those who don’t have your same religious radical belief.”
Truly ironic that you attempt to admonish anyone to “stick to the subject” as you flit around from one topic to the next when your comments are refuted. Too, I always wonder about those who constantly make statements about “religious beliefs”, “payments”, “corruption” , etc. when there has been nothing stated by anyone else to support such statements. My best guess is that it is nothing but attempts to project their own mindset onto others. As you seem so hung up on “religious beliefs”, my suggestion would be for you to examine your own, and allow the rest of us to keep the discussion on a scientific basis.
As for your “questions” which I have repeatedly addressed….yet once again:
1. “Mother’s milk”. Irrelevant. You have as yet to address my point about the deficiency of iron and Vitamin D in “mother’s milk” since you and Connett deem this content to be of paramount importance.
2. “Total exposure”. Addressed in full in my comment about total fluoride intake from all sources, in relation to IOM established daily upper limits. Go back and read it again, if you so desire.
3. “Dental Expenses”. There are none in regard to fluoridated water. The only financial considerations for patients are the cost savings they incur as a result of fluoridation.
4. “Biomarkers of excess fluoride exposure”. Once again, that of which you personally deem such biomarkers to be indicative, is meaningless in the absence of valid, peer-reviewed scientific evidence to support your opinions.
First you produce an error filled Gish gallop, then when you are told that this is inappropriate for a science blog, you start using anecdotes instead.
You’ve convinced me that you have opinions without supporting science – was that your intention?
P.S. Chlorine makes water safer to drink by preventing many diseases, such as cholera and other forms of gastroenteritis. As I said, it meets the same definition of “drug” that you use for fluoride, a definition that only seems to be used by anti-fluoridationists. If you are against one as a drug, then why not the other? It seems that your definition of “drug” changes depending on the substance that you are talking about.
My only comment is: MY DENTIST IS NOT MY DOCTOR – WHY SHOULD I BE FORCED TO INGEST SOMETHING WHICH IS MAKING ME ILL. All that is doing is creating more work for the dentist and certainly more work for medicos.
And you have lived in a non fluoridated area and fluoridated to get a comparision,, I dont remember you going to the international space station that is the only place where you can be sure of not getting any fluoride, maybe
“MY DENTIST IS NOT MY DOCTOR ”
Uh…..okay, no argument from me. Relevance to water fluoridation?
“WHY SHOULD I BE FORCED TO INGEST SOMETHING WHICH IS MAKING ME ILL.”
You shouldn’t. Relevance to water fluoridation?
“All that is doing is creating more work for the dentist and certainly more work for medicos”
Ahh, finally something of relevance to water fluoridation. Yes, you are 100% correct. Elimination of fluoridation would create an avalanche of more work for dentists and medicos.
Stuart,
Jurisdiction over a chemical in the USA is dependent on the intent of use. If the intent is pesticide, then it is not a drug. If it is to sanitize, treat water to make it safe, then NSF. If the intent is t treat people or animals, then FDA.
That is the law in the USA.
You can squirm around that issue by saying NZ is not the USA. True. But NZ fluoridates because of bogus opinions in the USA. If NZ were in tune with Europe, NZ would not fluoridate. NZ is simply following in the foot steps of flawed USA policy. Start thinking for yourselves. Look at the research for yourselves and quit being so blood subserviant to flawed USA policy.
Bill, we have been through this all before and you just demonstrate political propagandising rather than genuine discussion. Or will you Please provide one prospective randomized controlled trial on the fluoridation showing fluoride in unsafe and not effective..
Thank you for responding to my questions. Hard to show which are your words and mine so I will add names.
1. Bill: “Mother’s milk”.
Steve: Irrelevant. You have as yet to address my point about the deficiency of iron and Vitamin D in “mother’s milk” since you and Connett deem this content to be of paramount importance.
Bill: The American Academy of Pediatrics says mother’s milk is the normative value against which all other infant nutritions must be compared. Our species is alive because of mother’s milk. Please provide your research evidence that infants on mother’s milk are deficient in iron and Vit D. I’m not a pediatrician but as a nutritionist I can assure you that sunshine is important for humans regardless of age. Perhaps an infant not exposed to sun would become deficient in D. Give them sunshine and it will help more than just the D.
Iron: Here is a recent publication on iron, abstract below:
Am J Hum Biol. 2014 Jan-Feb;26(1):10-7. doi: 10.1002/ajhb.22476. Epub 2013 Oct 21.
Too much of a good thing: evolutionary perspectives on infant formula fortification in the United States and its effects on infant health.
Quinn EA.
Author information
“Abstract
Recently, there has been considerable debate regarding the appropriate amount of iron fortification for commercial infant formula. Globally, there is considerable variation in formula iron content, from 4 to 12 mg iron/L. However, how much fortification is necessary is unclear. Human milk is low in iron (0.2-0.5 mg/L), with the majority of infant iron stores accumulated during gestation. Over the first few months of life, these stores are depleted in breastfeeding infants. This decline has been previously largely perceived as pathological; it may be instead an adaptive mechanism to minimize iron availability to pathogens coinciding with complementary feeding. Many of the pathogens involved in infantile illnesses require iron for growth and replication. By reducing infant iron stores at the onset of complementary feeding, infant physiology may limit its availability to these pathogens, decreasing frequency and severity of infection. This adaptive strategy for iron regulation during development is undermined by the excess dietary iron commonly found in infant formula, both the iron that can be incorporated into the body and the excess iron that will be excreted in feces. Some of this excess iron may promote the growth of pathogenic, iron requiring bacteria disrupting synergistic microflora commonly found in breastfed infants. Evolutionarily, mothers who produced milk with less iron and infants who had decreased iron stores at the time of weaning may have been more likely to survive the transition to solid foods by having limited iron available for pathogens. Contemporary fortification practices may undermine these adaptive mechanisms and increase infant illness risk.”
2. “Total exposure”.
Steve: Addressed in full in my comment about total fluoride intake from all sources, in relation to IOM established daily upper limits. Go back and read it again, if you so desire.
Bill: IOM has almost no data provided on the basis for their daily upper limits, what they have is historical, they did not evaluate the risks, nor do they have jurisdiction over fluoride ingestion. The NRC 2006 report has much more detail and basis showing excess exposure. May I encourage you to read the report, especially on total exposure. ATSDR recommending less than 0.02 mg/L in serum is also more precise.
Remember, even with the IOM estimates (and all others), many are exceeding their daily upper limits.
3. “Dental Expenses”.
Steve: There are none in regard to fluoridated water. The only financial considerations for patients are the cost savings they incur as a result of fluoridation.
Bill: Please provide research you rely on for cost savings. Provide measured published data on the public at large, not just a clinic here compared to a clinic there. We have computers keeping track of dental expenses and we have tremendous detail from dental insurance companies. What is the average cost of dental treatment each year for a person in a fluoridated compared to non-fluoridated community in NZ or the USA. Measured data. Not estimates of assumptions.
4. “Biomarkers of excess fluoride exposure”.
Steve: Once again, that of which you personally deem such biomarkers to be indicative, is meaningless in the absence of valid, peer-reviewed scientific evidence to support your opinions.
Bill: There are two primary biomarkers of excess fluoride exposure. Skeletal fluorosis and dental fluorosis. Do a pub med search for the research. Hundreds of articles.
When fluoridation first started, researchers expected no more than 10% of the population would get dental fluorosis. Now we have 41% with dental fluorosis. Constantly increasing percentage of the population with dental fluorosis, a sign total fluoride exposure is increasing.
Would you like 100% of the population to have dental fluorosis?
As you said, “Jurisdiction over a chemical in the USA is dependent on the intent of use. If the intent is pesticide, then it is not a drug. If it is to sanitize, treat water to make it safe, then NSF. If the intent is t treat people or animals, then FDA.”
You persist in defining the chemical used to fluoridate water supplies as a drug. The FDA doesn’t have jurisdiction over the chemical, so by your own quote, the USA does not consider it a drug. Can’t you see the contradictions in your own comments?
Let’s see if I can summarise your opinions:
1. The halogen compound used in community water fluoridation (call it “fluoride”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (dental caries), so you consider it a drug.
2. The halogen compound used in community water chlorination (call it “chlorine”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (cholera), but you don’t consider it a drug.
To which I will add:
3. The halogen compound used in iodised salt (call it “iodine”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (goitre). I don’t know whether you consider it a drug or not, but whichever you decide on will directly contradict your opinion on one of the other two.
If you actually followed the science rather than Gish galloping through cherry picked papers that don’t actually say what you think they say, you would have a common opinion on all three of the above products.
As I said previously, “It’s annoying errors and behaviours like this from the anti-fluoridationists that are turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.”
Do you really fail to understand how your errors, self-contradictions and behaviour in blogs is pushing people away from anti-fluoridationists?
When reading an abstract from a paper, replace the word “may” in the abstract with “may not”.
I find it makes me think more about the abstract and wait until I have read the entire paper before forming an opinion.
Compare “I may crash my car driving to work today” with “I may not crash my car driving to work today.” Neither says anything definite and neither does the use of “may” in an abstract.
Another suggestion, which I would pass on to everybody who wants to understand the pros and cons of community water fluoridation:
Get hold of a current textbook on dentistry or community medicine, it doesn’t matter which.
Read the chapter on community water fluoridation. It may require a diversion into the science of statistical analysis if that wasn’t previously part of your education.
At the end of the chapter you will find a list of references. Read the entire referenced papers, not just the abstracts, as well.
Each of those papers will have references. Read those too.
At that stage you will have a basic understanding of the benefits, side effects and economics of community water fluoridation. Not an advanced understanding, just basic.
NOW you are able to ask about some of the fine details of CWF and may even be able to partially understand the answers. It’s more probable that you will find that you have already read the answers and have very few questions left.
You may even find out that the people who have made this a lifelong study and recommend community water fluoridation actually do understand the science.
Please provide evidence the FDA CDER does not have jurisdiction over substances used with the intent to prevent disease.
Jurisdiction is the most fundamental question needing to be answered.
Who has jurisdiction over the ingestion of fluoride with the intent to prevent dental caries?
FDA says they do.
Congress says FDA.
Boards of Pharmacy say FDA
HHS says FDA
EPA says they do NOT
CDC says they do NOT
NSF says they do NOT
doctors do NOT
As you base your belief in regard to fluoride content of “mother’s milk” on that which you claim the American Academy of Pediatrics “says”, obviously you consider the AAP to be a respected, authoritative source. The AAP fully supports the public health initiative of water fluoridation. It has a website with a wealth of information on fluoridation. Such information would be an excellent starting point for you to begin properly educating yourself on this issue.
“www.ilikemyteeth.org”
1. “Mother’s milk”
Interesting that you, as a nutritionist, are not aware of the deficiency of Vitamin D and iron in human breast milk. Also interesting that you recommend infants be exposed to sunlight, in contradiction to current recommendations of AAP.
“While breastfeeding is the recommended method of infant feeding and provides infants with necessary nutrients and immune factors, breast milk alone does not provide infants with an adequate intake of vitamin D. ”
“Furthermore, there exists a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure (visit: Skin Cancer.)
“As a result, in April 2003, the American Academy of Pediatrics (AAP) published guidelines for vitamin D intake, recommending that all infants have a minimum intake of 200 IU of vitamin D per day, beginning during the first 2 months of life. In November 2008, the AAP published a new statement to replace their 2003 guidelines. The 2008 report recommends a daily intake of vitamin D of 400 IU/day for all infants and children beginning in the first few days of life.”
“Human milk typically contains a vitamin D concentration of 25 IU per liter or less. Therefore, a supplement of 400 IU per day of vitamin D is recommended for all breastfed infants. Adequate amounts of vitamin D can be achieved by currently available multivitamin products containing 400 IU of vitamin D per mL or the newly available preparations that contain 400 IU/mL vitamin D alone without other vitamins. These products are available over the counter. Prescription preparations of vitamin D have very high vitamin D concentration and are not for routine home use.”
“Breastfed infants need supplemental vitamin D. This vitamin is naturally manufactured by the skin when it is exposed to sunlight. However, the American Academy of Pediatrics feels strongly that all children should be kept out of the direct sun as much as possible and wear sunscreen while in the sun to avoid long-term risk of sun exposure, which may contribute to skin cancer.”
Yes, there is speculation for the reason of iron deficiency in human breast milk. However, this does not preclude the need for supplementation, as you deem does the fluoride content of breast milk.
“An AAP clinical report being early-released, Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children 0 Through 3 Years, http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010-2576v1, also will appear in the November issue of Pediatrics. The report contains, for the first time, AAP recommendations for iron supplementation; it is a revision and extension of the 1999 policy on iron fortification of formulas.”
“In addition to universal screening, the report recommends the use of iron supplements for breastfed infants beginning at the age of 4 months”.
“The physicians explained that full-term healthy babies receive enough iron from their mothers in the third trimester of pregnancy to last for the first four months of life. However, human milk contains little iron, so infants who are exclusively breastfed are at increased risk of iron deficiency after 4 months of age.”
“The clinical report recommends giving breastfed infants 1 mg/kg/day of a liquid iron supplement until solid foods, such as iron-fortified cereals, are introduced. For partially breastfed infants, the iron recommendation remains the same as that for fully breastfed infants if more than half of the daily feedings are from human milk and the child is not receiving iron-containing complementary foods.”
Given that fluoride at the optimal level is simply a mineral which humans have been ingesting in water since the beginning of time, and given that in the entire 69 year history of water fluoridation, there have been no proven adverse effects…..the IOM established daily upper limits have been borne out to be entirely valid. The “many” which you claim are exceeding their daily upper limit would only be those in teeth developing years of 0-8 years, as the daily limit jumps to 10 mg, after that point. The only consequence of exceeding the daily upper limit for those 0-8 years would be mild to very mild dental fluorosis, a benign effect we have discussed previously.
In regard to the development of the IOM reference values.
“The scientific data used to develop Dietary Reference Intakes (DRIs) have come from observational and experimental studies. Studies published in peer-reviewed journals were the principal source of data. Life stage and gender were considered to the extent possible, but the data did not provide a basis for proposing different requirements for men and for nonpregnant and nonlactating women in different age groups for many of the micronutrients. Two of the categories of reference values—the Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA)—are defined by specific criteria of nutrient adequacy; the third, the Tolerable Upper Intake Level (UL), is defined by a specific endpoint of adverse effect, when one is available. In all cases, data were examined closely to determine whether a functional endpoint could be used as a criterion of adequacy. The quality of studies was examined by considering study design; methods used for measuring intake and indicators of adequacy; and biases, interactions, and confounding factors.”
DIETARY REFERENCE INTAKES FOR Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc
A Report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Uses of Dietary Reference Intakes, and the
Standing Committee on the Scientific Evaluation of Dietary Reference Intakes
Food and Nutrition Board
Institute of Medicine
NATIONAL ACADEMY PRESS
Washington, D.C.
“Findings suggest that Medicaid-eligible children in communities without fluoridated water were three times more likely than Medicaid-eligible children in communities with fluoridated water to receive dental treatment in a hospital OR, and the cost of dental treatment per eligible child was approximately twice as high.”
Water Fluoridation and the Cost of Medicaid Treatment For Dental Decay——Louisiana 1995-1996
“An Economic Evaluation of Community Water Fluoridation”1 presents the results of an economic analysis of water fluoridation under modern conditions of widespread availability of fluorides. Researchers from CDC and Terry College of Business, University of Georgia, found that under typical conditions, the annual per-person cost savings in fluoridated communities ranged from $16 in very small communities (20,000). The analysis takes into account the costs of installing and maintaining necessary equipment and operating water plants, the expected effectiveness of fluoridation, estimates of expected cavities in non-fluoridated communities, treatment of cavities, and time lost visiting the dentist for treatment.”
—–Cost Savings For Community Water Fluoridation”
US Centers For Disease Control and Prevention
“RESULTS:
With base-case assumptions, the annual per person cost savings resulting from fluoridation ranged from $15.95 in very small communities to $18.62 in large communities. Fluoridation was still cost saving for communities of any size if we allowed increment, effectiveness, or the discount rate to take on their worst-case values, individually. For simultaneous variation of variables, fluoridation was cost saving for all but very small communities. There, fluoridation was cost saving if the reduction in carious surfaces attributable to one year of fluoridation was at least 0.046.
CONCLUSION:
On the basis of the most current data available on the effectiveness and cost of fluoridation, caries increment, and the cost and longevity of dental restorations, we find that water fluoridation offers significant cost savings.”
—— Public Health Dent. 2001 Spring;61(2):78-86.
An economic evaluation of community water fluoridation.
Griffin SO, Jones K, Tomar SL.
4. “Biomarkers”
It is not encumbent on me to do a “pubMed search” in regard to your unsubstantiated claims. If you have “hundreds of articles” that support your personal speculation as to that of which “biomarkers of fluoride overexposure” are indicative, then present them, properly cited from their primary sources.
The 41% to which you refer arose from the 2010 CDC study by Beltran-Aguilar, et al. The 41% was broken down as follows: 37.1% mild to very mild dental fluorosis, 3.8% moderate dental fluorosis. Severe dental fluorosis was negligible.
Your hypocrisy is clearly evident in your “concern” for the barely detectable mild dental fluorosis while discounting the black discoloration of teeth, extreme pain, debilitation, development of serious medical conditions, and life-threatening infection resultant of untreated dental decay which is preventible with water fluoridation.
In regard to the 2006 NRC report which you would “encourage” me to read, I would encourage you to read the final recommendation of this Committee. If you do, you will discover that the only stated reasons for its recommendation to lower the primary MCL from its current 4.0 ppm, were risk of severe dental fluorosis, bone fracture, and skeletal fluorosis, with chronic consumption of water with a fluoride content of 4.0 ppm or greater. No other stated concerns of fluoride at this level. Additionally, this Committee made no recommendation to lower the secondary MCL of 2.0 ppm, which it was also charged to evaluate.
Water is fluoridated at 0.7 ppm, one third the secondary MCL the NRC Committee made no recommendation to lower.
Just to be clear, the topical fluoride preparations and oral fluoride supplements to which you refer have nothing to do with community water fluoridation.
All my comments refer to community water fluoridation.
“I am always amazed at how some people will crudely misrepresent the scientific literature in their efforts to pretend their particular political agenda is scientifically valid. The way they will dredge the scientific literature searching for studies they can quote and misrepresent seems an extreme form of cherry picking and confirmation bias. Surely those indulging in such crude literature dredging are fully aware of what they are doing.”
It is a reality that fluoride ions are regulated in various ways depending on their use.
It is very similar to sodium chloride (NaCl) which can be a food preservative, a nutritional mineral, a prescription medication, an over the counter medication.
Equally clearly fluoride ions can be a natural mineral, a mineral nutrient, a water additive, an over the counter medication, a prescription medication, an industrial chemical (including extremely pure forms), an industrial pollutant, a fumigant, and a rat poison.
This is as clear a reality as the sky is blue. There are important, critical distinctions between each use, each concentration, and purity standards which define the various incarnations of “fluoride.”
The willful refusal to acknowledge these clear and easily understood distinctions is an important element in opponents mistaken views opposing fluoridation.
Courts around the country have uniformly ruled that fluoridation is not the act of medicating and further that water districts have both the right and the obligation to determine the chemical composition of their product within regulatory limits. Individual citizens do not have the right to demand a chemical composition of the drinking water. Further courts, both in the US and abroad, have specifically denied your contention that the reason for the ion’s presence is sufficient to mandate it be considered a medication.
A new decision is available from New Zealand: NEW HEALTH NEW ZEALAND INC v SOUTH TARANAKI DISTRICT COUNCIL [2014] NZHC 395 [7 March 2014].
In addition to New Zealand precedent Judge Hansen includes references to Irish, Swiss, Canadian and US court decisions in his opinion. Readers interested in both the fluoridation qua forced medication will find this opinion representative of world-wide legal opinion. I have copied some important quotations from this decision below.
Clearly fluorophobes will bear some inconvenience and expense but that inconvenience is small compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.
It is incredibly self centered to insist on water your way when the legitimate medical, dental and public health expert communities overwhelmingly agree that CWF is safe, beneficial, inexpensive, and properly regulated as a water additive. My view is that the important debate has occurred in the minds and offices of thousands of professionals resulting in the favorable consensus in favor of fluoridation. No public health scientist wishes to harm people. Scientific education includes learning the discipline to change one’s mind with the facts demand that. The very name Ken Perrot has chosen for his blog makes this point. There can be no conspiracy large enough to conceal scientific truth from legions of professionals.
Fluoridation simply prevents cavities. It is straightforward.
Chuck Haynie
From NEW HEALTH NEW ZEALAND INC v SOUTH TARANAKI DISTRICT COUNCIL, March 2014
“On appeal the Supreme Court declined to resolve the case on that narrow basis, particularly without sufficient evidence as to the practicality of removing the fluoride. The Court held that, as fluoridation had no effect on the “wholeness or the soundness” of the body of a consumer, the ingestion of fluoridated water could not constitute an infringement of or a failure to respect the bodily integrity of the individual. The Court also rejected the contention that fluoridation involved mass medication or mass administration of “drugs” through water. The Court said that fluoridation is a process by which an element which naturally occurs in water is raised to a concentration at which it is found in wholesome water with an outcome that did not differ from what occurred in nature. The Court quoted from the conclusion of the New Zealand Commission of Inquiry 195744 that fluoride is not a drug but a nutrient and fluoridation is a process of food fortification.”. . . .
“[Fluoridation programs, even if considered to be medication in the true sense of the word, are so necessarily and reasonably related to the common good that the rights of the individual must give way.”
“The Florida District Court of Appeal (4th Circuit) held that the introduction of fluoride is not a medical procedure. The Court rejected the contention that fluoridation amounted to “compulsory medication”, pointing out that the city’s fluoridation of its water stops at the water faucet: The city is not compelling [the plaintiff] to drink it. He is free to filter it, boil it, distil it, mix it with purifying spirits, or purchase bottled drinking water. His freedom to choose not to ingest fluoride remains intact.”
“In Dowel v City of Tulsa the plaintiffs challenged the validity of an ordinance authorizing fluoridation of Tulsa’s water supply as, among other things, involving a violation of the 14th Amendment of the US Constitution. 60 The Court rejected the argument that fluoridation should be distinguished from the addition of chlorides, both of which achieved demonstrable public health benefits, the one by killing germs in the water, the other by reducing the incidence of tooth decay. The Court said at: To us it seems ridiculous and of no consequence in considering the public health phase of the case that the substance to be added to the water may be classed as a mineral rather than a drug, antiseptic or germ killer; just as it is of little, if any, consequence whether fluoridation accomplishes its beneficial result to the public health by killing germs in the water, or by hardening the teeth or building up immunity in them to the bacteria that causes caries or tooth decay. If the latter, there can be no distinction on principle between it and compulsory vaccination or inoculation, which, for many years, has been well-established as a valid exercise of police power.”
Thanks for the suggestion of the textbook. Unfortunately, I’m not into preventive dentistry.
As I said, I’m not a dentist. I have dentistry texts because my job requires me to do some basic dentistry, usually following trauma. I tend to refer people who need more advanced work to dentists who have more skills and equipment than myself.
I’m much more interested in the community health aspect of CWF. I wasn’t… but then I started observing the antics of anti-fluoridationists in Hamilton, other areas around New Zealand, and on blogs like Ken’s.
Trev, there’s nothing in that SCHER opinion that you link too that disputes the viewpoint that CWF is safe and helpful in reducing incidence of dental decay.
Bill,
Far away from New Zealand and much closer to home: No court of last resort has ever ruled that fluoridation is forced medication or a drug. In 2011 Port Angeles, WA and Forks, WA were sued for the umteenth time by you and your fellow anti-fluoronistas. Here was the final ruling.
Jefferson County Superior Court Judge Craddock Verser dismissed the case Friday on the grounds that fluoride cannot be considered a prescription drug when used in a public water supply.
The two cities, in their motion to dismiss the case, said that designation does not apply to their use of fluoride because the FDA does not regulate public drinking water.
He wrote that the plaintiffs would have to meet two criteria to prove their case: that fluoride is a prescription drug under federal law and that it is listed in the 2009 edition of the Drug Topics Red Book.
“Because the FDA does not regulate public drinking water or drinking water additives, it is impossible for plaintiffs to prove that the first requirement for being a [prescription drug] under Washington law is met,” he said.
So, Bill, fluoridation is NOT a drug in the U.S.A, Canada, New Zealand, Australia, or anywhere that fluoridation is practiced.
Regarding courts:
Drugs are approved by the FDA CDER a Federal Agency. I am unaware of any Federal case on whether the FDA CDER has jurisdiction over fluoride chemicals when used with the intent to prevent disease. Please provide if you do have such a case.
In Port Angeles, the court case, not about drugs, decision 5/4 was about who was to make the decision. The voters wanted to go to a vote and the City refused to permit the voters to make the decision. The Court agreed with the City that the City had jurisdiction to make the determination.
A reasonable decision. Much easier in Washington for us to get water district and city representatives to make the decision than thousands and hundreds of thousands of voters.
In 1952, the Washington State Supreme Court 5/4 ruled artificial fluoridation was not a drug, however, Federal laws have changed.
Another case in Washington State found fluoridated water was not a drug. Therefore, fluoridated water is regulated under poison laws. Now that the courts have placed the city with authority and fluoride regulated not as a drug but rather as a poison, highly toxic, the city is even more at risk.
Based on the state courts ruling, any water district could add penicillin, viagra, or any other product to public water, make a claim of benefit and put it in a bottle without FDA approval and sell. The ruling is based on state laws, not Federal laws.
Kurt’s “umteenth” number happens to be two times. I did write amicuses to the court.
Kurt, as you know, the Red book is not an FDA document, but rather an American Academy of Pediatrics book. The judge was seriously confused trying to protect artificial fluoridation. The judge should have done a search of the FDA drug data base and Federal law requires.
Remember, Pediatricians don’t usually pull teeth. When a child has a hurting tooth they can give antibiotics and pain meds which are not very effective. In desperation to do something for teeth, pediatricians protect fluoride and prescribe fluoride even though it is not approved.
Your comment that artificial fluoridation is legal in the USA is not true at the Federal level or state. It will take time and money to go to court.
The Australian drug enforcement agency also confirmed artificial fluoridation is a drug.
“Another case in Washington State found fluoridated water was not a drug. Therefore, fluoridated water is regulated under poison laws. Now that the courts have placed the city with authority and fluoride regulated not as a drug but rather as a poison, highly toxic, the city is even more at risk.”
The only thing “at risk” here is any semblance of credibility you may still hope to have, if you continue attempting this “forced medication” nonsense. The courts have been clear on this. Fortunately in the US, you don’t get to twist existing laws to suit your personal ideology.
Your interviews with Merola are a much better setting for you to keep putting out this junk. His audience is far more receptive to it.
“Your comment that artificial fluoridation is legal in the USA is not true at the Federal level or state. It will take time and money to go to court.”
The “law” according to Bill Osmunson. Fortunately we live in the United States of America, not the United States of Osmunson.
It never ceases to amaze. The science doesn’t support antifluoridationist ideology, so they simply deny the science and make up their own version. The law doesn’t support antifluoridationist ideology, so they simply deny the law and make up their own version.
As you well know, RCTs are all but impossible for fluoridation. Given that fluoride ions, identical to those which have existed in water since the beginning of time, and barely detectable trace comtaminants, are the only substances ingested as a result of fluoridation, the real question is….what exactly is it that you deem needs testing?
As you obviously don’t know, but should, HFA does not exist at the tap in fluoridated water. It is not ingested. Therefore there are no requirements, nor any need, for “one study on the safety of hydrofluorosilic acid”.
As I stated previously, if you want a determination of an “optimal fluoride concentration of dentin or enamel which prevents tooth decay”, then do the research to determine it. Your personal desire for such is no reason to deprive entire populations of the dental decay benefit of the public health initiative of water fluoridation.
Steve, your moaning and groaning about a little hard work almost brought tears to my eyes. A quality study “all but impossible” you say. So sorry for suggesting we demand good science after 60 years of giving people fluoride without their consent. Your lame excuse is a cut and paste from public health policy pushers too scared to find out the truth. They are even scared of quality research on measured cost effectiveness.
US CDC is spending $31 million to market, promote, lobby for fluoridation over the next 5 years. I think you and I could do an excellent RCT with half that. OK, you take half and I’ll take the other half!!!!!
Perhaps a couple thousand cohorts. Simply ensure each person uses the bottled water given to them. The bottles coded and double blinded. Results start after 2 years. Control for confounding factors.
After about 60 years of fluoridation without consent and without safety studies and without proper approval, as public health and dental professionals we must be ashamed, humbled, and embarrassed no high quality studies have been done on artificial fluoridation. Talk about sloppy, poor, lousy science. Artificial fluoridation is one of the top ten public health blunders of the 20th Century. We are now in the 21st Century and need to do some quality research. I just read research where the study did not consider whether the DMFT were more ‘filled” or “decayed” for each group correction for dental treatments. More of the teeth filled indicated more dental visits, more oral hygiene instruction, etc.
The hard part would be consent. Just think about getting people to sign up for bottled water. Probably easy. But keeping them when they start looking at the science would be a serious problem. All studies with human cohorts require a Human Subjects Review Committee (HSRC) approval. You know. To avoid violations of experimentation on humans. For example University of Washington:
“Human subjects asked to contribute their time and effort to research should consent to do so freely. The consent should be given only after the subject understands what he or she is consenting to, and any risks that may be involved. Subjects should be assured that there will be no penalties for declining to participate, and that they are free to withdraw from the research at any time after they have given their initial consent.” University of Washington http://www.washington.edu/research/hsd/hsdman4.html
Retention in a study might be a concern without full disclosure. Perhaps a HSRC might approve fluoride bottled water, but retention of the cohort once they became aware of the toxicity and problems with fluoridation would be inclined to drop out of the study. A prospective randomized controlled trial on efficacy covering 5 or 10 years could be done.
Well, good scientists could do the study. Not sure if fluoridationists are up to the challenge of supporting their belief’s with real science.
No, sorry, Bill, I don’t see any evidence that I have “moaned and groaned” about anything. I’ve simply stated facts. Too, unlike you, I don’t “cut and paste” without proper citation. More delusions on your part, I suppose. You probably should just stick to the science and cease your attempts to project your characteristics unto me.
So, just give your subjects some bottled water and tell them to use it. Uh….yeah, okay. Assuming 100% compliance with these “instructions” how do you plan to control for food and beverages they consume made with fluoridated water? How do you plan on controlling for water they drink at school or work which may be fluoridated?
You remember Warren/Levy which you attempted to portray as a condemnation of the optimal level? They could not overcome the halo, and other effects which prevent adequate segregation between fluoridated and non-fluoridated groups……yet you plan to do so by handing your subjects some bottled water and instructing them to use it. Good luck with that.
Antifluoridationists have had 69 years to test the fluoride ion they’ve been consuming their entire lives. If you want more testing of this ion, then feel free to do it. In the meantime, this is noreason to deprive entire populations of the dental decay preventive benefit of fluoridation.
Your question on why there have not been RCT on fluoridation is the key answer to the topic of your article on “Science Dredging.”
Here are my thoughts:
A. Jurisdictional oversight. In the USA, our laws are focused on money, profit, sales, etc. The laws put the burden of scientific proof on the shoulders of the companies making the product. In this case the substance with claim of preventing dental caries. The manufacturer of the substance (drug) are public agencies who are told by public health agencies and simply believe these agencies that the EPA regulates water and the CDC approves the fluoridation and FDA CDER approval is not necessary. The FDA is deferring regulatory action.
B. Public Health Professionals are usually skilled educators and administrators and seldom hard core numbers and research nurds. The educators and administrators simply follow and promote policy without looking at the science.
C. Demand. As long as scientists don’t demand RCT studies, they won’t be done. All of us need to request quality studies.
D. Fear the studies will not find benefit. RCT studies may have been done and not published. In the 1970’s I was told measured cost benefit studies were in progress. Why were these never published? Did they not find a cost savings? If that is true, it would be highly unethical. Delta Dental Insurance assured me several years ago they were doing a careful evaluation of cost savings in fluoridated communities and would release their results. But they have not.
E. Unless the results of the study find favor for fluoridation, the study will probably not be published and the researchers will lose funding, not gain tenure or have it delayed, etc. Fluoridation is a carrier buster.
I would have thought Paul Connett would have led such a project. He is after all the World Authority of fluoridation*, has screeds of outstanding peer reviewed papers on the topic, and is considered the first person to go to when researching the topic.
Why has he done nothing? And why has FAN, which both you and Paul work in, not done anything?
“Assuming 100% compliance with these “instructions” how do you plan to control for food and beverages they consume made with fluoridated water? How do you plan on controlling for water they drink at school or work which may be fluoridated?”
The “halo” effect needs to be controlled, your concern is absolutely valid. About one third to two thirds of the fluoride ingested even in fluoridated communities comes from other sources than fluoridated water. And many confounding factors need to be controlled. Diet, medications, and much more.
Bottled water at schools can be provided at schools or work. As a prospective study, if the study starts before conception, work water is a factor.
The Chinese and Iranian studies use blood and urine serum fluoride concentrations in their IQ studies. What a novel idea for third world countries to have higher quality measurements than generally used in the USA studies. With high quality labs which have been calibrated, fasting fluoride concentrations and teeth concentrations need to be measured. Teeth could be measured when the primary second molars exfoliate or thirds extracted. The target organ is the tooth and both my professions are absolutely clueless on the optimal fluoride concentration for enamel and dentin.
Steve, you refer to Warren/Levy. Where is the measured data on serum and urine concentrations of cohorts for their reports? And they did admit the term “optimal” should no longer be used.
Their studies were good historically, but now they need to catch up with China and Iran and India, et al and use measured data. Remember, those countries have some serious skeletal fluorosis which has made them look closer at what levels are safe. And they have more respect for excess fluoride exposure.
And one last point to your post, Steve. The responsibility for spending millions of dollars on research MUST NOT be dumped on the patient. Those marketing fluoridation, selling the stuff, making the profit, have the legal responsibility to provide the research to the FDA CDER who have the policies and experts to weigh the complex controversial evidence and approve with appropriate label for dosage and cautions like they have done for toothpaste.
So if you say RCT studies can be done, Why has your organization not done them? If you really thought that you had a valid case. I,m sure you would have jumped at the chance to prove fluoride is the nasty you say it is
Bill . .the reason that Viagra or any other drug cannot be added to the water supply is the simple fact that only authorized water additives meeting NSF/AWWA STD-60 are allowed. Sodium fluoride, HFSA and sodiumFS are three of the nearly 50 chemicals which are water additives.
This isn’t something that needs to be proven, it is simply the way it is. If you think federal law has changed then you should bring yet another case and see if you are correct.
In part, you are correct and in part your concept is flawed. My point is that adding a drop of public water (or a million acer feet) to a medication, does not change the jurisdiction from the FDA to the EPA if the intent is to prevent diseases in humans.
You are correct that NSF 60 provides for about 50 chemicals which can be added to public water to make the water safe and more palatable. However, NSF 60 only permits the contaminants in the products to react 10% of the EPA’s MCL. In other words, for fluoride, the EPA’s MCL is 4 ppm. And even a bald dentist knows 10% of 4 is 0.4 ppm.
In other words, water fluoridation over 0.4 ppm violates NSF Standard 60.
So I called NSF and asked why more than 0.4 is permitted. Their response was they do not regulate the safety or efficacy of chemicals added to water. Their job is to simply ensure the contaminants within the product do not exceed 10% of MCL.
So I asked NSF, if the HFS were called by a different name would the maximum permitted by 0.4 ppm. They refused to respond.
Chuck, do NOT rely on NSF for safety or efficacy of artificial fluoridation. Not their job.
When asking NSF for copies of the assays of the fluoridation products they have tested, very few are available. NSF is not a government agency and is not required to actually disclose testing results.
Chris, You asked why I have not done RCT trials? You fund it, I’ll do it.
The responsibility for providing the FDA CDER with quality research is not the patient, me. The responsibility is not the FDA CDER to get the research. The law requires the manufacturer to give the FDA CDER the research.
Chris,
Further to your comment, “So if you say RCT studies can be done, Why has your organization not done them?”
Ethically, I could not subject people to a highly toxic chemical which has almost 40 human studies showing IQ loss. And as the NRC 2006 report laid out, concerns for many diaereses.
If we were to introduce fluoridation today, with the research we have, can you imagine a Human Subject Review Committee permitting the mass medication of everyone without their consent? Many developed countries do not fluoridate the water because of freedom of choice, the lack of ability to gain informed consent from everyone.
The answer is simple. Money. We do not have corporate funding or tax payer funding for lobby work and research.
We are not selling anything.
We make no money from fluoridation.
The water districts and cities selling the water make the money off of water. In theory, they are not to make a profit, but they sell the water. It is their job to do the research.
At least we agree there are no prospective RCT studies. No gold standard studies. No high quality studies. And we agree many have not given their consent. And we agree fluoridated water is not done under a doctor’s orders/prescription and could not to patients not of record.
Ken, it is not just the most fundamental basics of scientific research prospective RCT studies which are lacking.
Most research on fluoridation have numerous problems:
Not one Randomized Controlled Trial
Socioeconomic status usually not controlled
Inadequate size
Difficulty in diagnosing decay
Delay in tooth eruption
Diet: Vitamin D, calcium, strontium, sugar, variables not controlled.
Total exposure of Fluoride and measured blood and/or urine fluoride concentration not determined
Oral hygiene habits unknown
Not evaluating life time benefit
Estimating or assuming subject actually drinks the fluoridated water.
Dental treatment expenses
Breast feeding and infant formula not determined
Fraud or gross errors.
Genetics and Dental office visits
Synergistic effects
Any quality scientist must demand these fundamental problems of fluoridation be controlled prior to use as a public health measure.
This debate series is most interesting, but is not of a sufficient scientific level to prove much. Unfortunately those opposed to Dr Osmunson’s views lapse rapidly into personal attack and don’t stay with factual argument.
However, maybe that is OK, since science cannot be the only arguments that eventually decide whether a community fluoridates, or continues with fluoridation.
I remember when my former city of Geelong, Australia was having fierce debates about fluoridation, 2003 to 2009. The chairman of the water supply authority, Dr Vaughan, was a medical doctor now involved in public administration. Whenever asked by the media to comment, he had an interesting take. He would say that there were two issues to consider (1) the scientific / medical facts, and (2) the issues of community values with regard to legitimate use of water supplies.
On the science he frequently said that there seemed to be strong arguments on both sides, and scientific experts would have to come to conclusions on that. On the community values issue he pointed out that we had not yet had that debate in a fairly moderated way for the whole community to express their views and wishes. Well, it never happened. Fluoridation finally got enforced in about 2009 or 10, by executive order of government.
The community values issues, that never got a proper airing or a vote, were such matters as (i) is it okay to use the water supply to carry additives other than those that purify the water? (ii) is it okay to administer a health treatment via the water supply to both those that want it and those that don’t? (iii) if an additive is being added for a health treatment purpose is it okay that it be an industrial grade by-product, or should it be required to be purified to the standard required of that substance if it were prepared into pill or other medicinal form?
I don’t think that many of the cities that practice fluoridation have really had that debate thoroughly at a well-moderated community level.
David, people are getting angry with Bill because he is a veteran Gish galloper and really is not honest in his approach to the discussion. Hardly suprising as he is a political activist on Paul Connett’s FAN team.
I personally don’t consider it worth engaging with him because it is impossible to get him to stick to a point. I learned that long ago.
I agree completely there are two issues here. And very often the values/ethical question is not discussed because scientific misinformation is used to divert away from that.
As for the scientific issues I personally think the science is pretty clear – but as in all science is always open to further cosnideration. Community Water fluoridation is safe and effective. I have discussed this in many articles on this blog.
However, it is often difficult for the layperson to appreciate the scientific literature on this. It is complex and must be approached intelligently and critically. And one must be aware that all the time there are ideologically-driven people who are trying to cloud the science.
If you think we should discuss the ethical issues further here you are welcome to make some points for discussion. I would welcome that.
I have written several pieces on the ethics and get frustrated because every time anti-fluoride propaganoidsts make scientific assertions in reply which are just wrong, thereby diverting the discussion. In the end I do not think those people really have an ethical leg to stand on – and that is a reason why they refuse to allow a proper discussion of the ethics.
Perhaps to start of the ethics isue I will comment on your 3 points.
(i) Water is treated for a number of reasons, not all directly related to purity. Chlorination and fluoridation help make the water safe and acceptable for health. But that is a decision for consumers – some consumers for example object to chlorination and often take steps to remove it. I think the same can be done with fluoridation. In the end we live in a society and society as a whole makes decisions on this via democratic procedurers like referenda and representative electiosn and voting.
(ii) A social health policy like fluoride and water disinfection must be made available to all by definition – but this does not mean that everyone has to take it. No one is force as there are always alternatives – just as in social policies like education and hospitals. People can, and often do, filter their water or find alternative sources. This is not expensive.
But I object very strongly to the idea that a minority of people can deny a beneficial and safe social health policy supported by the majority just because they have an ideological hang-up. They should be reposnsible and make alternative arrangments in that case.
(iii) Here you are switching back to the science – and repeating misnformation. The chemicals used for water fluoridation are required to pass stringent regulations about purity and contamination are are chemically tested. I have written on it extensively here because as a research chemist I actually did do some research on fluorosilic acid which brought home to me how pure the material is and how blatantly anti-fluoride propagandist lie about this.
OK, David, I would love to receive you response to my comments.
Bill . . I understand your argument. Quite obviously your self-referential view of how the fluoride MCL might be applied to the fluoride water additive itself is not how NSF-60 purity standards for regulated microcontaminants is being used.
To my knowledge this argument has never been raised in court. Surely Attorney Deal would litigate this pro bono. There is really no point to the public debate of idiosyncratic interpretations of EPA regulations. You should just go to court and we will then both know if your are correct or not. The law is exactly what judges say it to be.
Bill says “Any quality scientist must demand these fundamental problems of fluoridation be controlled prior to use as a public health measure.”
No, Bill, no quality scietists is going to refuse to recognise the fact that a real world exists and that one has to do the best one can with that real world. We going ahead and design our trials and experiments to get the best results – not sitting back and whining as you do.
What a quality scientist does is approach these studies and the scientific literature in general in an intelligent and critical way. Checking out things like social economic status, whether non-fuoridated groups have recieved alternative fluoride treatments, etc. etc. I personally have had a gutsful of anti-fluoride propagandists like you and Paul Connett making claims and quoting papers when they have either not checked such details, not read the paper, or have covered up the facts that undermine their story.
Bill
When I asked you why your organization did not do the tests to prove how bad fluoride is, you pulled out the “poor me’ card. We have no funding ect. But is saying that you have a full time legal team working for you, Plus full time activists, and they would not be there for their health, and all the costs incurred in the lost law suits must cost a bit, so really you have plenty of money,
You just choose to use it the wrong way, because you know as well as I do thet fluoride in drinking water at .7-1PPM is harmless And once that came out, and people accepted it as the fact it is ,you would be out of a job
——-“The “halo” effect needs to be controlled, your concern is absolutely valid. About one third to two thirds of the fluoride ingested even in fluoridated communities comes from other sources than fluoridated water. And many confounding factors need to be controlled. Diet, medications, and much more.”
Yes, my questions are valid……obviously. Yes, the “halo” effect needs to be controlled. Yes, the confounding factors need to be controlled. Control of these factors cannot be accomplished in any manner adequate for RCTs of fluoridation. That’s exactly the point. Handing subjects a bottle of water at school or work, offers no control for any variables.
The CDC estimates that 75% of daily fluoride intake comes from water and beverages.
——-“The Chinese and Iranian studies use blood and urine serum fluoride concentrations in their IQ studies.”
If the Chinese and Iranian studies to which you refer are the infamous “27”, there is no evidence that these seriously flawed studies were even peer-reviewed or that they controlled for much of anything.
——-“Warren/Levy”
We have discussed the optimal level previously. If you continue to have a problem with this level, take it up with the US DHHS.
——–“Their studies were good historically, but now they need to catch up with China and Iran and India, et al and use measured data. Remember, those countries have some serious skeletal fluorosis which has made them look closer at what levels are safe. And they have more respect for excess fluoride exposure.”
Skeletal Fluorosis is so rare in the US as to be nearly non-existent. If this disorder was a consequence of fluoridated water, in the 74.6% US, SF would be rampant.
Given the lack of any valid proof of adverse effects of optimal level fluoride, in the 69 year history of this Initiative, there is no reason to believe that the US does not have “respect” for fluoride overexposure. That respected science and healthcare sees no need to disprove all unsubstantiated claims made by antifluoridationists, is not indicative of any lack of respect for fluoride overexposure. It is indicative of the transparent attempts of antifluoridationists to further their personal ideology through constant demands of testing, demands which would never end regardless of the amount, or quality, of such testing.
“And one last point to your post, Steve. The responsibility for spending millions of dollars on research MUST NOT be dumped on the patient.”
—-I have not stated that the “responsibility for spending millions of dollars on research” should be “dumped” on the patient. It is the responsibility of those who constantly put forth unsubstantiated claims, then demand they be disproven. There is no valid evidence that supports any adverse effects of fluoride at the optimal level. Those such as you who constantly clamor for more testing of the fluoride ion they’ve been ingesting since birth, have the responsibility for providing valid evidence of problems before credibly demanding that these claims be disproven.
—–The FDA has no jurisdiction over mineral additives to water, of which optimal level fluoride is one. This jurisdiction belongs to the EPA. Thus, there is no requirement, legal or otherwise, to provide any study results of fluoride, or any other drinking water additive, to the FDA.
“You are correct that NSF 60 provides for about 50 chemicals which can be added to public water to make the water safe and more palatable. However, NSF 60 only permits the contaminants in the products to react 10% of the EPA’s MCL. In other words, for fluoride, the EPA’s MCL is 4 ppm. And even a bald dentist knows 10% of 4 is 0.4 ppm.”
Fluoride is not a contaminant in HFA, it is the primary product being added to water, using HFA as the vehicle. HFA does not reach the tap and is not ingested. The purpose of Standard 60 is to ensure that unwanted contaminants in products added to water, do not exceed safe levels. Fluoride in drinking water is subject to the EPA mandated primary MCL of 4.0 ppm. It is not subject to Standard 60 maximum levels for contaminants.
Chris,
Based on my memory of the finances, FAN has given $1,000 to lawyers for legal work. That is not a “legal team.” I have not received any money and have spent over $100,000 of my own money and time raising the awareness of the public to the risks and harm caused by excess fluoride exposure in the USA.
Ken said, “No, Bill, no quality scietists is going to refuse to recognise the fact that a real world exists and that one has to do the best one can with that real world. We going ahead and design our trials and experiments to get the best results – not sitting back and whining as you do.”
I am demanding quality studies and I am working with the best we have. My answer and your answer are not mutually exclusive. I agree with both. We must demand better and must work with what we have.
You hold a double hypocritical position.
You accept lower quality studies of efficacy but demand high quality studies on risks.
Chuck,
If I had the money to go to court I would.
For several reasons, courts do not like to review science and make rulings about science. For one thing, science should and must constantly be subject for review and not written in stone.
Courts are better at holding people and agencies accountable for the law.
A suit against the EPA and FDA for failure to follow the law is more reasonable for a court.
The EPA scientists presented an Amicus to the court back in 1986:
“The process by which EPA arrived at the RMCL for fluoride is scientifically irrational and displays an unprofessional review of relevant scientific data.” Amicus to the US Court of Appeals, DC Circuit, Natural Resources Defense Council, Inc., v EPA Civ. No. 85-1839
Bill,
“My point is that NSF makes no sense. Call HFA by another name and it would not be permitted beyond 0.4 ppm.”
NSF makes perfect sense. It is you who does not. NSF standards begin with water at the tap. HFA does not exist at the tap. Thus, your statement that under a different name HFA would only be allowed up to 0.4 ppm is nonsensical.
David,
You are a gentleman in this discussion and I respect your professional presentation.
May I add to your comment on public understanding:
If a person wants to ingest fluoride, they can simply swallow a small baby pea size of toothpaste which contains 0.25 mg of fluoride, the same as a glass of fluoridated water. (FDA warns not to swallow that much) We can give people the freedom to choose and save the money spent on artificial fluoridation.
“I am the patient. You are the patient. Who is the doctor?”
Sure, countless people in this world are “patients”. If that is how you want to describe antifluoridationists who make constant unsubstantiated claims against fluoridation, fine with me. Call them whatever you wish. Whomever makes unsubstantiated claims of problems associated with fluoride at the optimal level bears the responsibility of providing valid evidence that those problems do exist, before credibly demanding proof that they do not.
Have you talked to NSF? I have called them several times and had email contact. I think you are mistaken. NSF’s job is at the water treatment plant and at the faucet. And makes no difference whether the 1 ppm of fluoride is measured at the plant or at the faucet. They should be the same and generally are.
If water suppliers followed NSF 60, they would not permit the fluoride contaminant to exceed 10% of the maximum contaminant level of 4 ppm.
“Fluorosilicates do not require a toxicological assessment specifically for the fluorosilicate ion, because measurable levels of this ion do not exist in potable water at the fluoride concentrations and pH levels typical of public drinking water. There is currently no US EPA-derived MCL for silicate in drinking water. NSF established a SPAC for silicate at 16 mg/L based on the typical use level of sodium silicate in Table 5.1 of NSF/ANSI 60, which was based on the value from the Water Chemicals Codex.2 A fluorosilicate product, applied at its maximum use level, results in silicate drinking water levels that are substantially below the 16 mg/L SPAC established by NSF. For example, a sodium fluorosilicate product dosed at a concentration into drinking water that would provide the maximum concentration of fluoride currently permitted by the Standard (1.2mg/L) would only contribute 0.8 mg/L of silicate – or five percent of the SPAC allowed by NSF 60.”
Bill, pots and kettles for you to characterise my support for dealing with the real world instead of demanding the impossible. Your boss, Paul Connett is the classic example of someone not only accepting, but also promoting, low quality studies because they confirm his bias. He also makes the inexcusable practice of misrepresenting good studies to pretend they support his claim that fluoride is ineffective.
I see in the Waikato Times an article entitled ‘Science for sale denies public a legacy’
“Science is no longer a search for truth but a commodity to be bought and sold”.
That Ken is what happened to fluoridation – those who sought to profit from it bought the science needed to support its claimed safety and benefits. Unfortunately the same process, ably assisted by people like yourself, is still in train today.
Believe everything you read in the Waikato Times, do you Trev. 🙂
Come on, your analysis of social pressures on science is going to have to be more subtle than that.
You could start by looking at Paul Connett and analysing how his ideology and group thinking has twisted his ability to read the scientific literature.
He is a shocker for cherry picking and confirmation bias as our exchange on fluoridation showed.
For the most part, Trevor, when intelligent people are confronted with the fact that science does not agree with their position on a scientific issue, they reexamine their position.
When antifluoridationists are confronted with the fact that science does not agree with their position, do they allow this to deter them? Naaah, they simply declare the science to be corrupt, and keep on spewing their nonsense without missing a step.
If nothing else, you guys are a constant source of entertainment!
Those without evidence, attack the messenger rather than the message.
Seve and Ken,
39 human studies on neurologic harm from excess fluoride. Two did not find harm, 37 did.
Certainly those have been critically examined, as they should. However, they are the best we have and the quantity of studies and consistency of the studies is remarkable. I doubt a human research review committee would not permit an RCT to determine the least observed adverse effect.
Toxicologists have taken the fluoride human studies and determined
“Safe*” levels of fluoride in drinking water (MCLG):
From Choi et al. data: 0.021 – 0.027 ppm
From Xiang et al. data 0.0086a or 0.00021bppm
Current EPA standard 4 ppm
Likely new EPA standard ~ 2 ppm
a Using LOAEL/NOAEL = uncertainty factors
b Benchmark Dose Method
* Levels before accounting for other fluoride exposure
ppm = mg/L
Instead of attacking the messenger, focus your comments on the message. What have your toxicologists determined LOAEL/NOAEL?
Ken,
An example of attacking the messenger rather than the message can be found in the comment, “your boss.” I have offered to answer calls from people primarily on the West Coast with questions regarding fluoridation. I am not paid, nor am I told what to say. Paul is not my boss, although I find his approach to be global, logical and based on the best science and laws available from all sides. Instead of attacking me with speculation and assumptions, do the ethical and scientific approach by simply asking me. Try the same approach with science. Personally investigate rather than assumptions, estimates and speculation. Some people on this forum may actually believe you and think I am being paid by FAN. Spreading untruths and rumors about me without asking me is cruel and unprofessional. I’m concerned the same approach is being used with the scientific evidence on fluoridation. You have not personally check your sources.
I am requesting a public apology from you.
In the end, judgment needs to be used. Not on who is better looking or more crafty with words, but all sides of the science. The theory is complex and controversial. That is why the best minds and experts need to review and continually review the scientific evidence. The appropriate question is, “who has jurisdiction?” Who is responsible for reviewing the scientific evidence?
With fluoridation, I have contacted all agencies public water suppliers rely on for evidence of efficacy and safety. These are HHS, CDC, EPA, and Surgeon General. None of those claim jurisdiction to determine the safety or efficacy of fluoridation. HHS started and backed off. CDC is very clear on the phone and on their web site that they do not determine the safety of fluoridation. EPA is prohibited by law from regulating anything which is used for the prevention of disease in man or animals and they have repeatedly confirmed their lack of jurisdiction.
So I contacted the FDA CDER and asked if they had jurisdiction and FDA CDER confirmed they have jurisdiction over fluoride when used with the intent to prevent disease..
The FDA has rejected 35 new drug applications for fluoride/vitamin combinations because, “There is NO substantial evidence of drug effectiveness as prescribed, recommended, or suggested in labeling.” Drug Therapy June 1975
I contacted the FDA CDER and they responded in part, “A search of the Drugs@FDA database . . . of approved drug products and the Electronic Orange Book. . . does not indicate that sodium fluoride, silicofluoride, or hydrofluorosilicic acid has been approved under a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA) for ingestion for the prevention or mitigation of dental decay. . . . At the present time, the FDA is deferring any regulatory action on sodium fluoride products. . .”
Proponents of fluoridation have failed to provide any documentation to refute the FDA CDER’s jurisdiction.
Bill, this is just typical of your personal attacks as a way of avoiding the issues. You are referring to a comment I made as follow:
“Bill, pots and kettles for you to characterise my support for dealing with the real world instead of demanding the impossible. Your boss, Paul Connett is the classic example of someone not only accepting, but also promoting, low quality studies because they confirm his bias. He also makes the inexcusable practice of misrepresenting good studies to pretend they support his claim that fluoride is ineffective.
It’s clear who the hypocritical parties are.
Now the fact is in the exchange with Paul Connett, again and again he used low quality studies or misrepresents studies. When I pulled him up on this, pointed to the factors he covered up, he usually ignored, tried to avoid or diverted the discussion.
You use the same tactic and your last comment is simply another attempt to divert.
It is pathetic to see a grown man behaving so childishly.
Ken,
You attack me personally and call me childish, etc. Yet you fail to answer the most basic questions.
What about giving me and those of use who do not want fluoride, FREEDOM? We have been harmed from too much fluoride, in part from fluoridation. Give us freedom.
I’ve asked for studies with measured cost benefits, reduced dental expenses in fluoridated communities, and you have been silent. There is only one reasonable study, Maupome.
I’ve asked for for the “optimal” fluoride serum concentration which would give us the “optimal” enamel and dentin fluoride concentration which mitigates or prevents dental caries and you have failed.
I’ve asked for one prospective RCT on fluoridation efficacy and safety, and you have failed.
I’ve asked for any study using HFS, and you have failed.
I’ve asked for the government authority who admits they have jurisdiction over determining exposure, efficacy and safety, and you have failed.
I’ve presented evidence of countries stopping fluoridation and you are silent.
Yet you call me childish for asking for quality scientific studies and freedom not to be forced to have fluoride in my water.
Don’t be silly silly, Bill. Your relationship with FAN is public – you are listed as part of their team on their web site. Even if your didn’t declare your interests in commenting here.
Bill, you seriously need to get over yourself. If you can’t take the heat about your affiliation with Connett and FAN, then separate yourself from them and their nonsense.
You have posted so much junk up and down this page that it would take a dumptruck to take it all to the landfill where it belongs. Then you have the absurd brazenness to demand an apology??
As far as “failures”, all of your “requests” have been fully addressed, several times in most cases. That you don’t like the answers is your problem, not any “failure” on anyone else’s part. Perhaps if you actually read the responses, you would see this. That you demand something does not mean that it is reasonable, relevant, or requiring of the response you deem should be given.
If you want to talk about “failures”, how about the studies you requested of me in regard to cost savings of fluoridation? Silence from you when I provided them. How about your attempts to lump all levels of dental fluorosis into one? Silence when I’ve exposed that ploy. How about your inference that it costs “thousands” to treat mild to very mild dental fluorosis? Silence when I called you on that. How about your attempts to misuse 2006 NRC? Plucking quotes while disregarding the final stated concerns of this Committee?
You falsely assumed Paul was my boss,
just as you falsely assume fluoridation is safe and effective.
Your assumptions about me came across as disparaging and an apology is in order.
Why have you made these assumptions about me and the fluoridation? Perhaps you seriously want to help prevent dental caries. Perhaps you blindly follow some Americans and failed to include the non-English speaking countries and scientists in your deliberation. Perhaps you have not quietly read the literature for yourself. I don’t know for sure.
For the health of your family, I suggest you encourage them to be cautious and reduce their total exposure to fluoride.
Some research shows 26 out of 28 teeth are good and caries free regardless of fluoridation. The same data when comparing surfaces of the teeth suggest out of 128 tooth surfaces about 120 surfaces are good without fluoridation and about 121 surfaces are good with fluoridation. That is less than 1% improvement and many confounding factors were not considered in the study of over 29,000.
Perhaps there is a “sweet” spot where a little fluoride shows slight improvement, but the same research consistently shows a little more fluoride erases any benefit and starts to increase dental caries. Are you sure that “sweet” spot is being hit with water highly variable consumption of fluoridated water, fluoride toothpastes, pesticides, medications and foods with fluoride? Are you sure that “sweet” spot with less than one percent improvement is worth the risks as outlined by the National Research Council 2006 report and subsequent 8 years of research?
Just like you made assumptions about me without asking me, you have made assumptions about fluoridation.
My apology. I did not see your response to my request for the published articles on measured cost savings for dental treatment for the public at large. And a quick look at your posts above I keep missing them.
Please post them again.
I did see where I had not responded to your comments about NSF 60 and silica in the water. Maybe I should be concerned about the silica, but I am not informed concerns of silica.
My concern is the fluoride. NSF 60 permits 10% of the MCL (Contaminant) and EPA MCL is 4 ppm. 10% of 4 ppm is 0.4 ppm. Fluoride is classified by the EPA as a contaminant and NSF permits 10% of EPA’s MCL.
It has taken me time to respond to your comment,
“. . . that inconvenience is small compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.”
We are all concerned about cavities. However, I can fix teeth, I can’t fix brains cooked by excess fluoride.
The ADA awarded the state of Kentucky for 50 years of fluoridation at the same time as Kentucky topped out with the most edentulous adults, 44%.
Several cities such as Boston claim a crisis of dental caries and they have had fluoridation for decades.
Comparing fluoridated versus nonfluoridated developed countries, states or counties shows no public health benefit. British Columbia is 98% fluoridation free and has the lowest dental caries rates of any Canadian Provence.
While public health agencies fight and spend millions to add fluoride to water and think the fluoride policy is a star in their crown, the thought and good feelings are not backed up with reasonable scientific evidence.
My public health profession is taught that any public health measure’s effectiveness must be measured in the community at large, not just in vitro or in vivo.
Fluoridation no longer shows a public health benefit if it ever did.
Standard 60 applies to unwanted contaminants introduced by a primary water additive. Fluoride is a primary additive. HFA is simply the vehicle utilized to transfer this ion into water, The only mandated maximum for fluoride in drinking water is the EPA primary MCL of 4.0 ppm.
In your response to Chuck you state: “My public health profession is taught that any public health measure’s effectiveness must be measured in the community at large, not just in vitro or in vivo.”
Exactly! The peer-reviewed obversational studies which you disparage, while constantly demanding blood and urine levels, do just that. They clearly demonstrate the benefit of the public health initiative of water fluoridation on whole populations.
The evidence clearly shows there is no current public health benefit with fluoridation. The decline in dental caries is not due to fluoridation when looking at the public at large.
Steve, we agree the evidence must be measured in the public at large. Perhaps you have not seen the evidence. May I send you some research? I need your email. (And anyone else who would like some).
Thank you Bill, but I have no need for “research” from “fluoridealert”.
The following peer-reviewed evidence does indeed clearly show a current public health benefit of fluoridation:
1) Results
Children from every age group had greater caries prevalence and more caries experience in areas with negligible fluoride concentrations in the water (<0.3 parts per million [ppm]) than in optimally fluoridated areas (≥0.7 ppm). Controlling for child age, residential location, and SES, deciduous and permanent caries experience was 28.7% and 31.6% higher, respectively, in low-fluoride areas compared with optimally fluoridated areas. The odds ratios for higher caries prevalence in areas with negligible fluoride compared with optimal fluoride were 1.34 (95% confidence interval [CI] 1.29, 1.39) and 1.24 (95% CI 1.21, 1.28) in the deciduous and permanent dentitions, respectively.
——Community Effectiveness of Public Water Fluoridation in Reducing Children's Dental Disease
Jason Mathew Armfield, PhD
2) CONCLUSIONS:
Children with severe dental caries had statistically significantly lower numbers of lesions if they lived in a fluoridated area. The lower treatment need in such high-risk children has important implications for publicly-funded dental care.
——Community Dent Health. 2013 Mar;30(1):15-8.
Fluoridation and dental caries severity in young children treated under general anaesthesia: an analysis of treatment records in a 10-year case series.
Kamel MS, Thomson WM, Drummond BK.
Source
Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand.
3). CONCLUSIONS:
The survey provides further evidence of the effectiveness in reducing dental caries experience up to 16 years of age. The extra intricacies involved in using the Percentage Lifetime Exposure method did not provide much more information when compared to the simpler Estimated Fluoridation Status method.
—–Community Dent Health. 2012 Dec;29(4):293-6.
Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland.
Mullen J, McGaffin J, Farvardin N, Brightman S, Haire C, Freeman R.
Source
Health Service Executive, Sligo, Republic of Ireland.
4) Abstract
The effectiveness of fluoridation has been documented by observational and interventional studies for over 50 years. Data are available from 113 studies in 23 countries. The modal reduction in DMFT values for primary teeth was 40-49% and 50-59% for permanent teeth. The pattern of caries now occurring in fluoride and low-fluoride areas in 15- to 16-year-old children illustrates the impact of water fluoridation on first and second molars.
—-Caries Res. 1993;27 Suppl 1:2-8.
Efficacy of preventive agents for dental caries. Systemic fluorides: water fluoridation.
Murray JJ.
Source
Department of Child Dental Health, Dental School, University of Newcastle upon Tyne, UK.
5). CONCLUSIONS:
Data showed a significant decrease in dental caries across the entire country, with an average reduction of 25% occurring every 5 years. General trends indicated that a reduction in DMFT index values occurred over time, that a further reduction in DMFT index values occurred when a municipality fluoridated its water supply, and mean DMFT index values were lower in larger than in smaller municipalities.
—-Int Dent J. 2012 Dec;62(6):308-14. doi: 10.1111/j.1875-595x.2012.00124.x.
Decline in dental caries among 12-year-old children in Brazil, 1980-2005.
Lauris JR, da Silva Bastos R, de Magalhaes Bastos JR.
Source
Department of Paediatric Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Steve,
“Thank you Bill, but I have no need for “research” from “fluoridealert”.”
Fluoridealert, to my knowledge, does not do research. I presume you mean if FAN has the research on their website then automatically it is of no value? Regardless of whether it comes from the British Medical Journal, Journal of American Dental Association or any other Journal. If fluoride alert has it on their website then you reject it automatically. Or am I misunderstanding you? If so, be more specific.
Biull,
‘If fluoride alert has it on their website then you reject it automatically.”
I automatically reject any cite to “fluoridealert”. Connett has so distorted information on that site through the years that nothing on there can trusted for accuracy. If you care to cite something which I will take seriously, then do so from its primary location. I have no desire to waste time reading anything that has been filtered through “fluoridealert” or any other such antifluoridationist website.
If you are attempting to make the delayed eruption argument, it has no merit.
Thanks Bill. Its funny how these people slink from actually looking at FAN’s site when asked – yes, to look at all the 1000’s of quality and diverse research done from all over the world – and just because they want to pick a fight over (a Professor of Toxicology) Paul Connett’s mighty efforts to provide a Universal perspective along with a depth of reports, Science and Research done by reputable organisations, including governments, Dental Associations, Chinese, British and European Scientists. But, hey, the FAN website doesn’t need Sloth’s or Parrott’s ‘say so’ anyway – the site speaks for itself – reputable and reliable; and millions of people use that site now, and as the research is not FAN’s – no – it is decades of other professional and Scientific people working to raise awareness of fluorides effects on soft tissues (and not just on ‘teeth’ as if that was the only part of the body that exists like the Sloth’s and Parrots would have us all believe). These researchers can’t ALL be ‘wrong’ just because a few promoters of fluoridation don’t like the Truth being told. Word of mouth has brought people to FAN’s site; not promoters spending the big bucks to peddle their industrial waste slurry muck from the Aluminium smokestack chimneys! Simple integrity has won; not, bucks or lies. And, people can make up their own minds once they do their own research. FAN doesn’t tell people how to think; just provides the studies in one convenient website (depth and breadth over 1000’s of quality, fully referenced, Scientific, articles) for anyone – Medical, professional or lay people – to do their own research and come to their own conclusions. FAN are not bullying or forcing their opinions on others – unlike the promotors who have dumped waste into the water so no-one can avoid the stuff. So who cares in the long run, what the promotors opionions are. We are all entitled to choose what we put in our bodies; and if our teeth rot due to lack of poor diet and too much sugar, we pay our own bills thank you very much – not the dentists or promotors who profit.
ASWLA is an archive of letters – not a research site – from people all over Australia, doing their best to extract honest answers from politicians, government bodies, doctors, medical and university people, who have yet to provide research answers. BTW… its now being read on a regular basis each and every day from people all over the world – over 95 countries now. Take it or leave it Sloth, you are not going to win your battle by denouncing all those 100’s of 1000’s of people asking for valid answers. You only make yourself look really silly by doing so – that is bully-boy tactics to demean people asking valid questions. Its the public’s right to ask; and demand answers from the ‘health’ bodies – information which they are not receiving, unless you call en-masse letters that continue to support fluoridation blanket form, without responding to the individual questions raised. ASWLA is not a research site (although many letters have fantastic links to various Scientific sites, journals and political archives); no, it is simply, a letter archive – little or not in reputation; and that is all ASWLA aims to be. ASWLA does not seek anyone’s approval or disapproval – and especially, not from promotors. No, this site was set up just to archive letters, and keep a record of what was asked of our political, medical and dental bodies; and we ask the public to send through the responses they receive. Funny though, that almost every letter archived, has not received a response from those written to….. Letters that ask the truth of those in power including mainstream media who rarely, if ever, publish any of the public’s valid enquiries. Funny that, as if fluoride was so transparent, why do the media love to avoid and hide, public enquiry on fluoridation? What a whitewash. Our little site is doing just fine with or without you Sloth. The public will continue to ask questions and write letters. If you are so upset by our little site, don’t worry your sweet head about a thing. We’ll stay a little volunteer group; but read all over the world despite you. We let people speak their mind; and make up their own minds, according to the (lack of) response they receive. Its just a record of letters. Nothing for you to be worried about, eh, if fluoride is so good for everyone, all ages, regardless of health, age or, need for the stuff. What are you worrying about then…. why even bother to raise the issue with ASWLA. You already have had your way…. a forced masse medication on everyone.
Who said I was “upset” by your little site? I didn’t even know you existed, much less had a site, until I saw your previous posts on this site……nor could I care less. Little antifluoridationist websites proclaiming they have the “truth” are truly comical, are a dime a dozen, and are accessed only by other antifluoridationists seeking confirmation of their bias.
Oh good then. Be happy Sloth. ASWLA loves to see you happy. Dime a dozen or not, just like yours, eh. And by the way, we’ve noticed that even government bodies are reading the letters (WordPress has a way of seeing where enquiries come from). But, nothing to worry about, eh. Glad you are not upset at all. Cheers. Enjoy your happiness Sloth.
PS. Thats government bodies from all over the world. You see, some countries don’t fluoridate; and that means they wonder why those that do, do – especially when those countries are not transparent in their responses to the public. Those countries are not silly enough to ignore valid concerns of their people; and so, they wonder why (in this instance) the Australian government and its buddies, do ignore their people. Take care Sloth; and in the meantime, ASWLA wishes you good dental health from ingesting what you wish to; but one day you may realise, that the care of teeth does not revolve at all around the proverbial tooth fairy God of fluoridation. Millions of other people in the bulk of the worlds unfluoridated countries (including most of Europe) have proven that; and they also realise that giving people a choice in what they put in their body is ethical and, just, which is more that the promotors believe in forcing their archaic, outdated practice upon us all.
“Just like yours”? Hmmm, news to me. I had no idea I had a website.
Yes, maybe “government bodies” are reading whatever “letters” you have on your little site. Government workers need some good comic relief from time to time. Helps to relieve some of the stresses for when they return to their important duties.
“but one day you may realise, that the care of teeth….”
OMG!!! What remarkable dental insight and wisdom from the caretaker of yet another in a loooong line of little “Safe Water (fill in the name of your community)” websites!
So, you’re leaving, just when it’s getting hilarious?? Where to now? NASA to set straight their engineers with your wisdom and insight on space exploration?
“Just like yours” ie. That means, comments (from other people) – just like your comments. ASWLA little site knows that you like to blog incessantly on many many forums, website hopping like a frog in a pot of warming water, spouting your own very unique brand of caustic acid tongued writing, deriding any one’s feelings (god help anyone who feels anything as one must never do that, eh, even if they suffer sensitivity from fluoridation’s caustic affects). Yes Sloth, you are a lot like fluoride acid – eating away at all that is whole, but professing purity and goodness – that you have everyone’s best intentions at heart, but quietly, you corrode. Yes Sloth – you are such an angel, we all know that now….. (mmmmm). But you know dear Sloth, there will always be those who will defend their right to put into their body, what they wish to – and that is their business and ethical right. So go and look after those that want fluoride, ok? Leave those that don’t, alone – you have no right to say they are wrong for choosing so. You are, after all, already happy, eh. So go be happy, and leave others to speak their own mind if they wish to – that they don’t want fluoride – just as you want to have it – so goody for you Sloth – go enjoy your daily dose of fluorosilic acid ions. ASWLA is very happy you in your right to spout off your viewpoint — just like those letter writers do too. Enjoy your writing on a zillion websites – websites you don’t want to have the responsiblity to put together yourself — mmm, why you are a bit of an analogy here – one could liken you to a well veneered mouth (due to fluoridations non-effects against the mighty sugar intake that a modern diet entails) – yes, a mouth full of it but doing no good really, in stemming the tide of rot. I hope the laughs that all those stressed government people have gets alleviated enough so they can finally respond to some of those letters…. that would be really novel and finally give the public what they are asking for ie. Transparent studies on the long-term effects of ingesting industrial waste year in, year out, without anyone checking on the health effects of said individuals.
Steve,
We have gone over this ecological study before in rather significant detail. I just read it again and here are a few concerns.
“Community Effectiveness of Public Water Fluoridation in Reducing Children’s Dental Disease” Jason Mathew Armfield, PhD
I appreciate Jason writing the report and my comments are not an attack on him personally, but rather emphasis on limitations of the study. Perhaps Jason would agree and perhaps he would not. I have not contacted him.
Jason is the sole author. Would no other authors join him? Jason has consistently promoted fluoridation and like all of us, he has bias which is evident in the article. His award from Colgate should be noted.
The study is not a prospective randomized controlled trial; however, the study includes a large number of cohorts which must be qualified by a random sampling of those cohorts. How many were actually used in the study is not stated.
Jason speculates without reference: “In countries such as the U.S., where there are no established school dental programs to provide preventive and restorative treatment to school-aged children, water fluoridation is perhaps even more important and is likely to be even more effective as a population preventive oral health practice.”
Dental examiners were not calibrated.
Delay in tooth eruption was not considered. That factor in and of itself could negate any differences with fluoridation.
80% of younger children seen by SDS and substantially decreasing as they get older. One would expect SDS appeals to low income families due to cost. Again, one area may have more utilization than another area due to SES. SES is a very powerful confounding factor.
Postal code was used for SES. Confidence is not high.
Did the cohorts actually drink the water?
A non-normal distribution of dmft and DMFT scores was acknowledged.
Standard deviation since last dental visit was significantly more for non-fluoridated. Obviously those on fluoridated water are seeing the dentist/hygienist more frequently, probably higher dental education, motivation, and encouragement.
SES is a highly significant factor for dental caries. I’m not sure why, but it is significant.
Non-fluoridated cohorts were younger and significantly poorer (unweighted) with more rural.
Fluoridated non-fluoridated
35% of high SES 13% high SES
87% Metropolitan 26% Metropolitan
Lets look, for example, closer at the DMFT data for 8 to 15 year olds. The data is reasonably consistent at each age finding some difference. However, when corrected for delayed eruption of the teeth (different studies finding from 4 months to a year or more delay), the benefit is reduced or wiped out. In other words, the study needs to be done measuring how long the teeth had been in the mouth rather than how old the cohort is.
Let me be specific with the example.
8 year olds on <0.3 ppm had 0.50 DMFT and 9 year olds had exactly the same.
9 year olds on low fluoride had 0.59 DMFT and 10 year olds on high fluoride had similar of 0.57.
And if we are going to be correct statisticians, we will measure from the total possible teeth rather than 0. In other words, 15 year olds have 28 teeth. Not including the delay in eruption:
15 year olds on low fluoride had 25.82 good teeth.
15 year olds on high fluoride had 26.35 good teeth.
That represents about half a tooth or about 2% DMFT improvement.
Statistical methods were then used to flesh out a theoretical benefit.
Jason acknowledged confounding factors such as whether the child actually lived in the fluoridated communities all their lives or moved.
Individual exposure data was not collected which in other studies finds about 10% error just for fluoridated water to the house where the child lived.
The author does not approach the study from a null hypothesis but is and has shown a strong bias to fluoridation. He found what he was looking for.
Steve, the author is rather candid, "Researchers typically avoid the community-level approach adopted in this study because it fails to control for a number of individual-level factors that may also be related to caries experience." Perhaps that is why no other authors were willing to sign on to this report."
Measured serum and urine fluoride concentrations were not included. This study is little more than estimates and assumptions.
The author brings up the potential of "other differences between the two populations" but then addresses the potential for greater fluoride in the fluoridated communities, "However, there is no reason to believe that children living in fluoridated areas have a greater use of other fluoride products than do children living in non-fluoridated areas."
Of most concern to me is the failure to even mention or consider the huge unknown confounding factor which cut dental caries in from 12 teeth to 6 teeth before fluoridation started in the USA. A change of half a tooth is very small compared to 6 teeth. The rate of decline before and after fluoridation has been consistent, fluoridation has not shown a change in rate.
What caused the huge monster decline in dental caries prior to dental fluoridation? Could it be that the difference of 2% (or about 25% depending on which way you calculate the change) is simply the result of that huge unknown?
Jason's conclusion is not supported by the data. However, it should be added to the numerous studies of similar quality and limitations which have found either benefit or lack of benefit.
I’ve got it!! It just dawned on me where you could have obtained your remarkable wisdom and insight on proper dental health. Sesame Street quite often has a “tooth fairy” segment on Saturday mornings, featuring Oscar, Cookie Monster, Bert, Ernie……. the whole gang learning how to care for their teefies! That explains it!
Thank you, but you are not qualified, or objective enough to give a proper critique of peer-reviewed studies such as these. You have clearly demonstrated your confirmation bias in your acceptance of the absurdly flawed Chinese studies dug out of obscure Chinese journals, studies for which there exists no evidence that they were even peer-reviewed, yet which agree with your ideology……while criticizing high quality, properly peer-reviewed studies published in respected scientific journals, but which disagree with your ideology.
As I stated previously, the theory of delayed eruption due to fluoride has no merit.
“CONCLUSION:
Exposure to fluoride in drinking water did not delay the eruption of permanent teeth. The observed difference in dental caries experience among children exposed to different fluoride levels could not be explained by the timing of eruption of permanent teeth.
‘However, while there is well established evidence of differences in dental
development at similar ages across cultural and ethnicity groups, there is not evidence that water fluoridation is a cause of differential tooth eruption.
Information recently published by the Fluoride Action Network based on Australian data, suggesting a substantial difference in tooth eruption between fluoridated and non fluoridated areas of Australia, have been confirmed as being based on erroneous data.
The Australian research centre (ARCPOH) responsible for these data have confirmed the data error and reported that when the error is corrected there is little variation in the number of permanent teeth present at each age between children in Queensland and all of Australia.
The studies and reports cited by Professor Connett to try and validate an argument for delayed tooth eruption either do not make the claims he suggests, or do not have direct relevance to trying to assess the issue. The claimed association is at odds with the published literature which indicates minimal variation in eruption time of permanent teeth by exposure to fluoride. A rational explanation exists for the minimal variations that have been reported based on the relationship between fluoride exposure, caries experience in the primary teeth and emergence timing for the permanent teeth.
Information on the effect of water fluoridation on adult oral health, when any
potential effect from delayed tooth eruption would have disappeared, continue to show a benefit from from water fluoridation both in international and in New Zealand data”
— National Fluoridation Information Service (2011): Does Delayed Tooth
Eruption Negate The Effect of Water Fluoridation? National Fluoridation Information Service
Advisory June 2011, Wellington, New Zealand.
You can always tell the activists are in town ,when they get pushed into a corner, they start calling people names or use CAPS. It happens all the time and the more upset they are, the more caps they use. It must be something that is missing out of their water?
If I had a nickel for every time I’ve been called a liar by a cornered, frustrated antifluoridationist, I could retire. That’s always the final defense……..or well, I guess the final, final defense would be when they call me a LIAR. That’s when I know I’ve sliced into the sweet spot of the right nerve.
Steve:
You don’t like the peer reviewed research from China but you are happy to drink their contaminants. Amazing.
You said, “Thank you, but you are not qualified, or objective enough to give a proper critique of peer-reviewed studies such as these.” Your pious humility amazes me. You are qualified, but I am not? I suggest the FDA CDER but you want me to trust you and believe you instead of the FDA CDER.
Again, you attack the messenger. Stick to the science instead of putting other people down.
The research is mixed on delay in eruption, efficacy, safety, exposure, and most all aspects of science. Your categorical rejection of research which does not support fluoridation is bias to the extreme.
That is why I demand FDA CDER oversight and demand prospective RCT studies.
Are you suggesting the Choi, Grandjean Harvard School of Public Health study was not peer reviewed? Of course it was. And the studies they used were peer reviewed. In fact, the measured evidence using serum and urine fluoride concentrations along with dental fluorosis and evaluating confounding factors such as iodine and arsenic is a step ahead of research here in the USA. Good scientists here have been calling for those measurements for years and generally lacking in USA studies.
Is it all studies from other countries and languages or just China which you reject? Is it a race thing or a language thing which brings out your anger?
Once upon a time, when the ASWLAs of this world popped their heads up and out of their burrows we could all expect a right royal entertainment show as he surgically decapitated them.
And yet, fluoride in water is already regulated by the EPA. Another government agency. What, exactly, makes you think that simply by switching which government agency regulates fluoride in water, you will somehow alter their standards or recommendations?
What makes you think that, if fluoridate in water could be demonstrated to be dangerous in concentrations between 0.7 – 1ppm, the EPA would not put a stop to the practice of fluoridation and, equally importantly, mandate that naturally-occurring fluoride (presently allowed at up to 2ppm) be removed from the USA’s water supplies?
It’s pretty clear that you’re obsessed with trying to get people to believe fluoride in water ought to be regulated as a drug (a nonsensical proposition, given it’s naturally occurring), rather than actually trying to demonstrate any harm arising from the practice of water fluoridation.
A Bayesian analysis of multivariate
doubly-interval-censored dental data
ARNOSˇT KOMA´ REK∗, EMMANUEL LESAFFRE
Biostatistics (2005), 6, 1, pp. 145–155
“Our analysis shows no convincing effect of fluoride-intake on caries development. . .
The results show that the protective effect of fluoride-ingestion is not
convincing. We observed a positive effect only for mandibular teeth of boys. This agrees with current guidelines for the use of fluoride in caries prevention, where only the topical application (e.g. fluoride in
tooth paste) is considered to be essential (Oulis et al., 2000).”
Ainsworth NJ. (1933). Mottled teeth. British Dental Journal 55: 233-250.
Campagna L, et al. (1995). Fluoridated drinking water and maturation of permanent teeth at age 12. Journal of Clinical Pediatric Dentistry 19(3):225-8. “Girls from the fluoridated Boston area were shown in this study to have a significantly (p<0.05) delayed dental age when compared to their chronological age according to the tables of Nolla."
Feltman R, Kosel G. (1961). Prenatal and postnatal ingestion of fluorides – Fourteen years of investigation – Final report. Journal of Dental Medicine 16: 190-99.
Freitas JA, et al. (1971). Influence of fluoridation in the chronology of eruption of permanent teeth. Estomatologia e Cultura 5: 156-165.
Kunzel VW. (1976). [Cross-sectional comparison of the median eruption time for permanent teeth in children from fluoride poor and optimally fluoridated areas] Stomatol DDR. 5:310-21. "Abstract
Nearly 57000 children (aged from 4 years, 4 months to 15 years, 9 months) of Karl-Marx-Stadt (1.0 ppm F) and Plauen (0.2 ppm F) were examined to compare the mean eruption times of permanent teeth before and after 12 years of water fluoridation. Whereas a direct influence of internally administered fluorides is to be excluded, an indirect action on the premolars may be assumed with certainty. The delayed eruption of all premolars in children of the area with optimally fluoridated water was the only systematic effect which could be detected. This normalization is explained by a prolonged stay of the deciduous teeth in the dental arch which is due to a lesser caries prevalence."
Lemmon JR. (1934). Mottled enamel of teeth in children. Texas State Journal of Medicine 30: 332-336.
Leroy R, et al. (2003). The effect of fluorides and caries in primary teeth on permanent tooth emergence. Community Dentistry and Oral Epidemiology 31(6):463-70. "Caries experience in the primary molars had a more pronounced impact on the timing of emergence of the successors than exposure to any of the four fluoride parameters."
Limeback, H. (2002). Systemic Fluoride: Delayed Tooth Eruption and DMFT vs Age Profiles. abstract presented at IADR/AADR/CADR 80th General Session. San Diego, California. March 6-9. "CONCLUSION: The small benefit that remains today from water fluoridation can, in part, be explained by fluoride ingestion retarding tooth eruption, resulting in a delay in dental caries. The effect of the delay in tooth eruption from systemic fluoride is likely less evident in more recent fluoridation studies because of increasing ingestion of other sources of fluoride such as fluoridated dentifrices."
Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.
Short EM. (1944). Domestic water and dental caries. VI. The relation of fluoride domestic waters to permanent tooth eruption. Journal of Dental Research 23:247-255.
Virtanen JI, et al. (1994). Timing of eruption of permanent teeth: standard Finnish patient documents. Community Dentistry and Oral Epidemiology 22(5 Pt 1):286-8."The emergence of the teeth of the second phase of the mixed dentition was later in the children living in an endemic fluoride area, this difference being statistically greater for the boys than for the girls (95% Cl for differences between means was used to evaluate statistical significance)."
Bill, in order to overcome the charge of cherry-picking could you take, for example, the first paper. Described to us what was actually measured, where the study was done, what form did the fluoride intake take (eg, water, supplements, etc).
I have indeed made charges that fluoridationists cherry pick the literature to support their bias. And those wanting freedom cherry pick the evidence supporting their side. For 25 years I supported fluoridation and the last 8 I now support freedom of choice.
Like I said, there are articles on both sides of the issue and the best scientists who weigh evidence are the FDA CDER.
Steve has presented some articles which did not find a delay and I provided some which did find a delay, predominantly for girls. Unless the study specifically evaluates gender differences, the results may not be significant.
Komarek is a Biostatistics article and I will provide some of the information here. This study has some unique features in evaluating the time from true emergence of the tooth until true caries were diagnosed, rather than age of the patient.
Komarek felt there was no good way of measuring individual fluoride exposure and used dental fluorosis. I would suggest urine and serum fluoride are reasonable sources for measuring individual exposure. However, I believe it was later that Levy et al worked on calibration of national laboratories to gain more consistent serum and urine fluoride concentration testing. Difficult testing at such low concentrations.
Let me know if you would like the full article. I am not a biostatistician, but the first part is pasted here and answers some of your questions.
Summary
“A Bayesian survival analysis is presented to examine the effect of fluoride-intake on the time to caries
development of the permanent first molars in children between 7 and 12 years of age using a longitudinal
study conducted in Flanders. Three problems needed to be addressed. Firstly, since the emergence time
of a tooth and the time it experiences caries were recorded yearly, the time to caries is doubly interval
censored. Secondly, due to the setup of the study, many emergence times were left-censored. Thirdly,
events on teeth of the same child are dependent. Our Bayesian analysis is a modified version of the
intensity model of H¨ark¨anen et al. (2000, Scandinavian Journal of Statistics 27, 577–588). To tackle the
problem of the large number of left-censored observations a similar Finnish data set was introduced. Our
analysis shows no convincing effect of fluoride-intake on caries development.
1. RESEARCH QUESTION AND COLLECTED DATA
In this paper, we present a Bayesian analysis of a longitudinal dental data set (the Signal Tandmobiel
study) to tackle the following research question: Does fluoride-intake at a young age have a protective
effect on caries in permanent teeth? Our analyses will be limited to the caries experience of the four
permanent first molars (teeth number 16, 26, 36, 46 in European dental notation).
In this study, detailed oral health data at tooth and tooth-surface level (caries experience, gingivitis,
etc.) from 4468 Flemish schoolchildren (2315 boys and 2153 girls) born in 1989 were collected annually
between 1996 and 2001. The children were cluster-sampled from randomly chosen Flemish schools. Two
stratification factors, geographical location (five provinces) and educational system (three school systems),
were taken into account. Further details on the design of the study can be found in Vanobbergen et al.
(2000).
Our data suggest that the use of fluoride reduces caries experience in primary teeth, see Vanobbergen
et al. (2001) and that fluoride-intake delays the emergence of the permanent teeth, see Leroy et al. (2003).
The latter result raises the question whether the fluoride-intake only reduces the time at risk or whether it
has also a direct protective effect on caries experience.
Unfortunately, fluoride-intake in children cannot be measured accurately. Indeed, fluoride-intake can
come from: (1) fluoride supplements (systemic), (2) accidental ingestion of toothpaste or (3) tap water.
Further, the intake from these sources can be recorded only crudely. Therefore, it was decided to measure
fluoride-intake by the degree of fluorosis on some reference teeth. Fluorosis is the most common sideeffect
of fluoride-intake and appears as white spots on the enamel of teeth. For this analysis, a child was
considered fluoride-positive (covariate fluor = 1) if there were white spots on at least two permanent
maxillary incisors during the fourth year of the study or during both the fifth and sixth year of the study.
The prevalence of fluorosis was relatively low (480 children, 10.8%). In our analysis, 480 fluorosis
children and 960 randomly selected fluorosis-free children are included. Case-control subsampling was
done to reduce computation time. To check that it did not destroy the stratification, we constructed a
5 × 3 × 2 contingency table with factors province, school system and whether the child is in the
subsample or not (subsample). A p-value of 0.13 was obtained for the significance of the interaction of
the third factor with the other two using a likelihood-ratio test in a log-linear model, implying that the
stratification is similar in the used and the discarded subsamples.
The prevalence of caries experience at the age of 12 was negligible (at most 1.4%) for all permanent
teeth except for the first molars (teeth used in the analysis). For these teeth, the prevalence was 25.8% in
children with fluorosis compared to 29.4% in fluorosis-free children, with prevalence of 23.3% and 27.7%
for boys, and 27.9% and 31.2% for girls, respectively. Thus, at first sight, the impact of fluoride-intake
seems to be minor. However, since the emergence of permanent teeth might be delayed by fluoride-intake,
evaluating the impact of fluoride-intake should take into account the time at risk for caries. Hence, in
our analysis, the response will be the time between emergence and the onset of caries development.”
Note that Komarak included data from Virtanen, 2001 to better estimate true eruption time for some cohorts because 86% of first molars had erupted when the study began. Combining studies can have problems and lowers the confidence.
I have the article Bill, and my impression was also that no measurement of F intake was made. One has to go to other papers to find the details but my impression is that children were not exposed to water fluoridation, but fluoride supplements.
Frankly, I would pay more attention to the others papers reporting this study.
However, I find your blanket listing of references as if they prove something rather childish. One should use citations as part of a balanced argument â not as a sort of pissing competition.
It amazes me how anti-fluoridationists will post links or citations without any discussion and think it proves something. It doesnât, except immaturity on their part.
Ken,
Now you call me “childish.” Every time you belittle me, attack me personally and use disparaging remarks it is because the flawed theory of fluoridation cannot be supported with adequate quality science and fluoridationists have to resort to personal attacks. Resorting to personal attacks is a desperate attempt to deflect the cruel and embarrassing fact that fluoridation is not based on quality science, ethics or law.
Steve presented two references from biased sources reporting no significant delay in tooth eruption due to the toxic effects of excess fluoride ingestion. Steve cherry picked the research. In his defense, he made no representation that he was providing research on both sides of the eruption controversy.
To balance Steve’s submission, I provided the other side with 11 studies (human) reporting delay in eruption. There is at least one animal study which I have seen.
Did Steve cherry pick the evidence to make his point? Yes. Did I pick studies to counter his? Yes. Your response is a personal attack calling me “childish.”
When a person has little or no evidence to counter the message, they attack the messenger.
It is long past time to have the FDA CDER review the scientific evidence on efficacy and safety of fluoride ingestion and approve a label with dosage and cautions.
Oh, right. FDA CDER has already made that judgment and sent a letter to 35 fluoride manufacturers withdrawing approval because the research did not show that ingesting fluoride was effective.
I agree, Chris! Uh….I mean, I AGREE, Chris!! I’ve wondered the same. No one, certainly including me, can hold a candle to his hilarious surgical precision!
——-“Is it all studies from other countries and languages or just China which you reject? Is it a race thing or a language thing which brings out your anger?”
Your bizarre reference to “race” is clear evidence of your own bigotry. There is nothing in my comments to even suggest such a ridiculous mindset on my part, nor is there anything to suggest I have any “anger” in regard to fluoridation studies. As with your bizarre references to “religious beliefs” with which you attempted to discredit me, you need to cease your lame attempts to project your own mindset onto me, and focus on the issue.”
——“You don’t like the peer reviewed research from China but you are happy to drink their contaminants. Amazing.”
First of all, there is no evidence that the 27 Chinese studies on which you and Connett base your absurd claims of “IQ reduction”, were ever peer-reviewed. If you have such evidence, present it.
Second, two of the largest manufacturers of HFA utilized in the US to fluoridate its water systems, are Mosaic, of Florida, and Key, of North Carolina. These two states have an ample supply of the naturally occurring phosphorite rock from which HFA is extracted. Be this as it may, however, I certainly have no problem with fluoridation products from China being utilized to fluoridate my water system. Unlike you, I have no paranoid distrust of the US government, or its EPA. I have full confidence that, regardless the source of fluoridating compounds, the water from my tap meets all EPA mandated Standard 60 certification requirements, or it would not be allowed.
——”Your pious humility amazes me. You are qualified, but I am not? I suggest the FDA CDER but you want me to trust you and believe you instead of the FDA CDER.”
“Again, you attack the messenger. Stick to the science instead of putting other people down.”
I am qualified for what, exactly? My claims that the Chinese studies were absurdly flawed come directly from Choi and Grandjean, themselves. Let me know, and I will gladly cite, page by page of their Review in which they report such flaws in these studies.
I couldn’t care less who you trust. The fact remains, that the FDA has no jurisdiction or regulatory authority over fluoridated water. That is under the full control of the EPA.
I haven’t attacked any “messenger”. I have stated facts. The “messenger” nonsense is simply a transparent, lame attempt to insinuate that your personal opinions and ideology are some sort of objective “message” that you are simply delivering. It is a tactic that is constantly attempted by antifluoridationists. Your continual defensiveness and whining about being “attacked” have gotten very tiresome
——-“That is why I demand FDA CDER oversight and demand prospective RCT studies.”
Fine with me. Demand to your heart’s content.
——-“Are you suggesting the Choi, Grandjean Harvard School of Public Health study was not peer reviewed? Of course it was. And the studies they used were peer reviewed.”
I’ve concluded that either you can’t read, or you have a problem with reading comprehension. I did not state that the Harvard Review was not peer-reviewed. I stated that there is no evidence that the Chinese studies which they reviewed, were peer-reviewed. Understand the difference? Once again, if you have valid evidence that these Chinese studies were peer-reviewed, present it.
Your continual attempts to defend these Chinese studies while discarding the high quality, properly peer-reviewed studies which disagree with your personal ideology are clear evidence of your confirmation bias and incompetence in evaluating scientific studies. I stand by my statement…..you are not qualified, or objective enough, to properly critique peer-reviewed scientific studies such as those I have presented.
Steve, “First of all, there is no evidence that the 27 Chinese studies on which you and Connett base your absurd claims of “IQ reduction”, were ever peer-reviewed. If you have such evidence, present it.”
When they were published, I checked on peer review. They were peer reviewed before publishing.
Because the theory of fluoridation is not supported with good science, proponents resort to personal attacks.
Steve said, “I stated that there is no evidence that the Chinese studies which they reviewed, were peer-reviewed.”
Are you speculating that the Harvard researchers simply grabbed garbage and presented the garbage for publication and the peer reviewers reviewing Choi/Grandjean agreed the garbage was just fine?
You know fully well the evidence on IQ and neurological harm has been peer reviewed acceptable at least when Choi/Grandjean used the data. And when the research was originally published it was peer reviewed at that time.
I gave up counting the number of papers you have cited in this blog before I got half way. They read like a list of references at the end of a paper in a peer reviewed journal.
Peer reviewed papers use their references to support the original work detailed in the guts of the paper.
Presenting the references by themselves gives the impression: “I’ll give the references. The people who read them will then know exactly what I got from them. That means that I don’t have to write any coherent arguments that people can pin me down to and refute using published research. I can then say that’s not what I meant and change the goalposts whenever I want.”
Your points may be clear to you, but not to many (most?) who read your comments.
—-“When they were published, I checked on peer review. They were peer reviewed before publishing.”
Sorry, but your anecdotal assertions are meaningless. Choi and Grandjean performed no quality assessment of the studies, with only one of the studies seeming to have appeared in a peer-reviewed journal.
—-“Because the theory of fluoridation is not supported with good science, proponents resort to personal attacks.”
More whining about “attacks”. Yes, we’ve seen your definition of “good science”: Anything that supports antifluoridationist nonsense, regardless the quality, quantity, or validity.
——“Are you speculating that the Harvard researchers simply grabbed garbage and presented the garbage for publication and the peer reviewers reviewing Choi/Grandjean agreed the garbage was just fine?”
I’m not “speculating” anything. I have no idea as to what Choi and Grandjean did. It’s unclear as to whether anybody does. I’m stating the fact that there is no evidence that these studies were even peer-reviewed.
—–“You know fully well the evidence on IQ and neurological harm has been peer reviewed acceptable at least when Choi/Grandjean used the data. And when the research was originally published it was peer reviewed at that time.”
I “know fully well” nothing of the sort. The “evidence” on which is based the absurd “IQ reduction” claim is nothing but a collection of Chinese studies dug out of obscure Chinese journals, on the effects of high levels of naturally occurring fluoride in the well-water of various Chinese, Iranian, and Mongolian villages. The level of fluoride in these wells ranged as high as 11.5 ppm. According to the Harvard reviewers themselves, these studies were missing key information, had questionable methodologies, and inadequate control for confounders.
Once again, that you ridiculously continue to defend these studies as being valid evidence of anything, while claiming that peer-reviewed studies published in respected journals, are not up to your “standards” of quality research…..is clear infication of your confirmation bias, and incompetence in evaluating scientific literature.
I find this claim of Bill’s very questionable – “When they were published, I checked on peer review. They were peer reviewed before publishing.”
Whether individual papers were peer reviewed or not is really meaningless for our own judgment of the research. However, the articles Choi et al used are extremely variable – some were just newsletter items, most were only a page or so long. One would be foolish to make any summary claim about them.
Choi et al admitted themselves they selected these reports to exclude western papers and because of their higher water F concentrations. This actually violates the principles of the statistical meta analysis they did.
And of course Choi et al are cited ad nauseum by at int-fluoridationists claiming it proves something about CWF – when of course it doesn’t.
I personally see some value in a few of these papers and these are worth pursuing. It is just a pity that none of them chose to analyse the obvious factor, severe dental fluorosis, and it’s possible role in learning difficulties..
This would be of real value for countries like China and India but of course is irrelevant to New Zealand where severe dental fluorosis is non-existent.
May I suggest contacting the authors and Journals directly.
Here is contact for some authors.
Dr Xiang Quanyong, Department of Occupational Health, School of Public Health, Fudan University (Formerly Shanghai Medical University), Shanghai, 200032, China. E-mail: quanyongxiang@yahoo.com.cn or yxliang@shmu.edu.cn.
Center for Disease Control and Prevention, Jiangsu Province, China. Center for Disease Control and Prevention, Sihong County, Jiangsu Province, China.
I would have more concern about peer review if most of the studies had been published by one Journal. But several Journals were used. Here are a few:
Chinese Journal of Public Health Management
Chinese Primary Health Care
Chinese Journal of Pathology
Chinese Journal of Control of Endemic Diseases
Journal of Applied Clinical Pediatrics
Endemic Diseases Bulletin (China)
Chinese Journal of Epidemiology
Chinese Journal of Endemiology
China with a fifth of the world’s population, has over 5,000 scientific Journals and a rich history with more than 2,000 years of research.
Here is an example:
Effects of endemic fluoride poisoning on the intellectual development
of children in Baotou
Li, Jing, Chen, Lin, Wang
161 161
[Translated by Julian Brooke and published with the concurrence of the Chinese Journal of Public Health Management 2003:19(4):337-8.]
EFFECTS OF ENDEMIC FLUORIDE POISONING ON THE
INTELLECTUAL DEVELOPMENT OF CHILDREN IN BAOTOU
Another:
Effects of fluoride on child intellectual development
under different environments
Hong, Cao, Yang, Wang
156 156
[Translated by Julian Brooke and published with the concurrence of
Chinese Primary Health Care 2001;15(3):56-7.]
RESEARCH ON THE EFFECTS OF FLUORIDE ON CHILD
INTELLECTUAL DEVELOPMENT UNDER DIFFERENT
ENVIRONMENTAL CONDITIONS
Another:
The effect of fluorine on the developing human brain
327 Du, Wan, Cao, Liu 327
[Translated by Shan Ying and published with the permission of the Chinese Journal of Pathology
1992;21(4):218-20.]
THE EFFECT OF FLUORINE ON THE DEVELOPING HUMAN BRAIN
Another
Effects of fluorine on the human fetus
321 He, Cheng, Liu 321
[Translated by Julian Brooke and published with the permission of the Chinese Journal of Control of Endemic
Diseases 1989;4(3):136-8.]
EFFECTS OF FLUORINE ON THE HUMAN FETUS
Steve, “The “evidence” on which is based the absurd “IQ reduction” claim is nothing but a collection of Chinese studies dug out of obscure Chinese journals,”
Please list the studies used by Choi which you have actually read and please forward a copy of them, or at least the abstract, to me. bill@teachingsmiles.com
Bill, you are missing the point. I don’t care whether the studies were peer-reviewed or not. Grandjean and Choi make clear the seriousness of the flaws, to the extent where they dissociate the studies from CWF in the US. My point is that these studies so lack credibility that it is questionable as to whether they had even been peer-reviewed, a bare minimum for credibility.
Your continuing attempt to defend them while claiming the peer-reviewed studies which refute your ideology are of poor quality….is simply ludicrous.
My understanding is that attempts to contact these authors have been unsuccessful, anyway.
I am currently writing a post (probably up on Monday) replying to the attack by Theissen and Neurath on the Royal Society of NZ review. This will include some more comments on the Choi et al paper.
“Please list the studies used by Choi which you have actually read…..”
If you will read my comment, you will see that the evidence of the serious flaws to which I referred were in the Harvard Review, itself. The following are some of the flaws, and evidence of high concentration levels studied, which Choi and Grandjean noted in the Review.
From page 4 Conclusion:
“The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.”
——Developmental Fluoride Neurotoxicity: A Systematic
Review and Meta-Analysis
Anna L. Choi, Guifan Sun, Ying Zhang, Philippe Grandjean
Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 9
“Six of the 34 studies identified were excluded due to missing information on the number of subjects or the mean and variance of the outcome (see Figure 1 for a study selection flow chart and Supplemental Material, Table S1 for additional information on studies that were excluded from the analysis). ”
Page 13
“Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.”
Once again, note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration, exactly in the range of the control groups in this study.
Page 13-14
“While most reports were fairly brief and complete information on covariates was not available, the results tended to support the potential for fluoride-mediated developmental neurotoxicity at relatively high levels of exposure in some studies.”
Incomplete information on covariates (controls). Relatively HIGH levels of fluoride. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 15
“The present study cannot be used to derive an exposure limit, as the actual exposures of the individual children are not known. Misclassification of children in both high- and low-exposure groups may have occurred if the children were drinking water from other sources (e.g., at school or in the field).”
Page 15-16
“Still, each of the articles reviewed had deficiencies, in some cases rather serious, which limit the conclusions that can be drawn. However, most deficiencies relate to the reporting, where key information was missing. The fact that some aspects of the study were not reported limits the extent to which the available reports allow a firm conclusion. Some methodological
limitations were also noted. Most studies were cross-sectional, but this study design would seem appropriate in a stable population where water supplies and fluoride concentrations have remained unchanged for many years. The current water-fluoride level likely also reflects past developmental exposures. In regard to the outcomes, the inverse association persisted between studies using different intelligence tests, although most studies did not report age adjustment of the cognitive test scores.”
Steve, you said,
“I don’t care whether the studies were peer-reviewed or not.”
OK. Serious back peddle.
Steve, “Once again, that you ridiculously continue to defend these studies as being valid evidence of anything, while claiming that peer-reviewed studies published in respected journals, are not up to your “standards” of quality research…..is clear infication of your confirmation bias, and incompetence in evaluating scientific literature.”
Obviously you have not read or understood what I have written.
There are no prospective randomized controlled trials on fluoridation or the chemicals used to fluoridate. There are no high quality studies. That’s on both sides of the issue. I am not defending any studies as high quality. You are trying to put words in my mouth which I have never said.
Again, it is I who am demanding FDA CDER review the science which we have. They are the most competent evaluators of science. In effect, I want the FDA CDER to “peer review” the evidence to see if they will approve it and what label should be used.
I don’t know what you think are “respected journals.” Even the so called best journals publish weak research. Each study should be read for its own merit. This is not religion where one Journal is the “Bible” and has no flaws and all research is perfect.
Because you do not have the science to back the flawed theory of fluoridation, you continue to attack personally.
Steve,
I’m glad you are looking at the research. Instead of measuring with words like “high” and “low” it would be helpful for you to put a number to those terms.
Remember, water consumption is highly variable. Some drink 10 times more water than others. And in the USA some swallow a great deal of fluoride toothpaste which pushes their total exposure significantly higher than average.
Choi listed 8 studies reporting IQ changes with less than 3 ppm fluoride in the water, the average of the 8 studies was 2.3 ppm fluoride in the water. Many people, such as laborers and athletes in the USA drink 2.3 times as much water as the “average” person. Add fluoride toothpaste and fluoride medications, dental products, pesticides etc and there is a reasonable probability that the total exposure of many in the USA reach the levels in these studies.
Of those 8 studies the average IQ drop was 8.4 IQ points.
Ken,
So cool you added a chart here. How can I do that?
Yes, I think all of us agree the studies are weak. But they are a hell of a lot better than what proponents have presented finding no decrease in IQ.
The studies individually are weak. With the number of studies available and the consistency of the results, I would bet higher quality is published soon.
The question is not whether fluoride causes brain damage. Fluoride is highly toxic and can kill. The question is at what dosage and age.
The fluoridation ship is sinking and some will sink with the ship. My choice is to be cautious and start reducing total fluoride exposure. The best place to start is with Freedom of Choice.
Bill, you are straw-clutching. Despite now acknowledging the weakness of these studies overall you want to still draw conclusions. Here are some problems.
You want to draw an overall conclusion â even a quantitative one! But one of the weaknesses in Choi et alâs paper is that they ignored several pitfalls in applying their statistical meta-analysis. I have referred to those before.
As individual studies I think a few of the papers are of value in showing problems with high F intakes. Donât forget that is a general problem in those countries. The mistake, I think, is to assume âbrain damage: with absolutely no evidence or possible mechanism. The results are far more likely to be due to learning difficulties connected with severe dental and skeletal fluorosis or educational and social factors which have not been properly considered.
But that issue is of course irrelevant to our situation with CWF.
Itâs silly to go on about F being able to kill â so can H2O. And similarly you talk of freedom has been well refuted here â you donât improve your argument one iota by trashing a dead horse.
WTF have sinking ships got to do with this issue. Friday night drinkies, I guess, if you were in NZ. J
Bill
You admit the research is weak and then follow that with “Higher quality
research would be published soon”Do you know something we dont know?
And who would be doing the translation??FANN was involved in the last one and the original papers were not made available from what I read ,So the chance of them being ‘Doctored’ to suit the desired result would be quite high
While you are here another question The activists are always telling us how bad fluoride is at a dilution of .7-1 PPM in drinking water, and how it is a poison. And then in the next breath you say that typical is a better way, with fluoride toothpaste being the treatment of choice
So really what you say is water containing fluoride at the lower dose is poison. But when you put it in toothpaste at 1000-1500 PPM it is ok, we just put a warning label on the tube and that will stop any child taking too much, and tell them the size of the application ,and they will all use what we say.
I really think that fluoridated water is a lot safer than toothpaste, mainly because you would be sick from water long before you reached the danger level for fluoride, But that will not fit the desired result and the scaremonger tactics
“Thank you for looking at some science rather than simply attacking me personally.
You said, “Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.”
Most water is still at 0.7 to 1.2 ppm.
Mother’s milk with no detectible fluoride in most samples and 0.004 ppm is extremely low concentration.”
You need to get the chip off your shoulder, stop whining about being “attacked”, and focus on the issue.
Yes, the current optimal level of fluoride is a range between 0.7 ppm and 1.2 ppm. As DHHS is expected to lower this recommendation to simply the low end of that range, in the near future, many water systems are now choosing to fluoridate at 0.7 ppm. This in no manner affects the flaws of the Chinese studies, or the fact that these studies were of the effect of high levels of naturally occurring fluoride in well-water of various Chinese, Mongolisn, and Iranian villages.
Chris,
Bill said, ” ‘You admit the research is weak and then follow that with “Higher quality research would be published soon.’ Do you know something we dont know?”
More research is always needed and beneficial. Science is not stagnant. Don’t you think it is rather embarrassing that so few studies on the neurological safety of fluoridation are from the USA, NZ, England, Canada and Australia? No direct profit in doing research on something which might stop sales. Early studies on any theory are weaker until critics appropriately point out weakness and researchers correct for those weaknesses.
The NRC 2006 called for more studies on neurological harm. We now have more studies and need more.
“RECOMMENDATIONS
On the basis of information largely derived from histological, chemical, and molecular
studies, it is apparent that fluorides have the ability to interfere with the functions of the brain
and the body by direct and indirect means. To determine the possible adverse effects of fluoride,
additional data from both the experimental and the clinical sciences are needed.” p 187.
“Choi listed 8 studies reporting IQ changes with less than 3 ppm fluoride in the water, the average of the 8 studies was 2.3 ppm fluoride in the water. Many people, such as laborers and athletes in the USA drink 2.3 times as much water as the “average” person. Add fluoride toothpaste and fluoride medications, dental products, pesticides etc and there is a reasonable probability that the total exposure of many in the USA reach the levels in these studies.”
It makes no difference what concentrations Choi reported. There is no way to draw any conclusions from studies which inadequately control for the variables, have key information missing, and questional methodologies.
Laborers and athletes may very well drink 2 to 3 times the amount of water as the “normal” individual. However, this is only when they are exerting, and losing water through perspiration, not on an average basis. Additionally, as you know from your public health background, public health initiatives cannot be expected to accomodate all extreme behaviors. Those who may be consuming an abnormally high amount of water bear the responsibility of understanding any consequences of this action.
Chris asked, “And who would be doing the translation??FANN was involved in the last one and the original papers were not made available from what I read ,So the chance of them being ‘Doctored’ to suit the desired result would be quite high.”
The original papers are published. You can get a copy if you want. I can’t read Chinese so they don’t do me any good. I’m sure you can translate them yourself or pay for them to be translated.
I have always called for higher quality studies, prospective randomized controlled trials. The evidence is strong enough that I doubt a Human Subjects Review Committee would permit an RCT on humans measuring IQ loss.
You also asked about topical versus systemic and your concern for toothpaste is valid. The research that topical has benefit is stronger than systemic. In addition, the FDA CDER has approved fluoride toothpaste with the warning not to swallow. The FDA CDER is not flawless, but they are the best at making judgments of efficacy and safety of substances used with the intent to prevent disease.
Some scientists are recommending fluoride toothpaste be sold only by prescription. That maybe one reason Colgate purchased Thoms of Maine.
“The NRC 2006 called for more studies on neurological harm. We now have more studies and need more.”
Had the 2006 NRC Committee on Fluoride in Drinking Water had concerns of neurological harm with chronic consumption of water with a fluoride content of 4.0 ppm or less, it would have stated so in its final recommendation. It did not.
Swearing only shows you do not have the science to support fluoridation. Calm down. The end of fluoridation will come soon but the world will not end.
You suggest, “The mistake, I think, is to assume âbrain damage: with absolutely no evidence or possible mechanism.”
“It has been said in this regard “every molecule of AlFx is the messenger of false information” NRC 2006 p 185.
The NRC 2006 talks a great deal about the mechanism of fluoride on the brain.
7. NEUROTOXICITY AND NEUROBEHAVIORAL EFFECTS…………………………………………173
Human Studies, 173
Animal Studies, 179
Neurochemical Effects and Mechanisms, 184
Findings, 185
Recommendations, 187
Start at 184 for a more complete discussion. Here are a few items.
“The most prominent changes were found in phosphatidylethanolamine, phosphatidylcholine, and phosphatidylserine. . .
Fluoride has been shown to decrease the activities of superoxide dismutase (Guan et al. 1989) and glutathione peroxidase (Rice-Evans and Hoschstein 1981), the consequences being increased free radicals. . . Using slices of rat neocortex, Jope (1988) found that NaF stimulated the hydrolysis of phosphoinositide by activation of a G protein, Gp. . .”
Apparently low amounts of aluminum and fluoride have a synergistic adverse effect.
NRC 2006 continues,
“Many of the untoward effects of fluoride are due to the formation of AlFx complexes. AlFx and BeFx complexes are small inorganic molecules that mimic the chemical structure of a phosphate. . . .
“AlFx also impairs the polymerization-depolarization cycle of tubulin. This could account for some of the intensely stained neurofilaments in cells in the brains of animals exposed to chronic NaF (Varner et al. 1993, 1998). AlFx appears to bind to enzyme-bound GDP or ADP, thus imitating GTP or ATP and, in a sense, generating “false messages” within the brain. This binding ability is probably due to the molecular similarities between AlF3(OH) and a phosphate group in the molecular structure, in particular, a tetrahedral arrangement (Strunecka and Patocka 2002).
“It has been said in this regard “every molecule of AlFx is the messenger of false information” (Strunecka and Patocka 2002, p. 275). This may be an accurate synopsis of the AlFx effect at a single synapse, but the brain is a highly redundant and dispersed communication system containing millions of synapses. Because of this, observable alterations in mental or motor
actions might require the formation of a multitude of false messages in a number of brain circuits acting over a prolonged period of time. Thus, the number of false messages required to disrupt an “action pattern” in the brain probably will vary according to the nature of the ongoing
activities.”
“An especially important neurochemical transmitter that reaches almost all areas of the brain is ACh. As discussed above, some studies show that NaF and SiF inhibit cholinesterases, including acetylcholinesterase. The progressive accumulation of ACh at synaptic locations produced by the diminished esterase activity leads to a number of complex effects that can be summarized as an initial increase in stimulation of the target cells but ultimately leads to diminished stimulation—even a blockade of all activity.”
“These results are of interest because changes in the nicotinic receptors
have been related to the development of Alzheimer’s disease (Lindstrom 1997; Newhouse et al. 1997) and, in frontal brain areas, to schizophrenia (Guan et al. 1999).”
Ken, I would suggest you read the NRC 2006 report on fluoride. If you want a copy, I can give you mine.
Steve,
DHHS has no legal authority to lower or raise fluoride to 0.7 ppm in water. They asked for comments on the proposal and said they would have a response by the summer of 2011. Three years later and we have a deafening silence. And the research over the last three years is even more to digest. This is a job for the FDA CDER, not public health managers and PR/media people at HHS.
“DHHS has no legal authority to lower or raise fluoride to 0.7 ppm in water.”
It seems I have yet once again overestimated your understanding of the optimal level, so let me simplify. The optimal level of fluoride is that recommended level which provides maximum dental decay benefit with no adverse effects. As I have repeatedly stated, this is a recommendation, not a legally binding mandate. This recommendation is set by DHHS.
The CDC, in 2011, recommended the resetting of the optimal level, from the current range of 0.7 ppm – 1.2 ppm to simply the low end of that range, 0.7 ppm. They based this recommendation on recent research showing there to no longer be a significant discrepancy in the amount of water consumed due to climate differences, and the greater availability of fluoride from multiple sources now than when the optimal was originally set.
DHHS has as yet to adopt this CDC recommendation, but is expected to do so. Given that the 2006 NRC Committee made no recommendation to lower the EPA secondary MCL down from its current 2.0 ppm, there is no urgency in adopting the CDC recommendation. The only risks of concern noted by 2006 NRC in the 4.0 ppm range were severe dental fluorosis, skeletal fluorosis, and bone fracture. Given that severe dental fluorosis does not occur in association with water with a fluoride content of 2.0 ppm or less, that skeletal fluorosis is so rare in the US as to be nearly non-existant, and there is no evidence to support concerns of bone fracture in this range, obviously, there is no urgency in lowering the optimal.
FDA CDER has no jurisdiction over fluoridated water. This jurisdiction is entirely under the EPA.
Please provide a reference for HHS recommendation as you claim, “The optimal level of fluoride is that recommended level which provides maximum dental decay benefit with no adverse effects. As I have repeatedly stated, this is a recommendation, not a legally binding mandate. This recommendation is set by DHHS.”
What we are considering is judgment on benefit versus risks of ingested fluoride. The evidence is weak. The evidence is growing that even small amounts of fluoride, 0.2 mg/Kg BW has adverse effects. A safety factor of 100 from LOEL is customary. 0.002 mg/Kg BW would be considered safe. The chance of better science finding fluoride is safer is much less than finding even lower dosages are safe.
The FDA safety is 0.25 mg/day. FDA CDER has caution not to swallow 0.25 mg of fluoride (a pea size of toothpaste) or 0.05 mg/kg/day BW for a 5 Kg child. That caution was a compromise since 5 mg/kg BW is considered lethal and the FDA used a safety factor of only 100 from lethal. Not great.
The EPA’s RfD is 0.06 mg/kg/BW or about 0.3 mg for a 5 Kg infant, somewhat less protective than even the FDA.
Safety somewhere between 0.002 mg/Kg/day and 0.06 mg/kg/day is usually not disputed. With better testing, those numbers are more likely to go down, than up.
An 5 Kg infant on 1 liter of fluoridated water made into formula is ingesting 1 mg of fluoride/day. Divide that by 5 Kg BW gives 0.2 mg/kg/day of fluoride dosage.
The reference you gave is a proposal by HHS. The US Public Health Service had the recommendation. Those are the same people who were doing the Tuskegee syphilis study of black men without their consent and giving them the impression they were being treated when in fact they were not. I can go on about the US PHS.
I am in agreement with the NRC 2006 report and their grading of the research for the research they had at the time. I do not think I would have come to the same conclusion. And, if I was aware, would have followed the law, coming up with a new MCLG. More later.
Steve, you have avoided my concern for infants and excess fluoride exposure. Those little brains are most susceptible to injury.
Lethal 5 mg/Kg/day BW
FDA 0.05 mg/Kg/day BW
EPA 0.06 mg/Kg/day BW
Neurological with margin of safety 0.002 mg/Kg/day BW
A 5 Kg infant on 1 liter of 1 ppm fluoridated water is ingesting 0.2 mg/Kg/day BW
DHHS oversees water fluoridation in the US. DHHS makes the official recommendation for the optimal level of fluoride. It is of no concern to me whether you belive this or not. Facts are facts.
Since you have such concern for those “little brains”, then produce valid, peer-reviewed, scientific evidence of any harm, whatsoever to those “little brains” resultant of water fluoridated at the optimal level. Too, you might care to explain why you have so little regard for those “little brains” that could and have become fatally infected as a direct result of untreated, preventible dental decay on one surface of one tooth.
Consider Dr Robert Carton’s comments. Dr. Carton worked at the EPA for 30 years managing risk assessments on high priority toxic chemicals and wrote the first regulations controlling asbestos.
(Paraphrased) The NRC examined the scientific basis for the MCLG of fluoride. Due to misdirection by EPA management, who requested the report, the NRC committee identified only health effects known with total certainty. This is contrary to the intent of the SDWA, which requires the EPA to determine “whether any adverse effects can be reasonably anticipated, even though not proved to exist.” Further misdirection by EPA consisted of instructing the committee not to identify a new MCLG – in other words, not to determine a safe level of fluoride in drinking water, and not to discuss silicofluorides, phosphate fertilizer manufacturing by-products used in most cities to fluoridate their water. . . .
Dr. Carton brings up a valid point which is a source of our disagreement here.
Does the evidence reach a certainty which is “total” or “reasonable”?
I am totally certain fluoride affects the teeth and makes them harder. Whether that translates into better health for the teeth with fewer caries or simply greater difficulty and delay in diagnosis; whether the teeth last longer or are more brittle; or whether dental expenses are reduced lacks confidence.
I am also totally certain not everyone receives the same dosage, is in the mean or average. Reports of some drinking over 10 liters of water and others drinking less than 1 liter means we need a 10 fold margin of safety just for the difference in water consumption.
I am totally certain some swallow much more fluoride toothpaste than they should.
I am totally certain we don’t understand the synergistic effects of the other chemicals being consumed with fluoride.
I am also totally certain some people are able to handle toxins and chemicals better than others.
I am also totally certain that infants need to be protected even more than adults, they are chemically more fragile. Mother’s milk with no fluoride in most samples is a good starting point.
I am very certain that total exposure to fluoride is increasing, due to increases in dental fluorosis.
I am very confident fluoride is a wonderful and powerful element for manufacturing.
In my judgment, total fluoride exposure needs to be reduced. The EPA reducing fluorine refrigerants is a great place to start reducing exposure, but not enough. Another option is reducing fluoride medications and fluoride pesticides, which I think unwise, although there is a push to stop fluorine anesthesia at the hospitals.
The most logical place to reduce excess exposure is stop artificial fluoridation. It is a belief system who’s time is long past.
Carton is a long time antifluoridationist who, in conjunction with Hirzy, performed a study which formed the basis of Hirzy’s petition to the EPA last year to cease recommendation of use of HFA to fluoridate water systems, in favor of NaF. The EPA reviewers discovered a miscalculation by Hirzy and Carton which resulted in a 70-fold error in their calculations. When corrected for the error it was found that the data demonstrated the opposite of what Hirzy and Carton had concluded. The EPA rejected the petition.
Carton is hardly an objective or credible source of opinion on fluoridation.
Anyone drinking 10 liters of water per day is engaging in extreme behavior. Your public health background should tell you that no public health initiative can be expected to account for all extreme behaviors. Individuals consuming that much water must accept responsibility for understanding the content of that water.
The IOM upper limit of 10 mg per day has been born out to be accurate, given the lack of any proof of adverse effect of optimal level fluoride in 69 years. The difference between 0.7 mg/liter fluoride in water and 10 mg upper limit is so broad that if anyone exceeds that upper limit, the minuscule 0.7 mg/liter fluoride in their water would be the least of concerns.
Your beliefs and opinions are your beliefs and opinions. You are certainly welcome to them.
You just brush off those drinking a great deal of water as stupid for drinking so much water. The military sends water for soldiers to drink about that much.
And you side stepped infants, say:
“you might care to explain why you have so little regard for those “little brains” that could and have become fatally infected as a direct result of untreated, preventible dental decay on one surface of one tooth.”
My goodness, my goodness. If I had not read the NRC 2006 report, CDC and others, I might have serious concern at your comment that infants become fatally infected with dental caries which could be prevented with water fluoridation. All aspects of your comment are simply not true.
1. NCR 2006 and others, fluoride is effective topically, not systemically.
2. Infants don’t have any or many teeth. Infants with dental caries are the results of ECC, sleeping with a bottle of juice or milk. No amount of fluoride will prevent that poor diet practice. If you look at primary teeth with ECC, you will notice that the upper anterior teeth may have serious caries, but the lowers do not usually. Fluoridation did not help the bottom and miss the top. If fluoridation were to help reduce caries, it would help the top where the water is coming into contact, not the bottom. If you think fluoridation has helped the bottom teeth but not the top, please explain the mechanism.
3. The development of the tooth (below the skin) is when the theoretical effects of fluoride might be beneficial. The teeth entering into the mouth during the first year have started forming in utero. Unless the fetus is drinking fluoridated water, it would not be beneficial.
I seldom diagnose dental fluorosis in primary teeth and only in the posterior regions.
Please provide research on the deaths of children from preventable dental caries in the primary anterior region.
Bill, I’ve not “side-stepped” anything. I just have no desire to discuss every little tangent you mention, and every opinion of yours that you throw out. If you object to the parameters and charges to the 2006 NRC Committee by the EPA, then go argue your opinion in court.
“You just brush off those drinking a great deal of water as stupid for drinking so much water. The military sends water for soldiers to drink about that much.”
“Stupid”?? You need to go back to your reading classes again. I said “extreme behavior”. This is not a judgement, simply a characterization. If you don’t understand the difference between “extreme behavior” and “stupid” you are worse off than even I imagined.
Again with the reading problem. I did not state that “infants become fatally infected with dental caries”. Perhaps I just haven’t been speaking in proper antifluoridationist form. So, let me quote what I said in a form with which you may be more comfortable:
“TOO, YOU MIGHT CARE TO EXPLAIN WHY YOU HAVE SO LITTLE REGARD FOR THOSE ‘LITTLE BRAINS’ THAT COULD AND HAVE BECOME FATALLY INFECTED AS A DIRECT RESULT OF UNTREATED, PREVENTIBLE DECAY ON ONE SURFACE OF ONE TOOTH”.
1. Neither the NRC, The CDC, nor any other credible source has stated that “fluoride is effective topically, not systemically”.
2. If you care to provide valid, scientifically sound evidence on the relative incidence of dental decay in maxillary and mandible teeth, I’ll certainly be glad to look at it. Your anecdotal opinion on such is meaningless.
3. Permanent anteriors begin development prenatally and continue through infancy and eruption at age 5-6 with root completion around age age 10.
The mild dental fluorosis which you and other antifluoridationists constantly attempt to portray as being a major disorder, can only occur systemically during tooth development. Kumar has shown mildly fluorosed teeth to be more decay resistant, a definite benefit.
Additionally:
“Conclusions: While 6-year-old children who had not ingested
fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.”
Your alleged deaths from dental caries for infants is not a tangent.”
And, where exactly did I state that they were? You know, Bill, you perfectly example the common antifluoridationist tactics. You have misrepresented my statements so many times that I couldn’t begin to count. You post misinformation. You post half-truths. You attempt to divert with claims of “personal attacks”. And you gish gallop so much it would take a leash to keep you in check.
U.S. Food and Drug Administration
Center for Drug Evaluation and Research
Rockville, MD 20857
Dear Sirs,
This letter supports the petition to ban the intentional infusion of fluorosilicic acid and sodium fluoride into public water supplies, which attempts to prevent dental caries in humans (petition FDA2007-P-0346) but is ineffective and harmful to man.
Actions by Ilisa Bernstein, acting director, U.S. Food and Drug Administration Office of Compliance.
In a very positive and helpful way, the FDA is now fighting back against unapproved and counterfeit drugs. The FDA is conducting an information campaign to raise awareness of illegal operations that peddle bogus drug
substances intended for dissemination to consumers (FDA Getting Info out about Bogus Drugs, Associated Press,
San Diego Union Tribune, September 24, 2014 p. C-4). Director Bernstein stated that “we’re fighting back with their own medicine, which is aggressive marketing tactics to offer medications at discount rates.” The FDA makes
it clear how to spot drug substances that are not FDA approved. Unfamiliar dosing instructions are a common issue.
Fluorosilicic acid addition into water supplies is use of a counterfeit unapproved drug substance for ingestion. Dosage instructions are improper because no information is provided from the supplier or manufacturer as to what amount of water daily must be consumed to achieve a proper daily intake of the substance. Some Material Safety Data Sheets, required to accompany the wholesale product delivered to water utilities, actually list a maximum use concentration of 6 ppm (see attached MSDS pages). This proves that manufacturers do not follow requirements of either the EPA or the FDA. The EPA requires warning consumers when water reaches 2 ppm fluoride ion, and at 4 ppm it is not considered potable water. Some MSDS sheets state no specific intended purpose for the treatment of humans. Some state a “Recommended Use” is for “welding and soldering agents, metallurgy, the glass industry, dental applications and water treatment”. The term “dental applications” is so non-specific that it could be for livestock teeth or a topical agent, and “water treatment” merely describes the treatment of water, not humans. This ambiguity is entirely inconsistent with FDA regulations for substances being used, as reported by water utilities, as
drugs to treat, prevent or cure dental disease in humans.
Second, manufacturers do not provide full safety information for their product when ingested. No information is provided as to long-term effects of fluoride ingestion on bone weakening, dental fluorosis, the increased incidence of fluorosis in Blacks and Hispanics, the increased incorporation of fluoride into those with kidney disease, or explicit instructions for those with bone, mental, thyroid, and other conditions. MSDS sheets usually do state under Toxicological Information, “Chronic exposure may entail dental or skeletal fluorosis.” But no indication is made for what subgroups are more susceptible or what dosage should be avoided to prevent the damage. Also, the admission is not passed on to consumers, even though this is required by the FDA.
A product name that differs from the name for an FDA approved drug is a common method to detect a counterfeit or bogus drug. Fluorosilicic acid is not natural calcium fluoride for which the initial idea, that its consumption
would affect dental caries, came about. FSA requires sodium hydroxide to neutralize water acidity and adds silicic acid and sodium into the water supply, in addition to fluoride. Neither sodium fluoride nor fluorosilicic acid share the low level of chronic toxicity, or the nonexistent acute toxicity, of natural calcium fluoride. Both of these synthetic industrial fluorides are listed toxics due to their full solubility in water and full assimilation after ingestion
(see MSDS pages and Jour. Envir. Pub. Health, 2013 article 439490).
The FDA now recommends that health professionals buy drugs only from wholesale distributors licensed in their States. Under the new Federal law, all wholesalers must be State licensed by January, 2015. Fluorosilicic acid
suppliers for materials to be ingested for dental benefit in water supplies are not licensed in any U.S. State to produce this substance for use as an ingestible treatment. Fluorosilicic acid and sodium fluoride are soluble
replacement substances for calcium fluoride of low solubility that is poorly-assimilated and far more safe.
“Fluoride” is misbranding of a substance used as a drug.
U.S. medical schools do not provide courses on the toxicology of fluoride-containing substances. Also, dental schools do not consider the known toxic effects of systemic fluoride ion after ingestion and assimilation into the
bloodstream. Thus, the practice of ingesting fluoride compounds as oral ingestible dental prophylactics has basically found its way “through the cracks” of our chief health institutions. Those who recommend the practice
are not well versed in the systemic toxicology of fluoride ion. Those trained in toxicology (who usually do not recommend the ingestion of industrial fluorides) are not given authority to regulate fluorosilicic acid manufacturers
and suppliers who disseminate fluoride compounds to the public for ingestion in the act of whole body treatment with fluoride ion.
Material Safety Data Sheets provided with the purchased products to the formulators of “fluoridated” water— cities and water districts, but not the end consumers of the treated water–identify the substances as either sodium
fluoride or fluorosilicic acid. The vast differences in toxicity between naturally occurring calcium fluoride (found in some groundwater) and the products being added to public water supplies are indicated by the fact that sodium
fluoride and fluorosilicic acid carry a label with a Health Hazard Rating of “3” (see attached MSDS pages). Calcium fluoride of course has a Health Hazard Rating of “0” (being non-toxic acutely by ingestion).
The infusion of industrial fluoride containing compounds represents purposeful misbranding of a drug and purposeful false information given to consumers by manufacturers with adverse health consequences in vulnerable populations. Currently, manufacturers of “NSF certified” fluorosilicic acid intended for ingestion in treated water state that all product safety information is held by the U.S. Centers for Disease Control (see attached letter), rather than themselves. The FD&CA does not require either the CDC or the NSF to provide this information, but rather the manufacturers and distributors of the material.
What actually is “fluoridation”?
Please understand that there is no such chemical that can be purchased by the name “fluoride.” Fluoride is not a chemical element, and fluoride is not a compound. Likewise, iodide is not an element, and iodide is not a chemical
compound. There are chemicals that contain the fluoride ion or the iodide ion, and fluorine and iodine are elements.
No chemical substance can be isolated that would bear the exclusive name fluoride or iodide. Therefore the term “fluoridation” has no actual meaning, rather it is an interpretation. If “fluoridation” refers to adding into water
either arsenic fluoride, lead fluoride, or sodium fluoride, this is a false practice. Each of these fluoride containing compounds share comparable acute toxicity (LD50 = approximately 80 mg/kg single oral acute lethal dose in mammals, Merck Index, 1976, Rahway, NJ). “Fluoridation” with calcium fluoride would not cause acute toxicity in man or animal. Its known chronic abnormal effects on bone structure require far higher total intake than for
manufactured fluoride-containing compounds used in “fluoridation” in the U.S., which mostly refers to the infusion of fluorosilicic acid into water. The fact that synthetic fluoride treatment of water is using the ion as a drug is proven by the facts that: fluoridated water is not required over non-treated water for agricultural, industrial, laundry, bathing, or recreational uses, etc. Fluoride compound addition into water does not therefore represent “treatment of water” or “fortification of water”, but rather is to affect dental health in humans through its ingestion. Added fluoride compounds are thus used as drugs and must comply with all appropriate FDA regulations (as listed in the enclosed attachment).
Concluding Request.
Please apply the new 2015 drug substance law, which requires State licensure for manufacturers of all drug substances for ingestion in the U.S., to fluoride-containing compounds now widely disseminated through public
water systems to treat humans. None of the manufacturing procedures used to produce non-prescription ingestible sodium fluoride or fluorosilicic acid comply with manufacturing requirements of the FD&CA. Many who use these materials believe that “fluoride” may be virtually any compound that contains fluoride ion and that it provides a food, nutrient or supplement. But the FDA ruled correctly that the fluoride ion from fluoride-containing compounds is not a mineral nutrient and is not considered safe to add to food (i.e. from any compound). The fluoride ion exerts no biologic function associated with ingestion.
Millions of people consuming this substance on a daily basis lifetime are in dire need of full disclosure. It would be advantageous and appropriate for the CDER to consult with the Office of Compliance on this matter, without of
course any transfer of authority to rule on this petition to that office.
Thank you again,
Richard Sauerheber, Ph.D.
Partial List of Food Drug and Cosmetic Act Requirements for Manufacturers of Substances used as Drugs. We would also greatly appreciate it if the FDA would contact suppliers of industrial fluorosilicic acid and sodium fluoride to inform them of the following requirements, consistent with the Food Drug and Cosmetic Act for all foreign synthetic substances administered for ingestion for drug purposes:
a) State licensure to specifically manufacture these substances intended to be ingested to treat dental caries without a prescription
b) providing only the specific proper name for the substance used, not deferring to the simplistic label “fluoride”
c) prior FDA approval
d) complete dosage instructions and required modifications with use of other fluoride dental products
e) complete disclosure of product safety information for long-term continuous ingestion in healthy man
f) published data from clinical trials testing for clinical pharmacology with specific mechanisms of action
g) lists of drug interactions, in particular drugs that treat bone disorders, such as bisphosphonates (Fosamax)
h) detailed descriptions of pharmacokinetics of the ingested material
i) descriptions of ingested fluoride effects on bone histology, with % incorporation as a function of age
j) incidence reports of allergy to fluoride
k) incidence reports of dental fluorosis
l) lists of expected % reductions in dental decay when product is consumed by various age groups
m) lists of contraindications in those with bone disorders, thyroid or kidney conditions, or diabetes
n) descriptions of side effects possible with pediatric use, use in the elderly, and in pregnancy
o) gastrointestinal disturbance incident reports due to conversion of fluoride to HF in the acidic stomach
p) all contraindications for use and precautions regarding carcinogenesis, mutagenesis, impairment of fertility
Addition important comments:
From the fluorosilicic acid producer Simplot, on their MSDS sent to Metropolitan Water, Los Angeles, we read its purpose is a “Liquid drinking water treatment chemical for use in the purification of water consumption.”
From the key publication of the American Water Works Association entitled ANSI Standard for Fluorosilicic Acid, 2008, we read “fluosilicic acid is presently being added to drinking water to reduce the incidence of dental
caries.”
And “the fluosilicic acid supplied from the manufacture shall contain no substances in quantities capable of producing deleterious or injurious effects on the health of those consuming water that has been properly treated with fluosilicic acid.”
And “the purchaser may require an affidavit from the manufacturer that the FSA provided complies with all requirements of this standard.”
This means that FSA suppliers are guilty of selling materials they agree to have certified by NSF/AWWA to reduce dental decay through drinking water. Meanwhile, those manufacturers rely on the CDC for all safety information. The manufacturers do no toxicological testing prior to sale and the AWWA/NSF does no toxicologic studies before certification.
Regardless of a purchaser asking for affidavits or not, the FDA is in charge of all drug substances used for ingestion in the U.S. All drugs require clinical trials testing for FDA approva and require prescriptions. Next January all manufacturers of those materials sold for ingestion purposes must be State licensed for that purpose. Solvay attempts to use the CDC for its authority to sell the material, but the CDC has no jurisdiction in regulation of drug substances. That is the exclusive authority of the FDA.
Richard Sauerhaber is an antifluoridationist who is the “Scientific Consultant” for antifluoridationist lawyer, James Deal. Deal has a website devoted entirely to attempts at scaring up class action lawsuits from which he presumably would profit in the highly event that he is ever successful at so doing. Sauerheber is hardly a credible resource.
You probably should better research your “sources” before again making such a fool of yourself with nonsense such as this. But, hey, yet once again, thanks for the comic relief!
Again, deflect and dodge the issue. Attack the messenger instead of the message. Refuse to protect infants.
Fluoridationists have no response for the overdosing of infants with fluoridation. Seems to go right over their heads as though infants are disposable commodities, lab rats, potatoes or pests. Fluoridation is like a religion and no amount of evidence can shake their belief system.
Infants are humans and more fragile than adults, more sensitive to chemicals. “There may be developmental periods (i.e., windows of vulnerability) when the endocrine, reproductive, immune, visual, or nervous systems are particularly sensitive to certain chemicals.” Differences in Sensitivity of Children and Adults to Chemical Toxicity: The NAS Panel Report 2000.
I agree the science is mixed on most issues, but not for the safety of infants.
The only ‘fool’ here Sloth, is yourself. ALOT of people are watching you right now… and Parrott too; and all your ilk. We are all aware of your actions and words. So lets just keep enjoying you all showing your true colours. Alot of people are behind the words of Richard’s; and others like him, who are working towards raising awareness of the deficiencies of research.. and, the pushers complete lack of ethics. So what if “Richard Sauerhaber is an antifluoridationist who is the “Scientific Consultant” for antifluoridationist lawyer, James Deal.” Great for us! ASWLA didn’t post the letter as a ‘source’ – no. The letter was posted to raise awareness of what is happening a good representation of the many written by the public who know what is being done by the F promoter/pushers who are against the will of the people; and the point being, your opinions and rantings are actually highlighting the typical stance of arrogance by promotors – against the flow of many people who don’t want fluoride in their water. Bully-boy’s like yourself, who have a real attitude; who love to demean and deride any efforts by anyone to point out the gaps of ethics and Science will soon find that in the people’s minds, your pride is already causing your falleth. You really do read and look like a real piece of (uncaring) work Sloth – certainly not one we trust or respect. Live by the sword; and you all (F pushers), die by your sword. Enjoy your mirth. Its disgusting you laugh at suffering. ASWLA sees this all the time, in the many letters written that are now archived. A silence by those in power, to answering the valid questions; or a derision by people like you, funded by the industry lackeys. You are against many who suffer terribly from fluorides built-up effects in the body; and whom don’t want to be forced fluoride (one cannot avoid the stuff these days, and who is regulating the dose each day?? no one); so no matter the semantics you love to nit pick over; or even, what you deem to be your truth, the fact is that people just don’t want fluoride in their water any longer – the jig is up Sloth. Let those who want fluoride ingest tablets, toothpaste or, fluoridated salt if they want it. Laugh away…. you just show your colours when you spit in other’s face who don’t want this measure. So its your own egg on your face Sloth, at your complete arrogance. Enjoy your life – you really are seen a goon with no ethics, a person who no-one likes, respects or trusts…. Richard on the other hand, is trusted- he cares for others he will never meet by his actions of writing to change archaic laws; yes, Richardh has ethics – he works for the many who suffer. But no one is checking eh, the stats of sufferers. Don’t look; Won’t find. And as for your Ethics? For all your verbose spin and harsh ‘shooting the messenger’ tactics (for you deride anyone against fluoride), you just look shameless. So shame on you. ASWLA loves seeing you squirm out of the ethical issues… touting tired phrases and hiding behind organisations who are politically motivated is very boring reading…. Grow up Sloth. Its 2014. People are awake to the spin and mantra’s of the promotors – ‘safe and effective”safe and effective”safe and effective”safe and effective”safe and effective”safe and effective’. So give us the long-term safety data on Fluoride’s health effects on all populations and sub-populations of all races, ages and health brackets please. But you won’t, because, you cannot. There is no evidence yet on such studies, as no one has funded that research. But there is a tonne of evidence of which you (all F promotors) dismiss completely, that show the (often ill) effects of fluoride on other organs, other than, teeth. YES, ASLWA will put ONE link – and so what, your little opinion of it – people can work it out for themselves, the varied studies sitting in one site from researchers of over 80 years of worldwide work – FAN, your arch enemy: http://fluoridealert.org/studytracker/ Cheers Sloth, laugh away; but just know, every time you deride people – they are not laughing at your mirth – its a disgusting lack of empathy or caring. The public are not just ‘teeth’.
Hang on there Who are the bully boys, I dont see the pro fluoride people threatening local goverment with court action if they dont stop fluoride,You need to remember one little sentence
Now if their arguments against fluoride were so good , you would think they would stand up to public scrutiny on their own ,without legal help. If they have to take legal action to pass them, it is obvious they are not
How many suffer from fluoride buildup in their bodys with fluoride at .7-1PPM
I,m sure you have to peer reviewed papers to prove that
Yes I agree Richard is trusted and cares. All he care about is how he can screw some poor council who wants to keep fluoride by threats and mis information
‘People are awake to the spin and mantra of the promoters’
CDC has released the latest statistics on community water fluoridation for the nation on its Web site (www.cdc.gov/fluoridation/statistics/2012stats.htm).
The latest data show that in 2012, 74.6% of the U.S. population on community water systems, or a total of 210.7 million people, had access to optimally fluoridated water. This is significant progress from the Healthy People 2020 baseline of 72.4% (2008) towards the target of 79.6%. Since 2008, an additional 15 million people have received the benefit of fluoridated water. Evidence shows that the prevalence of tooth decay is substantially lower in communities with water fluoridation.
For more information on water fluoridation, visit the CDC Web site at http://www.cdc.gov/fluoridation.
And they want fluoride
As I have said before ,if you are so sure fluoride is the nasty you say it is ,how come there has not been any proven dangers in 70 years, If there was valid evidence it would be all over the net like a virus by now , but nothing.
And you quote study tracker, as a valid source, Why would I look at an activist website for quality research, Sorry I would rather look at the source paper myself, That way I can be sure it has not been ‘doctored’ to suit the required result And as I have said before ,if there was anything of value there, it would be all over the net by now
So really Study tracker is a waste of time
Chris: “how come there has not been any proven dangers in 70 years”
Because there have been no long term studies done.
Your disgraceful un-sourced comment about Richard, “how he can screw some poor council who wants to keep fluoride by threats and mis information” is truly pathetic – please supply the sources of your comment with that concise information to us all reading this blog.
And as for Australia? The councils are threatened by government departments with huge fines (after mandating (forcing) fluoride) if they don’t comply to put fluoride in the water, even if the people voted ‘no’ to having it. That is not democratic and against the will of the people – who is the bully here??? That’s an infliction of will against the people. After all, people have to pay their own dental bills – so let them. We don’t need a nanny state of govt officials telling us all what we should have to ingest.
ASWLA’s people have personally seen many many people who are hypersensitive to fluoride’s toxic affects in the past five years alone.
But in Australia, no one can get testing for fluoride’s toxic effects (not easily); and the government has refused to the long-term studies recommended by it’s own department — the NHMRC — 25 YEARS ago.
Chris, with an attitude like that, its no surprise you have not bothered to look at study tracker. There are many papers if you care to look, in their original formats – not doctored to suit a desired result – what a disgraceful comment! ASWLA is not interested in your apathy… and can’t be bothered spoon feeding you to ‘try’ at least look. But, shame on you. Activists for the most part, do look at both sides. The pushers, don’t.
ASWLA – I have put you under moderation and will not allow any future posts from you which are personally abusive or use childish name-calling of the sort you used in your previous post.
Come on, we are adults here and such name calling does not support your argument.
ASWLA
. Richard Sauerheber, PhD. Sauerhaber is the “scientific consultant” for “Attorney Deal” in his class-action stirring attempts. A look at Deal’s website will show Sauerhaber and his opinions plastered all over it. What fees Sauerhaber may or may not receive for his fluoride “consulting” is anyone’s guess.
So now I suppose you will try and tell me he is the Tea boy and has no input into the court cases
ASWLA
I have a question, I see in the news that chlorine gas has been used in Syria, Now if that is the case you made a big thing about fluoride being a poison when it was connected to sarin, now what are you going to do about chlorine?? The same rules apply ,are you going to start a movement to stop this so called poison too. It is added to water the same as fluoride
Or is it selective. I think the answer has a lot to do with credibility ,dont you
I look forward to your answer.Then we will see how committed your are to pure water
ASWLA
table salt (NaCl) can be a food preservative, a nutritional mineral, a prescription medication, an over the counter medication.
Equally clearly fluoride ions can be a natural mineral, a mineral nutrient, a water additive, an over the counter medication, a prescription medication, an industrial chemical (including extremely pure forms), an industrial pollutant, a fumigant, and a rat poison.
All of these are true and there are important, critical distinctions between each use, each concentration, and the purity standards which define the various incarnations of “fluoride.”
The willful refusal to acknowledge these clear and easily understood distinctions is an important element in anti-fluoridation propaganda.
Courts around the country have uniformly ruled that fluoridation is not medication and further that water districts have both the right and the obligation to determine the chemical composition of their product. Individual citizens do not have the right to demand an specific chemical composition of the drinking water.
Clearly fluorophobes will bear some inconvenience and expense avoiding 0.7 ppm fluoride but that inconvenience is trivial compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.
It is incredibly self centered to insist on water your way when the entire legitimate medical, dental and public health expert communities agree that CWF is safe, effective, inexpensive, and properly regulated as a water additive.
Fluoridation simply prevents cavities. It is straightforward.
Chris, you can boil out chlorine. Fluoride concentrates. Chlorine is used to treat the water. Fluoride is used as a treatment of people. Ethics of choice are removed when such measure are put in place. Ken, we note you have put ASWLA’s comments under moderation ie. that you will cherry pick which comments you want to post. However, we have saved our comments, and will get them out to our lists. Lets see how ‘fair’ you are in this debate; or, like all promotors, choose to remove the truth, as it is shown.
See, ASWLA, you can use people’s correct names. But I am going to continue moderation and hold back any posts where you continue to use derogatory names in this childish manner.
Fluoride cannot be removed from drinking water easily, unless by expensive whole house and reverse osmosis filters; or time intensive distillation process that many cannot afford; so avoiding fluoride is difficult. But Chlorine can be removed easily – it can be filtered out by even simple charcoal filters even on shower heads; or, putting drinking water in the sunlight. Both chemicals are toxic, yes. Fluoride is way harder to remove/avoid.
BTW Chris, we think you are confused – ASWLA has made no comment about Sarin gas – where on earth did you cook that idea up from? ie. you have said in your post that, “you made a big thing about fluoride being a poison when it was connected to sarin, now what are you going to do about chlorine??” – these are your thoughts, and has nothing to do with anything that ASWLA has written.
Are you saying they are both drugs, right? but there is no problem with chlorinated town supplies because it’s easy to remove and there is a problem with fluoridated supplies because it’s harder to remove?
That it’s just a matter of degree in difficulty in removal?
“Again, deflect and dodge the issue. Attack the messenger instead of the message. Refuse to protect infants.”
Nice try, but, obviously, the only one here who is deflecting and dodging is you. I have repeatedy requested that you provide valid, peer-reviewed evidence of any adverse effect on infants by water fluoridated at the optimal level. You have provided none. Your “concern” for infants amounts to nothing more than a transparent reprehensible exploitation of emotion.
You seriously should get some help for whatever is this hangup you have for religion. Your continued references to it are indeed bizarre.
What a shock that you agree with Sauerber. With his bias and gross conflict of interest, he has no creddibility on this issue.
It’s always comical when antifluoridationists refer to my “ilk”. A clear sign of their frustration. Not sure what an “ilk” is, but it has a good ring to it. “Milk” minus the “M” maybe? A misspelling of “ink”, maybe? I don’t know, but comical just the same.
Excellent rant!! Sometime when I have time to waste and am in need of a good laugh, I may even read it.
Steve,
“I have repeatedy requested that you provide valid, peer-reviewed evidence of any adverse effect on infants by water fluoridated at the optimal level. You have provided none.”
I have responded:
First. I have repeatedly responded that Federal and state laws require the manufacturer of the substance used with the intent to prevent disease to gain FDA CDER approval which would require valid peer-reviewed evidence. FDA CDER has rejected all applications due to lack of evidence. In other words, it is not the patient who is to provide the research to prevent the legal intermediary or manufacturer from forcing the substance into the patient. Proof is in the lap of the manufacturer.
“First. I have repeatedly responded that Federal and state laws require the manufacturer of the substance used with the intent to prevent disease to gain FDA CDER approval which would require valid peer-reviewed evidence. FDA CDER has rejected all applications due to lack of evidence. In other words, it is not the patient who is to provide the research to prevent the legal intermediary or manufacturer from forcing the substance into the patient. Proof is in the lap of the manufacturer.”
This is valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level? Uh….no. Your skewed “interpretation” of the law can certainly be argued in court if you wish, but obviously, is evidence of nothing but your skewed “interpretation” of the law.
“Second. Mother’s milk”. Uh….no, again. We’ve already discussed the absurdity of this “argument”. Obviously not valid evidence of any harm to infants.
Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of “concern” for their health.
Bill
“Regardless of a purchaser asking for affidavits or not, the FDA is in charge of all drug substances used for ingestion in the U.S. All drugs require clinical trials testing for FDA approva and require prescriptions. Next January all manufacturers of those materials sold for ingestion purposes must be State licensed for that purpose”.
So if this is the case How come your partners in crime ,the natural health industry fought tooth and nail to stop any testing on their “drugs’
On June 7, 1991, Henry Waxman introduced the Food, Drug, Cosmetic, and Device Enforcement Amendments, which “authorized any district court to order the recall of a food, drug, device, or cosmetic which is in violation of the [law] if the violation involves fraud or presents a significant risk to human or animal health.” The word most important to Waxman and Kessler [the FDA commissioner]—and that most frightened the supplement industry—was fraud. The FDA knew that claims of safety and effectiveness by supplement manufacturers were either unsubstantiated or wrong;
Four of the industry’s top thirty manufacturers—Weider, Nutraceutical Corporation, Nature’s Way, and Nu Skin International—were located in Utah. (It was the only state with its own supplement trade association: the Utah Natural Products Alliance.) … Utah benefited from several billion dollars in profits from supplement sales. Hatch’s campaigns also benefited…. Between 1989 and 1994 Herbalife International gave Hatch $49,250; MetaboLife, $31,500; and Rexall Sundown, Nu Skin International, and Starlight International a total of $88,550. In addition, according to his financial disclosures for 2003, Hatch owned 35,621 shares of Pharmics, a Utah-based nutritional supplement company. In the early 1990s,
The failure of the FDA to regulate natural products appropriately can be attributed not only to the actions of powerful senators such as Orrin Hatch of Utah and Tom Harkin of Iowa, but also to prominent physicians and scientists who stumble in rebutting their agendas. Dr. David Kessler, as commissioner of the FDA, was grilled by Hatch during Senate hearings about regulation of the supplement industry.
So if the drugs made by the Natural health industry do not need testing ,Why do you keep saying fluoride is poison,and needs testing, It comes under the same description You call it a drug the same as hundreds of non regulated ‘poisons’ sold by your partners like Mercola
You simply can’t hold a professional conversation, can you. You suggest I have “partners” in the “natural health industry.” Did you have to spit the words out in disgust? I’m sorry you are so angry with your paper tiger.
I don’t take any supplements, probably should. I don’t have any partners. Stick to the facts, if that is possible.
Look up the legal definition for a highly toxic substance, poison.
Sodium fluoride is a highly toxic substance, poison, based on legal terms.
Highly toxic substances are exempt from highly toxic substance and poison laws when regulated as pesticides or drugs. Dilution of the substance does not exempt the substance from jurisdiction.
Your reasoning seems flawed. The intent of use determines whether it is a drug regardless of concentration, efficacy or safety. I know natural supplement manufacturers who have been shut down by the FDA because of claims of intent without FDA approval. They need to get FDA approval.
Please name one of the supplement ingredients which is a poison.
Fluoride is stronger and more toxic than any of those ingredients, to my knowledge.
Please name one of those “natural” supplements or ingredients which I am forced to ingest without my consent?
Steve,
You state, “Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of “concern” for their health.”
Go to this link and read each of the sections. They are short and explain drugs in clear simple terms.
The possibility of harm caused by natural products … isn’t theoretical. Blue cohosh can cause heart failure; nutmeg can cause hallucinations; comfrey, kava, chaparral, Crotalaria, Senecio, jin bu huan, Usnea lichen, and valerian can cause hepatitis; monkshood and plantain can cause heart arrhythmias; wormwood can cause seizures; stevia leaves can decrease fertility; concentrated green tea extracts can damage the liver; milkweed seed oil and bitter orange (Citrus aurantium) can cause heart damage; thujone can cause neurological damage; and concentrated garlic can cause bleeding….And it’s not just the supplements themselves that might be harmful, but what’s contaminating them. In 2004, researchers at Harvard Medical School tested Indian (Ayurvedic) remedies obtained from shops near Boston’s City Hall. They found that 20 percent contained potentially harmful levels of lead, mercury, and arsenic….And you may argue about the toxicity of this list ,but it is the same as fluoride, It is all in the dose
The difference with fluoride is it is covered by a highly controlled set of standards to guarantee safety, where as your mates natural products have no such control, and they dont want it ,wonder why?
No one is forced to ingest anything, It is your choice ,and as justice Hanson said at a recent court case in NZ, {You should know all about them, being Attorney Deals right hand man}
Justice Hansen made this argument in his recent judgment on the fluoridation issue [Hansen 2014]
“Providing it does not have consequences for public health, a person has the right to make even the poorest decisions in respect of their own health. But where the state, either directly or through local government, employs public health interventions, the right is not engaged. Were it otherwise, the individuals right to refuse would become the individuals right to decide outcomes for others. It would give any person a right of veto over public health measures, which it is not only the right, but, often the responsibility of local authorities to deliver”
You say you have no ties to the Natural Health industry in your work [and stopping fluoride in drinking water is you job, and you are doing it here so this is work} well that seems to be false, as in 2012 this was released by FANN
the Fluoride Action Network (FAN) joined the Health Liberty Coalition, formed by Mercola.com, the National Vaccine Information Center (NVIC), the Institute for Responsible Technology (IRT), the Organic Consumers Association (OCA), and Consumers for Dental Choice.
The purpose of forming the nonprofit partnership was to advocate and actively campaign for the freedom of individuals to make personal health decisions, and to increase access to unbiased and accurate health information.
“You state, ‘Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of ‘concern’ for their health.”
“Go to this link and read each of the sections. They are short and explain drugs in clear simple terms.”
1. There is no peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, in the literature to which you provide a link.
2. Fluoride at the optimal level is not a “drug”. It is simply a mineral identical to that which has existed in water since the beginning of time.
3. The US EPA has full jurisdiction and regulatory authority over all additives to drinking water, not the FDA.
4. “You have flipped jurisdiction on its head, reversed jurisdiction”
I have not “flipped” anything. I have no authority to determine jurisdiction of fluoride, or anything else.
5. “It is not the consumer who is to provide evidence of safety or efficacy. That job is the manufacturer.”
In the case of fluoride or any other additives to drinking water it is not the consumer or the manufacturer who is to provide evidence of safety and efficacy. It is the job of the EPA to provide evidence of safety of additives to drinking water. It does so by requiring all drinking water from the tap to meet the stringent Standard 60 certification requirements of the National Sanitary Foundation.
6. “It is not your job or my job to determine safety of substances intended to prevent disease. That is the job of the FDA CDER”.
You are correct. It is not your job or my job to determine the safety of substances intended to prevent disease. If you are referring to optimal level fluoride in drinking water, however, this is the job of the EPA, not the FDA.
Like you, I once thought the EPA was in charge of the addition of fluoride to water. First I read the law:
“No national primary drinking water regulation may require the addition of any substance for preventive health care purposes unrelated to contamination of drinking water. ” 42 USC 300g-1(b)(11):
Next I contacted the EPA with an FOI request and they responded:
“The Safe Drinking Water Act prohibits the deliberate addition of any substance to drinking water for health-related purposes other than disinfection of the water.”
FOIA Request HQ-FOI-01418-10
Then I talked to an EPA official for confirmation and they said the NSF is in charge of substances added to water.
When I have time, I will respond to your other statements. Look up the Relative Source Contribution Analysis done by the EPA and the Dose Response Analysis. Read those. Especially the chart, I believe it is 8-1.
Facts are facts. The EPA has jurisdiction and regulatory authority over fluoride additives to drinking water, not the FDA.. If you believe this to be an error on the part of the US government, then go argue your case in court.
“Steve, You allege,
“Facts are facts. The EPA has jurisdiction and regulatory authority over fluoride additives to drinking water, not the FDA.”
That’s what I thought also, until I read the law and talked to lawyers and talked to the EPA and FDA.
I have a choice:
A. Believe what the FDA, CDC, laws, HHS, Congress actually say.
OR
B. Believe Steven D. Slott DDS.”
I don’t “allege” anything. I state facts.
Apparently you are under the delusion that I have any concern whatsoever what you “believe”. That’s entirely up to you. I simply expose the fallacies of your comments.
Again, if you want to believe that the US government is in error over jurisdiction of additives to drinking water, that’s certainly your prerogative. But, you should probably take your arguments to court. It is highly doubtful that the laws will change because you repeatedly keep posting the same nonsense on this website.
If you believe there to be some sort of conspiracy, coverup, or corruption within the US government, then you should report this to the appropriate authorities.
For some bizarre reason, you think I disagree with the jurisdiction of artificial fluoridation being with the FDA CDER. Why would I go to court when I agree with the law and these agencies that the FDA CDER has jurisdiction.
Of course I would not take the EPA to court when the EPA does not have jurisdiction over the ADDITION of fluoride to water. EPA has jurisdiction over the EXISTING fluoride in water. Their MCLG is not protective, but that is a different subject.
Steve, you fail to give any legal reference or notice from the EPA that the EPA has jurisdiction over the ADDITION of fluoride to water with the intent to prevent dental caries.
Wow, this a long comment stream. I just got thru part of it and found this quote from dentist Steve Slott: “The reasons that European countries may or may not fluoridate their water systems are myriad, few, if any, related to effectiveness or health concerns of optimal level fluoride. They are also irrelevant to that which is done by New Zealand, the US, or any other countries, in the best interests of their respective citizenries.”
Ok, so where can I read about European countries and their experience with fluoridation? Where can I find out about the myriad real “reasons?” And please don’t tell me to ask the ADA or consult their “Fluoridation Facts.” The ADA no longer answers questions from the public. Years ago I exposed their lie that “60 nations practice water fluoridation” The next edition of “Fluoridation Facts” took that false statement out. They knew that statement was false but printed it anyway.
In the current “Fluoridation Facts” it says “Many fluoridation systems that used to operate in Eastern and Central Europe did not function properly and, when the Iron Curtain fell in 1989-90, shut down because of obsolete technical equipment and lack of knowledge as to the benefits of fluoridated water.3” That actually is an insult to the engineers and public health people in those countries. This implies that the engineers were too stupid to fix fluoridation equipment. Or It implies that the country is too poor to fix equipment. As for the “lack of knowledge as to the benefits” what happened? Did they forget why they were adding fluoride to water? Did they see a lack of effectiveness in their country when they were supposed to ignore that? Another insult.
And the ADA still lies about Europe, stating that: “No country in Europe has banned community water fluoridation.” and “Political actions contrary to the recommendations of health authorities should not be interpreted as a negative response to water fluoridation. For example, although fluoridation is not carried out in Sweden and the Netherlands, both countries support World Health Organization’s recommendations regarding fluoridation as a preventive health measure, in addition to the use of fluoride toothpastes, mouthrinses and dietary fluoride supplements.138,350”
Of course political actions can be a negative response to water fluoridation. Just like they can be a positive response to a proposal to add fluroide to water. I expect this section to be re-written in the next edition of “Fluoridation Facts” which I think should be out fairly soon.
So in the Netherlands they had fluoridation and then said it was no longer allowed. They banned it. They changed laws, they had court decisions. In Sweden the legislature said no. If the what the ADA said was true, then we must believe that any water system in the Netherlands or Sweden could start up fluoridation if it wanted to. But none have done so in the many decades since it was banned. Why not? There are plenty of people in those countries who support fluoridation, but the ADA story says these public health officials chose voluntarily on their own to stop fluoridation and never start up another fluoridation scheme anywhere. For some unexplained reason they supposedly did that.
But of course that is not what most of the world believes about fluoridation in the Netherlands and Sweden. I find it incredible that the ADA would make these statements. Most of the world agrees that fluoridation is banned in those countries.
There has been something fishy about statements regarding European fluoridation for a long time now. I’m not going to accept what Steve Slott said about Europe until I can see something significant and specific that supports him. I know it is hard to gather the historical data on fluoridation around the world, but the British Fluoridation Society eventually did a fair job of it. Their first attempt had errors and misleading stuff, but they made an effort to fix it after I complained. The BFS never claimed that there were “60 nations practicing fluoridation.” And I bet the BFS would never make the claim that “No country in Europe has banned fluoridation.”
Open Parachute 
It takes a scorecard to try to keep up with the science the Connetts have garbled, twisted, quoted out-of-context, and misrepresented to appear to support their personal ideology against fluoridation.
Steven D. Slott, DDS
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Ken,
I’m surprised you would stoop lower than such crude smearing.
Did you attend the Fluoride Conference and listen to Michael Connett? I didn’t see you there. If you had, you would know you have cherry picked four of his slides and completely distorted them.
Rats and mice do not have the same toxicological reaction to toxins such as fluoride as humans, about seven fold. The value of animal studies is to understand the potential for harm in humans. Those studies demonstrate too much fluoride does indeed cause neurological harm.
What you failed to consider and evaded are the many human studies finding significant harm with lower IQ from fluoride exposure similar to the fluoride exposure of many in the USA. This is confirmed by estimates of total exposure and urine and serum fluoride concentrations.
Remember, water is not the only source of fluoride. Toothpaste for some can be an even larger source of fluoride exposure. Quality studies include measurements and avoid estimates of assumptions which the American Dental Association and the US Centers for Disease Control rely on.
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Yes, I am not surprised you were at the Connett get together Bill. You are, after all, on the team.
Yes the 4 slides are selected (from 27 slides) – by Michael – to show studies from 2014 he claims shows water fluoridation damages our brains. I was simply providing some information from the papers (and please note this is in the form of quotes) showing that the studies are not relevant to community water fluoridation. They are just examples of crude dredging of the literature.
Useful information for readers that Michael certainly didn’t include on his slides. did he actually point out the limitations of what he was doing in his talk, Bill?
Yes. I am aware that some claim that one needs to use higher concentrations with rates and mice to make this equivalent to human situation. But that is controversial and really amounts to special pleading. When researcher use concentrations of 100 ppm and more where a proportion of the rats actually die it is dishonest to pretend the results are relevant to community water fluoridation.
The crass violation of scientific ethos involved in this literature dredging is disgusting and you should be ashamed to be openly supporting it.
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So when you scratch the surface, Why would a lawyer work for a group like Fluoride action network? the money must be good to support all the hangers on, and you cant tell me they are there for their health,and the list of lost court cases must cost a lot. Someone is funding it ,and I bet the Natural Health Industry has its hand in the pocket And if you look at the local group they are always after money as well
So really it is not about the fluoride, it is about any way to fund the family business, and fluoride is a convenient scapegoat
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Ken,
You are the one who did the crude dredging of scientific literature and now you are starting to back peddle. Pathetic, unprofessional, and quackery at its extreme.
The research on animals speaks for itself and you distorted and crudely dredged his presentation to fit your agenda. Michael did not present the animal studies with a claim those studies demonstrated harm to human brains. The studies you presented were animal studies, not human studies.
Ken, your crude cherry picking of Michael’s presentation is a mockery of science. You failed to mention that eight of the studies referenced by Choi et al in their Harvard meta analysis had subjects drinking less than 3 ppm fluoride in the water and the average IQ drop was 8 IQ points.
Ken, think “total exposure” of fluoride rather than simply water concentration of fluoride. The subjects in the 8 studies used almost no fluoride toothpaste which can often provide more fluoride than fluoridated water. Therefore, many in the USA are drinking more water than “average”, swallowing toothpaste, receiving fluoride varnish and fluoride medications which make their “total exposure” very similar to the 8 studies with fluoride concentrations lower than the Maximum Contaminant Level Goal (MCLG) set out by the US EPA of 4 ppm.
The excess fluoride exposure is confirmed when fluoride urine and serum concentrations are compared.
The question is not whether fluoride causes neurological harm, rather at what dosage and age is the harm taking place.
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Bill, I realise that as you are the West Coast Spokesman for the Connetts’ Fluoride Action Network you have irons in the fire and a point of view to promote. But you are being ridiculous.
Michael was the one who did the literature dredging. I simply checked out the papers he dredged up. That is the normal response of an intelligent researcher. And isn’t literature dredging one of Michael’s “special projects?” Isn’t that how he builds up the database for anti-fluoride propagandists to use?
The fact is that again and again the Connett’s and their off-siders use the tactic of quoting literature where much higher concentrations are used to claim that there is a problem with fluoridation – or at least a possible problem is indicated. But in the thinking of the political activists a possible indication quickly becomes a fact and is perceived as a fact. It’s a simple political tactic. But it is dishonest.
Of course the animal studies speak for themselves but the dishonest presenter can easily take them out of their proper context, not communicate the actual details of the study and use them to promote misinformation.
Isn’t that exactly what Connett’s outfit does again and again?
My article purely presented a neat little example of literature dredging. As for the Choi paper I have written several times on it and will be doing so again when I review the document you guys produced to attack the NZ Royal Society Review. Why don’t you check back and get stuck into my comments on them in one of those articles. It is silly to claim there is something. Wrong for me not to have included it is this article. Silly.
You are into special pleading in your homilies on “total exposure” – partly for the very reason that most of the studies in Choi’s paper are so weak you cannot find information on “total exposure” Your are forced to assume or speculate.
As for your claim of neurological harm – come off it? Where is the established mechanism? Why do you rely on such poor studies? And why do you ignore the role that severe dental fluorosis will have on children’s learning? You are so busy trying to invent a neurological mechanism you may be blind to what sticks out like a sore thumb. To my mind if tooth decay can cause learning difficulties then surely so also can severe dental fluorosis. And these studies comes from an area of the world where fluorosis is endemic. Unlike NZ and USA.
Even the authors of Choi’s review have stated it is not relevant to community water fluoridation.
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“The crass violation of scientific ethos involved in this literature dredging is disgusting and you should be ashamed to be openly supporting it.” Pot kettle and black Ken with regards to your support of the Gluckman/Skegg review. That report is one of the best examples of cherry picking you could ever find. It’s more a political than scientific report. Reminiscent of tobacco science and lead. With lead top scientists insisted that the low levels of weren’t toxic.We already know that fluoride levels found in fluoridated water affect some people adversely.
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Really? We know that fluoridated water (ie with concentrations of 0.7-1ppm) adversely affects people? Remarkable. Would you care to share the studies which demonstrate this?
I mean, call me a skeptic, but if we have evidence of harm to people at those concentrations, then what the heck is Connett doing wasting everybody’s time with studies on rats at fluoride concentrations which are orders of magnitude higher?
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Bill
It is always facinating to see you, Connett and other antifluoridationists constantly attempting to use the 27 studies dug out of obscure Chinese journals and reviewed by Choi and Grandjean, as the basis for your IQ nonsense. These studies were so ridiculously flawed and irrelevant that it is a marvel that any intelligent person would embarrass him/her self by putting them forth as evidence of anything, other than a prime example of the flimsy base on which antifluoridationists rest their constant attempts to deprive entire populations of the benefits of water fluoridation. It is not a certainty that these studies were even peer-reviewed.
You hypocritically rely on these 27 “studies” to justify neurotoxicity claims against CWF, claims grounded in the paranoid fear of “mind control” which pervaded antifluoridationist ideology from the very beginning of the initiative, while attacking Broadbent, a properly peer-reviewed study published in a highly respected journal. Broadbent is a study of the effects of exposure to CWF not of exposure to high fluoride levels, is not missing key information, does not have missing pages, and did not employ questionable methodologies.
The following are examples of the flaws pointed out by Grandjean and Choi, themselves, in the “infamous 27” upon which you rely:
From:
——Developmental Fluoride Neurotoxicity: A Systematic
Review and Meta-Analysis
Anna L. Choi, Guifan Sun, Ying Zhang, Philippe Grandjean
Page 4 Conclusion:
“The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.”
Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 9
“Six of the 34 studies identified were excluded due to missing information on the number of subjects or the mean and variance of the outcome (see Figure 1 for a study selection flow chart and Supplemental Material, Table S1 for additional information on studies that were excluded from the analysis). ”
Page 13
“Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.”
Once again, note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration, exactly in the r. ange of the control groups in this study.
Page 13-14
“While most reports were fairly brief and complete information on covariates was not available, the results tended to support the potential for fluoride-mediated developmental neurotoxicity at relatively high levels of exposure in some studies.”
Incomplete information on covariates (controls). Relatively HIGH levels of fluoride. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 15
“The present study cannot be used to derive an exposure limit, as the actual exposures of the individual children are not known. Misclassification of children in both high- and low-exposure groups may have occurred if the children were drinking water from other sources (e.g., at school or in the field).”
Page 15-16
“Still, each of the articles reviewed had deficiencies, in some cases rather serious, which limit the conclusions that can be drawn. However, most deficiencies relate to the reporting, where key information was missing. The fact that some aspects of the study were not reported limits the extent to which the available reports allow a firm conclusion. Some methodological
limitations were also noted. Most studies were cross-sectional, but this study design would seem appropriate in a stable population where water supplies and fluoride concentrations have remained unchanged for many years. The current water-fluoride level likely also reflects past developmental exposures. In regard to the outcomes, the inverse association persisted between studies using different intelligence tests, although most studies did not report age adjustment of the cognitive test scores.”
As I’ve said, the 27 Chinese studies were so flawed as to have no value, whatsoever, in evaluating water fluoridated at 0.7 ppm in the U.S.
Steven D. Slott, DDS
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Chris, you obviously do not understand antifluoridationist code. Let me explain.
“We” is defined as: uninformed antifluoridationists.
“Know” is defined as: speculate, argue, put forth, desperately wish to be true, and that for which “we” can provide anecdotes of our own ailments and those of horses, as proof.
Steven D. Slott, DDS
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Steve,
You are great at telling stories and cutting people down, but you have not talked about science.
Why don’t you shoot the message instead of the messenger?
Show us your science on fluoride and neurological risks.
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You “shoot the messenger” when he/she alters the ‘message” to fit his/ her personal ideology.
How about if you show us your science on fluoride and neurological risks, remaining relevant to fluoride at the optimal level. You’re the one making unsubstantiated claims, not I. It is not encumbent on me, or anyone else, to disprove such claims.
Steven D. Slott, DDS
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You don’t like Choi et al. Then perhaps you would be kind enough to provide a prospective randomized controlled trial on benefits or risks of fluoridation.
You assume “low” fluoride is 0.7 ppm. Low fluoride is mother’s milk with most samples measuring no detectable fluoride and mean of 0.004 ppm. What you consider to be “low” at 0.7 ppm is 175 times more concentrated than mother’s milk. The terms in the study “high” and “low” were not equating “safe” and “harm.” The low fluoride cohorts were the comparison. One study had low of 0.88 ppm finding harm, 8 studies had water fluoride concentrations under 3 ppm and the average IQ drop was 8 IQ points. Don’t forget the US EPA says 4 ppm is safe. Yet 8 studies are lower than 3 ppm.
You assume the only fluoride exposure is from water. Total exposure in the “high” cohorts is similar to what many are ingesting in the USA.
A lower limit cannot be determined from the studies because that was not the purpose of those studies. The kind of study you are suggesting is not ethically possible and I don’t think would be permitted by human study review boards. Nuremburg Trials and Tuskegee study etc. have shut down the experimentation on humans of toxic substances to expected harmful concentrations.
QUESTIONS:
Have you actually read the studies? Have you read Tang’s review of the fluoride neurological studies? What dosage of fluoride do you think is safe and effective?
What is the maximum fluoride concentration in urine and serum which you feel is safe and effective? The intent of artificial fluoridation is not to treat water, but to treat people. When we treat people, we dispense an amount to achieve a result in the person. What is safe and effective in the person?
What concentration of fluoride in dentin and enamel prevents or mitigates tooth decay?
You talk about “high” vs “low”. Please explain in ppm or mg/L and also mg/Kg/day BW what you mean by “low” and “high” fluoride exposure.
Please provide the criteria of a quality study on humans which would be accepted by a human study review board that you would also accept. Do you really think a human study review board would accept giving fluoride to cohorts and measuring the dosage when they would have neurological harm? Therefore, we are left with low quality studies. Fortunately we have numerous studies and they are all finding consistent results.
The question is not whether fluoride causes neurological harm but at what dosage.
Until a dosage is determined, the safe dosage for infants would be the same as mother’s milk, less than 0.001 mg/Kg/day.
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Steve,
Artificial fluoridation is the act of using police powers to force a person to ingest fluoride. Almost impossible to avoid because it is in processed foods, etc.
Freedom to chose medications is a fundamental right and should be protected.
As a public health professional, I agree with courts that public health should have police powers and the courts are clear, those powers can only be used for highly contagious diseases. Tooth decay is not highly contagious.
When governments remove my freedom to choose substances intended to prevent disease (drugs, medications), governments must have clear and strong scientific evidence of safety and efficacy and provide me with appropriate label and doctor’s supervision. None of that is happening with water fluoridation.
Israel stopped artificial water fluoridation. Why?
Most of Europe has stopped or never started fluoridation of public water and most salt does not have fluoride.
Why are you opposed to letting me have freedom?
Question: What concentration of fluoride in the dentin and enamel body has been shown to be “optimal” for the prevention of dental caries?
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Steve,
You want me to show you the data on risk. Remember, it is you that says artificial fluoridation is safe for everyone. Not I.
Help me understand how to down load graphs and documents on this site and I’ll provide more evidence.
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Bill
“Artificial fluoridation” is a misnomer used by antifluoridationists to mislead the public into believing that the fluoride added to water systems is somehow “man-made” and not the “natural fluoride” provided by CaF. You should know, as well as I do, that the HFA utilized to fluoridate the majority of systems, is derived from phosphorite rock as a co-product of the process utilized to derive phosphoric acid. You should also know that the fluoride ions released by HFA are identical to those released by CaF, NaF, or any other compound. Please don’t waste my time or yours by attempting the argument about heavy metal contaminants. If you have the need, complete information on these contaminants is found on the National Sanitary Foundation website.
No one is forced to anything in regard to fluoridation. People are entirely free to consume it or not. No one will tie them down and force fluoridated water down their throats. Inconvenience, regardless the degree, does not equate with “force”. The “forced medication” argument is nothing but an unconscionable attempt to invoke emotion by exploitation of the sufferings of those unfortunate ones throughout history who truly have been subjected to forced medication. “Forced medication” has been repeatedly attempted in US courts through the decades. It has been rejected each and every time by those same courts. You are certainly free to try it yet again, but I don’t much like your chances with that.
Water fluoridation in no manner interferes with anyone’s “freedom to chose [sic] medications. Local governments and/or water boards are entirely free and authorized to determine the content of their local water supply in compliance with all applicable laws and regulations.
Israel ceased fluoridation due entirely to the unilateral action of one person, their Minister of Health, who deemed her personal ideology to be more important than the best interests of the citizens of Israel. Over the vehement objections of the respected healthcare community of Israel, this Minister had made it her mission, since taking office last year, to impose her antifluoridationist ideology onto the entire Israeli citizenry, as she had years before in the community over which she presided as mayor. Unfortunately, the Israeli system of government allowed her the authority to do so. Given the staunch opposition by the Israeli healthcare community, and even the Prime Minister himself, to this grievous action by the Health Minister, I, personally, would not like to have her prospects for job security.
The reasons that European countries may or may not fluoridate their water systems are myriad, few, if any, related to effectiveness or health concerns of optimal level fluoride. They are also irrelevant to that which is done by New Zealand, the US, or any other countries, in the best interests of their respective citizenries.
I am not opposed to letting you have freedom. That, however, is irrelevant to water fluoridation.
As you well know, Warren and Levy attempted to ascertain if there could be determined an optimal level of fluoride which would provide a caries-free dentition, with no adverse effects. As you also well know, due to halo effects and other variables, they were unable to do so to any degree improved over that which is currently utilized as the optimal level. This in no manner negates the decay preventive benefit of the current optimal level of 0.7 ppm to 1.2 ppm. It simply means that they were unable to improve upon this determination. Given the countless, peer-reviewed studies clearly demonstrating the effectiveness of fluoridation, coupled with the lack of any proven adverse effects of fluoride at this level, the validity of the current optimal level has been borne out over the 69 year history of this initiative.
Steven D. Slott, DDS
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Bill
You asked me to show you my “science on fluoride and neurological risks”. You are the one claiming neurological risks, not I. Once again, it is not encumbent on me, or anyone else, to disprove your unsubstantiated claims. It is of no concern to me what you present here. I am simply exposing the fact that your claims are unsubstantiated.
Steven D. Slott, DDS
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In today’s paper:
The Times of India
High fluoride content in drinking water major public health risk
Syed Intishab Ali,TNN | Sep 15, 2014, 10.02 AM IST
JAIPUR: High content of fluorides in drinking water are not only causing skeletal damages but it is also causing non-skeletal damages including infertility and mental disorders.
In the state, a total of 2,749 samples (up to August 2014) was taken from different sources of water in 18 different districts and found that 1,717 of them contain 1ppm to 3 ppm of fluoride, while 314 contain 3ppm-5ppm and 99 of them contain more than 5 ppm of fluoride.
According to health experts, 1ppm to 1.5ppm concentration of fluoride in water is the standard and recommended upper limit.
Water with high fluoride content put people at risk of getting affected with gastric problems, mental retardation, paraplegia and burning sensation during urination.
Health officers checked the content of fluoride in urines and they found that out of 7,649 samples, 5,869 have fluoride more than 1 ppm, which is above the permissible level.
“Fluorosis is a public health problem resulting in major health disorders like dental fluorosis, skeletal fluorosis and non-skeletal fluorosis besides inducing ageing. There are cases of infertility, mental disorders and others which we have found during the survey in areas with high fluoride contents in drinking water,” Dr Ramavatar Jaiswal, state nodal officer for fluorosis said.
He said the harmful effects are permanent and irreversible in nature.
A health department’s physical report on fluorosis releasing figures up to August 2014, shows that there are 4,850 suspected cases of non-skeletal fluorosis including cases of suspected cases of infertility due to fluorosis in different districts.
In the survey, the health department conducted tests on more than 2,76 lakh people and found that 90,122 were suspected cases of dental fluorosis and 17,160 persons were suspected cases of skeletal fluorosis but it came as a shock for the health authorities when they found that there are cases of 4,850 suspected non-skeletal cases.
Dr Jaiswal said they do not have separate figures of cases of infertility linked to fluorosis as they are included in suspected non-skeletal cases. The other non-skeletal cases are persons suffering from swollen joints, muscular tenderness and systematic rigidity.
The survey was conducted in 18 districts of the state. The highest number of non-skeletal cases were found in Jodhpur (2,262), Churu (1,325) and Jaipur (1,068).
Rajasthan is one of the states with the best National Programme for Prevention and Control of Fluorosis (NPPCF) and the director general of the Union ministry of health is expected to visit the state soon.
http://timesofindia.indiatimes.com/City/Jaipur/High-fluoride-content-in-drinking-water-major-public-health-risk/articleshow/42509648.cms
ASWLA comment: Funny how those that have no knowledge of the ‘debate’ on this blog, are doing their best to remove fluoride from causing suffering to people via drinking water supplies; whilst those supporting fluoride on this blog, do their best to inflict it on everyone without any concern for suffering people might have. Interesting ethics Ken, don’t you think?!
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If a person drinks more than one litre of water a day, they are getting more than the ‘recommended’ dose of 1mg a day. The same as those poor people mentioned in The Times of India, who have to deal with calcium fluoride – not the industrial waste fluorosilicic acid muck forced into Australian, American, UK or Irish water!
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Sorry to impinge, Jen, but I can’t resist…..
ASWLA……….Seriously? High fluoride intake and skeletal fluorosis in India? You really have no clue as to the irrelevance of this to water fluoridation in NZ or the US have you?
Steven D. Slott,,DDS
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ASWLA
Here’s another toxic poison about which we need to enlighten the unwitting public. Think maybe you could form a group and a website to oppose the forced medication of us all with this noxious substance?
http://www.scientificamerican.com/article/strange-but-true-drinking-too-much-water-can-kill/
Maybe name it “Water Free Australia”, or something, with websites such as “wateralert.org”, “waterresearch.org”, “waterfacts.com”…….or something?
Maybe have a blog of “the things your corrupt government doesn’t want you to know about water”, have an investigative arm to find out how pro-water lobbyists are paid by the corporate water industry.
Demand absolute, irrefutable proof that water does not cause cancer, and that the moon is not made of green cheese, before any more of this toxic waste is allowed into our public utility systems…..
Steven D. Slott, DDS
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Sloth, ASWLA knows EXACTLY the relevance. But the point of putting up that article being, other people in the world know how TOXIC fluoride is to the human system. You Sloth – and your kin – arrogantly believe that people are only their teeth; and we can ingest industrial waste without any problems, no matter age, health, or even, need (what if you don’t have your teeth anymore Sloth – you don’t need to ingest anything, eh!); and you continue to ignore any relevance to any other studies, results or problems other people are dealing with in the world that state a different tale to your agenda – that of selling fluoride as a magic cure-all for too much sugar, poor diet and chemical imbalances, that will not be fixed by snake oil sales of an outdated mode of ingesting a corrosive acid. Your kin like to impinge your will on all of us, with a very very narrow focus – teeth. Grow up. The world is awake these days, to this aluminium waste product you call ‘fluoride’. One day you will see, people don’t want to drink, ingest or have forced upon them, the will of the industrial merchants peddling their waste products or those wearing white coats and touting ‘safe and effective’ as a mantra. NZ and Australia have high rates of arthritis, thyroid, kidney, heart and fluorosis. And the skeleton is the final resting place of these chemicals that destroy the softer tissue health first. No matter what you bluster on about, India is leading the way. And whether you like it or not Sloth, the world has cottoned on to the scam perpetuated for way too long – the scam that industrial waste is somehow, ‘good for us’, ‘safe’, and ‘effective’. Show us the long term safety date of ingesting this stuff – you still have not coughed it up Sloth. ASWLA has asked you more than a dozen times now, on different blogs. But, you never produce the hard evidence of safety – as there is none. You just go silent, and move on the peddle more of your opinions, caring not one iota for the welfare of those who don’t want or need this stuff; and suffer because they cannot avoid it – tap water is in everything processed. Meanwhile, India is doing its best to remove natural forms of fluoride, to look after its people.
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You do waffle on.
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Aswla
“If a person drinks more than one litre of water a day, they are getting more than the ‘recommended’ dose of 1mg a day.”
Exactly whom, besides ASWLA, has deemed 1 mg to be the
” ‘recommended’ daily dose” of fluoride?
Steven D. Slott, DDS
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Pray tell dear Sloth, all who deem you the God of fluoride chemistry and who knows what is the ‘safe’ dosage for all – with a one size fits all approach that water fluoridation demands: What dose is recommended by you, oh mighty doctor of all babies, elderly, indigenous, kidney diseased, heart diseased, thyroid diseased or other? And how does one measure a daily dose from all sources of water fluoridated foods and beverages; and pay tell, please, if you KNOW, tell us all what that recommended daily dose is, for each of us, regardless of our need or health status? If 1ppm is deemed ‘safe’ per day, how does one measure that dose in all sources?
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Where IS that safety data for long term ingestion? Hmmm…. doesn’t seem to be any, does there. We’ve asked so many times for it. Never materialises, does it Sloth. You’ve still avoided producing it. If fluoride is so safe, then cough up the evidence please. We’re all still waiting. ASWLA has better things to do than waste time on this little blog. Time to leave. If you do happen to find that evidence of perfect safety for long term ingestion, please do us all a favour – we’ll go away permanently then – and provide it for us. Even the Australian TGA cannot provide such evidence. We rest our case. Cheers! ASWLA now has more important things to do, than prop up the egos in this mighty sad ‘debate’. For fluoride as a ‘safe and effective’ solution to too much sugar, is just like this blogs name – an open parachute – falling, falling, falling down. Ciou!
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ASWLA
I see not one scrap of valid evidence to support these ridiculous claims you make. Please provide such, keeping relevant to fluoride at the optimal level, and bearing in mind that your personal opinion, and/or links to “fluoridealert” do not constitute evidence of anything.
As for my going “silent” when challenged by you, and other antifluoridationists, to disprove the constant barrage of unsubstantiated claims you make….far from it. Each and every time you attempt that nonsensical tactic, I remind you that it is not a responsibility of mine, or anyone else, to disprove your unsubstantiated claims. It is when I ask you for valid evidence that a problem exists in relation to water fluoridated at the optimal level, that occurs the silence you have observed.
Steven D. Slott, DDS
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Ah yes, ASWLA, in predictable manner, you disappear when challenged to provide valid evidence of any problem with water fluoridated at the optimal level. Comical.
Steven D. Slott, DDS
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ASWLA
Wow! Please let me know who are all these people who deem me to be a “God” so I may thank them! Think maybe I could be deemed the “Premier International Authority on Fluoride”? Oh wait….somebody has already anointed himself with that moniker…oh well.
As far as daily recommended “dose” and other diatribe in your comment, this information is readily to anyone, even you, who put forth a bit more effort than is required for the lazy copy/pasting of nonsense spoon-fed to them from “fluoridealert”.
But, alas, since the reality is that you will never exert such an additional effort, I will explain this to you…..
Simply put, water is fluoridated at 0.7 mg/liter (ppm=mg/liter). Thus, for every liter of fluoridated water consumed, the “dose” of fluoride intake is 0.7 mg. The average daily water consumption by an adult is 2-3 liters per day. So, let’s go to an extreme and double that to an excessive 6 liters of fluoridated water consumption per day. This translates to 4.2 mg “dose” of fluoride intake per day from the water. The CDC estimates that of the total daily intake, or “dose”, of fluoride from all sources including dental products, 75% is from the water. Thus as 4.2 mg is 75% if the total daily intake from all sources, the total daily intake, or “dose” from all sources would be 5.6 mg for an individual who consumed an excessive 6 liters of fluoridated water per day.
The Institute of Medicine has established that the daily upper limit for fluoride intake from all sources, for adults, before adverse effects will occur, short or long term, is 10 mg. Thus, even the excessive 6 liter per day consumer of water will still only take in a daily “dose” of fluoride that is slightly more than half the upper limit before adverse effects.
The range of safety between the miniscule few parts per million fluoride that are added to existing fluoride levels in your water, is so wide that “dose” is not an issue. Before the UL of 10 mg could be reached, water toxicity would be the concern, not fluoride.
Click to access ULs%20for%20Vitamins%20and%20Elements.pdf
Steven D. Slott, DDS
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In all that rubbish from the ASWLA we did not get one peer reviewed paper to back up any statement made. Typical of the anti fluoride/vaccine lot
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Sorry, Chris, it looks like ASWLA has disappeared like a wisp of smoke in the wind. Seems he has more “important” things to do than hang around us rude people with the gall to hold him accountable.
Steven D. Slott, DDS
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Bill’s special pleading over the a Choi et al review is typical of the arguments being used currently by anti-fluoride propagandists because of the directions coming from Connett’s organisation at the moment.
Bill says “One study had low of 0.88 ppm finding harm.” Of course if this was at all convincing. he would have gone into details but he chooses not to (not part of the direction). He is referring to the report of Lin et al. This is 1 and 1/2 pages long and omits important details. No information on the range of F concentrations in drinking water – just a bald mean for 2 of the areas. No details about level of dental fluorosis found, just a bald percentage. I could go on.
But the significant feature Connett et al always cover up is this was a study of subclinical cretinism basically due to I deficiency. The comparison was of the I deficient areas with a control area given I supplementation. 14% of the studied children were mentally retarded, and 69% of these exhibited subclinical cretinism.
The study showed a significant difference between the I deficient and supplemented areas. Differences between the two I deficient areas were far less convincing. However, the straw clutching and special pleading required to claim this study is at all relevant the CWF where I is not deficient is extreme.
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Ken,
I have my health and my families health and our freedom at stake.
You distorted and put words in Michael’s mouth which he did not use or say. You did not attend the convention. You intentionally misrepresented the research to fit your agenda. Michael did not say or imply what you wrote.
You accuse Michael of “crudely misrepresenting” the scientific data. He did not.
You Ken.
You Ken, crudely misrepresented Michael’s references to animal data.
Steve, you asked me to provide research on risks at the “optimal” level of fluoride intake.
Sure. Lets first define “optimal.” Use science, not religion.
What is optimal? Mother’s milk. Most samples have no detectible fluoride. That is optimal.
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Bill, is this fact-free emotional response of yours the answer to my point about your special pleading with the Lin et al report?
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ken,
All studies on fluoridation are weak. Not a single prospective randomized controlled trial. And only 8 human studies with fluoride concentrations less than 3 ppm.
And based on the lack of scientific evidence, you support forcing me to consume more fluoride without my consent.
The problem Ken and Steve is judgment. Stand back for a moment and consider.
1. Poor quality studies on efficacy and safety:
• A. Not one Study corrects for Unknown Confounding Factors
• B. Not one Prospective Randomized Controlled Trial
• C. Socioeconomic status usually not controlled
• D. Inadequate size
• E. Difficulty in diagnosing decay
• F. Delay in tooth eruption not controlled
• G. Diet: Vitamin D, calcium, strontium, sugar, fresh and frozen year around vegetables and fruit consumption not controlled.
• H. Total exposure of Fluoride not determined
• I. Oral hygiene not determined
• J. Not evaluating Life time benefit
• K. Estimating or assuming subject actually drinks the fluoridated water.
• L. Dental treatment expenses not considered
• M. Breast feeding and infant formula excluded
• N. Fraud, gross errors, and bias not corrected.
• O. Genetics not considered
2. Mother’s milk 0.004 ppm
3. No known optimal tooth fluoride concentration.
4. Recommended serum fluoride concentration less than 0.02 ppm and many have higher.
5. Fluoridation cessation studies finding no increase in caries.
6. Animal studies finding harm.
7. Human studies finding harm
8. Fluoride given without consent.
9. Defined by law as a poison, legal to dispense under pesticide laws or drug laws. Approved by the FDA CDER for topical use only. “DO NOT SWALLOW”. The FDA CDER warning is for the same amount of fluoride as one glass of water.
10. Many studies finding no benefit with the ingestion of fluoride.
11. No margin of safety.
12. No enzymatic or neurological safety studies
13. Not approved by the drug regulatory agency.
14. Most developed countries not fluoridating and reducing dental caries to the same as those fluoridating.
Again. Stand back and look at the big picture. With so much uncertainty both on safety and efficacy why refuse to give people the freedom to choose?
Give me freedom.
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I repeat, Bill, is the new fact-free emotional comment a response to my comment on the problems with the Lin et al study? You were the one that brought up the study – I would think you would want to discuss it.
By the way I don’t support forcing anyone to adjust their dietary intake. No-one. But again this is an emotional response, isn’t it?
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Bill,
“I have my health, my families health and our freedom at stake”
Oh, for gosh sakes, Bill, save the drama for Broadway. I doubt that your whining about your “freedom” would garner much sympathy from anyone whose freedom had ever truly been at stake. Get over yourself.
The “optimal level of fluoride” is a term used to identify that level established by the US Department of Health and Human Services at which maximum dental decay prevention will occur with no adverse effects. The current optimal level is a range of 0.7 ppm to 1.2 ppm. Although this is a recommended level which has no legal mandate, public water systems generally abide by this recommendation when fluoridating.
Your personal opinion as to what is the optimal level of fluoride is meaningless. You and Connett are the ones using religion, not I. For some inexplicable reason you both seem to think you have a special pipeline to the Almighty, such that you, and you alone know what He has intended in terms of how much fluoride is “safe” for infants. Human breast milk is deficient in iron and Vitamin D. Please ask the Almighty next time you and Connett meet with Him, if He intended for infants to be anemic and develop Ricketts.
Once again, you are the one making unsubstantiated claims about “neurological risks” of fluoride. I couldn’t care less what you post, but if you expect credence for these claims then provide valid, peer-reviewed scientific evidence of support, relevant to fluoride at the optimal level.
Steven D. Slott, DDS
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Bill
“The problem Ken and Steve is judgment. Stand back for a moment and consider.”
1.Humans have been ingesting this identical fluoride ion in water since the beginning of time
2. Sixty nine years of fluoridation, hundreds of millions having chronically ingested it.
3. Fluoridation being the most most discussed, tested, poked, prodded, twisted, and squeezed to find any adverse effect that could conceivably, in any possible manner, be attributed to it….than any other public health initiative in history.
4. Countless peer-reviewed scientific studies clearly demonstrate the effectiveness of fluoridation.
5. No proven adverse effects
Seems the one with the judgment problem is you, Bill.
Steven D. Slott, DDS
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Steve,
Thank you for responding regarding, “optimal.”
What government agency determined “optimal?” What was the scientific evidence and what was the date and mg/Kg/day?
Most important, who is reviewing the total exposure people are ingesting from all sources today?
The ever increasing biomarker of excess fluoride ingestion, dental fluorosis, continues to increase, now at 41%. HHS 3 years ago asked for input on making 0.7 ppm maximum giving 90 days because they were going to make a decision within 6 months. Still no response.
EPA in their Dose Response Analysis admits about a third of children will ingest too much fluoride even when they ignore infants and the 10% of the population drinking the most water and claiming fluoride is now safer by 33%. This in direct contradiction to the NRC 2006 report that EPA’s MCLG of 4 ppm is not protective.
Steve, you are trusting the American Government to determine “optimal” and the US Government is not doing what you (or I or Congress and the law) expect and require.
With fluoridation, the US Government cannot be trusted.
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Bill, what is dental fluorosis a marker of? Dental fluorosis perhaps?
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Ken,
Thank you for your response that you do not think anyone should be forced to change their dietary habits. I agree. Freedom of choice for food and drugs is a fundamental right.
Now lets talk about fluoride which is not a dietary nutrient.
Fluoride is not a food. No physiological function requires fluoride. The absence of fluoride does not cause any disease.
Mother’s milk does not contain fluoride in most samples.
Fluoride is not exempt from toxic poison laws as a food, only as a drug or pesticide.
The FDA has repeatedly stated that fluoride is a drug.
Toothpaste labels with fluoride say “drug facts” and “do not swallow.”
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Judgment.
When fluoridation started, researchers were confident fluoridated water would not increase dental fluorosis. Other sources of fluoride were started, such as fluoride toothpaste, mouthwashes, fluoride medications, teflon pots and pans, and much more.
No one is seriously monitoring total exposure of fluoride.
Few US studies include serum or urine fluoride concentrations.
And dental fluorosis has increased to 41%. A clear sign that many are ingesting too much fluoride. While those promoting the “optimal” fluoride concentration in water, few are seriously considering the total fluoride intake.
Instead of carefully considering the law or science, public health policy simply promotes tradition.
With so many ingesting excess fluoride and increasing amounts of fluoride being ingested, at what point should total fluoride be reduced? And what should be reduced?
Pesticides? We gain quality produce with fluoride pesticides.
Toothpaste? Topical fluoride is FDA approved to help prevent dental caries.
Medications? Lives are saved with fluoride medications.
Fluoridated water serves no additional intent, is done without consent of the patient, is the contaminated waste product of industry, increases lead blood levels, etc.
To reduce the excess fluoride consumption of the public, the most reasonable exposure to reduce is water fluoridation. All other sources have good reasons to use them.
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Steve,
I agree the fluoride ion is the same regardless of source. However, NaF and hydrofluorosilicic acid readily give F ions whereas the CaF does not dissolve as readily and is far less toxic. Natural fluoride is usually found in calcium rich water, hard water, and is less toxic.
And fluoridated water is not by choice. How do you know your processed foods have or do not have fluoridated water? We don’t know. The “halo” effect is without label.
Many are ingesting too much fluoride. Give people freedom.
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Bill, you seem to take my agreement that no-one should have dietary requirements forced on them to apply to you but not to me. You wish to force on me the requirement of a fluoride-free diet, despite my rejection of your misinformation and assessment fluoride deficiency is bad for my oral health.
The simple fact is that no-one has the right to demand society be organised purely according to their own beliefs and hang ups. For the last year I was in the situation where our city council provided water deficient in F. I opposed this because it was against the declared request of the majority of voters â not because of my particular beliefs. If voters had supported the council I would have accepted this and taken my own steps to overcome the problem. Fortunately public pressure has forced our council to listen to the majority and reverse their mistake.
I think that is the responsible approach and just wish those people whining about fluoridation would be as responsible. If the community wants it then they should have it. Those among the minority who donât want it should take steps to accommodate their own hang ups â not demand others be forced to do something they have clearly said they donât want to.
You have many alternatives for choosing alternative water supplies or filtering your water. If yore community chooses to fluoridate the water then your responsible action is surely clear â stop your whining and misinformation. Take steps to get what you want without denying the benefits to others.
That is what a responsible adult would do.
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Ken,
Your logic makes no sense.
If you want to swallow fluoride, swallow a small pea size of toothpaste which contains 0.25mg of fluoride. Fluoride is easy to find and ingest. And the dosage can be controlled.
Avoiding fluoride is complex because we don’t know which foods have had it added.
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we cant have that Ken, the family business would be out of work ,and out of income, it does not matter what is right or wrong , the bottom line is the money, And Mercola would stop paying
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Bill, my logic makes perfect sense to me. And as the majority of my community has finally got their democratic rights accepted on the matter I am happy – even though all this whining is going on. It can be amusing though.
Your insistence in avoiding F is your hang up. It is not rational but you are welcome to it. Don’t expect me to have to suffer or lose my freedoms because of it. Especially as democracy and science has spoken in the matter.
Community water fluoridation is well established as beneficial and safe. Much more so than swallowing toothpaste. What a stupid suggestion.
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If the input was in a properly controlled situation like Community Fluoridated Water at .7-1PPM ,A person would be very sick from water ingestion before any fluoride damage at that level, is that not a better control situation, than telling the public to use this amount of fluoride toothpaste that can contain fluoride at 1000-1500PPM, And leaving the amount they use up to them, and to cover your arse putting a warning label on the tube.
You make a big thing about the damage caused by high fluoride levels and then promote the source of fluoride that carries the highest dosage
You dont need a warning label on the tap
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Bill
“Steve, you are trusting the American Government to determine “optimal” and the US Government is not doing what you (or I or Congress and the law) expect and require.
With fluoridation, the US Government cannot be trusted.”
Thank you, but I’m fine with trusting the US Centers for Disease Control, the US Environmental Protection Agency, the US Department of Health and Human Services, the United States Public Health Service, the United States Institute of Medicine, and the past 5 US Surgeons General……..as opposed to trusting the “Fluoride Action Network”, Declan Waugh, non peer-reviewed books by a retired chemist/activist and an “investigative reporter”, filtered and edited “information” posted on activist websites and blogs, out-of-context quotes, half-truths, and misinformation.
Once again, the optimal level of fluoride is that level, established by the US Department of Health and Human Services, which provides maximum dental decay prevention with no adverse effects. As I provided previously, Warren and Levy attempted to ascertain whether an even more precise optimal level could be determined which would provide caries-free dentition, with no adverse effect. They concluded that it could not be done. Given the volume of peer- reviewed science clearly demonstrating effectiveness of fluoridation, and the lack of any proven adverse effects of fluoridation since its beginning 69 years ago, the DHHS recommended optimal level has been borne out to be valid. If you have a problem with this recommended level, you are certainly free to contact DHHS with your complaint.
The US Department of Health and Human Services oversees the US water fluoridation initiative.
The US EPA oversees and regulates all additives to drinking water. This includes fluoride. In order to monitor the effectiveness of its guidelines and mandates, in accordance with requirements of the Safe Drinking Water Act, the EPA periodically requests the National Research Council to review all pertinent fluoride literature to determine the adequacy of the EPA primary and secondary MCLs for fluoride, 4.0 ppm and 2.0 ppm respectively, to protect the public against adverse effects. The past two such reviews were in 1993 and 2006.
The “41%” of dental fluorosis to which you refer comes from a 2010 CDC study by Beltran-Aguilar in which researchers found that 41% of adolescents whom they examined, showed signs of dental fluorosis. This 41% was composed of 37.1% mild to very mild dental fluorosis and 3.8% moderate dental fluorosis. Pendry concluded in 2004, that moderate dental fluorosis is resultant of improper ingestion of toothpaste, improper prescription of fluoride supplements, use of fluoridated water to reconstitute powdered infant formula, and/ or exposure to high levels of environmental or well-water fluoride, in relation to children during the tooth developing years. The mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse.
The optimal level of fluoride was originally set by the USPHS service as a range of 0.7 ppm to 1.2 ppm. It was set as a range to allow for differing levels of water consumption in different climates. Recent studies have shown that, due to air-conditioning and other modern amenities, a significant discrepancy in water consumption between climates no longer exists. In recognition of this finding and of the greater availability of fluoride now than when the optimal was originally set, the CDC, in 2011, recommended that the optimal level be reset to simply the lower end of the current range, 0.7 ppm. Although the DHHS has as yet to officially adopt this recommendations, most public water systems are utilizing this recommended optimal of 0.7 ppm. when setting the fluoride level.
Yes the 2006 NRC Committee on Fluoride in Drinking Water deemed the EPA primary MCL “to not be protective”. The other half of this truth is that it only deemed it not protective against severe dental fluorosis, skeletal fluorosis, and bone fracture when water with a fluoride content of 4.0 ppm or greater is chronically ingested. No other concerns were stated in regard to fluoride at or below 4.0 ppm. The Committee made no recommendation to lower the secondary MCL of 2.0 ppm. As water is fluoridated at 0.7 ppm, one third the level the 2006 NRC Committee made no recommendation to lower, the final recommendation of this Committee has no bearing on water fluoridation.
Steven D. Slott, DDS
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Bill
“I agree the fluoride ion is the same regardless of source. However, NaF and hydrofluorosilicic acid readily give F ions whereas the CaF does not dissolve as readily and is far less toxic. Natural fluoride is usually found in calcium rich water, hard water, and is less toxic.”
One fluoride ion is no more toxic than another, regardless the source compound. If there was an uncontrolled amount of HFA being added to water supplies your solubility argument might have some merit. However, there is not. HFA is carefully diluted to a 23 % aqueous solution which is then added to drinking water only in the amount which will raise the existing fluoride level up to the optimal. It, thus makes no difference as to differences in solubility rates between HFA and CaF. We are only concerned with the fluoride ions which they actually release into the water.
Steven D. Slott, DDS
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Ken,
I understand you to suggest that it is OK to dispense fluoride to each other if the majority of the voters vote in favor. In other words, those with the most money to advertise convincing the most people win. Most European nations have rejected fluoridation because it does not give freedom of choice.
The suggestion that fluoridation is safe and effective is held by several english speaking countries, but not most developed countries. Unfortunately science does not support either effective or safe.
If fluoridation were effective we would see lower rates of dental caries in fluoridated countries, states, counties, and cities. Not true. Same caries rates where socioeconomics is similar. Dental expenses would be lower and fewer dentists would be found and when fluoridation stopped, dental caries would increase. None of those indications have been found.
Please provide at least one prospective randomized controlled trial of fluoridation’s effectiveness. Or do you rely on junk science?
Please provide at least one prospective randomized on fluoridation’s safety.
The claim of efficacy and safety are based on tradition and myth in English speaking countries.
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Steve,
Look up the toxicity of ingesting hydrofluorosilicic and sodium fluorides. My memory is about 5 mg/kg/day BW. And compare that with CaF, again my memory is over 600 mg/kg/day BW. My understanding is the difference is due to the free ions. One of the reasons CaF is not used to fluoridate water is because it clogs the equipment, does not dissolve well.
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Steve,
You wrote, “Thank you, but I’m fine with trusting the US Centers for Disease Control, the US Environmental Protection Agency, the US Department of Health and Human Services, the United States Public Health Service, the United States Institute of Medicine, and the past 5 US Surgeons General……..”
So did I for 25 years of dental practice and then I looked at the law and science. None of those government agencies determine the safety or efficacy of any chemicals, drugs, or substances. You could have listed the department of highways, school boards, or a long list of other government agencies. They do not have jurisdiction over substances used with the intent to prevent disease. Even the EPA does not approve substances added to public water. Sorry. You are trusting agencies with no jurisdiction.
The government agency set up by Congress to determine the safety and efficacy of substances used with the intent to prevent disease is the Food and Drug Administration Center for Drug Evaluation and Research by the Food, Drug and Cosmetic Act.
The FDA has testified in Congress and in FOIA documents that fluoride when used with the intent to prevent disease is a drug. The FDA CDER has approved fluoride as a drug to be used in toothpaste with the appropriate label. The FDA CDER has publicly stated they are deferring regulatory action on fluoridated water. The FDA regulates drugs by having the manufacturer go to the FDA for approval. Applications for fluoride supplements have repeatedly been rejected because of lack of scientific evidence of efficacy.
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The FDA CDER says unapproved drugs are illegal. The marketing of any product at any concentration, even a placebo, must be FDA CDER approved or it is missbranded and illegal.
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Bill,
“Look up the toxicity of ingesting hydrofluorosilicic and sodium fluorides. My memory is about 5 mg/kg/day BW. And compare that with CaF, again my memory is over 600 mg/kg/day BW.”
HFA is not ingested in fluoridated water. It immediately and completely hydrolyzes, once added to drinking water, into fluoride ions and trace contaminants. HFA no longer exists in that water after this point. It does not reach the tap. It is not ingested. That to which is commonly referred as “Naturally occurring fluoride” is simply those fluoride ions released into water by CaF. It makes no difference how quickly they are released, it is simply a measure of those which are released. The fluoride ions released by HFA are identical to those released by CaF. Only that amount of HFA is added to water which, when taking into account the existing fluoride ions from CaF, will raise the level of fluoride ions in that water, to the optimal level.
Steven D. Slott, DDS
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Bill,
“So did I for 25 years of dental practice and then I looked at the law and science. None of those government agencies determine the safety…..”
The EPA has full jurisdiction and regulatory authority over all additives to drinking water. This includes optimal level fluoride. You are certainly free to argue your personal interpretation of the law in court, but I don’t much like your chances.
Your “interpretations”, are precisely why I trust the US regulatory system over the “information” provided by “FAN” and other such antifluoridationists groups.
Steven D. Slott, DDS
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Bill,
‘The FDA CDER says unapproved drugs are illegal. The marketing of any product at any concentration, even a placebo, must be FDA CDER approved or it is missbranded and illegal.”
No matter how many times you express your personal opinion, no matter how desperately you seek to impose your own “interpretation” of the law unto society, the facts will remain the same. Fluoride added to water at the optimal level is not a “drug”. It is simply a mineral identical to that which has existed in water since the beginning of time. As the EPA has full jurisdiction and regulatory authority over all such water additives, there is no requirement, nor any need, for FDA approval.
Steven D. Slott, DDS
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You accuse me of a political agenda and then you reference politics (EPA, CDC et al) instead of science. Did it ever dawn on you that you are relying on politics instead of science?
You have (and so did I) serious misunderstandings of jurisdiction. EPA under the Clean Water Act, has jurisdiction over naturally occurring contaminants, not substances added to water. If water has too much, for example, arsenic or fluoride, then EPA has MCL and MCLG maximums.
However, the scientists of the EPA did speak out through their Union. These are the scientists who evaluate the toxicological effects of the contaminants. They said,
“”In summary, we hold that fluoridation is an unreasonable risk. That is, the toxicity of fluoride is so great and the purported benefits associated with it are so small – if there are any at all – that requiring every man, woman and child in America to ingest it borders on criminal behavior on the part of governments.”
Dr. J. William Hirzy, Senior Vice-President, Headquarters Union,
US Environmental Protection Agency, March 26, 2001″
A very strong statement from the scientists you are relying on. They are not saying fluoridation is safe or effective.
Please provide law or statements from the EPA which give you the evidence to rely on the EPA that the addition of fluoride to public water is safe and effective.
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The FDA CDER rejected 35 applications for fluoride/vitamin combinations,
“There is NO substantial evidence of drug effectiveness as prescribed, recommended, or suggested in labeling.”
Drug Therapy June 1975
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“The recommended optimal fluoride intake for children to maximize caries prevention and minimize the occurrence of dental fluorosis is often stated as being 0.05-0.07 mg/kg/day (Levy 1994; Heller et al. 1999, 2000).
On page 68 of the 2006 NRC report on fluoride, it states, “Burt (1992) attempted to track down the origin of the estimate of 0.05-0.07 mg/kg/day as an optimum intake of fluoride but was unable to find it.” NRC 2006 p 68.
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The amount of fluoride dispensed in water is not controlled and concentration is not dosage.
“Some subpopulations consume much greater quantities of water than the 2 L per day that EPA assumes for adults, including outdoor workers, athletes, and people with certain medical conditions, such as diabetes insipidus.” NRC 2006 P 23
The 90th percentile consume 2 L/day and the 99th percentile 5L/day and there are reports of 13 L/day. Also remember, some don’t drink water. The amount of fluoride ingested from water fluoridation varies from 0 to over 10 mg/day.
Of most concern is when we consider dosage, mg/kgBW/day. A 5 Kg infant with 1L of formula made from fluoridated water will consume 1 mg of fluoride or about 0.2mg/Kg/day of fluoride, much more than mother’s milk at 0.004 mg/Kg/day or 0.05mg/Kg/day the theoretical political “optimal”.
The highest risk of excess fluoride exposure are the fetus, infant, and young children.
The question is not whether fluoride causes brain damage, the question is at what age and what dosage. The MCLG must be zero to protect subpopulations.
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“For ages 1.5-9 months, approximately 40% of the infants exceeded a mass-normalized intake level for fluoride of 0.07 mg/kg/day;
for ages 12-36 months, about 10-17% exceeded that level (Levy et al. 2001b).” NRC 2006.
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Steve,
Remember, fluoridation is targeting 100% of the population. Those with or without teeth, everyone.
“. . . fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children…”
CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of
Drinking Water to Prevent Dental Caries. MMWR, 48(41); 933-940, October 22.
Toothpaste at about 1,000 to 1,500 ppm is FDA CDER approved, apparently showing some benefit if not swallowed.
Fluoride varnish in some studies shows some benefit at 22,500 ppm
Contact time for water and concentration at 1 ppm means the topical effect from drinking artificially fluoridated water shows no topical benefit.
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Most people looking at the EPA’s lack of jurisdiction will try to hide under the umbrella of the CDC. Doesn’t work.
CDC: “Ingestion of fluoride is not likely to reduce tooth decay.” CDC (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. MMWR, 48(41); 933-940, October 22
CDC: “It is not CDC’s task to determine what levels of fluoride in water are safe.” http://www.cdc.gov/fluoridation/safety.htm 5/26/2012
MANY HAVE EXCESS FLUORIED IN SERUM
CDC: “Normal serum fluoride levels are <20 mcg/L (0.02 ppm) but varies substantially. . . .”http://www.bt.cdc.gov/agent/sulfurylfluoride/casedef.asp
Taves (‘66) normal <0.013 ppm
Sowers controls 0.05 ppm (4th quartile)
Sandhu controls 0.042 ppm and tumors at 0.072 ppm (Xiang 0.064 ppm)
Zang controls 0.04 ppm and 8 IQ loss 0.08 ppm
Rathe controls 0.025 ppm and stones at 0.12 ppm
Hossney (2003) Mother’s Milk most samples – none detected
What is your fluoride serum concentration? What is the mean fluoride serum concentration in your community, city, country?
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Steve,
You persist in suggesting fluoride is not a drug. Both Federal and State laws define drugs the same way:
Drugs are defined as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” [FD&C Act, sec. 201(g)(1)].
Do you suggest fluoride is added to water for some other purpose than with the intent to prevent dental caries?
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Washington Board of Pharmacy: “Fluoride is a legend drug regulated under chapter 69.41 RCW.
Idaho Board of Pharmacy confirmed fluoride is a drug.
FOIA sent to me from the FDA
FDA “A search of the Drugs@FDA database . . . of approved drug products and the Electronic Orange Book. . . does not indicate that sodium fluoride, silicofluoride, or hydrofluorosilicic acid has been approved under a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA) for ingestion for the prevention or mitigation of dental decay. . . . At the present time, the FDA is deferring any regulatory action on sodium fluoride products. . .”[1] Email from the FDA (7-22-09)
Please provide your evidence fluoride when ingested with the intent to prevent disease is not a drug.
For heavens sake, read the fluoridated toothpaste label. “DRUG FACTS.”
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SODIUM FLUORIDE IS A HIGHLY TOXIC POISON
ORS 453.005 (8) “Highly toxic” means any substance that falls within any of the following categories:
(a) Produces death within 14 days in one-half or more of a group of 10 or more laboratory white rats each weighing between 200 and 300 grams, at a single dose of 50 milligrams or less per kilogram of body weight, when orally administered;”
About 5 mg/Kg of body weight of NaF is considered lethal for an adult.
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Bill,
“You accuse me of a political agenda and then you reference politics (EPA, CDC et al) instead of science. Did it ever dawn on you that you are relying on politics instead of science?”
No, I have not accused you of any “political agenda”. I guess that’s just one more figment of your very active imagination. Your distrust of government and respected government regulatory agencies such as the CDC and the EPA is unfortunate for you, but of no concern to me and irrelevant to water fluoridation.
The EPA has jurisdiction over additives to public drinking water supplies. This includes fluoride at the optimal level. That is a simple fact. Whether you choose to believe it or not is of no concern to me. Take your arguments to court and see how far you get.
The EPA union to which you refer was simply a small union of 1200 or so EPA employees led by the current paid lobbyist for the New York antifluoridationist faction, “FAN”, William Hirzy. Nearly a decade and a half ago, a small group of executive committee members of this union voted to support the antifluoridationist activities of leader Hirzy, as he had requested of them. This action did not represent the EPA in any manner, it was simply that of this small union. Shortly after this action, this union went defunk and was usurped by the much larger EPA Union.
In regard to Hirzy, in 2013, he petitioned the EPA to recommend cessation of use of HFA to fluoridate water systems due to what he claimed were abnormally high costs of cancer cases related to HFA use. Hirzy based his petition on data from a recent study that he and fellow antifluoridationist Robert Carton had completed. When EPA officials reviewed Hirzy’s petition, they discovered that Hirzy had made a basic miscalculation in his data which resulted in a 70-fold error in his conclusions. When the reviewers corrected this error, they found that Hirzy’s and Carton’s data actually demonstrated the opposite of what Hirzy had concluded. Needless to say, Hirzy’s petition was rejected. When notified of this error and rejection, Hirzy stated that he was “embarrassed”, as well he should have been.
So, given the choice between placing my trust in a now defunk small employee union which voted to support the dubious activities of its biased, incompetent leader who is now a paid lobbyist for an antifluoridationist faction…….and placing my trust in the US CDC, the US EPA, the US Institute of Medicine, the past 5 US Surgeons General, the ADA, the WHO, the American Academy of Pediatrics……….I’ll take the latter option.
Steven D. Slott, DDS
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Bill
“Predominantly” does not equate to “completely”. The actions of of fluoride are both systemic and topical. The mild to very mild dental fluorosis which antifluoridationists constantly attempt to pump into being a major disorder, is clear evidence of the systemic benefit of fluoride. Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth. Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, a definite benefit. Mild dental fluorosis can only occur systemically.
Additionally, the systemic incorporation of fluoride into saliva results in the the consistent bathing of the dentition in a low concentration of fluoride throughout the day, an effective means of decay prevention.
“Fluoride works to control early dental caries in several ways. Fluoride concentrated in plaque and saliva inhibits the demineralization of sound enamel and enhances the remineralization (i.e., recovery) of demineralized enamel (12,13). As cariogenic bacteria metabolize carbohydrates and produce acid, fluoride is released from dental plaque in response to lowered pH at the tooth-plaque interface (14). The released fluoride and the fluoride present in saliva are then taken up, along with calcium and phosphate, by de-mineralized enamel to establish an improved enamel crystal structure. This improved structure is more acid resistant and contains more fluoride and less carbonate (12,15–19) (Figure 1). Fluoride is more readily taken up by demineralized enamel than by sound enamel (20). Cycles of demineralization and remineralization continue throughout the lifetime of the tooth.”
——http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm
I will gladly cite as many peer-reviewed studies clearly demonstrating the effectiveness of fluoridation, as you would reasonably care to see.
Steven D. Slott, DDS
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Bill,
“You persist in suggesting fluoride is not a drug. Both Federal and State laws define drugs the same way:”
I am not “suggesting” anything. I am stating a fact. Fluoride at the optimal level is simply a mineral identical to that which has existed in water since the beginning of time. Fluoride is in the water already. Fluoridation is nothing but the increasing of these ions up to the optimal level where they will provide the maximum of what has been noted to be a benefit of this mineral, dental decay reduction. For those systems whose existing fluoride content is found to be already at or above the optimal level, fluoridation is not necessary and is not done.
You are free to take your “forced medication” argument to court, however, given that the US courts have rejected this nonsense each and every time antifluoridationists have wasted court time and resources with it, I don’t much like your chances.
Steven D. Slott, DDS
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Bill,
“SODIUM FLUORIDE IS A HIGHLY TOXIC POISON”
WATER IS A HIGHLY TOXIC POISON
“Liquid H2O is the sine qua non of life. Making up about 66 percent of the human body, water runs through the blood, inhabits the cells, and lurks in the spaces between. At every moment water escapes the body through sweat, urination, defecation or exhaled breath, among other routes. Replacing these lost stores is essential but rehydration can be overdone. There is such a thing as a fatal water overdose”.
—–Strange but True: Drinking Too Much Water Can Kill
http://www.scientificamerican.com/article/strange-but-true-drinking-too-much-water-can-kill/
If you eliminate every substance that is toxic with no consideration of concentration use level, you can ingest absolutely nothing and will be dead within a week.
If you care to present valid evidence of toxicity to humans of water fluoridated at the optimal level, then do so.
Steven D. Slott, DDS
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Bill,
I catch up with Ken’s blog over breakfast most days, so I’ve just read your Gish Gallop and gradual shifting of the goalposts in a single go.
I’m aware of the literature over community water fluoridation, and most of the stuff you’ve cherry picked does not say what you appear to think it says. It’s annoying errors and behaviours like this from the anti-fluoridationists that are turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.
I suggest that you read what you have written in this blog and then consider it. There are many places where you have directly contradicted yourself because you haven’t reviewed what you have previously said, or at least if you have reviewed it you haven’t cared that you contradict yourself. A single example will suffice (paraphrasing):
You want evidence from Steve that CWF works; you say it doesn’t in spite of all of the evidence it does (“If fluoridation were effective we would see lower rates of dental caries in fluoridated countries, states, counties, and cities. Not true.”) You then define fluoride as a drug (using a non-standard definition) because it’s being used to prevent disease in the form of dental caries. Well, if fluoride doesn’t work, then it does not meet your definition of a drug. Does fluoride work to prevent/reduce caries, or not? You can’t have it both ways.
I’d like to point out that another halogen, chlorine, is also added to community water supplies to prevent disease (eg gastroenteritis). Chlorine has all the same dose related health problems that fluorine has, and the salt used in community water supplies also tends to be prepared as an industrial poison. When are you going to start campaigning against water chlorination? If not, why not? Again, you can’t have it both ways.
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*Non-standard definition of a drug as a practicing physician in NZ.
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I would like to second Stuart’s comment about behaviour like Bill’s being responsible for”turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.”
My experience is similar. I accepted the simple science of the beneficial role of F in apatites in a “ho hum” way while at the same time sort of accepting some of the environmental claims of the anti-fluoride people. However, just over 10 years ago I analysed a sample of fluorosilicic acid we we using for researching its use for removing heavy metals from biosolids wastes and was shocked to discover that contamination in the fluorosilicic acid was extremely low. This made me realise I should not trust the claims io political activists and since then I have checked many if their other claims out and found them to be false.
So I find the sort of misinformation and distortions presented in rants like those of Bill rather silly. He should realise such misinformation is counterproductive if and when readers actually are exposed to more factual material. It turns them against the political activists.
Of course, many readers really just don’t bother looking at these rants anyway. For them such behaviour is counterproductive from the start.
>
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Well put, Stuart.
(prediction: Bill will now perform one of his regular disappearing acts)
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Richard,
I do have other things to do than try to explain the most fundamentals of drug laws and science to blind believers. Sort of like trying to change the mind of ISIS believers.
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Ken,
Instead of providing good evidence, you attack the messenger.
Contaminants in HFS? I did not bring up the issue. You are changing the subject because you have no laws or science to counter the lack of efficacy or safety of fluoridation. Your support is little more than religious belief.
Why not read the assay of the manufacturer? Yes, very small amounts of contaminants, but there is some in many samples. And most samples are not tested as NSF claims. How much lead and arsenic do you want added to your body?
You suggest I’m ranting by posting laws? Talk to those who made the laws.
More important, provide your laws you rely on to support fluoridation.
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Stuartg,
Slow down and read what I posted again. No contradictions. A drug is defined by intent of use or listed in the US Pharmacopeia.
INTENT OF USE.
Read that again. If the intent is to prevent or treat disease, then it is a drug. Makes no difference if it works, simply intent of use.
So lets look at a “Guidance Document” from the FDA.
“The legal difference between a cosmetic and a drug is determined by a product’s intended use. . .
The FD&C Act defines drugs, in part, by their intended use, as ‘articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease’ and ‘articles (other than food) intended to affect the structure or any function of the body of man or other animals’ [FD&C Act, sec. 201(g)(1)]. . . .
“Intended use may be established in a number of ways. Among them are:
Claims stated on the product labeling, in advertising, on the Internet, or in other promotional materials. . . .”
“The legal difference between a cosmetic and a drug is determined by a product’s intended use. . .
The FD&C Act defines drugs, in part, by their intended use, as ‘articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease’ and ‘articles (other than food) intended to affect the structure or any function of the body of man or other animals’ [FD&C Act, sec. 201(g)(1)]. . . .
“Consumer perception, which may be established through the product’s reputation. This means asking why the consumer is buying it and what the consumer expects it to do.”
“Ingredients that may cause a product to be considered a drug because they have a well known (to the public and industry) therapeutic use. An example is fluoride in toothpaste.” FDA GUIDANCE DOCUMENT
“INTENT OF USE” IS KEY.
Not dilution or even placebo exempts the substance.
The FDA CDER (not the voters, you, me, CDC, EPA, ADA, et al) have the experts and policy to weigh the benefits and risks of a substance, determine a label, dosage, cautions, and supervision.
Drugs are defined as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” [FD&C Act, sec. 201(g)(1)].
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Bill, there is plenty of evidence in my article here – and you attacked me for it instead of engaging. Attacking the messenger is what you guys do all the time.
You are just Gish Galloping – in an extreme way. Flitting from one attack to another, one extreme claim to another.
Even my personal reflection of discovering the misinformation about fluorislicic acid seems to have gone above your head. It was a warning to you of how counterproductive such propaganda and distortions are – not an invitation for you to present more misinformation.
You are ranting.
If instead, you had dealt with the details of the above post instead of attacking me for showing how young Michael was literature dredging then we could have had a reasonable discussion. But I really don’t think you know how.
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Steven,
You are correct, water can be lethal. We have the choice to drink too much. We do not have the individual choice to drink fluoridated water unless it is labeled and an alternative source is available.
Laws define fluoride as a poison and highly toxic, similar to arsenic.
The FDA CDER has the experts to determine whether fluoride at 1 ppm or 0.004 ppm is safe. No doubt they would provide some cautions not to drink too much if they approved artificial fluoridation of water.
Mother’s milk contains no detectible fluoride in most samples.
Fluoridated water is 175 to 250 times more concentrated than the mean fluoride concentration of those samples which had some detectible fluoride.
There is no margin of safety for infants.
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Steven, “Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth”
I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis. If I took my key and scratched your car, would you call that “no damage.” Cosmetic damage is damage. 41% now have dental fluorosis. Up from 10%. In your opinion, what percentage of the population should have dental fluorosis? Should it increase to 100%?
And only the most blinded faithful fluoridationsits would claim a biomarker of excess fluoride exposure only affects teeth and has no affect on any other structures.
What is the optimal fluoride concentration of tooth structure? NO ONE has responded to that question.
Lab research finds teeth with more fluoride to be harder, more brittle and fracture more. Preliminary research in humans finds this might be true. What research evaluates increased fracture rate with more fluoride exposure? Harder teeth, more brittle, more complete cusp fractures.
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“An NDA (New Drug Application) is the vehicle through which drug sponsors formally propose that FDA approve a new pharmaceutical for sale and marketing in the U.S. FDA only approves an NDA after determining, for example, that the data are adequate to show the drug’s safety and effectiveness for its proposed use and that its benefits outweigh the risks. . . .”
“A note on “new drugs”: Despite the word “new,” a “new drug” may have been in use for many years. If a product is intended for use as a drug, no matter how ancient or “traditional” its use. . .”
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Bill, please stop this Gish Galloping.
If you have an issue stick with it, provide the citations and stop darting off to other things.
As I have tried to warn you, such Gish galloping is counterproductive for your side. It reinforces the view that you avoid proper discussion. It turns readers off and just clutters up the comments with irrational raving.
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Bill
“You are correct, water can be lethal. We have the choice to drink too much. We do not have the individual choice to drink fluoridated water unless it is labeled and an alternative source is available”
Note, your statement that ‘we do not have the choice unless……’.
“Forced” means that there is no choice. “Unless” means there is a choice.
Yes, fluoride at improper levels is toxic…..as is every other substance known to man. Your point?
“No doubt they would provide some cautions..”, another example of antifluoridationist “evidence”. What you deem to not be doubtful is meaningless.
“Mother’s milk” is deficient in iron and vitamin D. Have you and Connett yet asked the Almighty if He meant for infants to be anemic and develop Ricketts?
Steven D. Slott, DDS
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Bill,
“I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis.”
To “treat” what level of dental fluorosis? If you and other dentists are doing “many thousands of dollars of cosmetics” to “treat” mild to very mild dental fluorosis, someone needs to report this to your state dental board immediately.
If you took a key and scratched my car down to the metal, this would be permanent damage requiring expensive repair, analogous to severe dental fluorosis. If you took a key and scratched my car to a noticeable level, but not down to the metal, this would be damage requiring cosmetic repair, but not nearly as expensive as the first scratch. This would be analogous to moderate dental fluorosis. If you took your key, covered it in felt, and “scratched” my car to no degree that was even noticeable outside of close examination under a magnifying glass and strong light, this would be analogous to mild to very mild dental fluorosis. If this last key “scratch” rendered my car more resistant to dents and corrosive rust…..then you could scratch my car in such a manner with my full blessing.
What you personally deem that a “biomarker of excess fluoride exposure” affects, is meaningless in the absence of valid evidence.
I have repeatedly responded to your questions regarding the optimal level of fluoride at which maximum dental decay protection occurs with no adverse effects, which is the purpose of water fluoridation. If you have an overwhelming desire to know the “optimal fluoride concentration of tooth structure” then do the research to find out.
Properly cite whatever “lab research” and “preliminary research in humans” to which you refer, if you desire any credence for whatever claim you are attempting to make.
Steven D. Slott, DDS
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Bill,
The New Zealand legal definition of a drug is different to that in the USA. OK, it may be splitting hairs, but this is a New Zealand blog and fluoride does not meet the definition of a drug in New Zealand. That’s why I supplemented my earlier comment.
My understanding is that many court cases both in the USA and other countries have established that fluoride as used for CWF is not a drug.
The chemical used for CWF is not listed in the US pharmacopeia as a drug. It’s not listed in the British National Formulary, by New Zealand’s PHARMAC, or the Australian Pharmaceutical Formulary and Handbook. I don’t have any formularies from other countries to hand.
That’s why I referred to your personal definition of a drug, and noted that chlorine as used in water chlorination also meets your definition.
Are you now going to object to community water chlorination as well as to community water fluoridation?
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Bill,
“I have numerous pictures of patients where dentists (more than just me) have done many thousands of dollars of cosmetics to treat dental fluorosis.”
If you are allowed to use anecdotes…
I’m not a dentist, but I have to examine the mouths of many people. In more than two decades of practice in a fluoridated area, I can’t recall a single case of fluorosis.
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Obviously, the problems with the literature dredging by Little Connett, and the other tactics used by antifluoridationists, emanate, in large part, from Connett. In the interactions I’ve had with him, and certainly as Ken exposed in his online debate with him, Connett has seemed surprisingly uninformed, given his educational level. The use of out-of-context information, flawed studies, misrepresented study conclusions, half-truths, misunderstanding of the science, etc. etc. seem to be, to him, valid evidence. His belief in these tactics and his seeming ignorance on basic facts of fluoridation travel down through the ranks of FAN, and are disseminated via his “fluoridealert”. When you have someone such as this at the top, seemingly well educated, who garners fierce loyalty amongst his followers, it creates problems in properly educating citizens and community leaders.
Those such as Bill are insiduous. While Connett seems to truly believe in his tactics, not understanding any better, those such as Bill, do know better. One has only to look at his comments in this section to see examples of most of the standard tactics used by antifluoridationists. The half-truths, out-of-context information, references to properties of high level fluoride, gish-gallop, and posting of misinformation…… are all here. When there are such individuals who do understand the fallacy of these tactics, who do understand the deceptive nature of them, but intentionally continue to use them anyway, the problem is exacerbated. It is difficult to battle with truth and accuracy, against those who have no regard for such and who do not, in any manner, limit themselves to operating within these tenets.
I certainly don’t know the answer to these people, other than to keep doing as is Ken….educate, educate, educate. That has worked well in the US, where fluoridation has increased, and also seems to be making a difference in NZ through the efforts of Ken and the rest of the marvelous folks who have been working so hard and so effectively to combat the Connett puppet FANNZ and its zealous leaders.
Steven D. Slott, DDS
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Stuartg,
No Federal Court has rejected artificial fluoridation as a drug in any country that I know.
You suggest chlorine fits in the definition of a drug, but that is not true. The intent of chlorine and the other chemicals added to water have the intent to treat water, to make water safer to drink. Artificial fluoridation has no intent to make water safer to drink, but rather the intent is the prevention of dental caries. (Mitigation is a more accurate term.)
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Stuartg,
You don’t remember seeing dental fluorosis and neither did I because I was not looking for dental fluorosis. If you know what you are looking for and look for it. I diagnose it in about half of children on artificial fluoridation and about a third of children on fluoride free water.
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Steve,
You again spend a long post on attacking those who don’t hold your belief system.
Answer my simple questions above. Stick to the subject rather than attacking those who don’t have your same religious radical belief.
Mother’s milk.
Total exposure.
Optimal tooth fluoride concentration.
Dental expenses.
Biomarkers of excess fluoride exposure.
etc.
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Bill,
“You don’t remember seeing dental fluorosis and neither did I because I was not looking for dental fluorosis.”
Growing up, and practicing for 32 years, in a fluoridated community surrounded by fluoridated communities, I have most certainly known what I was looking for, and have indeed looked for it. Once again, in my entire 32 year career, I have as yet to see one single case of dental fluorosis in any manner attributable to water fluoridation, that would even be detectable outside of my dental chair.
Of the cases of mild dental fluorosis I have seen which could be attributable to fluoridated water, there are none that required any treatment, most certainly not “many thousands of dollars worth” as you have stated that you have done.
Steven D. Slott, DDS
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Bill,
“Answer my simple questions above. Stick to the subject rather than attacking those who don’t have your same religious radical belief.”
Truly ironic that you attempt to admonish anyone to “stick to the subject” as you flit around from one topic to the next when your comments are refuted. Too, I always wonder about those who constantly make statements about “religious beliefs”, “payments”, “corruption” , etc. when there has been nothing stated by anyone else to support such statements. My best guess is that it is nothing but attempts to project their own mindset onto others. As you seem so hung up on “religious beliefs”, my suggestion would be for you to examine your own, and allow the rest of us to keep the discussion on a scientific basis.
As for your “questions” which I have repeatedly addressed….yet once again:
1. “Mother’s milk”. Irrelevant. You have as yet to address my point about the deficiency of iron and Vitamin D in “mother’s milk” since you and Connett deem this content to be of paramount importance.
2. “Total exposure”. Addressed in full in my comment about total fluoride intake from all sources, in relation to IOM established daily upper limits. Go back and read it again, if you so desire.
3. “Dental Expenses”. There are none in regard to fluoridated water. The only financial considerations for patients are the cost savings they incur as a result of fluoridation.
4. “Biomarkers of excess fluoride exposure”. Once again, that of which you personally deem such biomarkers to be indicative, is meaningless in the absence of valid, peer-reviewed scientific evidence to support your opinions.
Steven D. Slott, DDS
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Bill
The point was that you are using anecdotes.
Anecdotes are not science.
First you produce an error filled Gish gallop, then when you are told that this is inappropriate for a science blog, you start using anecdotes instead.
You’ve convinced me that you have opinions without supporting science – was that your intention?
P.S. Chlorine makes water safer to drink by preventing many diseases, such as cholera and other forms of gastroenteritis. As I said, it meets the same definition of “drug” that you use for fluoride, a definition that only seems to be used by anti-fluoridationists. If you are against one as a drug, then why not the other? It seems that your definition of “drug” changes depending on the substance that you are talking about.
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My only comment is: MY DENTIST IS NOT MY DOCTOR – WHY SHOULD I BE FORCED TO INGEST SOMETHING WHICH IS MAKING ME ILL. All that is doing is creating more work for the dentist and certainly more work for medicos.
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it had to happen, we get the activist coming on with caps on and all guns blazing with no real facts to enhance the discussion, standard procedure
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And you have lived in a non fluoridated area and fluoridated to get a comparision,, I dont remember you going to the international space station that is the only place where you can be sure of not getting any fluoride, maybe
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Sandra,
“MY DENTIST IS NOT MY DOCTOR ”
Uh…..okay, no argument from me. Relevance to water fluoridation?
“WHY SHOULD I BE FORCED TO INGEST SOMETHING WHICH IS MAKING ME ILL.”
You shouldn’t. Relevance to water fluoridation?
“All that is doing is creating more work for the dentist and certainly more work for medicos”
Ahh, finally something of relevance to water fluoridation. Yes, you are 100% correct. Elimination of fluoridation would create an avalanche of more work for dentists and medicos.
Steven D. Slott, DDS
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Sorry, Chris. I didn’t quite understand your last comment. Would you PLEASE use your caps so that we may all UNDERSTAND YOUR POINT?
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I fully agree with your comment Stuart that anecdotes are not scientific studies. Good. So why don’t you stop using them.
Please provide one prospective randomized controlled trial on the efficacy or safety of fluoridation.
Thank you.
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Stuart,
Jurisdiction over a chemical in the USA is dependent on the intent of use. If the intent is pesticide, then it is not a drug. If it is to sanitize, treat water to make it safe, then NSF. If the intent is t treat people or animals, then FDA.
That is the law in the USA.
You can squirm around that issue by saying NZ is not the USA. True. But NZ fluoridates because of bogus opinions in the USA. If NZ were in tune with Europe, NZ would not fluoridate. NZ is simply following in the foot steps of flawed USA policy. Start thinking for yourselves. Look at the research for yourselves and quit being so blood subserviant to flawed USA policy.
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Bill, we have been through this all before and you just demonstrate political propagandising rather than genuine discussion. Or will you Please provide one prospective randomized controlled trial on the fluoridation showing fluoride in unsafe and not effective..
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Steve,
Thank you for responding to my questions. Hard to show which are your words and mine so I will add names.
1. Bill: “Mother’s milk”.
Steve: Irrelevant. You have as yet to address my point about the deficiency of iron and Vitamin D in “mother’s milk” since you and Connett deem this content to be of paramount importance.
Bill: The American Academy of Pediatrics says mother’s milk is the normative value against which all other infant nutritions must be compared. Our species is alive because of mother’s milk. Please provide your research evidence that infants on mother’s milk are deficient in iron and Vit D. I’m not a pediatrician but as a nutritionist I can assure you that sunshine is important for humans regardless of age. Perhaps an infant not exposed to sun would become deficient in D. Give them sunshine and it will help more than just the D.
Iron: Here is a recent publication on iron, abstract below:
Am J Hum Biol. 2014 Jan-Feb;26(1):10-7. doi: 10.1002/ajhb.22476. Epub 2013 Oct 21.
Too much of a good thing: evolutionary perspectives on infant formula fortification in the United States and its effects on infant health.
Quinn EA.
Author information
“Abstract
Recently, there has been considerable debate regarding the appropriate amount of iron fortification for commercial infant formula. Globally, there is considerable variation in formula iron content, from 4 to 12 mg iron/L. However, how much fortification is necessary is unclear. Human milk is low in iron (0.2-0.5 mg/L), with the majority of infant iron stores accumulated during gestation. Over the first few months of life, these stores are depleted in breastfeeding infants. This decline has been previously largely perceived as pathological; it may be instead an adaptive mechanism to minimize iron availability to pathogens coinciding with complementary feeding. Many of the pathogens involved in infantile illnesses require iron for growth and replication. By reducing infant iron stores at the onset of complementary feeding, infant physiology may limit its availability to these pathogens, decreasing frequency and severity of infection. This adaptive strategy for iron regulation during development is undermined by the excess dietary iron commonly found in infant formula, both the iron that can be incorporated into the body and the excess iron that will be excreted in feces. Some of this excess iron may promote the growth of pathogenic, iron requiring bacteria disrupting synergistic microflora commonly found in breastfed infants. Evolutionarily, mothers who produced milk with less iron and infants who had decreased iron stores at the time of weaning may have been more likely to survive the transition to solid foods by having limited iron available for pathogens. Contemporary fortification practices may undermine these adaptive mechanisms and increase infant illness risk.”
2. “Total exposure”.
Steve: Addressed in full in my comment about total fluoride intake from all sources, in relation to IOM established daily upper limits. Go back and read it again, if you so desire.
Bill: IOM has almost no data provided on the basis for their daily upper limits, what they have is historical, they did not evaluate the risks, nor do they have jurisdiction over fluoride ingestion. The NRC 2006 report has much more detail and basis showing excess exposure. May I encourage you to read the report, especially on total exposure. ATSDR recommending less than 0.02 mg/L in serum is also more precise.
Remember, even with the IOM estimates (and all others), many are exceeding their daily upper limits.
3. “Dental Expenses”.
Steve: There are none in regard to fluoridated water. The only financial considerations for patients are the cost savings they incur as a result of fluoridation.
Bill: Please provide research you rely on for cost savings. Provide measured published data on the public at large, not just a clinic here compared to a clinic there. We have computers keeping track of dental expenses and we have tremendous detail from dental insurance companies. What is the average cost of dental treatment each year for a person in a fluoridated compared to non-fluoridated community in NZ or the USA. Measured data. Not estimates of assumptions.
4. “Biomarkers of excess fluoride exposure”.
Steve: Once again, that of which you personally deem such biomarkers to be indicative, is meaningless in the absence of valid, peer-reviewed scientific evidence to support your opinions.
Bill: There are two primary biomarkers of excess fluoride exposure. Skeletal fluorosis and dental fluorosis. Do a pub med search for the research. Hundreds of articles.
When fluoridation first started, researchers expected no more than 10% of the population would get dental fluorosis. Now we have 41% with dental fluorosis. Constantly increasing percentage of the population with dental fluorosis, a sign total fluoride exposure is increasing.
Would you like 100% of the population to have dental fluorosis?
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Bill
As you said, “Jurisdiction over a chemical in the USA is dependent on the intent of use. If the intent is pesticide, then it is not a drug. If it is to sanitize, treat water to make it safe, then NSF. If the intent is t treat people or animals, then FDA.”
You persist in defining the chemical used to fluoridate water supplies as a drug. The FDA doesn’t have jurisdiction over the chemical, so by your own quote, the USA does not consider it a drug. Can’t you see the contradictions in your own comments?
Let’s see if I can summarise your opinions:
1. The halogen compound used in community water fluoridation (call it “fluoride”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (dental caries), so you consider it a drug.
2. The halogen compound used in community water chlorination (call it “chlorine”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (cholera), but you don’t consider it a drug.
To which I will add:
3. The halogen compound used in iodised salt (call it “iodine”) is toxic to humans at high doses. It is produced as a by-product of industrial processes. Its use is not covered by the FDA, so it actually isn’t a drug. It is used in an attempt to prevent disease (goitre). I don’t know whether you consider it a drug or not, but whichever you decide on will directly contradict your opinion on one of the other two.
If you actually followed the science rather than Gish galloping through cherry picked papers that don’t actually say what you think they say, you would have a common opinion on all three of the above products.
As I said previously, “It’s annoying errors and behaviours like this from the anti-fluoridationists that are turning me from a “ho-hum” supporter of fluoridation into a much more active supporter of CWF.”
Do you really fail to understand how your errors, self-contradictions and behaviour in blogs is pushing people away from anti-fluoridationists?
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Bill
A suggestion for you:
When reading an abstract from a paper, replace the word “may” in the abstract with “may not”.
I find it makes me think more about the abstract and wait until I have read the entire paper before forming an opinion.
Compare “I may crash my car driving to work today” with “I may not crash my car driving to work today.” Neither says anything definite and neither does the use of “may” in an abstract.
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Bill
Another suggestion, which I would pass on to everybody who wants to understand the pros and cons of community water fluoridation:
Get hold of a current textbook on dentistry or community medicine, it doesn’t matter which.
Read the chapter on community water fluoridation. It may require a diversion into the science of statistical analysis if that wasn’t previously part of your education.
At the end of the chapter you will find a list of references. Read the entire referenced papers, not just the abstracts, as well.
Each of those papers will have references. Read those too.
At that stage you will have a basic understanding of the benefits, side effects and economics of community water fluoridation. Not an advanced understanding, just basic.
NOW you are able to ask about some of the fine details of CWF and may even be able to partially understand the answers. It’s more probable that you will find that you have already read the answers and have very few questions left.
You may even find out that the people who have made this a lifelong study and recommend community water fluoridation actually do understand the science.
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(Sorry, Ken. If I put all that in a single post, I suspect most people would skim!)
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Stuart,
I would suggest you read the text book,
Comprehensive Preventive Dentistry by Hardy Limebak which can be purchased on Amazon.
A well referenced and balanced text on preventive dentistry.
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Stuart,
Please provide evidence the FDA CDER does not have jurisdiction over substances used with the intent to prevent disease.
Jurisdiction is the most fundamental question needing to be answered.
Who has jurisdiction over the ingestion of fluoride with the intent to prevent dental caries?
FDA says they do.
Congress says FDA.
Boards of Pharmacy say FDA
HHS says FDA
EPA says they do NOT
CDC says they do NOT
NSF says they do NOT
doctors do NOT
What is your evidence?
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Stuart,
Your summary of my comments is incorrect. You have not been reading what I have been writing. Start over and spend the time to carefully read it.
FDA testified to Congress they have jurisdiction over fluoride when used to prevent disease in man or animals.
FDA rejected fluoride supplements.
FDA sent a letter to 35 fluoride supplement manufacturers to stop.
FDA said fluoride supplements do not show benefit.
FDA has approved topical fluoride with the warning “DO NOT SWALLOW”
If the intent is to prevent disease, FDA has jurisdiction. FDA says they are deferring regulatory action on artificial fluoridation.
Show your evidence otherwise.
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Bill,
As you base your belief in regard to fluoride content of “mother’s milk” on that which you claim the American Academy of Pediatrics “says”, obviously you consider the AAP to be a respected, authoritative source. The AAP fully supports the public health initiative of water fluoridation. It has a website with a wealth of information on fluoridation. Such information would be an excellent starting point for you to begin properly educating yourself on this issue.
“www.ilikemyteeth.org”
1. “Mother’s milk”
Interesting that you, as a nutritionist, are not aware of the deficiency of Vitamin D and iron in human breast milk. Also interesting that you recommend infants be exposed to sunlight, in contradiction to current recommendations of AAP.
“While breastfeeding is the recommended method of infant feeding and provides infants with necessary nutrients and immune factors, breast milk alone does not provide infants with an adequate intake of vitamin D. ”
“Furthermore, there exists a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure (visit: Skin Cancer.)
“As a result, in April 2003, the American Academy of Pediatrics (AAP) published guidelines for vitamin D intake, recommending that all infants have a minimum intake of 200 IU of vitamin D per day, beginning during the first 2 months of life. In November 2008, the AAP published a new statement to replace their 2003 guidelines. The 2008 report recommends a daily intake of vitamin D of 400 IU/day for all infants and children beginning in the first few days of life.”
“Human milk typically contains a vitamin D concentration of 25 IU per liter or less. Therefore, a supplement of 400 IU per day of vitamin D is recommended for all breastfed infants. Adequate amounts of vitamin D can be achieved by currently available multivitamin products containing 400 IU of vitamin D per mL or the newly available preparations that contain 400 IU/mL vitamin D alone without other vitamins. These products are available over the counter. Prescription preparations of vitamin D have very high vitamin D concentration and are not for routine home use.”
—–http://www.cdc.gov/breastfeeding/recommendations/vitamin_d.htm
“Breastfed infants need supplemental vitamin D. This vitamin is naturally manufactured by the skin when it is exposed to sunlight. However, the American Academy of Pediatrics feels strongly that all children should be kept out of the direct sun as much as possible and wear sunscreen while in the sun to avoid long-term risk of sun exposure, which may contribute to skin cancer.”
——-http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Vitamin-Iron-Supplements.aspx
Yes, there is speculation for the reason of iron deficiency in human breast milk. However, this does not preclude the need for supplementation, as you deem does the fluoride content of breast milk.
“An AAP clinical report being early-released, Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children 0 Through 3 Years, http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010-2576v1, also will appear in the November issue of Pediatrics. The report contains, for the first time, AAP recommendations for iron supplementation; it is a revision and extension of the 1999 policy on iron fortification of formulas.”
“In addition to universal screening, the report recommends the use of iron supplements for breastfed infants beginning at the age of 4 months”.
“The physicians explained that full-term healthy babies receive enough iron from their mothers in the third trimester of pregnancy to last for the first four months of life. However, human milk contains little iron, so infants who are exclusively breastfed are at increased risk of iron deficiency after 4 months of age.”
“The clinical report recommends giving breastfed infants 1 mg/kg/day of a liquid iron supplement until solid foods, such as iron-fortified cereals, are introduced. For partially breastfed infants, the iron recommendation remains the same as that for fully breastfed infants if more than half of the daily feedings are from human milk and the child is not receiving iron-containing complementary foods.”
——–http://aapnews.aappublications.org/content/early/2010/10/05/aapnews.20101005-1.full?rss=1
2. Total Exposure”
Given that fluoride at the optimal level is simply a mineral which humans have been ingesting in water since the beginning of time, and given that in the entire 69 year history of water fluoridation, there have been no proven adverse effects…..the IOM established daily upper limits have been borne out to be entirely valid. The “many” which you claim are exceeding their daily upper limit would only be those in teeth developing years of 0-8 years, as the daily limit jumps to 10 mg, after that point. The only consequence of exceeding the daily upper limit for those 0-8 years would be mild to very mild dental fluorosis, a benign effect we have discussed previously.
In regard to the development of the IOM reference values.
“The scientific data used to develop Dietary Reference Intakes (DRIs) have come from observational and experimental studies. Studies published in peer-reviewed journals were the principal source of data. Life stage and gender were considered to the extent possible, but the data did not provide a basis for proposing different requirements for men and for nonpregnant and nonlactating women in different age groups for many of the micronutrients. Two of the categories of reference values—the Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA)—are defined by specific criteria of nutrient adequacy; the third, the Tolerable Upper Intake Level (UL), is defined by a specific endpoint of adverse effect, when one is available. In all cases, data were examined closely to determine whether a functional endpoint could be used as a criterion of adequacy. The quality of studies was examined by considering study design; methods used for measuring intake and indicators of adequacy; and biases, interactions, and confounding factors.”
DIETARY REFERENCE INTAKES FOR Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc
A Report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Uses of Dietary Reference Intakes, and the
Standing Committee on the Scientific Evaluation of Dietary Reference Intakes
Food and Nutrition Board
Institute of Medicine
NATIONAL ACADEMY PRESS
Washington, D.C.
—–http://www.nap.edu/openbook.php?record_id=10026&page=8
3. “Dental Expenses”
“Findings suggest that Medicaid-eligible children in communities without fluoridated water were three times more likely than Medicaid-eligible children in communities with fluoridated water to receive dental treatment in a hospital OR, and the cost of dental treatment per eligible child was approximately twice as high.”
Water Fluoridation and the Cost of Medicaid Treatment For Dental Decay——Louisiana 1995-1996
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4834a2.htm
“An Economic Evaluation of Community Water Fluoridation”1 presents the results of an economic analysis of water fluoridation under modern conditions of widespread availability of fluorides. Researchers from CDC and Terry College of Business, University of Georgia, found that under typical conditions, the annual per-person cost savings in fluoridated communities ranged from $16 in very small communities (20,000). The analysis takes into account the costs of installing and maintaining necessary equipment and operating water plants, the expected effectiveness of fluoridation, estimates of expected cavities in non-fluoridated communities, treatment of cavities, and time lost visiting the dentist for treatment.”
—–Cost Savings For Community Water Fluoridation”
US Centers For Disease Control and Prevention
“RESULTS:
With base-case assumptions, the annual per person cost savings resulting from fluoridation ranged from $15.95 in very small communities to $18.62 in large communities. Fluoridation was still cost saving for communities of any size if we allowed increment, effectiveness, or the discount rate to take on their worst-case values, individually. For simultaneous variation of variables, fluoridation was cost saving for all but very small communities. There, fluoridation was cost saving if the reduction in carious surfaces attributable to one year of fluoridation was at least 0.046.
CONCLUSION:
On the basis of the most current data available on the effectiveness and cost of fluoridation, caries increment, and the cost and longevity of dental restorations, we find that water fluoridation offers significant cost savings.”
—— Public Health Dent. 2001 Spring;61(2):78-86.
An economic evaluation of community water fluoridation.
Griffin SO, Jones K, Tomar SL.
4. “Biomarkers”
It is not encumbent on me to do a “pubMed search” in regard to your unsubstantiated claims. If you have “hundreds of articles” that support your personal speculation as to that of which “biomarkers of fluoride overexposure” are indicative, then present them, properly cited from their primary sources.
The 41% to which you refer arose from the 2010 CDC study by Beltran-Aguilar, et al. The 41% was broken down as follows: 37.1% mild to very mild dental fluorosis, 3.8% moderate dental fluorosis. Severe dental fluorosis was negligible.
Your hypocrisy is clearly evident in your “concern” for the barely detectable mild dental fluorosis while discounting the black discoloration of teeth, extreme pain, debilitation, development of serious medical conditions, and life-threatening infection resultant of untreated dental decay which is preventible with water fluoridation.
Steven D. Slott, DDS
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Bill,
In regard to the 2006 NRC report which you would “encourage” me to read, I would encourage you to read the final recommendation of this Committee. If you do, you will discover that the only stated reasons for its recommendation to lower the primary MCL from its current 4.0 ppm, were risk of severe dental fluorosis, bone fracture, and skeletal fluorosis, with chronic consumption of water with a fluoride content of 4.0 ppm or greater. No other stated concerns of fluoride at this level. Additionally, this Committee made no recommendation to lower the secondary MCL of 2.0 ppm, which it was also charged to evaluate.
Water is fluoridated at 0.7 ppm, one third the secondary MCL the NRC Committee made no recommendation to lower.
Steven D. Slott, DDS
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Bill
I referred to CWF. Why then does your comment refer to topical fluoride applications?
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Oops, preparations.
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Bill
Just to be clear, the topical fluoride preparations and oral fluoride supplements to which you refer have nothing to do with community water fluoridation.
All my comments refer to community water fluoridation.
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Bill
Ken’s first paragraph:
“I am always amazed at how some people will crudely misrepresent the scientific literature in their efforts to pretend their particular political agenda is scientifically valid. The way they will dredge the scientific literature searching for studies they can quote and misrepresent seems an extreme form of cherry picking and confirmation bias. Surely those indulging in such crude literature dredging are fully aware of what they are doing.”
Re-reading your comments…
Hmmm… I agree with Ken.
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Re: Are all fluoride ions medication?
Dr. Osmunson
It is a reality that fluoride ions are regulated in various ways depending on their use.
It is very similar to sodium chloride (NaCl) which can be a food preservative, a nutritional mineral, a prescription medication, an over the counter medication.
Equally clearly fluoride ions can be a natural mineral, a mineral nutrient, a water additive, an over the counter medication, a prescription medication, an industrial chemical (including extremely pure forms), an industrial pollutant, a fumigant, and a rat poison.
This is as clear a reality as the sky is blue. There are important, critical distinctions between each use, each concentration, and purity standards which define the various incarnations of “fluoride.”
The willful refusal to acknowledge these clear and easily understood distinctions is an important element in opponents mistaken views opposing fluoridation.
Courts around the country have uniformly ruled that fluoridation is not the act of medicating and further that water districts have both the right and the obligation to determine the chemical composition of their product within regulatory limits. Individual citizens do not have the right to demand a chemical composition of the drinking water. Further courts, both in the US and abroad, have specifically denied your contention that the reason for the ion’s presence is sufficient to mandate it be considered a medication.
A new decision is available from New Zealand: NEW HEALTH NEW ZEALAND INC v SOUTH TARANAKI DISTRICT COUNCIL [2014] NZHC 395 [7 March 2014].
In addition to New Zealand precedent Judge Hansen includes references to Irish, Swiss, Canadian and US court decisions in his opinion. Readers interested in both the fluoridation qua forced medication will find this opinion representative of world-wide legal opinion. I have copied some important quotations from this decision below.
Clearly fluorophobes will bear some inconvenience and expense but that inconvenience is small compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.
It is incredibly self centered to insist on water your way when the legitimate medical, dental and public health expert communities overwhelmingly agree that CWF is safe, beneficial, inexpensive, and properly regulated as a water additive. My view is that the important debate has occurred in the minds and offices of thousands of professionals resulting in the favorable consensus in favor of fluoridation. No public health scientist wishes to harm people. Scientific education includes learning the discipline to change one’s mind with the facts demand that. The very name Ken Perrot has chosen for his blog makes this point. There can be no conspiracy large enough to conceal scientific truth from legions of professionals.
Fluoridation simply prevents cavities. It is straightforward.
Chuck Haynie
From NEW HEALTH NEW ZEALAND INC v SOUTH TARANAKI DISTRICT COUNCIL, March 2014
“On appeal the Supreme Court declined to resolve the case on that narrow basis, particularly without sufficient evidence as to the practicality of removing the fluoride. The Court held that, as fluoridation had no effect on the “wholeness or the soundness” of the body of a consumer, the ingestion of fluoridated water could not constitute an infringement of or a failure to respect the bodily integrity of the individual. The Court also rejected the contention that fluoridation involved mass medication or mass administration of “drugs” through water. The Court said that fluoridation is a process by which an element which naturally occurs in water is raised to a concentration at which it is found in wholesome water with an outcome that did not differ from what occurred in nature. The Court quoted from the conclusion of the New Zealand Commission of Inquiry 195744 that fluoride is not a drug but a nutrient and fluoridation is a process of food fortification.”. . . .
“[Fluoridation programs, even if considered to be medication in the true sense of the word, are so necessarily and reasonably related to the common good that the rights of the individual must give way.”
“The Florida District Court of Appeal (4th Circuit) held that the introduction of fluoride is not a medical procedure. The Court rejected the contention that fluoridation amounted to “compulsory medication”, pointing out that the city’s fluoridation of its water stops at the water faucet: The city is not compelling [the plaintiff] to drink it. He is free to filter it, boil it, distil it, mix it with purifying spirits, or purchase bottled drinking water. His freedom to choose not to ingest fluoride remains intact.”
“In Dowel v City of Tulsa the plaintiffs challenged the validity of an ordinance authorizing fluoridation of Tulsa’s water supply as, among other things, involving a violation of the 14th Amendment of the US Constitution. 60 The Court rejected the argument that fluoridation should be distinguished from the addition of chlorides, both of which achieved demonstrable public health benefits, the one by killing germs in the water, the other by reducing the incidence of tooth decay. The Court said at: To us it seems ridiculous and of no consequence in considering the public health phase of the case that the substance to be added to the water may be classed as a mineral rather than a drug, antiseptic or germ killer; just as it is of little, if any, consequence whether fluoridation accomplishes its beneficial result to the public health by killing germs in the water, or by hardening the teeth or building up immunity in them to the bacteria that causes caries or tooth decay. If the latter, there can be no distinction on principle between it and compulsory vaccination or inoculation, which, for many years, has been well-established as a valid exercise of police power.”
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Bill
Thanks for the suggestion of the textbook. Unfortunately, I’m not into preventive dentistry.
As I said, I’m not a dentist. I have dentistry texts because my job requires me to do some basic dentistry, usually following trauma. I tend to refer people who need more advanced work to dentists who have more skills and equipment than myself.
I’m much more interested in the community health aspect of CWF. I wasn’t… but then I started observing the antics of anti-fluoridationists in Hamilton, other areas around New Zealand, and on blogs like Ken’s.
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The Waikato DHB cited SCHER as and authority that supported CWF. I am curious then why SCHER wrote the following: http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/l-2/5.htm#0
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Trev, there’s nothing in that SCHER opinion that you link too that disputes the viewpoint that CWF is safe and helpful in reducing incidence of dental decay.
I trust this observation satiates your curiosity.
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Bill,
Far away from New Zealand and much closer to home: No court of last resort has ever ruled that fluoridation is forced medication or a drug. In 2011 Port Angeles, WA and Forks, WA were sued for the umteenth time by you and your fellow anti-fluoronistas. Here was the final ruling.
Jefferson County Superior Court Judge Craddock Verser dismissed the case Friday on the grounds that fluoride cannot be considered a prescription drug when used in a public water supply.
The two cities, in their motion to dismiss the case, said that designation does not apply to their use of fluoride because the FDA does not regulate public drinking water.
He wrote that the plaintiffs would have to meet two criteria to prove their case: that fluoride is a prescription drug under federal law and that it is listed in the 2009 edition of the Drug Topics Red Book.
“Because the FDA does not regulate public drinking water or drinking water additives, it is impossible for plaintiffs to prove that the first requirement for being a [prescription drug] under Washington law is met,” he said.
So, Bill, fluoridation is NOT a drug in the U.S.A, Canada, New Zealand, Australia, or anywhere that fluoridation is practiced.
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Thankyou gentlemen.
I knew that I had read the court verdicts from several cases and countries, but was I interested enough to keep a record of them…?
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Regarding courts:
Drugs are approved by the FDA CDER a Federal Agency. I am unaware of any Federal case on whether the FDA CDER has jurisdiction over fluoride chemicals when used with the intent to prevent disease. Please provide if you do have such a case.
In Port Angeles, the court case, not about drugs, decision 5/4 was about who was to make the decision. The voters wanted to go to a vote and the City refused to permit the voters to make the decision. The Court agreed with the City that the City had jurisdiction to make the determination.
A reasonable decision. Much easier in Washington for us to get water district and city representatives to make the decision than thousands and hundreds of thousands of voters.
In 1952, the Washington State Supreme Court 5/4 ruled artificial fluoridation was not a drug, however, Federal laws have changed.
Another case in Washington State found fluoridated water was not a drug. Therefore, fluoridated water is regulated under poison laws. Now that the courts have placed the city with authority and fluoride regulated not as a drug but rather as a poison, highly toxic, the city is even more at risk.
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Based on the state courts ruling, any water district could add penicillin, viagra, or any other product to public water, make a claim of benefit and put it in a bottle without FDA approval and sell. The ruling is based on state laws, not Federal laws.
Kurt’s “umteenth” number happens to be two times. I did write amicuses to the court.
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Kurt, as you know, the Red book is not an FDA document, but rather an American Academy of Pediatrics book. The judge was seriously confused trying to protect artificial fluoridation. The judge should have done a search of the FDA drug data base and Federal law requires.
Remember, Pediatricians don’t usually pull teeth. When a child has a hurting tooth they can give antibiotics and pain meds which are not very effective. In desperation to do something for teeth, pediatricians protect fluoride and prescribe fluoride even though it is not approved.
Your comment that artificial fluoridation is legal in the USA is not true at the Federal level or state. It will take time and money to go to court.
The Australian drug enforcement agency also confirmed artificial fluoridation is a drug.
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Bill,
“Another case in Washington State found fluoridated water was not a drug. Therefore, fluoridated water is regulated under poison laws. Now that the courts have placed the city with authority and fluoride regulated not as a drug but rather as a poison, highly toxic, the city is even more at risk.”
The only thing “at risk” here is any semblance of credibility you may still hope to have, if you continue attempting this “forced medication” nonsense. The courts have been clear on this. Fortunately in the US, you don’t get to twist existing laws to suit your personal ideology.
Your interviews with Merola are a much better setting for you to keep putting out this junk. His audience is far more receptive to it.
Steven D. Slott, DDS
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Bill,
“Your comment that artificial fluoridation is legal in the USA is not true at the Federal level or state. It will take time and money to go to court.”
The “law” according to Bill Osmunson. Fortunately we live in the United States of America, not the United States of Osmunson.
It never ceases to amaze. The science doesn’t support antifluoridationist ideology, so they simply deny the science and make up their own version. The law doesn’t support antifluoridationist ideology, so they simply deny the law and make up their own version.
Inventive, if nothing else.
Steven D. Slott, DDS
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Steve,
Please provide one prospective randomized controlled trial of artificial fluoridation.
Please provide one study on the safety of hyrodluorosilicic acid.
What is the optimal fluoride concentration of dentin or enamel which prevents tooth decay.
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Bill,
As you well know, RCTs are all but impossible for fluoridation. Given that fluoride ions, identical to those which have existed in water since the beginning of time, and barely detectable trace comtaminants, are the only substances ingested as a result of fluoridation, the real question is….what exactly is it that you deem needs testing?
As you obviously don’t know, but should, HFA does not exist at the tap in fluoridated water. It is not ingested. Therefore there are no requirements, nor any need, for “one study on the safety of hydrofluorosilic acid”.
As I stated previously, if you want a determination of an “optimal fluoride concentration of dentin or enamel which prevents tooth decay”, then do the research to determine it. Your personal desire for such is no reason to deprive entire populations of the dental decay benefit of the public health initiative of water fluoridation.
Steven D. Slott, DDS
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RCT’s are not hard. Consent would be hard.
Steve, your moaning and groaning about a little hard work almost brought tears to my eyes. A quality study “all but impossible” you say. So sorry for suggesting we demand good science after 60 years of giving people fluoride without their consent. Your lame excuse is a cut and paste from public health policy pushers too scared to find out the truth. They are even scared of quality research on measured cost effectiveness.
US CDC is spending $31 million to market, promote, lobby for fluoridation over the next 5 years. I think you and I could do an excellent RCT with half that. OK, you take half and I’ll take the other half!!!!!
Perhaps a couple thousand cohorts. Simply ensure each person uses the bottled water given to them. The bottles coded and double blinded. Results start after 2 years. Control for confounding factors.
After about 60 years of fluoridation without consent and without safety studies and without proper approval, as public health and dental professionals we must be ashamed, humbled, and embarrassed no high quality studies have been done on artificial fluoridation. Talk about sloppy, poor, lousy science. Artificial fluoridation is one of the top ten public health blunders of the 20th Century. We are now in the 21st Century and need to do some quality research. I just read research where the study did not consider whether the DMFT were more ‘filled” or “decayed” for each group correction for dental treatments. More of the teeth filled indicated more dental visits, more oral hygiene instruction, etc.
The hard part would be consent. Just think about getting people to sign up for bottled water. Probably easy. But keeping them when they start looking at the science would be a serious problem. All studies with human cohorts require a Human Subjects Review Committee (HSRC) approval. You know. To avoid violations of experimentation on humans. For example University of Washington:
“Human subjects asked to contribute their time and effort to research should consent to do so freely. The consent should be given only after the subject understands what he or she is consenting to, and any risks that may be involved. Subjects should be assured that there will be no penalties for declining to participate, and that they are free to withdraw from the research at any time after they have given their initial consent.” University of Washington http://www.washington.edu/research/hsd/hsdman4.html
Retention in a study might be a concern without full disclosure. Perhaps a HSRC might approve fluoride bottled water, but retention of the cohort once they became aware of the toxicity and problems with fluoridation would be inclined to drop out of the study. A prospective randomized controlled trial on efficacy covering 5 or 10 years could be done.
Well, good scientists could do the study. Not sure if fluoridationists are up to the challenge of supporting their belief’s with real science.
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Bill â you claim âRCT’s are not hard.â
Then why has there never been any RCT to show that CWF is harmful or ineffective?
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No, sorry, Bill, I don’t see any evidence that I have “moaned and groaned” about anything. I’ve simply stated facts. Too, unlike you, I don’t “cut and paste” without proper citation. More delusions on your part, I suppose. You probably should just stick to the science and cease your attempts to project your characteristics unto me.
So, just give your subjects some bottled water and tell them to use it. Uh….yeah, okay. Assuming 100% compliance with these “instructions” how do you plan to control for food and beverages they consume made with fluoridated water? How do you plan on controlling for water they drink at school or work which may be fluoridated?
You remember Warren/Levy which you attempted to portray as a condemnation of the optimal level? They could not overcome the halo, and other effects which prevent adequate segregation between fluoridated and non-fluoridated groups……yet you plan to do so by handing your subjects some bottled water and instructing them to use it. Good luck with that.
Antifluoridationists have had 69 years to test the fluoride ion they’ve been consuming their entire lives. If you want more testing of this ion, then feel free to do it. In the meantime, this is noreason to deprive entire populations of the dental decay preventive benefit of fluoridation.
Steven D. Slott, DDS
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Ken,
Your question on why there have not been RCT on fluoridation is the key answer to the topic of your article on “Science Dredging.”
Here are my thoughts:
A. Jurisdictional oversight. In the USA, our laws are focused on money, profit, sales, etc. The laws put the burden of scientific proof on the shoulders of the companies making the product. In this case the substance with claim of preventing dental caries. The manufacturer of the substance (drug) are public agencies who are told by public health agencies and simply believe these agencies that the EPA regulates water and the CDC approves the fluoridation and FDA CDER approval is not necessary. The FDA is deferring regulatory action.
B. Public Health Professionals are usually skilled educators and administrators and seldom hard core numbers and research nurds. The educators and administrators simply follow and promote policy without looking at the science.
C. Demand. As long as scientists don’t demand RCT studies, they won’t be done. All of us need to request quality studies.
D. Fear the studies will not find benefit. RCT studies may have been done and not published. In the 1970’s I was told measured cost benefit studies were in progress. Why were these never published? Did they not find a cost savings? If that is true, it would be highly unethical. Delta Dental Insurance assured me several years ago they were doing a careful evaluation of cost savings in fluoridated communities and would release their results. But they have not.
E. Unless the results of the study find favor for fluoridation, the study will probably not be published and the researchers will lose funding, not gain tenure or have it delayed, etc. Fluoridation is a carrier buster.
Fluoridationists say it can’t be done. Not true.
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I would have thought Paul Connett would have led such a project. He is after all the World Authority of fluoridation*, has screeds of outstanding peer reviewed papers on the topic, and is considered the first person to go to when researching the topic.
Why has he done nothing? And why has FAN, which both you and Paul work in, not done anything?
*Self-described.
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Steve,
Now you are asking valid questions, such as,
“Assuming 100% compliance with these “instructions” how do you plan to control for food and beverages they consume made with fluoridated water? How do you plan on controlling for water they drink at school or work which may be fluoridated?”
The “halo” effect needs to be controlled, your concern is absolutely valid. About one third to two thirds of the fluoride ingested even in fluoridated communities comes from other sources than fluoridated water. And many confounding factors need to be controlled. Diet, medications, and much more.
Bottled water at schools can be provided at schools or work. As a prospective study, if the study starts before conception, work water is a factor.
The Chinese and Iranian studies use blood and urine serum fluoride concentrations in their IQ studies. What a novel idea for third world countries to have higher quality measurements than generally used in the USA studies. With high quality labs which have been calibrated, fasting fluoride concentrations and teeth concentrations need to be measured. Teeth could be measured when the primary second molars exfoliate or thirds extracted. The target organ is the tooth and both my professions are absolutely clueless on the optimal fluoride concentration for enamel and dentin.
Steve, you refer to Warren/Levy. Where is the measured data on serum and urine concentrations of cohorts for their reports? And they did admit the term “optimal” should no longer be used.
Their studies were good historically, but now they need to catch up with China and Iran and India, et al and use measured data. Remember, those countries have some serious skeletal fluorosis which has made them look closer at what levels are safe. And they have more respect for excess fluoride exposure.
And one last point to your post, Steve. The responsibility for spending millions of dollars on research MUST NOT be dumped on the patient. Those marketing fluoridation, selling the stuff, making the profit, have the legal responsibility to provide the research to the FDA CDER who have the policies and experts to weigh the complex controversial evidence and approve with appropriate label for dosage and cautions like they have done for toothpaste.
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So if you say RCT studies can be done, Why has your organization not done them? If you really thought that you had a valid case. I,m sure you would have jumped at the chance to prove fluoride is the nasty you say it is
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Bill . .the reason that Viagra or any other drug cannot be added to the water supply is the simple fact that only authorized water additives meeting NSF/AWWA STD-60 are allowed. Sodium fluoride, HFSA and sodiumFS are three of the nearly 50 chemicals which are water additives.
This isn’t something that needs to be proven, it is simply the way it is. If you think federal law has changed then you should bring yet another case and see if you are correct.
Chuck Haynie
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Hi Chuck,
Welcome to the shoot out at the OK coral!!!
In part, you are correct and in part your concept is flawed. My point is that adding a drop of public water (or a million acer feet) to a medication, does not change the jurisdiction from the FDA to the EPA if the intent is to prevent diseases in humans.
You are correct that NSF 60 provides for about 50 chemicals which can be added to public water to make the water safe and more palatable. However, NSF 60 only permits the contaminants in the products to react 10% of the EPA’s MCL. In other words, for fluoride, the EPA’s MCL is 4 ppm. And even a bald dentist knows 10% of 4 is 0.4 ppm.
In other words, water fluoridation over 0.4 ppm violates NSF Standard 60.
So I called NSF and asked why more than 0.4 is permitted. Their response was they do not regulate the safety or efficacy of chemicals added to water. Their job is to simply ensure the contaminants within the product do not exceed 10% of MCL.
So I asked NSF, if the HFS were called by a different name would the maximum permitted by 0.4 ppm. They refused to respond.
Chuck, do NOT rely on NSF for safety or efficacy of artificial fluoridation. Not their job.
When asking NSF for copies of the assays of the fluoridation products they have tested, very few are available. NSF is not a government agency and is not required to actually disclose testing results.
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Chris, You asked why I have not done RCT trials? You fund it, I’ll do it.
The responsibility for providing the FDA CDER with quality research is not the patient, me. The responsibility is not the FDA CDER to get the research. The law requires the manufacturer to give the FDA CDER the research.
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I keep repeating myself because most people don’t read all the posts.
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Chris,
Further to your comment, “So if you say RCT studies can be done, Why has your organization not done them?”
Ethically, I could not subject people to a highly toxic chemical which has almost 40 human studies showing IQ loss. And as the NRC 2006 report laid out, concerns for many diaereses.
If we were to introduce fluoridation today, with the research we have, can you imagine a Human Subject Review Committee permitting the mass medication of everyone without their consent? Many developed countries do not fluoridate the water because of freedom of choice, the lack of ability to gain informed consent from everyone.
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You keep repeating yourself, Bill, because you are an anti-fluoride troll. It goes with the territory and most people switch off quickly.
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Ken,
The answer is simple. Money. We do not have corporate funding or tax payer funding for lobby work and research.
We are not selling anything.
We make no money from fluoridation.
The water districts and cities selling the water make the money off of water. In theory, they are not to make a profit, but they sell the water. It is their job to do the research.
At least we agree there are no prospective RCT studies. No gold standard studies. No high quality studies. And we agree many have not given their consent. And we agree fluoridated water is not done under a doctor’s orders/prescription and could not to patients not of record.
Ken, it is not just the most fundamental basics of scientific research prospective RCT studies which are lacking.
Most research on fluoridation have numerous problems:
Not one Randomized Controlled Trial
Socioeconomic status usually not controlled
Inadequate size
Difficulty in diagnosing decay
Delay in tooth eruption
Diet: Vitamin D, calcium, strontium, sugar, variables not controlled.
Total exposure of Fluoride and measured blood and/or urine fluoride concentration not determined
Oral hygiene habits unknown
Not evaluating life time benefit
Estimating or assuming subject actually drinks the fluoridated water.
Dental treatment expenses
Breast feeding and infant formula not determined
Fraud or gross errors.
Genetics and Dental office visits
Synergistic effects
Any quality scientist must demand these fundamental problems of fluoridation be controlled prior to use as a public health measure.
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Ken,
Please read my earlier posts.
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This debate series is most interesting, but is not of a sufficient scientific level to prove much. Unfortunately those opposed to Dr Osmunson’s views lapse rapidly into personal attack and don’t stay with factual argument.
However, maybe that is OK, since science cannot be the only arguments that eventually decide whether a community fluoridates, or continues with fluoridation.
I remember when my former city of Geelong, Australia was having fierce debates about fluoridation, 2003 to 2009. The chairman of the water supply authority, Dr Vaughan, was a medical doctor now involved in public administration. Whenever asked by the media to comment, he had an interesting take. He would say that there were two issues to consider (1) the scientific / medical facts, and (2) the issues of community values with regard to legitimate use of water supplies.
On the science he frequently said that there seemed to be strong arguments on both sides, and scientific experts would have to come to conclusions on that. On the community values issue he pointed out that we had not yet had that debate in a fairly moderated way for the whole community to express their views and wishes. Well, it never happened. Fluoridation finally got enforced in about 2009 or 10, by executive order of government.
The community values issues, that never got a proper airing or a vote, were such matters as (i) is it okay to use the water supply to carry additives other than those that purify the water? (ii) is it okay to administer a health treatment via the water supply to both those that want it and those that don’t? (iii) if an additive is being added for a health treatment purpose is it okay that it be an industrial grade by-product, or should it be required to be purified to the standard required of that substance if it were prepared into pill or other medicinal form?
I don’t think that many of the cities that practice fluoridation have really had that debate thoroughly at a well-moderated community level.
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David, people are getting angry with Bill because he is a veteran Gish galloper and really is not honest in his approach to the discussion. Hardly suprising as he is a political activist on Paul Connett’s FAN team.
I personally don’t consider it worth engaging with him because it is impossible to get him to stick to a point. I learned that long ago.
I agree completely there are two issues here. And very often the values/ethical question is not discussed because scientific misinformation is used to divert away from that.
As for the scientific issues I personally think the science is pretty clear – but as in all science is always open to further cosnideration. Community Water fluoridation is safe and effective. I have discussed this in many articles on this blog.
However, it is often difficult for the layperson to appreciate the scientific literature on this. It is complex and must be approached intelligently and critically. And one must be aware that all the time there are ideologically-driven people who are trying to cloud the science.
If you think we should discuss the ethical issues further here you are welcome to make some points for discussion. I would welcome that.
I have written several pieces on the ethics and get frustrated because every time anti-fluoride propaganoidsts make scientific assertions in reply which are just wrong, thereby diverting the discussion. In the end I do not think those people really have an ethical leg to stand on – and that is a reason why they refuse to allow a proper discussion of the ethics.
Perhaps to start of the ethics isue I will comment on your 3 points.
(i) Water is treated for a number of reasons, not all directly related to purity. Chlorination and fluoridation help make the water safe and acceptable for health. But that is a decision for consumers – some consumers for example object to chlorination and often take steps to remove it. I think the same can be done with fluoridation. In the end we live in a society and society as a whole makes decisions on this via democratic procedurers like referenda and representative electiosn and voting.
(ii) A social health policy like fluoride and water disinfection must be made available to all by definition – but this does not mean that everyone has to take it. No one is force as there are always alternatives – just as in social policies like education and hospitals. People can, and often do, filter their water or find alternative sources. This is not expensive.
But I object very strongly to the idea that a minority of people can deny a beneficial and safe social health policy supported by the majority just because they have an ideological hang-up. They should be reposnsible and make alternative arrangments in that case.
(iii) Here you are switching back to the science – and repeating misnformation. The chemicals used for water fluoridation are required to pass stringent regulations about purity and contamination are are chemically tested. I have written on it extensively here because as a research chemist I actually did do some research on fluorosilic acid which brought home to me how pure the material is and how blatantly anti-fluoride propagandist lie about this.
OK, David, I would love to receive you response to my comments.
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Bill . . I understand your argument. Quite obviously your self-referential view of how the fluoride MCL might be applied to the fluoride water additive itself is not how NSF-60 purity standards for regulated microcontaminants is being used.
To my knowledge this argument has never been raised in court. Surely Attorney Deal would litigate this pro bono. There is really no point to the public debate of idiosyncratic interpretations of EPA regulations. You should just go to court and we will then both know if your are correct or not. The law is exactly what judges say it to be.
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Bill says “Any quality scientist must demand these fundamental problems of fluoridation be controlled prior to use as a public health measure.”
No, Bill, no quality scietists is going to refuse to recognise the fact that a real world exists and that one has to do the best one can with that real world. We going ahead and design our trials and experiments to get the best results – not sitting back and whining as you do.
What a quality scientist does is approach these studies and the scientific literature in general in an intelligent and critical way. Checking out things like social economic status, whether non-fuoridated groups have recieved alternative fluoride treatments, etc. etc. I personally have had a gutsful of anti-fluoride propagandists like you and Paul Connett making claims and quoting papers when they have either not checked such details, not read the paper, or have covered up the facts that undermine their story.
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Bill
When I asked you why your organization did not do the tests to prove how bad fluoride is, you pulled out the “poor me’ card. We have no funding ect. But is saying that you have a full time legal team working for you, Plus full time activists, and they would not be there for their health, and all the costs incurred in the lost law suits must cost a bit, so really you have plenty of money,
You just choose to use it the wrong way, because you know as well as I do thet fluoride in drinking water at .7-1PPM is harmless And once that came out, and people accepted it as the fact it is ,you would be out of a job
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Bill,
——-“The “halo” effect needs to be controlled, your concern is absolutely valid. About one third to two thirds of the fluoride ingested even in fluoridated communities comes from other sources than fluoridated water. And many confounding factors need to be controlled. Diet, medications, and much more.”
Yes, my questions are valid……obviously. Yes, the “halo” effect needs to be controlled. Yes, the confounding factors need to be controlled. Control of these factors cannot be accomplished in any manner adequate for RCTs of fluoridation. That’s exactly the point. Handing subjects a bottle of water at school or work, offers no control for any variables.
The CDC estimates that 75% of daily fluoride intake comes from water and beverages.
——-“The Chinese and Iranian studies use blood and urine serum fluoride concentrations in their IQ studies.”
If the Chinese and Iranian studies to which you refer are the infamous “27”, there is no evidence that these seriously flawed studies were even peer-reviewed or that they controlled for much of anything.
——-“Warren/Levy”
We have discussed the optimal level previously. If you continue to have a problem with this level, take it up with the US DHHS.
——–“Their studies were good historically, but now they need to catch up with China and Iran and India, et al and use measured data. Remember, those countries have some serious skeletal fluorosis which has made them look closer at what levels are safe. And they have more respect for excess fluoride exposure.”
Skeletal Fluorosis is so rare in the US as to be nearly non-existent. If this disorder was a consequence of fluoridated water, in the 74.6% US, SF would be rampant.
Given the lack of any valid proof of adverse effects of optimal level fluoride, in the 69 year history of this Initiative, there is no reason to believe that the US does not have “respect” for fluoride overexposure. That respected science and healthcare sees no need to disprove all unsubstantiated claims made by antifluoridationists, is not indicative of any lack of respect for fluoride overexposure. It is indicative of the transparent attempts of antifluoridationists to further their personal ideology through constant demands of testing, demands which would never end regardless of the amount, or quality, of such testing.
“And one last point to your post, Steve. The responsibility for spending millions of dollars on research MUST NOT be dumped on the patient.”
—-I have not stated that the “responsibility for spending millions of dollars on research” should be “dumped” on the patient. It is the responsibility of those who constantly put forth unsubstantiated claims, then demand they be disproven. There is no valid evidence that supports any adverse effects of fluoride at the optimal level. Those such as you who constantly clamor for more testing of the fluoride ion they’ve been ingesting since birth, have the responsibility for providing valid evidence of problems before credibly demanding that these claims be disproven.
—–The FDA has no jurisdiction over mineral additives to water, of which optimal level fluoride is one. This jurisdiction belongs to the EPA. Thus, there is no requirement, legal or otherwise, to provide any study results of fluoride, or any other drinking water additive, to the FDA.
Steven D. Slott, DDS
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Bill,
“You are correct that NSF 60 provides for about 50 chemicals which can be added to public water to make the water safe and more palatable. However, NSF 60 only permits the contaminants in the products to react 10% of the EPA’s MCL. In other words, for fluoride, the EPA’s MCL is 4 ppm. And even a bald dentist knows 10% of 4 is 0.4 ppm.”
Fluoride is not a contaminant in HFA, it is the primary product being added to water, using HFA as the vehicle. HFA does not reach the tap and is not ingested. The purpose of Standard 60 is to ensure that unwanted contaminants in products added to water, do not exceed safe levels. Fluoride in drinking water is subject to the EPA mandated primary MCL of 4.0 ppm. It is not subject to Standard 60 maximum levels for contaminants.
Steven D. Slott, DDS
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Steve,
We agree on NSF.
My point is that NSF makes no sense. Call HFA by another name and it would not be permitted beyond 0.4 ppm.
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The studies used by Choi from the Harvard School of Public Health were Peer Reviewed. Have you read them? Which ones? Do you still have copies?
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Steve, you said, “—-I have not stated that the “responsibility for spending millions of dollars on research” should be “dumped” on the patient.”
I am the patient. You are the patient. Who is the doctor?
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Chris,
Based on my memory of the finances, FAN has given $1,000 to lawyers for legal work. That is not a “legal team.” I have not received any money and have spent over $100,000 of my own money and time raising the awareness of the public to the risks and harm caused by excess fluoride exposure in the USA.
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Ken said, “No, Bill, no quality scietists is going to refuse to recognise the fact that a real world exists and that one has to do the best one can with that real world. We going ahead and design our trials and experiments to get the best results – not sitting back and whining as you do.”
I am demanding quality studies and I am working with the best we have. My answer and your answer are not mutually exclusive. I agree with both. We must demand better and must work with what we have.
You hold a double hypocritical position.
You accept lower quality studies of efficacy but demand high quality studies on risks.
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Chuck,
If I had the money to go to court I would.
For several reasons, courts do not like to review science and make rulings about science. For one thing, science should and must constantly be subject for review and not written in stone.
Courts are better at holding people and agencies accountable for the law.
A suit against the EPA and FDA for failure to follow the law is more reasonable for a court.
The EPA scientists presented an Amicus to the court back in 1986:
“The process by which EPA arrived at the RMCL for fluoride is scientifically irrational and displays an unprofessional review of relevant scientific data.” Amicus to the US Court of Appeals, DC Circuit, Natural Resources Defense Council, Inc., v EPA Civ. No. 85-1839
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Bill,
“My point is that NSF makes no sense. Call HFA by another name and it would not be permitted beyond 0.4 ppm.”
NSF makes perfect sense. It is you who does not. NSF standards begin with water at the tap. HFA does not exist at the tap. Thus, your statement that under a different name HFA would only be allowed up to 0.4 ppm is nonsensical.
Syeven D. Slott, DDS
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David,
You are a gentleman in this discussion and I respect your professional presentation.
May I add to your comment on public understanding:
If a person wants to ingest fluoride, they can simply swallow a small baby pea size of toothpaste which contains 0.25 mg of fluoride, the same as a glass of fluoridated water. (FDA warns not to swallow that much) We can give people the freedom to choose and save the money spent on artificial fluoridation.
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Bill,
“I am the patient. You are the patient. Who is the doctor?”
Sure, countless people in this world are “patients”. If that is how you want to describe antifluoridationists who make constant unsubstantiated claims against fluoridation, fine with me. Call them whatever you wish. Whomever makes unsubstantiated claims of problems associated with fluoride at the optimal level bears the responsibility of providing valid evidence that those problems do exist, before credibly demanding proof that they do not.
Steven D. Slott, DDS
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Steve,
Have you talked to NSF? I have called them several times and had email contact. I think you are mistaken. NSF’s job is at the water treatment plant and at the faucet. And makes no difference whether the 1 ppm of fluoride is measured at the plant or at the faucet. They should be the same and generally are.
If water suppliers followed NSF 60, they would not permit the fluoride contaminant to exceed 10% of the maximum contaminant level of 4 ppm.
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Bill,
“Have you talked to NSF? I have called……”
“Fluorosilicates do not require a toxicological assessment specifically for the fluorosilicate ion, because measurable levels of this ion do not exist in potable water at the fluoride concentrations and pH levels typical of public drinking water. There is currently no US EPA-derived MCL for silicate in drinking water. NSF established a SPAC for silicate at 16 mg/L based on the typical use level of sodium silicate in Table 5.1 of NSF/ANSI 60, which was based on the value from the Water Chemicals Codex.2 A fluorosilicate product, applied at its maximum use level, results in silicate drinking water levels that are substantially below the 16 mg/L SPAC established by NSF. For example, a sodium fluorosilicate product dosed at a concentration into drinking water that would provide the maximum concentration of fluoride currently permitted by the Standard (1.2mg/L) would only contribute 0.8 mg/L of silicate – or five percent of the SPAC allowed by NSF 60.”
Click to access NSF_Fact_Sheet_on_Fluoridation.pdf
Fluoride is not an unwanted contaminant of HFA, it is the primary product delivered to drinking water, utilizing HFA as the vehicle for delivery.
Steven D. Slott, DDS
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You make my point very well, Steve.
Thank you.
New name to the same product and artificial fluoridation would cease.
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Bill,
“You make my point very well, Steve.
Thank you.
New name to the same product and artificial fluoridation would cease”.
Typical antifluoridationist tactic. When all else fails, just declare victory….no matter how utterly nonsensical is that declaration.
Steven D. Slott, DDS
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Bill, pots and kettles for you to characterise my support for dealing with the real world instead of demanding the impossible. Your boss, Paul Connett is the classic example of someone not only accepting, but also promoting, low quality studies because they confirm his bias. He also makes the inexcusable practice of misrepresenting good studies to pretend they support his claim that fluoride is ineffective.
It’s clear who the hypocritical parries are.
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I see in the Waikato Times an article entitled ‘Science for sale denies public a legacy’
“Science is no longer a search for truth but a commodity to be bought and sold”.
That Ken is what happened to fluoridation – those who sought to profit from it bought the science needed to support its claimed safety and benefits. Unfortunately the same process, ably assisted by people like yourself, is still in train today.
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Believe everything you read in the Waikato Times, do you Trev. 🙂
Come on, your analysis of social pressures on science is going to have to be more subtle than that.
You could start by looking at Paul Connett and analysing how his ideology and group thinking has twisted his ability to read the scientific literature.
He is a shocker for cherry picking and confirmation bias as our exchange on fluoridation showed.
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For the most part, Trevor, when intelligent people are confronted with the fact that science does not agree with their position on a scientific issue, they reexamine their position.
When antifluoridationists are confronted with the fact that science does not agree with their position, do they allow this to deter them? Naaah, they simply declare the science to be corrupt, and keep on spewing their nonsense without missing a step.
If nothing else, you guys are a constant source of entertainment!
Steven D. Slott, DDS
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Those without evidence, attack the messenger rather than the message.
Seve and Ken,
39 human studies on neurologic harm from excess fluoride. Two did not find harm, 37 did.
Certainly those have been critically examined, as they should. However, they are the best we have and the quantity of studies and consistency of the studies is remarkable. I doubt a human research review committee would not permit an RCT to determine the least observed adverse effect.
Toxicologists have taken the fluoride human studies and determined
“Safe*” levels of fluoride in drinking water (MCLG):
From Choi et al. data: 0.021 – 0.027 ppm
From Xiang et al. data 0.0086a or 0.00021bppm
Current EPA standard 4 ppm
Likely new EPA standard ~ 2 ppm
a Using LOAEL/NOAEL = uncertainty factors
b Benchmark Dose Method
* Levels before accounting for other fluoride exposure
ppm = mg/L
Instead of attacking the messenger, focus your comments on the message. What have your toxicologists determined LOAEL/NOAEL?
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Ken,
An example of attacking the messenger rather than the message can be found in the comment, “your boss.” I have offered to answer calls from people primarily on the West Coast with questions regarding fluoridation. I am not paid, nor am I told what to say. Paul is not my boss, although I find his approach to be global, logical and based on the best science and laws available from all sides. Instead of attacking me with speculation and assumptions, do the ethical and scientific approach by simply asking me. Try the same approach with science. Personally investigate rather than assumptions, estimates and speculation. Some people on this forum may actually believe you and think I am being paid by FAN. Spreading untruths and rumors about me without asking me is cruel and unprofessional. I’m concerned the same approach is being used with the scientific evidence on fluoridation. You have not personally check your sources.
I am requesting a public apology from you.
In the end, judgment needs to be used. Not on who is better looking or more crafty with words, but all sides of the science. The theory is complex and controversial. That is why the best minds and experts need to review and continually review the scientific evidence. The appropriate question is, “who has jurisdiction?” Who is responsible for reviewing the scientific evidence?
With fluoridation, I have contacted all agencies public water suppliers rely on for evidence of efficacy and safety. These are HHS, CDC, EPA, and Surgeon General. None of those claim jurisdiction to determine the safety or efficacy of fluoridation. HHS started and backed off. CDC is very clear on the phone and on their web site that they do not determine the safety of fluoridation. EPA is prohibited by law from regulating anything which is used for the prevention of disease in man or animals and they have repeatedly confirmed their lack of jurisdiction.
So I contacted the FDA CDER and asked if they had jurisdiction and FDA CDER confirmed they have jurisdiction over fluoride when used with the intent to prevent disease..
The FDA has rejected 35 new drug applications for fluoride/vitamin combinations because, “There is NO substantial evidence of drug effectiveness as prescribed, recommended, or suggested in labeling.” Drug Therapy June 1975
I contacted the FDA CDER and they responded in part, “A search of the Drugs@FDA database . . . of approved drug products and the Electronic Orange Book. . . does not indicate that sodium fluoride, silicofluoride, or hydrofluorosilicic acid has been approved under a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA) for ingestion for the prevention or mitigation of dental decay. . . . At the present time, the FDA is deferring any regulatory action on sodium fluoride products. . .”
Proponents of fluoridation have failed to provide any documentation to refute the FDA CDER’s jurisdiction.
EPA/FDA had an MOU, but that was rescinded.
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Bill, this is just typical of your personal attacks as a way of avoiding the issues. You are referring to a comment I made as follow:
Now the fact is in the exchange with Paul Connett, again and again he used low quality studies or misrepresents studies. When I pulled him up on this, pointed to the factors he covered up, he usually ignored, tried to avoid or diverted the discussion.
You use the same tactic and your last comment is simply another attempt to divert.
It is pathetic to see a grown man behaving so childishly.
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Ken,
You attack me personally and call me childish, etc. Yet you fail to answer the most basic questions.
What about giving me and those of use who do not want fluoride, FREEDOM? We have been harmed from too much fluoride, in part from fluoridation. Give us freedom.
I’ve asked for studies with measured cost benefits, reduced dental expenses in fluoridated communities, and you have been silent. There is only one reasonable study, Maupome.
I’ve asked for for the “optimal” fluoride serum concentration which would give us the “optimal” enamel and dentin fluoride concentration which mitigates or prevents dental caries and you have failed.
I’ve asked for one prospective RCT on fluoridation efficacy and safety, and you have failed.
I’ve asked for any study using HFS, and you have failed.
I’ve asked for the government authority who admits they have jurisdiction over determining exposure, efficacy and safety, and you have failed.
I’ve presented evidence of countries stopping fluoridation and you are silent.
Yet you call me childish for asking for quality scientific studies and freedom not to be forced to have fluoride in my water.
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I am waiting for your apology for not asking me about my relationship with FAN.
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Don’t be silly silly, Bill. Your relationship with FAN is public – you are listed as part of their team on their web site. Even if your didn’t declare your interests in commenting here.
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Well if fluoride is not a drug, then what the hell do you call industrial grade radio active, heavy metal containing chimney waste?????
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Calm down, Peter, and do some reading of the articles hereoin fluoridation. You could start with this one – Fluoridation: emotionally misrepresenting contamination
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Bill, you seriously need to get over yourself. If you can’t take the heat about your affiliation with Connett and FAN, then separate yourself from them and their nonsense.
You have posted so much junk up and down this page that it would take a dumptruck to take it all to the landfill where it belongs. Then you have the absurd brazenness to demand an apology??
Antifluoridationists never cease to amaze…..
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As far as “failures”, all of your “requests” have been fully addressed, several times in most cases. That you don’t like the answers is your problem, not any “failure” on anyone else’s part. Perhaps if you actually read the responses, you would see this. That you demand something does not mean that it is reasonable, relevant, or requiring of the response you deem should be given.
If you want to talk about “failures”, how about the studies you requested of me in regard to cost savings of fluoridation? Silence from you when I provided them. How about your attempts to lump all levels of dental fluorosis into one? Silence when I’ve exposed that ploy. How about your inference that it costs “thousands” to treat mild to very mild dental fluorosis? Silence when I called you on that. How about your attempts to misuse 2006 NRC? Plucking quotes while disregarding the final stated concerns of this Committee?
Steven D. Slott, DDS
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Peter,
“Well if fluoride is not a drug, then what the hell do you call industrial grade radio active, heavy metal containing chimney waste?????”
Please allow me to answer this astute question.
You call it industrial grade radio active, heavy metal containing chimney waste.
Now my question…….What exactly is the relevance of this to water fluoridated at the optimal?
Steven D. Slott, DDS
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Ken,
You falsely assumed Paul was my boss,
just as you falsely assume fluoridation is safe and effective.
Your assumptions about me came across as disparaging and an apology is in order.
Why have you made these assumptions about me and the fluoridation? Perhaps you seriously want to help prevent dental caries. Perhaps you blindly follow some Americans and failed to include the non-English speaking countries and scientists in your deliberation. Perhaps you have not quietly read the literature for yourself. I don’t know for sure.
For the health of your family, I suggest you encourage them to be cautious and reduce their total exposure to fluoride.
Some research shows 26 out of 28 teeth are good and caries free regardless of fluoridation. The same data when comparing surfaces of the teeth suggest out of 128 tooth surfaces about 120 surfaces are good without fluoridation and about 121 surfaces are good with fluoridation. That is less than 1% improvement and many confounding factors were not considered in the study of over 29,000.
Perhaps there is a “sweet” spot where a little fluoride shows slight improvement, but the same research consistently shows a little more fluoride erases any benefit and starts to increase dental caries. Are you sure that “sweet” spot is being hit with water highly variable consumption of fluoridated water, fluoride toothpastes, pesticides, medications and foods with fluoride? Are you sure that “sweet” spot with less than one percent improvement is worth the risks as outlined by the National Research Council 2006 report and subsequent 8 years of research?
Just like you made assumptions about me without asking me, you have made assumptions about fluoridation.
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Steve,
My apology. I did not see your response to my request for the published articles on measured cost savings for dental treatment for the public at large. And a quick look at your posts above I keep missing them.
Please post them again.
I did see where I had not responded to your comments about NSF 60 and silica in the water. Maybe I should be concerned about the silica, but I am not informed concerns of silica.
My concern is the fluoride. NSF 60 permits 10% of the MCL (Contaminant) and EPA MCL is 4 ppm. 10% of 4 ppm is 0.4 ppm. Fluoride is classified by the EPA as a contaminant and NSF permits 10% of EPA’s MCL.
Fluoridation over 0.4 ppm exceeds NSF 60.
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Chuck,
It has taken me time to respond to your comment,
“. . . that inconvenience is small compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.”
We are all concerned about cavities. However, I can fix teeth, I can’t fix brains cooked by excess fluoride.
The ADA awarded the state of Kentucky for 50 years of fluoridation at the same time as Kentucky topped out with the most edentulous adults, 44%.
Several cities such as Boston claim a crisis of dental caries and they have had fluoridation for decades.
Comparing fluoridated versus nonfluoridated developed countries, states or counties shows no public health benefit. British Columbia is 98% fluoridation free and has the lowest dental caries rates of any Canadian Provence.
While public health agencies fight and spend millions to add fluoride to water and think the fluoride policy is a star in their crown, the thought and good feelings are not backed up with reasonable scientific evidence.
My public health profession is taught that any public health measure’s effectiveness must be measured in the community at large, not just in vitro or in vivo.
Fluoridation no longer shows a public health benefit if it ever did.
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Bill,
Standard 60 applies to unwanted contaminants introduced by a primary water additive. Fluoride is a primary additive. HFA is simply the vehicle utilized to transfer this ion into water, The only mandated maximum for fluoride in drinking water is the EPA primary MCL of 4.0 ppm.
Steven D. Slott, DDS
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Bill,
In your response to Chuck you state: “My public health profession is taught that any public health measure’s effectiveness must be measured in the community at large, not just in vitro or in vivo.”
Exactly! The peer-reviewed obversational studies which you disparage, while constantly demanding blood and urine levels, do just that. They clearly demonstrate the benefit of the public health initiative of water fluoridation on whole populations.
You are finally getting it!
Steven D. Slott, DDS
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Steve,
The evidence clearly shows there is no current public health benefit with fluoridation. The decline in dental caries is not due to fluoridation when looking at the public at large.
Steve, we agree the evidence must be measured in the public at large. Perhaps you have not seen the evidence. May I send you some research? I need your email. (And anyone else who would like some).
Mine is bill@teachingsmiles.com
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Thank you Bill, but I have no need for “research” from “fluoridealert”.
The following peer-reviewed evidence does indeed clearly show a current public health benefit of fluoridation:
1) Results
Children from every age group had greater caries prevalence and more caries experience in areas with negligible fluoride concentrations in the water (<0.3 parts per million [ppm]) than in optimally fluoridated areas (≥0.7 ppm). Controlling for child age, residential location, and SES, deciduous and permanent caries experience was 28.7% and 31.6% higher, respectively, in low-fluoride areas compared with optimally fluoridated areas. The odds ratios for higher caries prevalence in areas with negligible fluoride compared with optimal fluoride were 1.34 (95% confidence interval [CI] 1.29, 1.39) and 1.24 (95% CI 1.21, 1.28) in the deciduous and permanent dentitions, respectively.
——Community Effectiveness of Public Water Fluoridation in Reducing Children's Dental Disease
Jason Mathew Armfield, PhD
2) CONCLUSIONS:
Children with severe dental caries had statistically significantly lower numbers of lesions if they lived in a fluoridated area. The lower treatment need in such high-risk children has important implications for publicly-funded dental care.
——Community Dent Health. 2013 Mar;30(1):15-8.
Fluoridation and dental caries severity in young children treated under general anaesthesia: an analysis of treatment records in a 10-year case series.
Kamel MS, Thomson WM, Drummond BK.
Source
Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand.
3). CONCLUSIONS:
The survey provides further evidence of the effectiveness in reducing dental caries experience up to 16 years of age. The extra intricacies involved in using the Percentage Lifetime Exposure method did not provide much more information when compared to the simpler Estimated Fluoridation Status method.
—–Community Dent Health. 2012 Dec;29(4):293-6.
Caries status in 16 year-olds with varying exposure to water fluoridation in Ireland.
Mullen J, McGaffin J, Farvardin N, Brightman S, Haire C, Freeman R.
Source
Health Service Executive, Sligo, Republic of Ireland.
4) Abstract
The effectiveness of fluoridation has been documented by observational and interventional studies for over 50 years. Data are available from 113 studies in 23 countries. The modal reduction in DMFT values for primary teeth was 40-49% and 50-59% for permanent teeth. The pattern of caries now occurring in fluoride and low-fluoride areas in 15- to 16-year-old children illustrates the impact of water fluoridation on first and second molars.
—-Caries Res. 1993;27 Suppl 1:2-8.
Efficacy of preventive agents for dental caries. Systemic fluorides: water fluoridation.
Murray JJ.
Source
Department of Child Dental Health, Dental School, University of Newcastle upon Tyne, UK.
5). CONCLUSIONS:
Data showed a significant decrease in dental caries across the entire country, with an average reduction of 25% occurring every 5 years. General trends indicated that a reduction in DMFT index values occurred over time, that a further reduction in DMFT index values occurred when a municipality fluoridated its water supply, and mean DMFT index values were lower in larger than in smaller municipalities.
—-Int Dent J. 2012 Dec;62(6):308-14. doi: 10.1111/j.1875-595x.2012.00124.x.
Decline in dental caries among 12-year-old children in Brazil, 1980-2005.
Lauris JR, da Silva Bastos R, de Magalhaes Bastos JR.
Source
Department of Paediatric Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Steven D.Slott, DDS
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Steve,
“Thank you Bill, but I have no need for “research” from “fluoridealert”.”
Fluoridealert, to my knowledge, does not do research. I presume you mean if FAN has the research on their website then automatically it is of no value? Regardless of whether it comes from the British Medical Journal, Journal of American Dental Association or any other Journal. If fluoride alert has it on their website then you reject it automatically. Or am I misunderstanding you? If so, be more specific.
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Biull,
‘If fluoride alert has it on their website then you reject it automatically.”
I automatically reject any cite to “fluoridealert”. Connett has so distorted information on that site through the years that nothing on there can trusted for accuracy. If you care to cite something which I will take seriously, then do so from its primary location. I have no desire to waste time reading anything that has been filtered through “fluoridealert” or any other such antifluoridationist website.
If you are attempting to make the delayed eruption argument, it has no merit.
Steven D. Slott, DDS
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Thanks Bill. Its funny how these people slink from actually looking at FAN’s site when asked – yes, to look at all the 1000’s of quality and diverse research done from all over the world – and just because they want to pick a fight over (a Professor of Toxicology) Paul Connett’s mighty efforts to provide a Universal perspective along with a depth of reports, Science and Research done by reputable organisations, including governments, Dental Associations, Chinese, British and European Scientists. But, hey, the FAN website doesn’t need Sloth’s or Parrott’s ‘say so’ anyway – the site speaks for itself – reputable and reliable; and millions of people use that site now, and as the research is not FAN’s – no – it is decades of other professional and Scientific people working to raise awareness of fluorides effects on soft tissues (and not just on ‘teeth’ as if that was the only part of the body that exists like the Sloth’s and Parrots would have us all believe). These researchers can’t ALL be ‘wrong’ just because a few promoters of fluoridation don’t like the Truth being told. Word of mouth has brought people to FAN’s site; not promoters spending the big bucks to peddle their industrial waste slurry muck from the Aluminium smokestack chimneys! Simple integrity has won; not, bucks or lies. And, people can make up their own minds once they do their own research. FAN doesn’t tell people how to think; just provides the studies in one convenient website (depth and breadth over 1000’s of quality, fully referenced, Scientific, articles) for anyone – Medical, professional or lay people – to do their own research and come to their own conclusions. FAN are not bullying or forcing their opinions on others – unlike the promotors who have dumped waste into the water so no-one can avoid the stuff. So who cares in the long run, what the promotors opionions are. We are all entitled to choose what we put in our bodies; and if our teeth rot due to lack of poor diet and too much sugar, we pay our own bills thank you very much – not the dentists or promotors who profit.
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Surprise, Surprise!!! ASWLA approves of “fluoridealert”
This shocking development says all that needs to be said about the credibility of that little website…..
Steven D. Slott, DDS
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ASWLA is an archive of letters – not a research site – from people all over Australia, doing their best to extract honest answers from politicians, government bodies, doctors, medical and university people, who have yet to provide research answers. BTW… its now being read on a regular basis each and every day from people all over the world – over 95 countries now. Take it or leave it Sloth, you are not going to win your battle by denouncing all those 100’s of 1000’s of people asking for valid answers. You only make yourself look really silly by doing so – that is bully-boy tactics to demean people asking valid questions. Its the public’s right to ask; and demand answers from the ‘health’ bodies – information which they are not receiving, unless you call en-masse letters that continue to support fluoridation blanket form, without responding to the individual questions raised. ASWLA is not a research site (although many letters have fantastic links to various Scientific sites, journals and political archives); no, it is simply, a letter archive – little or not in reputation; and that is all ASWLA aims to be. ASWLA does not seek anyone’s approval or disapproval – and especially, not from promotors. No, this site was set up just to archive letters, and keep a record of what was asked of our political, medical and dental bodies; and we ask the public to send through the responses they receive. Funny though, that almost every letter archived, has not received a response from those written to….. Letters that ask the truth of those in power including mainstream media who rarely, if ever, publish any of the public’s valid enquiries. Funny that, as if fluoride was so transparent, why do the media love to avoid and hide, public enquiry on fluoridation? What a whitewash. Our little site is doing just fine with or without you Sloth. The public will continue to ask questions and write letters. If you are so upset by our little site, don’t worry your sweet head about a thing. We’ll stay a little volunteer group; but read all over the world despite you. We let people speak their mind; and make up their own minds, according to the (lack of) response they receive. Its just a record of letters. Nothing for you to be worried about, eh, if fluoride is so good for everyone, all ages, regardless of health, age or, need for the stuff. What are you worrying about then…. why even bother to raise the issue with ASWLA. You already have had your way…. a forced masse medication on everyone.
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ASWLA
Who said I was “upset” by your little site? I didn’t even know you existed, much less had a site, until I saw your previous posts on this site……nor could I care less. Little antifluoridationist websites proclaiming they have the “truth” are truly comical, are a dime a dozen, and are accessed only by other antifluoridationists seeking confirmation of their bias.
Steven D. Slott, DDS
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Oh good then. Be happy Sloth. ASWLA loves to see you happy. Dime a dozen or not, just like yours, eh. And by the way, we’ve noticed that even government bodies are reading the letters (WordPress has a way of seeing where enquiries come from). But, nothing to worry about, eh. Glad you are not upset at all. Cheers. Enjoy your happiness Sloth.
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PS. Thats government bodies from all over the world. You see, some countries don’t fluoridate; and that means they wonder why those that do, do – especially when those countries are not transparent in their responses to the public. Those countries are not silly enough to ignore valid concerns of their people; and so, they wonder why (in this instance) the Australian government and its buddies, do ignore their people. Take care Sloth; and in the meantime, ASWLA wishes you good dental health from ingesting what you wish to; but one day you may realise, that the care of teeth does not revolve at all around the proverbial tooth fairy God of fluoridation. Millions of other people in the bulk of the worlds unfluoridated countries (including most of Europe) have proven that; and they also realise that giving people a choice in what they put in their body is ethical and, just, which is more that the promotors believe in forcing their archaic, outdated practice upon us all.
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“Just like yours”? Hmmm, news to me. I had no idea I had a website.
Yes, maybe “government bodies” are reading whatever “letters” you have on your little site. Government workers need some good comic relief from time to time. Helps to relieve some of the stresses for when they return to their important duties.
Steven D. Slott, DDS
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“but one day you may realise, that the care of teeth….”
OMG!!! What remarkable dental insight and wisdom from the caretaker of yet another in a loooong line of little “Safe Water (fill in the name of your community)” websites!
So, you’re leaving, just when it’s getting hilarious?? Where to now? NASA to set straight their engineers with your wisdom and insight on space exploration?
Steven D. Slott, DDS
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“Just like yours” ie. That means, comments (from other people) – just like your comments. ASWLA little site knows that you like to blog incessantly on many many forums, website hopping like a frog in a pot of warming water, spouting your own very unique brand of caustic acid tongued writing, deriding any one’s feelings (god help anyone who feels anything as one must never do that, eh, even if they suffer sensitivity from fluoridation’s caustic affects). Yes Sloth, you are a lot like fluoride acid – eating away at all that is whole, but professing purity and goodness – that you have everyone’s best intentions at heart, but quietly, you corrode. Yes Sloth – you are such an angel, we all know that now….. (mmmmm). But you know dear Sloth, there will always be those who will defend their right to put into their body, what they wish to – and that is their business and ethical right. So go and look after those that want fluoride, ok? Leave those that don’t, alone – you have no right to say they are wrong for choosing so. You are, after all, already happy, eh. So go be happy, and leave others to speak their own mind if they wish to – that they don’t want fluoride – just as you want to have it – so goody for you Sloth – go enjoy your daily dose of fluorosilic acid ions. ASWLA is very happy you in your right to spout off your viewpoint — just like those letter writers do too. Enjoy your writing on a zillion websites – websites you don’t want to have the responsiblity to put together yourself — mmm, why you are a bit of an analogy here – one could liken you to a well veneered mouth (due to fluoridations non-effects against the mighty sugar intake that a modern diet entails) – yes, a mouth full of it but doing no good really, in stemming the tide of rot. I hope the laughs that all those stressed government people have gets alleviated enough so they can finally respond to some of those letters…. that would be really novel and finally give the public what they are asking for ie. Transparent studies on the long-term effects of ingesting industrial waste year in, year out, without anyone checking on the health effects of said individuals.
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Steve,
We have gone over this ecological study before in rather significant detail. I just read it again and here are a few concerns.
“Community Effectiveness of Public Water Fluoridation in Reducing Children’s Dental Disease” Jason Mathew Armfield, PhD
I appreciate Jason writing the report and my comments are not an attack on him personally, but rather emphasis on limitations of the study. Perhaps Jason would agree and perhaps he would not. I have not contacted him.
Jason is the sole author. Would no other authors join him? Jason has consistently promoted fluoridation and like all of us, he has bias which is evident in the article. His award from Colgate should be noted.
The study is not a prospective randomized controlled trial; however, the study includes a large number of cohorts which must be qualified by a random sampling of those cohorts. How many were actually used in the study is not stated.
Jason speculates without reference: “In countries such as the U.S., where there are no established school dental programs to provide preventive and restorative treatment to school-aged children, water fluoridation is perhaps even more important and is likely to be even more effective as a population preventive oral health practice.”
Dental examiners were not calibrated.
Delay in tooth eruption was not considered. That factor in and of itself could negate any differences with fluoridation.
80% of younger children seen by SDS and substantially decreasing as they get older. One would expect SDS appeals to low income families due to cost. Again, one area may have more utilization than another area due to SES. SES is a very powerful confounding factor.
Postal code was used for SES. Confidence is not high.
Did the cohorts actually drink the water?
A non-normal distribution of dmft and DMFT scores was acknowledged.
Standard deviation since last dental visit was significantly more for non-fluoridated. Obviously those on fluoridated water are seeing the dentist/hygienist more frequently, probably higher dental education, motivation, and encouragement.
SES is a highly significant factor for dental caries. I’m not sure why, but it is significant.
Non-fluoridated cohorts were younger and significantly poorer (unweighted) with more rural.
Fluoridated non-fluoridated
35% of high SES 13% high SES
87% Metropolitan 26% Metropolitan
Lets look, for example, closer at the DMFT data for 8 to 15 year olds. The data is reasonably consistent at each age finding some difference. However, when corrected for delayed eruption of the teeth (different studies finding from 4 months to a year or more delay), the benefit is reduced or wiped out. In other words, the study needs to be done measuring how long the teeth had been in the mouth rather than how old the cohort is.
Let me be specific with the example.
8 year olds on <0.3 ppm had 0.50 DMFT and 9 year olds had exactly the same.
9 year olds on low fluoride had 0.59 DMFT and 10 year olds on high fluoride had similar of 0.57.
And if we are going to be correct statisticians, we will measure from the total possible teeth rather than 0. In other words, 15 year olds have 28 teeth. Not including the delay in eruption:
15 year olds on low fluoride had 25.82 good teeth.
15 year olds on high fluoride had 26.35 good teeth.
That represents about half a tooth or about 2% DMFT improvement.
Statistical methods were then used to flesh out a theoretical benefit.
Jason acknowledged confounding factors such as whether the child actually lived in the fluoridated communities all their lives or moved.
Individual exposure data was not collected which in other studies finds about 10% error just for fluoridated water to the house where the child lived.
The author does not approach the study from a null hypothesis but is and has shown a strong bias to fluoridation. He found what he was looking for.
Steve, the author is rather candid, "Researchers typically avoid the community-level approach adopted in this study because it fails to control for a number of individual-level factors that may also be related to caries experience." Perhaps that is why no other authors were willing to sign on to this report."
Measured serum and urine fluoride concentrations were not included. This study is little more than estimates and assumptions.
The author brings up the potential of "other differences between the two populations" but then addresses the potential for greater fluoride in the fluoridated communities, "However, there is no reason to believe that children living in fluoridated areas have a greater use of other fluoride products than do children living in non-fluoridated areas."
Of most concern to me is the failure to even mention or consider the huge unknown confounding factor which cut dental caries in from 12 teeth to 6 teeth before fluoridation started in the USA. A change of half a tooth is very small compared to 6 teeth. The rate of decline before and after fluoridation has been consistent, fluoridation has not shown a change in rate.
What caused the huge monster decline in dental caries prior to dental fluoridation? Could it be that the difference of 2% (or about 25% depending on which way you calculate the change) is simply the result of that huge unknown?
Jason's conclusion is not supported by the data. However, it should be added to the numerous studies of similar quality and limitations which have found either benefit or lack of benefit.
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ASWLA
I’ve got it!! It just dawned on me where you could have obtained your remarkable wisdom and insight on proper dental health. Sesame Street quite often has a “tooth fairy” segment on Saturday mornings, featuring Oscar, Cookie Monster, Bert, Ernie……. the whole gang learning how to care for their teefies! That explains it!
Steven
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You are so funny Sloth! Hilarious……………. ! Glad you are happy and laughing… Blimey, if a person believed you, they really do believe in tooth fairies!
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Bill,
Thank you, but you are not qualified, or objective enough to give a proper critique of peer-reviewed studies such as these. You have clearly demonstrated your confirmation bias in your acceptance of the absurdly flawed Chinese studies dug out of obscure Chinese journals, studies for which there exists no evidence that they were even peer-reviewed, yet which agree with your ideology……while criticizing high quality, properly peer-reviewed studies published in respected scientific journals, but which disagree with your ideology.
As I stated previously, the theory of delayed eruption due to fluoride has no merit.
“CONCLUSION:
Exposure to fluoride in drinking water did not delay the eruption of permanent teeth. The observed difference in dental caries experience among children exposed to different fluoride levels could not be explained by the timing of eruption of permanent teeth.
——Does fluoride in drinking water delay tooth eruption?
Jolaoso A, Kumar J, Moss ME.
J Public Health Dent. 2014 Aug;74(3):241-7. doi: 10.1111/jphd.12053. Epub 2014 Mar 17.
© 2014 American Association of Public Health Dentistry.”
‘However, while there is well established evidence of differences in dental
development at similar ages across cultural and ethnicity groups, there is not evidence that water fluoridation is a cause of differential tooth eruption.
Information recently published by the Fluoride Action Network based on Australian data, suggesting a substantial difference in tooth eruption between fluoridated and non fluoridated areas of Australia, have been confirmed as being based on erroneous data.
The Australian research centre (ARCPOH) responsible for these data have confirmed the data error and reported that when the error is corrected there is little variation in the number of permanent teeth present at each age between children in Queensland and all of Australia.
The studies and reports cited by Professor Connett to try and validate an argument for delayed tooth eruption either do not make the claims he suggests, or do not have direct relevance to trying to assess the issue. The claimed association is at odds with the published literature which indicates minimal variation in eruption time of permanent teeth by exposure to fluoride. A rational explanation exists for the minimal variations that have been reported based on the relationship between fluoride exposure, caries experience in the primary teeth and emergence timing for the permanent teeth.
Information on the effect of water fluoridation on adult oral health, when any
potential effect from delayed tooth eruption would have disappeared, continue to show a benefit from from water fluoridation both in international and in New Zealand data”
— National Fluoridation Information Service (2011): Does Delayed Tooth
Eruption Negate The Effect of Water Fluoridation? National Fluoridation Information Service
Advisory June 2011, Wellington, New Zealand.
Steven D. Slott, DDS
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ASWLA
The comic relief accorded by your comments is much appreciated! Say hi to Oscar and Miss Piggy for me!
Steven D. Slott, DDS
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You can always tell the activists are in town ,when they get pushed into a corner, they start calling people names or use CAPS. It happens all the time and the more upset they are, the more caps they use. It must be something that is missing out of their water?
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If I had a nickel for every time I’ve been called a liar by a cornered, frustrated antifluoridationist, I could retire. That’s always the final defense……..or well, I guess the final, final defense would be when they call me a LIAR. That’s when I know I’ve sliced into the sweet spot of the right nerve.
Steven D. Slott, DDS
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Steve:
You don’t like the peer reviewed research from China but you are happy to drink their contaminants. Amazing.
You said, “Thank you, but you are not qualified, or objective enough to give a proper critique of peer-reviewed studies such as these.” Your pious humility amazes me. You are qualified, but I am not? I suggest the FDA CDER but you want me to trust you and believe you instead of the FDA CDER.
Again, you attack the messenger. Stick to the science instead of putting other people down.
The research is mixed on delay in eruption, efficacy, safety, exposure, and most all aspects of science. Your categorical rejection of research which does not support fluoridation is bias to the extreme.
That is why I demand FDA CDER oversight and demand prospective RCT studies.
Are you suggesting the Choi, Grandjean Harvard School of Public Health study was not peer reviewed? Of course it was. And the studies they used were peer reviewed. In fact, the measured evidence using serum and urine fluoride concentrations along with dental fluorosis and evaluating confounding factors such as iodine and arsenic is a step ahead of research here in the USA. Good scientists here have been calling for those measurements for years and generally lacking in USA studies.
Is it all studies from other countries and languages or just China which you reject? Is it a race thing or a language thing which brings out your anger?
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Where’s Cedric?
Have we upset him over the Ukrainian topic?
Once upon a time, when the ASWLAs of this world popped their heads up and out of their burrows we could all expect a right royal entertainment show as he surgically decapitated them.
Steve’s doing well but it’s just not the same. 😉
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“That is why I demand FDA CDER oversight”
And yet, fluoride in water is already regulated by the EPA. Another government agency. What, exactly, makes you think that simply by switching which government agency regulates fluoride in water, you will somehow alter their standards or recommendations?
What makes you think that, if fluoridate in water could be demonstrated to be dangerous in concentrations between 0.7 – 1ppm, the EPA would not put a stop to the practice of fluoridation and, equally importantly, mandate that naturally-occurring fluoride (presently allowed at up to 2ppm) be removed from the USA’s water supplies?
It’s pretty clear that you’re obsessed with trying to get people to believe fluoride in water ought to be regulated as a drug (a nonsensical proposition, given it’s naturally occurring), rather than actually trying to demonstrate any harm arising from the practice of water fluoridation.
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A Bayesian analysis of multivariate
doubly-interval-censored dental data
ARNOSˇT KOMA´ REK∗, EMMANUEL LESAFFRE
Biostatistics (2005), 6, 1, pp. 145–155
“Our analysis shows no convincing effect of fluoride-intake on caries development. . .
The results show that the protective effect of fluoride-ingestion is not
convincing. We observed a positive effect only for mandibular teeth of boys. This agrees with current guidelines for the use of fluoride in caries prevention, where only the topical application (e.g. fluoride in
tooth paste) is considered to be essential (Oulis et al., 2000).”
Ainsworth NJ. (1933). Mottled teeth. British Dental Journal 55: 233-250.
Campagna L, et al. (1995). Fluoridated drinking water and maturation of permanent teeth at age 12. Journal of Clinical Pediatric Dentistry 19(3):225-8. “Girls from the fluoridated Boston area were shown in this study to have a significantly (p<0.05) delayed dental age when compared to their chronological age according to the tables of Nolla."
Feltman R, Kosel G. (1961). Prenatal and postnatal ingestion of fluorides – Fourteen years of investigation – Final report. Journal of Dental Medicine 16: 190-99.
Freitas JA, et al. (1971). Influence of fluoridation in the chronology of eruption of permanent teeth. Estomatologia e Cultura 5: 156-165.
Kunzel VW. (1976). [Cross-sectional comparison of the median eruption time for permanent teeth in children from fluoride poor and optimally fluoridated areas] Stomatol DDR. 5:310-21. "Abstract
Nearly 57000 children (aged from 4 years, 4 months to 15 years, 9 months) of Karl-Marx-Stadt (1.0 ppm F) and Plauen (0.2 ppm F) were examined to compare the mean eruption times of permanent teeth before and after 12 years of water fluoridation. Whereas a direct influence of internally administered fluorides is to be excluded, an indirect action on the premolars may be assumed with certainty. The delayed eruption of all premolars in children of the area with optimally fluoridated water was the only systematic effect which could be detected. This normalization is explained by a prolonged stay of the deciduous teeth in the dental arch which is due to a lesser caries prevalence."
Lemmon JR. (1934). Mottled enamel of teeth in children. Texas State Journal of Medicine 30: 332-336.
Leroy R, et al. (2003). The effect of fluorides and caries in primary teeth on permanent tooth emergence. Community Dentistry and Oral Epidemiology 31(6):463-70. "Caries experience in the primary molars had a more pronounced impact on the timing of emergence of the successors than exposure to any of the four fluoride parameters."
Limeback, H. (2002). Systemic Fluoride: Delayed Tooth Eruption and DMFT vs Age Profiles. abstract presented at IADR/AADR/CADR 80th General Session. San Diego, California. March 6-9. "CONCLUSION: The small benefit that remains today from water fluoridation can, in part, be explained by fluoride ingestion retarding tooth eruption, resulting in a delay in dental caries. The effect of the delay in tooth eruption from systemic fluoride is likely less evident in more recent fluoridation studies because of increasing ingestion of other sources of fluoride such as fluoridated dentifrices."
Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. H.K. Lewis Ltd, London.
Short EM. (1944). Domestic water and dental caries. VI. The relation of fluoride domestic waters to permanent tooth eruption. Journal of Dental Research 23:247-255.
Virtanen JI, et al. (1994). Timing of eruption of permanent teeth: standard Finnish patient documents. Community Dentistry and Oral Epidemiology 22(5 Pt 1):286-8."The emergence of the teeth of the second phase of the mixed dentition was later in the children living in an endemic fluoride area, this difference being statistically greater for the boys than for the girls (95% Cl for differences between means was used to evaluate statistical significance)."
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Bill, in order to overcome the charge of cherry-picking could you take, for example, the first paper. Described to us what was actually measured, where the study was done, what form did the fluoride intake take (eg, water, supplements, etc).
Thanks.
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I have indeed made charges that fluoridationists cherry pick the literature to support their bias. And those wanting freedom cherry pick the evidence supporting their side. For 25 years I supported fluoridation and the last 8 I now support freedom of choice.
Like I said, there are articles on both sides of the issue and the best scientists who weigh evidence are the FDA CDER.
Steve has presented some articles which did not find a delay and I provided some which did find a delay, predominantly for girls. Unless the study specifically evaluates gender differences, the results may not be significant.
Komarek is a Biostatistics article and I will provide some of the information here. This study has some unique features in evaluating the time from true emergence of the tooth until true caries were diagnosed, rather than age of the patient.
Komarek felt there was no good way of measuring individual fluoride exposure and used dental fluorosis. I would suggest urine and serum fluoride are reasonable sources for measuring individual exposure. However, I believe it was later that Levy et al worked on calibration of national laboratories to gain more consistent serum and urine fluoride concentration testing. Difficult testing at such low concentrations.
Let me know if you would like the full article. I am not a biostatistician, but the first part is pasted here and answers some of your questions.
Summary
“A Bayesian survival analysis is presented to examine the effect of fluoride-intake on the time to caries
development of the permanent first molars in children between 7 and 12 years of age using a longitudinal
study conducted in Flanders. Three problems needed to be addressed. Firstly, since the emergence time
of a tooth and the time it experiences caries were recorded yearly, the time to caries is doubly interval
censored. Secondly, due to the setup of the study, many emergence times were left-censored. Thirdly,
events on teeth of the same child are dependent. Our Bayesian analysis is a modified version of the
intensity model of H¨ark¨anen et al. (2000, Scandinavian Journal of Statistics 27, 577–588). To tackle the
problem of the large number of left-censored observations a similar Finnish data set was introduced. Our
analysis shows no convincing effect of fluoride-intake on caries development.
1. RESEARCH QUESTION AND COLLECTED DATA
In this paper, we present a Bayesian analysis of a longitudinal dental data set (the Signal Tandmobiel
study) to tackle the following research question: Does fluoride-intake at a young age have a protective
effect on caries in permanent teeth? Our analyses will be limited to the caries experience of the four
permanent first molars (teeth number 16, 26, 36, 46 in European dental notation).
In this study, detailed oral health data at tooth and tooth-surface level (caries experience, gingivitis,
etc.) from 4468 Flemish schoolchildren (2315 boys and 2153 girls) born in 1989 were collected annually
between 1996 and 2001. The children were cluster-sampled from randomly chosen Flemish schools. Two
stratification factors, geographical location (five provinces) and educational system (three school systems),
were taken into account. Further details on the design of the study can be found in Vanobbergen et al.
(2000).
Our data suggest that the use of fluoride reduces caries experience in primary teeth, see Vanobbergen
et al. (2001) and that fluoride-intake delays the emergence of the permanent teeth, see Leroy et al. (2003).
The latter result raises the question whether the fluoride-intake only reduces the time at risk or whether it
has also a direct protective effect on caries experience.
Unfortunately, fluoride-intake in children cannot be measured accurately. Indeed, fluoride-intake can
come from: (1) fluoride supplements (systemic), (2) accidental ingestion of toothpaste or (3) tap water.
Further, the intake from these sources can be recorded only crudely. Therefore, it was decided to measure
fluoride-intake by the degree of fluorosis on some reference teeth. Fluorosis is the most common sideeffect
of fluoride-intake and appears as white spots on the enamel of teeth. For this analysis, a child was
considered fluoride-positive (covariate fluor = 1) if there were white spots on at least two permanent
maxillary incisors during the fourth year of the study or during both the fifth and sixth year of the study.
The prevalence of fluorosis was relatively low (480 children, 10.8%). In our analysis, 480 fluorosis
children and 960 randomly selected fluorosis-free children are included. Case-control subsampling was
done to reduce computation time. To check that it did not destroy the stratification, we constructed a
5 × 3 × 2 contingency table with factors province, school system and whether the child is in the
subsample or not (subsample). A p-value of 0.13 was obtained for the significance of the interaction of
the third factor with the other two using a likelihood-ratio test in a log-linear model, implying that the
stratification is similar in the used and the discarded subsamples.
The prevalence of caries experience at the age of 12 was negligible (at most 1.4%) for all permanent
teeth except for the first molars (teeth used in the analysis). For these teeth, the prevalence was 25.8% in
children with fluorosis compared to 29.4% in fluorosis-free children, with prevalence of 23.3% and 27.7%
for boys, and 27.9% and 31.2% for girls, respectively. Thus, at first sight, the impact of fluoride-intake
seems to be minor. However, since the emergence of permanent teeth might be delayed by fluoride-intake,
evaluating the impact of fluoride-intake should take into account the time at risk for caries. Hence, in
our analysis, the response will be the time between emergence and the onset of caries development.”
Note that Komarak included data from Virtanen, 2001 to better estimate true eruption time for some cohorts because 86% of first molars had erupted when the study began. Combining studies can have problems and lowers the confidence.
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I have the article Bill, and my impression was also that no measurement of F intake was made. One has to go to other papers to find the details but my impression is that children were not exposed to water fluoridation, but fluoride supplements.
Frankly, I would pay more attention to the others papers reporting this study.
However, I find your blanket listing of references as if they prove something rather childish. One should use citations as part of a balanced argument â not as a sort of pissing competition.
It amazes me how anti-fluoridationists will post links or citations without any discussion and think it proves something. It doesnât, except immaturity on their part.
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Ken,
Now you call me “childish.” Every time you belittle me, attack me personally and use disparaging remarks it is because the flawed theory of fluoridation cannot be supported with adequate quality science and fluoridationists have to resort to personal attacks. Resorting to personal attacks is a desperate attempt to deflect the cruel and embarrassing fact that fluoridation is not based on quality science, ethics or law.
Steve presented two references from biased sources reporting no significant delay in tooth eruption due to the toxic effects of excess fluoride ingestion. Steve cherry picked the research. In his defense, he made no representation that he was providing research on both sides of the eruption controversy.
To balance Steve’s submission, I provided the other side with 11 studies (human) reporting delay in eruption. There is at least one animal study which I have seen.
Did Steve cherry pick the evidence to make his point? Yes. Did I pick studies to counter his? Yes. Your response is a personal attack calling me “childish.”
When a person has little or no evidence to counter the message, they attack the messenger.
It is long past time to have the FDA CDER review the scientific evidence on efficacy and safety of fluoride ingestion and approve a label with dosage and cautions.
Oh, right. FDA CDER has already made that judgment and sent a letter to 35 fluoride manufacturers withdrawing approval because the research did not show that ingesting fluoride was effective.
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“Where’s Cedric?”
I agree, Chris! Uh….I mean, I AGREE, Chris!! I’ve wondered the same. No one, certainly including me, can hold a candle to his hilarious surgical precision!
Cedric, we need you man!
Steven D. Slott, DDS
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Oops, sorry, Richard. I must’ve had Chris on my brain. Probably a function of my boredom wth Bill.
Steven D. Slott, DDS
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Bill,
——-“Is it all studies from other countries and languages or just China which you reject? Is it a race thing or a language thing which brings out your anger?”
Your bizarre reference to “race” is clear evidence of your own bigotry. There is nothing in my comments to even suggest such a ridiculous mindset on my part, nor is there anything to suggest I have any “anger” in regard to fluoridation studies. As with your bizarre references to “religious beliefs” with which you attempted to discredit me, you need to cease your lame attempts to project your own mindset onto me, and focus on the issue.”
——“You don’t like the peer reviewed research from China but you are happy to drink their contaminants. Amazing.”
First of all, there is no evidence that the 27 Chinese studies on which you and Connett base your absurd claims of “IQ reduction”, were ever peer-reviewed. If you have such evidence, present it.
Second, two of the largest manufacturers of HFA utilized in the US to fluoridate its water systems, are Mosaic, of Florida, and Key, of North Carolina. These two states have an ample supply of the naturally occurring phosphorite rock from which HFA is extracted. Be this as it may, however, I certainly have no problem with fluoridation products from China being utilized to fluoridate my water system. Unlike you, I have no paranoid distrust of the US government, or its EPA. I have full confidence that, regardless the source of fluoridating compounds, the water from my tap meets all EPA mandated Standard 60 certification requirements, or it would not be allowed.
——”Your pious humility amazes me. You are qualified, but I am not? I suggest the FDA CDER but you want me to trust you and believe you instead of the FDA CDER.”
“Again, you attack the messenger. Stick to the science instead of putting other people down.”
I am qualified for what, exactly? My claims that the Chinese studies were absurdly flawed come directly from Choi and Grandjean, themselves. Let me know, and I will gladly cite, page by page of their Review in which they report such flaws in these studies.
I couldn’t care less who you trust. The fact remains, that the FDA has no jurisdiction or regulatory authority over fluoridated water. That is under the full control of the EPA.
I haven’t attacked any “messenger”. I have stated facts. The “messenger” nonsense is simply a transparent, lame attempt to insinuate that your personal opinions and ideology are some sort of objective “message” that you are simply delivering. It is a tactic that is constantly attempted by antifluoridationists. Your continual defensiveness and whining about being “attacked” have gotten very tiresome
——-“That is why I demand FDA CDER oversight and demand prospective RCT studies.”
Fine with me. Demand to your heart’s content.
——-“Are you suggesting the Choi, Grandjean Harvard School of Public Health study was not peer reviewed? Of course it was. And the studies they used were peer reviewed.”
I’ve concluded that either you can’t read, or you have a problem with reading comprehension. I did not state that the Harvard Review was not peer-reviewed. I stated that there is no evidence that the Chinese studies which they reviewed, were peer-reviewed. Understand the difference? Once again, if you have valid evidence that these Chinese studies were peer-reviewed, present it.
Your continual attempts to defend these Chinese studies while discarding the high quality, properly peer-reviewed studies which disagree with your personal ideology are clear evidence of your confirmation bias and incompetence in evaluating scientific studies. I stand by my statement…..you are not qualified, or objective enough, to properly critique peer-reviewed scientific studies such as those I have presented.
Steven D. Slott, DDS
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Steve, “First of all, there is no evidence that the 27 Chinese studies on which you and Connett base your absurd claims of “IQ reduction”, were ever peer-reviewed. If you have such evidence, present it.”
When they were published, I checked on peer review. They were peer reviewed before publishing.
Because the theory of fluoridation is not supported with good science, proponents resort to personal attacks.
Steve said, “I stated that there is no evidence that the Chinese studies which they reviewed, were peer-reviewed.”
Are you speculating that the Harvard researchers simply grabbed garbage and presented the garbage for publication and the peer reviewers reviewing Choi/Grandjean agreed the garbage was just fine?
You know fully well the evidence on IQ and neurological harm has been peer reviewed acceptable at least when Choi/Grandjean used the data. And when the research was originally published it was peer reviewed at that time.
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Bill
I gave up counting the number of papers you have cited in this blog before I got half way. They read like a list of references at the end of a paper in a peer reviewed journal.
Peer reviewed papers use their references to support the original work detailed in the guts of the paper.
Presenting the references by themselves gives the impression: “I’ll give the references. The people who read them will then know exactly what I got from them. That means that I don’t have to write any coherent arguments that people can pin me down to and refute using published research. I can then say that’s not what I meant and change the goalposts whenever I want.”
Your points may be clear to you, but not to many (most?) who read your comments.
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Bill,
—-“When they were published, I checked on peer review. They were peer reviewed before publishing.”
Sorry, but your anecdotal assertions are meaningless. Choi and Grandjean performed no quality assessment of the studies, with only one of the studies seeming to have appeared in a peer-reviewed journal.
—-“Because the theory of fluoridation is not supported with good science, proponents resort to personal attacks.”
More whining about “attacks”. Yes, we’ve seen your definition of “good science”: Anything that supports antifluoridationist nonsense, regardless the quality, quantity, or validity.
——“Are you speculating that the Harvard researchers simply grabbed garbage and presented the garbage for publication and the peer reviewers reviewing Choi/Grandjean agreed the garbage was just fine?”
I’m not “speculating” anything. I have no idea as to what Choi and Grandjean did. It’s unclear as to whether anybody does. I’m stating the fact that there is no evidence that these studies were even peer-reviewed.
—–“You know fully well the evidence on IQ and neurological harm has been peer reviewed acceptable at least when Choi/Grandjean used the data. And when the research was originally published it was peer reviewed at that time.”
I “know fully well” nothing of the sort. The “evidence” on which is based the absurd “IQ reduction” claim is nothing but a collection of Chinese studies dug out of obscure Chinese journals, on the effects of high levels of naturally occurring fluoride in the well-water of various Chinese, Iranian, and Mongolian villages. The level of fluoride in these wells ranged as high as 11.5 ppm. According to the Harvard reviewers themselves, these studies were missing key information, had questionable methodologies, and inadequate control for confounders.
Once again, that you ridiculously continue to defend these studies as being valid evidence of anything, while claiming that peer-reviewed studies published in respected journals, are not up to your “standards” of quality research…..is clear infication of your confirmation bias, and incompetence in evaluating scientific literature.
Steven D. Slott, DDS
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I find this claim of Bill’s very questionable – “When they were published, I checked on peer review. They were peer reviewed before publishing.”
Whether individual papers were peer reviewed or not is really meaningless for our own judgment of the research. However, the articles Choi et al used are extremely variable – some were just newsletter items, most were only a page or so long. One would be foolish to make any summary claim about them.
Choi et al admitted themselves they selected these reports to exclude western papers and because of their higher water F concentrations. This actually violates the principles of the statistical meta analysis they did.
And of course Choi et al are cited ad nauseum by at int-fluoridationists claiming it proves something about CWF – when of course it doesn’t.
I personally see some value in a few of these papers and these are worth pursuing. It is just a pity that none of them chose to analyse the obvious factor, severe dental fluorosis, and it’s possible role in learning difficulties..
This would be of real value for countries like China and India but of course is irrelevant to New Zealand where severe dental fluorosis is non-existent.
>
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May I suggest contacting the authors and Journals directly.
Here is contact for some authors.
Dr Xiang Quanyong, Department of Occupational Health, School of Public Health, Fudan University (Formerly Shanghai Medical University), Shanghai, 200032, China. E-mail: quanyongxiang@yahoo.com.cn or yxliang@shmu.edu.cn.
Center for Disease Control and Prevention, Jiangsu Province, China. Center for Disease Control and Prevention, Sihong County, Jiangsu Province, China.
See also http://en.cnki.com.cn
I would have more concern about peer review if most of the studies had been published by one Journal. But several Journals were used. Here are a few:
Chinese Journal of Public Health Management
Chinese Primary Health Care
Chinese Journal of Pathology
Chinese Journal of Control of Endemic Diseases
Journal of Applied Clinical Pediatrics
Endemic Diseases Bulletin (China)
Chinese Journal of Epidemiology
Chinese Journal of Endemiology
China with a fifth of the world’s population, has over 5,000 scientific Journals and a rich history with more than 2,000 years of research.
Here is an example:
Effects of endemic fluoride poisoning on the intellectual development
of children in Baotou
Li, Jing, Chen, Lin, Wang
161 161
[Translated by Julian Brooke and published with the concurrence of the Chinese Journal of Public Health Management 2003:19(4):337-8.]
EFFECTS OF ENDEMIC FLUORIDE POISONING ON THE
INTELLECTUAL DEVELOPMENT OF CHILDREN IN BAOTOU
Another:
Effects of fluoride on child intellectual development
under different environments
Hong, Cao, Yang, Wang
156 156
[Translated by Julian Brooke and published with the concurrence of
Chinese Primary Health Care 2001;15(3):56-7.]
RESEARCH ON THE EFFECTS OF FLUORIDE ON CHILD
INTELLECTUAL DEVELOPMENT UNDER DIFFERENT
ENVIRONMENTAL CONDITIONS
Another:
The effect of fluorine on the developing human brain
327 Du, Wan, Cao, Liu 327
[Translated by Shan Ying and published with the permission of the Chinese Journal of Pathology
1992;21(4):218-20.]
THE EFFECT OF FLUORINE ON THE DEVELOPING HUMAN BRAIN
Another
Effects of fluorine on the human fetus
321 He, Cheng, Liu 321
[Translated by Julian Brooke and published with the permission of the Chinese Journal of Control of Endemic
Diseases 1989;4(3):136-8.]
EFFECTS OF FLUORINE ON THE HUMAN FETUS
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Ken,
Would you please name the articles used by Choi which as you say were “just newsletter items, most were only a page or so long.”
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Steve, “The “evidence” on which is based the absurd “IQ reduction” claim is nothing but a collection of Chinese studies dug out of obscure Chinese journals,”
Please list the studies used by Choi which you have actually read and please forward a copy of them, or at least the abstract, to me. bill@teachingsmiles.com
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Bill, you are missing the point. I don’t care whether the studies were peer-reviewed or not. Grandjean and Choi make clear the seriousness of the flaws, to the extent where they dissociate the studies from CWF in the US. My point is that these studies so lack credibility that it is questionable as to whether they had even been peer-reviewed, a bare minimum for credibility.
Your continuing attempt to defend them while claiming the peer-reviewed studies which refute your ideology are of poor quality….is simply ludicrous.
My understanding is that attempts to contact these authors have been unsuccessful, anyway.
Steven D. Slott, DDS
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Bill, have a read of my analysis of the Choi et al study at Quality and selection counts in fluoride research
I am currently writing a post (probably up on Monday) replying to the attack by Theissen and Neurath on the Royal Society of NZ review. This will include some more comments on the Choi et al paper.
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Here is a breakdown of the size of the reports:
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Bill,
“Please list the studies used by Choi which you have actually read…..”
If you will read my comment, you will see that the evidence of the serious flaws to which I referred were in the Harvard Review, itself. The following are some of the flaws, and evidence of high concentration levels studied, which Choi and Grandjean noted in the Review.
From page 4 Conclusion:
“The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.”
——Developmental Fluoride Neurotoxicity: A Systematic
Review and Meta-Analysis
Anna L. Choi, Guifan Sun, Ying Zhang, Philippe Grandjean
Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 9
“Six of the 34 studies identified were excluded due to missing information on the number of subjects or the mean and variance of the outcome (see Figure 1 for a study selection flow chart and Supplemental Material, Table S1 for additional information on studies that were excluded from the analysis). ”
Page 13
“Children who lived in areas with high fluoride exposure had lower IQ scores than those who lived in low exposure or control areas.”
Once again, note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration, exactly in the range of the control groups in this study.
Page 13-14
“While most reports were fairly brief and complete information on covariates was not available, the results tended to support the potential for fluoride-mediated developmental neurotoxicity at relatively high levels of exposure in some studies.”
Incomplete information on covariates (controls). Relatively HIGH levels of fluoride. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.
Page 15
“The present study cannot be used to derive an exposure limit, as the actual exposures of the individual children are not known. Misclassification of children in both high- and low-exposure groups may have occurred if the children were drinking water from other sources (e.g., at school or in the field).”
Page 15-16
“Still, each of the articles reviewed had deficiencies, in some cases rather serious, which limit the conclusions that can be drawn. However, most deficiencies relate to the reporting, where key information was missing. The fact that some aspects of the study were not reported limits the extent to which the available reports allow a firm conclusion. Some methodological
limitations were also noted. Most studies were cross-sectional, but this study design would seem appropriate in a stable population where water supplies and fluoride concentrations have remained unchanged for many years. The current water-fluoride level likely also reflects past developmental exposures. In regard to the outcomes, the inverse association persisted between studies using different intelligence tests, although most studies did not report age adjustment of the cognitive test scores.”
Steven D. Slott, DDS
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Steve, you said,
“I don’t care whether the studies were peer-reviewed or not.”
OK. Serious back peddle.
Steve, “Once again, that you ridiculously continue to defend these studies as being valid evidence of anything, while claiming that peer-reviewed studies published in respected journals, are not up to your “standards” of quality research…..is clear infication of your confirmation bias, and incompetence in evaluating scientific literature.”
Obviously you have not read or understood what I have written.
There are no prospective randomized controlled trials on fluoridation or the chemicals used to fluoridate. There are no high quality studies. That’s on both sides of the issue. I am not defending any studies as high quality. You are trying to put words in my mouth which I have never said.
Again, it is I who am demanding FDA CDER review the science which we have. They are the most competent evaluators of science. In effect, I want the FDA CDER to “peer review” the evidence to see if they will approve it and what label should be used.
I don’t know what you think are “respected journals.” Even the so called best journals publish weak research. Each study should be read for its own merit. This is not religion where one Journal is the “Bible” and has no flaws and all research is perfect.
Because you do not have the science to back the flawed theory of fluoridation, you continue to attack personally.
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Steve,
Thank you for looking at some science rather than simply attacking me personally.
You said, “Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.”
Most water is still at 0.7 to 1.2 ppm.
Mother’s milk with no detectible fluoride in most samples and 0.004 ppm is extremely low concentration.
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Steve,
I’m glad you are looking at the research. Instead of measuring with words like “high” and “low” it would be helpful for you to put a number to those terms.
Remember, water consumption is highly variable. Some drink 10 times more water than others. And in the USA some swallow a great deal of fluoride toothpaste which pushes their total exposure significantly higher than average.
Choi listed 8 studies reporting IQ changes with less than 3 ppm fluoride in the water, the average of the 8 studies was 2.3 ppm fluoride in the water. Many people, such as laborers and athletes in the USA drink 2.3 times as much water as the “average” person. Add fluoride toothpaste and fluoride medications, dental products, pesticides etc and there is a reasonable probability that the total exposure of many in the USA reach the levels in these studies.
Of those 8 studies the average IQ drop was 8.4 IQ points.
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Ken,
So cool you added a chart here. How can I do that?
Yes, I think all of us agree the studies are weak. But they are a hell of a lot better than what proponents have presented finding no decrease in IQ.
The studies individually are weak. With the number of studies available and the consistency of the results, I would bet higher quality is published soon.
The question is not whether fluoride causes brain damage. Fluoride is highly toxic and can kill. The question is at what dosage and age.
The fluoridation ship is sinking and some will sink with the ship. My choice is to be cautious and start reducing total fluoride exposure. The best place to start is with Freedom of Choice.
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Bill, you are straw-clutching. Despite now acknowledging the weakness of these studies overall you want to still draw conclusions. Here are some problems.
You want to draw an overall conclusion â even a quantitative one! But one of the weaknesses in Choi et alâs paper is that they ignored several pitfalls in applying their statistical meta-analysis. I have referred to those before.
As individual studies I think a few of the papers are of value in showing problems with high F intakes. Donât forget that is a general problem in those countries. The mistake, I think, is to assume âbrain damage: with absolutely no evidence or possible mechanism. The results are far more likely to be due to learning difficulties connected with severe dental and skeletal fluorosis or educational and social factors which have not been properly considered.
But that issue is of course irrelevant to our situation with CWF.
Itâs silly to go on about F being able to kill â so can H2O. And similarly you talk of freedom has been well refuted here â you donât improve your argument one iota by trashing a dead horse.
WTF have sinking ships got to do with this issue. Friday night drinkies, I guess, if you were in NZ. J
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Bill
You admit the research is weak and then follow that with “Higher quality
research would be published soon”Do you know something we dont know?
And who would be doing the translation??FANN was involved in the last one and the original papers were not made available from what I read ,So the chance of them being ‘Doctored’ to suit the desired result would be quite high
While you are here another question The activists are always telling us how bad fluoride is at a dilution of .7-1 PPM in drinking water, and how it is a poison. And then in the next breath you say that typical is a better way, with fluoride toothpaste being the treatment of choice
So really what you say is water containing fluoride at the lower dose is poison. But when you put it in toothpaste at 1000-1500 PPM it is ok, we just put a warning label on the tube and that will stop any child taking too much, and tell them the size of the application ,and they will all use what we say.
I really think that fluoridated water is a lot safer than toothpaste, mainly because you would be sick from water long before you reached the danger level for fluoride, But that will not fit the desired result and the scaremonger tactics
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Bill,
“Thank you for looking at some science rather than simply attacking me personally.
You said, “Note: HIGH fluoride exposure. Water is fluoridated at 0.7 ppm, an extremely LOW concentration.”
Most water is still at 0.7 to 1.2 ppm.
Mother’s milk with no detectible fluoride in most samples and 0.004 ppm is extremely low concentration.”
You need to get the chip off your shoulder, stop whining about being “attacked”, and focus on the issue.
Yes, the current optimal level of fluoride is a range between 0.7 ppm and 1.2 ppm. As DHHS is expected to lower this recommendation to simply the low end of that range, in the near future, many water systems are now choosing to fluoridate at 0.7 ppm. This in no manner affects the flaws of the Chinese studies, or the fact that these studies were of the effect of high levels of naturally occurring fluoride in well-water of various Chinese, Mongolisn, and Iranian villages.
Steven D. Slott, DDS
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Chris,
Bill said, ” ‘You admit the research is weak and then follow that with “Higher quality research would be published soon.’ Do you know something we dont know?”
More research is always needed and beneficial. Science is not stagnant. Don’t you think it is rather embarrassing that so few studies on the neurological safety of fluoridation are from the USA, NZ, England, Canada and Australia? No direct profit in doing research on something which might stop sales. Early studies on any theory are weaker until critics appropriately point out weakness and researchers correct for those weaknesses.
The NRC 2006 called for more studies on neurological harm. We now have more studies and need more.
“RECOMMENDATIONS
On the basis of information largely derived from histological, chemical, and molecular
studies, it is apparent that fluorides have the ability to interfere with the functions of the brain
and the body by direct and indirect means. To determine the possible adverse effects of fluoride,
additional data from both the experimental and the clinical sciences are needed.” p 187.
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Bill,
“Choi listed 8 studies reporting IQ changes with less than 3 ppm fluoride in the water, the average of the 8 studies was 2.3 ppm fluoride in the water. Many people, such as laborers and athletes in the USA drink 2.3 times as much water as the “average” person. Add fluoride toothpaste and fluoride medications, dental products, pesticides etc and there is a reasonable probability that the total exposure of many in the USA reach the levels in these studies.”
It makes no difference what concentrations Choi reported. There is no way to draw any conclusions from studies which inadequately control for the variables, have key information missing, and questional methodologies.
Laborers and athletes may very well drink 2 to 3 times the amount of water as the “normal” individual. However, this is only when they are exerting, and losing water through perspiration, not on an average basis. Additionally, as you know from your public health background, public health initiatives cannot be expected to accomodate all extreme behaviors. Those who may be consuming an abnormally high amount of water bear the responsibility of understanding any consequences of this action.
Steven D. Slott, DDS
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Chris asked, “And who would be doing the translation??FANN was involved in the last one and the original papers were not made available from what I read ,So the chance of them being ‘Doctored’ to suit the desired result would be quite high.”
The original papers are published. You can get a copy if you want. I can’t read Chinese so they don’t do me any good. I’m sure you can translate them yourself or pay for them to be translated.
I have always called for higher quality studies, prospective randomized controlled trials. The evidence is strong enough that I doubt a Human Subjects Review Committee would permit an RCT on humans measuring IQ loss.
You also asked about topical versus systemic and your concern for toothpaste is valid. The research that topical has benefit is stronger than systemic. In addition, the FDA CDER has approved fluoride toothpaste with the warning not to swallow. The FDA CDER is not flawless, but they are the best at making judgments of efficacy and safety of substances used with the intent to prevent disease.
Some scientists are recommending fluoride toothpaste be sold only by prescription. That maybe one reason Colgate purchased Thoms of Maine.
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Bill,
“The NRC 2006 called for more studies on neurological harm. We now have more studies and need more.”
Had the 2006 NRC Committee on Fluoride in Drinking Water had concerns of neurological harm with chronic consumption of water with a fluoride content of 4.0 ppm or less, it would have stated so in its final recommendation. It did not.
StevennD. Slott, DDS
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Ken,
Swearing only shows you do not have the science to support fluoridation. Calm down. The end of fluoridation will come soon but the world will not end.
You suggest, “The mistake, I think, is to assume âbrain damage: with absolutely no evidence or possible mechanism.”
“It has been said in this regard “every molecule of AlFx is the messenger of false information” NRC 2006 p 185.
The NRC 2006 talks a great deal about the mechanism of fluoride on the brain.
7. NEUROTOXICITY AND NEUROBEHAVIORAL EFFECTS…………………………………………173
Human Studies, 173
Animal Studies, 179
Neurochemical Effects and Mechanisms, 184
Findings, 185
Recommendations, 187
Start at 184 for a more complete discussion. Here are a few items.
“The most prominent changes were found in phosphatidylethanolamine, phosphatidylcholine, and phosphatidylserine. . .
Fluoride has been shown to decrease the activities of superoxide dismutase (Guan et al. 1989) and glutathione peroxidase (Rice-Evans and Hoschstein 1981), the consequences being increased free radicals. . . Using slices of rat neocortex, Jope (1988) found that NaF stimulated the hydrolysis of phosphoinositide by activation of a G protein, Gp. . .”
Apparently low amounts of aluminum and fluoride have a synergistic adverse effect.
NRC 2006 continues,
“Many of the untoward effects of fluoride are due to the formation of AlFx complexes. AlFx and BeFx complexes are small inorganic molecules that mimic the chemical structure of a phosphate. . . .
“AlFx also impairs the polymerization-depolarization cycle of tubulin. This could account for some of the intensely stained neurofilaments in cells in the brains of animals exposed to chronic NaF (Varner et al. 1993, 1998). AlFx appears to bind to enzyme-bound GDP or ADP, thus imitating GTP or ATP and, in a sense, generating “false messages” within the brain. This binding ability is probably due to the molecular similarities between AlF3(OH) and a phosphate group in the molecular structure, in particular, a tetrahedral arrangement (Strunecka and Patocka 2002).
“It has been said in this regard “every molecule of AlFx is the messenger of false information” (Strunecka and Patocka 2002, p. 275). This may be an accurate synopsis of the AlFx effect at a single synapse, but the brain is a highly redundant and dispersed communication system containing millions of synapses. Because of this, observable alterations in mental or motor
actions might require the formation of a multitude of false messages in a number of brain circuits acting over a prolonged period of time. Thus, the number of false messages required to disrupt an “action pattern” in the brain probably will vary according to the nature of the ongoing
activities.”
“An especially important neurochemical transmitter that reaches almost all areas of the brain is ACh. As discussed above, some studies show that NaF and SiF inhibit cholinesterases, including acetylcholinesterase. The progressive accumulation of ACh at synaptic locations produced by the diminished esterase activity leads to a number of complex effects that can be summarized as an initial increase in stimulation of the target cells but ultimately leads to diminished stimulation—even a blockade of all activity.”
“These results are of interest because changes in the nicotinic receptors
have been related to the development of Alzheimer’s disease (Lindstrom 1997; Newhouse et al. 1997) and, in frontal brain areas, to schizophrenia (Guan et al. 1999).”
Ken, I would suggest you read the NRC 2006 report on fluoride. If you want a copy, I can give you mine.
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Steve,
DHHS has no legal authority to lower or raise fluoride to 0.7 ppm in water. They asked for comments on the proposal and said they would have a response by the summer of 2011. Three years later and we have a deafening silence. And the research over the last three years is even more to digest. This is a job for the FDA CDER, not public health managers and PR/media people at HHS.
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Bill,
“Ken, I would suggest you read the NRC 2006 report on fluoride. If you want a copy, I can give you mine.”
Obviously you haven’t read the final recommendation of this Committee, Bill.
Steven D. Slott, DDS
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Bill,
“DHHS has no legal authority to lower or raise fluoride to 0.7 ppm in water.”
It seems I have yet once again overestimated your understanding of the optimal level, so let me simplify. The optimal level of fluoride is that recommended level which provides maximum dental decay benefit with no adverse effects. As I have repeatedly stated, this is a recommendation, not a legally binding mandate. This recommendation is set by DHHS.
The CDC, in 2011, recommended the resetting of the optimal level, from the current range of 0.7 ppm – 1.2 ppm to simply the low end of that range, 0.7 ppm. They based this recommendation on recent research showing there to no longer be a significant discrepancy in the amount of water consumed due to climate differences, and the greater availability of fluoride from multiple sources now than when the optimal was originally set.
DHHS has as yet to adopt this CDC recommendation, but is expected to do so. Given that the 2006 NRC Committee made no recommendation to lower the EPA secondary MCL down from its current 2.0 ppm, there is no urgency in adopting the CDC recommendation. The only risks of concern noted by 2006 NRC in the 4.0 ppm range were severe dental fluorosis, skeletal fluorosis, and bone fracture. Given that severe dental fluorosis does not occur in association with water with a fluoride content of 2.0 ppm or less, that skeletal fluorosis is so rare in the US as to be nearly non-existant, and there is no evidence to support concerns of bone fracture in this range, obviously, there is no urgency in lowering the optimal.
FDA CDER has no jurisdiction over fluoridated water. This jurisdiction is entirely under the EPA.
Steven D. Slott, DDS
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Steve,
Please provide a reference for HHS recommendation as you claim, “The optimal level of fluoride is that recommended level which provides maximum dental decay benefit with no adverse effects. As I have repeatedly stated, this is a recommendation, not a legally binding mandate. This recommendation is set by DHHS.”
What we are considering is judgment on benefit versus risks of ingested fluoride. The evidence is weak. The evidence is growing that even small amounts of fluoride, 0.2 mg/Kg BW has adverse effects. A safety factor of 100 from LOEL is customary. 0.002 mg/Kg BW would be considered safe. The chance of better science finding fluoride is safer is much less than finding even lower dosages are safe.
The FDA safety is 0.25 mg/day. FDA CDER has caution not to swallow 0.25 mg of fluoride (a pea size of toothpaste) or 0.05 mg/kg/day BW for a 5 Kg child. That caution was a compromise since 5 mg/kg BW is considered lethal and the FDA used a safety factor of only 100 from lethal. Not great.
The EPA’s RfD is 0.06 mg/kg/BW or about 0.3 mg for a 5 Kg infant, somewhat less protective than even the FDA.
Safety somewhere between 0.002 mg/Kg/day and 0.06 mg/kg/day is usually not disputed. With better testing, those numbers are more likely to go down, than up.
An 5 Kg infant on 1 liter of fluoridated water made into formula is ingesting 1 mg of fluoride/day. Divide that by 5 Kg BW gives 0.2 mg/kg/day of fluoride dosage.
Lethal 5 mg/Kg/day BW
FDA 0.05 mg/Kg/day BW
EPA 0.06 mg/Kg/day BW
Neurological 0.002 mg/Kg/day BW
A 5 Kg infant on 1 liter of 1 ppm fluoridated water is ingesting 0.2 mg/Kg/day BW.
That is significantly above the FDA , EPA and science.
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Bill,
“Please provide a reference for HHS recommendation as you claim, “The optimal level of fluoride is that recommended……”
https://www.federalregister.gov/articles/2011/01/13/2011-637/proposed-hhs-recommendation-for-fluoride-concentration-in-drinking-water-for-prevention-of-dental
“The evidence is weak etc, etc, etc….”
So, the 2006 NRC Committee which you are so fond of quoting, was incompetent, and negligent?
Steven D. Slott, DDS
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The reference you gave is a proposal by HHS. The US Public Health Service had the recommendation. Those are the same people who were doing the Tuskegee syphilis study of black men without their consent and giving them the impression they were being treated when in fact they were not. I can go on about the US PHS.
I am in agreement with the NRC 2006 report and their grading of the research for the research they had at the time. I do not think I would have come to the same conclusion. And, if I was aware, would have followed the law, coming up with a new MCLG. More later.
Steve, you have avoided my concern for infants and excess fluoride exposure. Those little brains are most susceptible to injury.
Lethal 5 mg/Kg/day BW
FDA 0.05 mg/Kg/day BW
EPA 0.06 mg/Kg/day BW
Neurological with margin of safety 0.002 mg/Kg/day BW
A 5 Kg infant on 1 liter of 1 ppm fluoridated water is ingesting 0.2 mg/Kg/day BW
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Bill,
DHHS oversees water fluoridation in the US. DHHS makes the official recommendation for the optimal level of fluoride. It is of no concern to me whether you belive this or not. Facts are facts.
Since you have such concern for those “little brains”, then produce valid, peer-reviewed, scientific evidence of any harm, whatsoever to those “little brains” resultant of water fluoridated at the optimal level. Too, you might care to explain why you have so little regard for those “little brains” that could and have become fatally infected as a direct result of untreated, preventible dental decay on one surface of one tooth.
Steven D. Slott, DDS
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Consider Dr Robert Carton’s comments. Dr. Carton worked at the EPA for 30 years managing risk assessments on high priority toxic chemicals and wrote the first regulations controlling asbestos.
(Paraphrased) The NRC examined the scientific basis for the MCLG of fluoride. Due to misdirection by EPA management, who requested the report, the NRC committee identified only health effects known with total certainty. This is contrary to the intent of the SDWA, which requires the EPA to determine “whether any adverse effects can be reasonably anticipated, even though not proved to exist.” Further misdirection by EPA consisted of instructing the committee not to identify a new MCLG – in other words, not to determine a safe level of fluoride in drinking water, and not to discuss silicofluorides, phosphate fertilizer manufacturing by-products used in most cities to fluoridate their water. . . .
Dr. Carton brings up a valid point which is a source of our disagreement here.
Does the evidence reach a certainty which is “total” or “reasonable”?
I am totally certain fluoride affects the teeth and makes them harder. Whether that translates into better health for the teeth with fewer caries or simply greater difficulty and delay in diagnosis; whether the teeth last longer or are more brittle; or whether dental expenses are reduced lacks confidence.
I am also totally certain not everyone receives the same dosage, is in the mean or average. Reports of some drinking over 10 liters of water and others drinking less than 1 liter means we need a 10 fold margin of safety just for the difference in water consumption.
I am totally certain some swallow much more fluoride toothpaste than they should.
I am totally certain we don’t understand the synergistic effects of the other chemicals being consumed with fluoride.
I am also totally certain some people are able to handle toxins and chemicals better than others.
I am also totally certain that infants need to be protected even more than adults, they are chemically more fragile. Mother’s milk with no fluoride in most samples is a good starting point.
I am very certain that total exposure to fluoride is increasing, due to increases in dental fluorosis.
I am very confident fluoride is a wonderful and powerful element for manufacturing.
In my judgment, total fluoride exposure needs to be reduced. The EPA reducing fluorine refrigerants is a great place to start reducing exposure, but not enough. Another option is reducing fluoride medications and fluoride pesticides, which I think unwise, although there is a push to stop fluorine anesthesia at the hospitals.
The most logical place to reduce excess exposure is stop artificial fluoridation. It is a belief system who’s time is long past.
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Bill,
Carton is a long time antifluoridationist who, in conjunction with Hirzy, performed a study which formed the basis of Hirzy’s petition to the EPA last year to cease recommendation of use of HFA to fluoridate water systems, in favor of NaF. The EPA reviewers discovered a miscalculation by Hirzy and Carton which resulted in a 70-fold error in their calculations. When corrected for the error it was found that the data demonstrated the opposite of what Hirzy and Carton had concluded. The EPA rejected the petition.
Carton is hardly an objective or credible source of opinion on fluoridation.
Anyone drinking 10 liters of water per day is engaging in extreme behavior. Your public health background should tell you that no public health initiative can be expected to account for all extreme behaviors. Individuals consuming that much water must accept responsibility for understanding the content of that water.
The IOM upper limit of 10 mg per day has been born out to be accurate, given the lack of any proof of adverse effect of optimal level fluoride in 69 years. The difference between 0.7 mg/liter fluoride in water and 10 mg upper limit is so broad that if anyone exceeds that upper limit, the minuscule 0.7 mg/liter fluoride in their water would be the least of concerns.
Your beliefs and opinions are your beliefs and opinions. You are certainly welcome to them.
Steven D. Slott, DDS
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Steve,
You are skilled in the ability to answer a different question and avoid the questions asked.
Instead of talking about the SDWA, you deflect to the person. Skilled debater, but lets stick to the subject.
Do you agree the SDWA the requires the EPA to determine “whether any adverse effects can be reasonably anticipated, even though not proved to exist.”
I’m specifically focusing in my comments above and her to the level of confidence.
I am specifically asking you whether you agree or not with the SDWA.
Please don’t go into a lengthy side step on the people voting for the SDWA and their bias. Stick to the subject we are talking about.
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You just brush off those drinking a great deal of water as stupid for drinking so much water. The military sends water for soldiers to drink about that much.
And you side stepped infants, say:
“you might care to explain why you have so little regard for those “little brains” that could and have become fatally infected as a direct result of untreated, preventible dental decay on one surface of one tooth.”
My goodness, my goodness. If I had not read the NRC 2006 report, CDC and others, I might have serious concern at your comment that infants become fatally infected with dental caries which could be prevented with water fluoridation. All aspects of your comment are simply not true.
1. NCR 2006 and others, fluoride is effective topically, not systemically.
2. Infants don’t have any or many teeth. Infants with dental caries are the results of ECC, sleeping with a bottle of juice or milk. No amount of fluoride will prevent that poor diet practice. If you look at primary teeth with ECC, you will notice that the upper anterior teeth may have serious caries, but the lowers do not usually. Fluoridation did not help the bottom and miss the top. If fluoridation were to help reduce caries, it would help the top where the water is coming into contact, not the bottom. If you think fluoridation has helped the bottom teeth but not the top, please explain the mechanism.
3. The development of the tooth (below the skin) is when the theoretical effects of fluoride might be beneficial. The teeth entering into the mouth during the first year have started forming in utero. Unless the fetus is drinking fluoridated water, it would not be beneficial.
I seldom diagnose dental fluorosis in primary teeth and only in the posterior regions.
Please provide research on the deaths of children from preventable dental caries in the primary anterior region.
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Bill, I’ve not “side-stepped” anything. I just have no desire to discuss every little tangent you mention, and every opinion of yours that you throw out. If you object to the parameters and charges to the 2006 NRC Committee by the EPA, then go argue your opinion in court.
Otherwise believe whatever you want.
Steven D. Slott, DDS
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Infants are not a tangent.
Your alleged deaths from dental caries for infants is not a tangent.
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Bill,
“You just brush off those drinking a great deal of water as stupid for drinking so much water. The military sends water for soldiers to drink about that much.”
“Stupid”?? You need to go back to your reading classes again. I said “extreme behavior”. This is not a judgement, simply a characterization. If you don’t understand the difference between “extreme behavior” and “stupid” you are worse off than even I imagined.
Again with the reading problem. I did not state that “infants become fatally infected with dental caries”. Perhaps I just haven’t been speaking in proper antifluoridationist form. So, let me quote what I said in a form with which you may be more comfortable:
“TOO, YOU MIGHT CARE TO EXPLAIN WHY YOU HAVE SO LITTLE REGARD FOR THOSE ‘LITTLE BRAINS’ THAT COULD AND HAVE BECOME FATALLY INFECTED AS A DIRECT RESULT OF UNTREATED, PREVENTIBLE DECAY ON ONE SURFACE OF ONE TOOTH”.
1. Neither the NRC, The CDC, nor any other credible source has stated that “fluoride is effective topically, not systemically”.
2. If you care to provide valid, scientifically sound evidence on the relative incidence of dental decay in maxillary and mandible teeth, I’ll certainly be glad to look at it. Your anecdotal opinion on such is meaningless.
3. Permanent anteriors begin development prenatally and continue through infancy and eruption at age 5-6 with root completion around age age 10.
The mild dental fluorosis which you and other antifluoridationists constantly attempt to portray as being a major disorder, can only occur systemically during tooth development. Kumar has shown mildly fluorosed teeth to be more decay resistant, a definite benefit.
Additionally:
“Conclusions: While 6-year-old children who had not ingested
fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.”
—Systemic effect of water fluoridation on dental caries prevalence
Cho HJ, Jin BH, Park DY, Jung SH, Lee HS, Paik DI, Bae KH.
Community Dent Oral Epidemiol 2014; 42: 341–348. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Steven D. Slott, DDS
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Bill,
“Infants are not a tangent.
Your alleged deaths from dental caries for infants is not a tangent.”
And, where exactly did I state that they were? You know, Bill, you perfectly example the common antifluoridationist tactics. You have misrepresented my statements so many times that I couldn’t begin to count. You post misinformation. You post half-truths. You attempt to divert with claims of “personal attacks”. And you gish gallop so much it would take a leash to keep you in check.
And you wonder why you have no credibility?
Steven D. Slott, DDS
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Dr. Richard Sauerheber
Palomar College
San Marcos, CA 92069
September 24, 2014
Email: richsauerheb@hotmail.com
U.S. Food and Drug Administration
Center for Drug Evaluation and Research
Rockville, MD 20857
Dear Sirs,
This letter supports the petition to ban the intentional infusion of fluorosilicic acid and sodium fluoride into public water supplies, which attempts to prevent dental caries in humans (petition FDA2007-P-0346) but is ineffective and harmful to man.
Actions by Ilisa Bernstein, acting director, U.S. Food and Drug Administration Office of Compliance.
In a very positive and helpful way, the FDA is now fighting back against unapproved and counterfeit drugs. The FDA is conducting an information campaign to raise awareness of illegal operations that peddle bogus drug
substances intended for dissemination to consumers (FDA Getting Info out about Bogus Drugs, Associated Press,
San Diego Union Tribune, September 24, 2014 p. C-4). Director Bernstein stated that “we’re fighting back with their own medicine, which is aggressive marketing tactics to offer medications at discount rates.” The FDA makes
it clear how to spot drug substances that are not FDA approved. Unfamiliar dosing instructions are a common issue.
Fluorosilicic acid addition into water supplies is use of a counterfeit unapproved drug substance for ingestion. Dosage instructions are improper because no information is provided from the supplier or manufacturer as to what amount of water daily must be consumed to achieve a proper daily intake of the substance. Some Material Safety Data Sheets, required to accompany the wholesale product delivered to water utilities, actually list a maximum use concentration of 6 ppm (see attached MSDS pages). This proves that manufacturers do not follow requirements of either the EPA or the FDA. The EPA requires warning consumers when water reaches 2 ppm fluoride ion, and at 4 ppm it is not considered potable water. Some MSDS sheets state no specific intended purpose for the treatment of humans. Some state a “Recommended Use” is for “welding and soldering agents, metallurgy, the glass industry, dental applications and water treatment”. The term “dental applications” is so non-specific that it could be for livestock teeth or a topical agent, and “water treatment” merely describes the treatment of water, not humans. This ambiguity is entirely inconsistent with FDA regulations for substances being used, as reported by water utilities, as
drugs to treat, prevent or cure dental disease in humans.
Second, manufacturers do not provide full safety information for their product when ingested. No information is provided as to long-term effects of fluoride ingestion on bone weakening, dental fluorosis, the increased incidence of fluorosis in Blacks and Hispanics, the increased incorporation of fluoride into those with kidney disease, or explicit instructions for those with bone, mental, thyroid, and other conditions. MSDS sheets usually do state under Toxicological Information, “Chronic exposure may entail dental or skeletal fluorosis.” But no indication is made for what subgroups are more susceptible or what dosage should be avoided to prevent the damage. Also, the admission is not passed on to consumers, even though this is required by the FDA.
A product name that differs from the name for an FDA approved drug is a common method to detect a counterfeit or bogus drug. Fluorosilicic acid is not natural calcium fluoride for which the initial idea, that its consumption
would affect dental caries, came about. FSA requires sodium hydroxide to neutralize water acidity and adds silicic acid and sodium into the water supply, in addition to fluoride. Neither sodium fluoride nor fluorosilicic acid share the low level of chronic toxicity, or the nonexistent acute toxicity, of natural calcium fluoride. Both of these synthetic industrial fluorides are listed toxics due to their full solubility in water and full assimilation after ingestion
(see MSDS pages and Jour. Envir. Pub. Health, 2013 article 439490).
The FDA now recommends that health professionals buy drugs only from wholesale distributors licensed in their States. Under the new Federal law, all wholesalers must be State licensed by January, 2015. Fluorosilicic acid
suppliers for materials to be ingested for dental benefit in water supplies are not licensed in any U.S. State to produce this substance for use as an ingestible treatment. Fluorosilicic acid and sodium fluoride are soluble
replacement substances for calcium fluoride of low solubility that is poorly-assimilated and far more safe.
“Fluoride” is misbranding of a substance used as a drug.
U.S. medical schools do not provide courses on the toxicology of fluoride-containing substances. Also, dental schools do not consider the known toxic effects of systemic fluoride ion after ingestion and assimilation into the
bloodstream. Thus, the practice of ingesting fluoride compounds as oral ingestible dental prophylactics has basically found its way “through the cracks” of our chief health institutions. Those who recommend the practice
are not well versed in the systemic toxicology of fluoride ion. Those trained in toxicology (who usually do not recommend the ingestion of industrial fluorides) are not given authority to regulate fluorosilicic acid manufacturers
and suppliers who disseminate fluoride compounds to the public for ingestion in the act of whole body treatment with fluoride ion.
Material Safety Data Sheets provided with the purchased products to the formulators of “fluoridated” water— cities and water districts, but not the end consumers of the treated water–identify the substances as either sodium
fluoride or fluorosilicic acid. The vast differences in toxicity between naturally occurring calcium fluoride (found in some groundwater) and the products being added to public water supplies are indicated by the fact that sodium
fluoride and fluorosilicic acid carry a label with a Health Hazard Rating of “3” (see attached MSDS pages). Calcium fluoride of course has a Health Hazard Rating of “0” (being non-toxic acutely by ingestion).
The infusion of industrial fluoride containing compounds represents purposeful misbranding of a drug and purposeful false information given to consumers by manufacturers with adverse health consequences in vulnerable populations. Currently, manufacturers of “NSF certified” fluorosilicic acid intended for ingestion in treated water state that all product safety information is held by the U.S. Centers for Disease Control (see attached letter), rather than themselves. The FD&CA does not require either the CDC or the NSF to provide this information, but rather the manufacturers and distributors of the material.
What actually is “fluoridation”?
Please understand that there is no such chemical that can be purchased by the name “fluoride.” Fluoride is not a chemical element, and fluoride is not a compound. Likewise, iodide is not an element, and iodide is not a chemical
compound. There are chemicals that contain the fluoride ion or the iodide ion, and fluorine and iodine are elements.
No chemical substance can be isolated that would bear the exclusive name fluoride or iodide. Therefore the term “fluoridation” has no actual meaning, rather it is an interpretation. If “fluoridation” refers to adding into water
either arsenic fluoride, lead fluoride, or sodium fluoride, this is a false practice. Each of these fluoride containing compounds share comparable acute toxicity (LD50 = approximately 80 mg/kg single oral acute lethal dose in mammals, Merck Index, 1976, Rahway, NJ). “Fluoridation” with calcium fluoride would not cause acute toxicity in man or animal. Its known chronic abnormal effects on bone structure require far higher total intake than for
manufactured fluoride-containing compounds used in “fluoridation” in the U.S., which mostly refers to the infusion of fluorosilicic acid into water. The fact that synthetic fluoride treatment of water is using the ion as a drug is proven by the facts that: fluoridated water is not required over non-treated water for agricultural, industrial, laundry, bathing, or recreational uses, etc. Fluoride compound addition into water does not therefore represent “treatment of water” or “fortification of water”, but rather is to affect dental health in humans through its ingestion. Added fluoride compounds are thus used as drugs and must comply with all appropriate FDA regulations (as listed in the enclosed attachment).
Concluding Request.
Please apply the new 2015 drug substance law, which requires State licensure for manufacturers of all drug substances for ingestion in the U.S., to fluoride-containing compounds now widely disseminated through public
water systems to treat humans. None of the manufacturing procedures used to produce non-prescription ingestible sodium fluoride or fluorosilicic acid comply with manufacturing requirements of the FD&CA. Many who use these materials believe that “fluoride” may be virtually any compound that contains fluoride ion and that it provides a food, nutrient or supplement. But the FDA ruled correctly that the fluoride ion from fluoride-containing compounds is not a mineral nutrient and is not considered safe to add to food (i.e. from any compound). The fluoride ion exerts no biologic function associated with ingestion.
Millions of people consuming this substance on a daily basis lifetime are in dire need of full disclosure. It would be advantageous and appropriate for the CDER to consult with the Office of Compliance on this matter, without of
course any transfer of authority to rule on this petition to that office.
Thank you again,
Richard Sauerheber, Ph.D.
Partial List of Food Drug and Cosmetic Act Requirements for Manufacturers of Substances used as Drugs. We would also greatly appreciate it if the FDA would contact suppliers of industrial fluorosilicic acid and sodium fluoride to inform them of the following requirements, consistent with the Food Drug and Cosmetic Act for all foreign synthetic substances administered for ingestion for drug purposes:
a) State licensure to specifically manufacture these substances intended to be ingested to treat dental caries without a prescription
b) providing only the specific proper name for the substance used, not deferring to the simplistic label “fluoride”
c) prior FDA approval
d) complete dosage instructions and required modifications with use of other fluoride dental products
e) complete disclosure of product safety information for long-term continuous ingestion in healthy man
f) published data from clinical trials testing for clinical pharmacology with specific mechanisms of action
g) lists of drug interactions, in particular drugs that treat bone disorders, such as bisphosphonates (Fosamax)
h) detailed descriptions of pharmacokinetics of the ingested material
i) descriptions of ingested fluoride effects on bone histology, with % incorporation as a function of age
j) incidence reports of allergy to fluoride
k) incidence reports of dental fluorosis
l) lists of expected % reductions in dental decay when product is consumed by various age groups
m) lists of contraindications in those with bone disorders, thyroid or kidney conditions, or diabetes
n) descriptions of side effects possible with pediatric use, use in the elderly, and in pregnancy
o) gastrointestinal disturbance incident reports due to conversion of fluoride to HF in the acidic stomach
p) all contraindications for use and precautions regarding carcinogenesis, mutagenesis, impairment of fertility
Addition important comments:
From the fluorosilicic acid producer Simplot, on their MSDS sent to Metropolitan Water, Los Angeles, we read its purpose is a “Liquid drinking water treatment chemical for use in the purification of water consumption.”
From the key publication of the American Water Works Association entitled ANSI Standard for Fluorosilicic Acid, 2008, we read “fluosilicic acid is presently being added to drinking water to reduce the incidence of dental
caries.”
And “the fluosilicic acid supplied from the manufacture shall contain no substances in quantities capable of producing deleterious or injurious effects on the health of those consuming water that has been properly treated with fluosilicic acid.”
And “the purchaser may require an affidavit from the manufacturer that the FSA provided complies with all requirements of this standard.”
This means that FSA suppliers are guilty of selling materials they agree to have certified by NSF/AWWA to reduce dental decay through drinking water. Meanwhile, those manufacturers rely on the CDC for all safety information. The manufacturers do no toxicological testing prior to sale and the AWWA/NSF does no toxicologic studies before certification.
Regardless of a purchaser asking for affidavits or not, the FDA is in charge of all drug substances used for ingestion in the U.S. All drugs require clinical trials testing for FDA approva and require prescriptions. Next January all manufacturers of those materials sold for ingestion purposes must be State licensed for that purpose. Solvay attempts to use the CDC for its authority to sell the material, but the CDC has no jurisdiction in regulation of drug substances. That is the exclusive authority of the FDA.
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ASWLA
Seriously?
Richard Sauerhaber is an antifluoridationist who is the “Scientific Consultant” for antifluoridationist lawyer, James Deal. Deal has a website devoted entirely to attempts at scaring up class action lawsuits from which he presumably would profit in the highly event that he is ever successful at so doing. Sauerheber is hardly a credible resource.
You probably should better research your “sources” before again making such a fool of yourself with nonsense such as this. But, hey, yet once again, thanks for the comic relief!
Steven D. Slott, DDS
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Steve,
Again, deflect and dodge the issue. Attack the messenger instead of the message. Refuse to protect infants.
Fluoridationists have no response for the overdosing of infants with fluoridation. Seems to go right over their heads as though infants are disposable commodities, lab rats, potatoes or pests. Fluoridation is like a religion and no amount of evidence can shake their belief system.
Infants are humans and more fragile than adults, more sensitive to chemicals. “There may be developmental periods (i.e., windows of vulnerability) when the endocrine, reproductive, immune, visual, or nervous systems are particularly sensitive to certain chemicals.” Differences in Sensitivity of Children and Adults to Chemical Toxicity: The NAS Panel Report 2000.
I agree the science is mixed on most issues, but not for the safety of infants.
Richard’s letter to the FDA is right on target.
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The only ‘fool’ here Sloth, is yourself. ALOT of people are watching you right now… and Parrott too; and all your ilk. We are all aware of your actions and words. So lets just keep enjoying you all showing your true colours. Alot of people are behind the words of Richard’s; and others like him, who are working towards raising awareness of the deficiencies of research.. and, the pushers complete lack of ethics. So what if “Richard Sauerhaber is an antifluoridationist who is the “Scientific Consultant” for antifluoridationist lawyer, James Deal.” Great for us! ASWLA didn’t post the letter as a ‘source’ – no. The letter was posted to raise awareness of what is happening a good representation of the many written by the public who know what is being done by the F promoter/pushers who are against the will of the people; and the point being, your opinions and rantings are actually highlighting the typical stance of arrogance by promotors – against the flow of many people who don’t want fluoride in their water. Bully-boy’s like yourself, who have a real attitude; who love to demean and deride any efforts by anyone to point out the gaps of ethics and Science will soon find that in the people’s minds, your pride is already causing your falleth. You really do read and look like a real piece of (uncaring) work Sloth – certainly not one we trust or respect. Live by the sword; and you all (F pushers), die by your sword. Enjoy your mirth. Its disgusting you laugh at suffering. ASWLA sees this all the time, in the many letters written that are now archived. A silence by those in power, to answering the valid questions; or a derision by people like you, funded by the industry lackeys. You are against many who suffer terribly from fluorides built-up effects in the body; and whom don’t want to be forced fluoride (one cannot avoid the stuff these days, and who is regulating the dose each day?? no one); so no matter the semantics you love to nit pick over; or even, what you deem to be your truth, the fact is that people just don’t want fluoride in their water any longer – the jig is up Sloth. Let those who want fluoride ingest tablets, toothpaste or, fluoridated salt if they want it. Laugh away…. you just show your colours when you spit in other’s face who don’t want this measure. So its your own egg on your face Sloth, at your complete arrogance. Enjoy your life – you really are seen a goon with no ethics, a person who no-one likes, respects or trusts…. Richard on the other hand, is trusted- he cares for others he will never meet by his actions of writing to change archaic laws; yes, Richardh has ethics – he works for the many who suffer. But no one is checking eh, the stats of sufferers. Don’t look; Won’t find. And as for your Ethics? For all your verbose spin and harsh ‘shooting the messenger’ tactics (for you deride anyone against fluoride), you just look shameless. So shame on you. ASWLA loves seeing you squirm out of the ethical issues… touting tired phrases and hiding behind organisations who are politically motivated is very boring reading…. Grow up Sloth. Its 2014. People are awake to the spin and mantra’s of the promotors – ‘safe and effective”safe and effective”safe and effective”safe and effective”safe and effective”safe and effective’. So give us the long-term safety data on Fluoride’s health effects on all populations and sub-populations of all races, ages and health brackets please. But you won’t, because, you cannot. There is no evidence yet on such studies, as no one has funded that research. But there is a tonne of evidence of which you (all F promotors) dismiss completely, that show the (often ill) effects of fluoride on other organs, other than, teeth. YES, ASLWA will put ONE link – and so what, your little opinion of it – people can work it out for themselves, the varied studies sitting in one site from researchers of over 80 years of worldwide work – FAN, your arch enemy: http://fluoridealert.org/studytracker/ Cheers Sloth, laugh away; but just know, every time you deride people – they are not laughing at your mirth – its a disgusting lack of empathy or caring. The public are not just ‘teeth’.
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Hang on there Who are the bully boys, I dont see the pro fluoride people threatening local goverment with court action if they dont stop fluoride,You need to remember one little sentence
Now if their arguments against fluoride were so good , you would think they would stand up to public scrutiny on their own ,without legal help. If they have to take legal action to pass them, it is obvious they are not
How many suffer from fluoride buildup in their bodys with fluoride at .7-1PPM
I,m sure you have to peer reviewed papers to prove that
Yes I agree Richard is trusted and cares. All he care about is how he can screw some poor council who wants to keep fluoride by threats and mis information
‘People are awake to the spin and mantra of the promoters’
CDC has released the latest statistics on community water fluoridation for the nation on its Web site (www.cdc.gov/fluoridation/statistics/2012stats.htm).
The latest data show that in 2012, 74.6% of the U.S. population on community water systems, or a total of 210.7 million people, had access to optimally fluoridated water. This is significant progress from the Healthy People 2020 baseline of 72.4% (2008) towards the target of 79.6%. Since 2008, an additional 15 million people have received the benefit of fluoridated water. Evidence shows that the prevalence of tooth decay is substantially lower in communities with water fluoridation.
For more information on water fluoridation, visit the CDC Web site at http://www.cdc.gov/fluoridation.
And they want fluoride
As I have said before ,if you are so sure fluoride is the nasty you say it is ,how come there has not been any proven dangers in 70 years, If there was valid evidence it would be all over the net like a virus by now , but nothing.
And you quote study tracker, as a valid source, Why would I look at an activist website for quality research, Sorry I would rather look at the source paper myself, That way I can be sure it has not been ‘doctored’ to suit the required result And as I have said before ,if there was anything of value there, it would be all over the net by now
So really Study tracker is a waste of time
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Chris: “how come there has not been any proven dangers in 70 years”
Because there have been no long term studies done.
Your disgraceful un-sourced comment about Richard, “how he can screw some poor council who wants to keep fluoride by threats and mis information” is truly pathetic – please supply the sources of your comment with that concise information to us all reading this blog.
And as for Australia? The councils are threatened by government departments with huge fines (after mandating (forcing) fluoride) if they don’t comply to put fluoride in the water, even if the people voted ‘no’ to having it. That is not democratic and against the will of the people – who is the bully here??? That’s an infliction of will against the people. After all, people have to pay their own dental bills – so let them. We don’t need a nanny state of govt officials telling us all what we should have to ingest.
ASWLA’s people have personally seen many many people who are hypersensitive to fluoride’s toxic affects in the past five years alone.
But in Australia, no one can get testing for fluoride’s toxic effects (not easily); and the government has refused to the long-term studies recommended by it’s own department — the NHMRC — 25 YEARS ago.
Chris, with an attitude like that, its no surprise you have not bothered to look at study tracker. There are many papers if you care to look, in their original formats – not doctored to suit a desired result – what a disgraceful comment! ASWLA is not interested in your apathy… and can’t be bothered spoon feeding you to ‘try’ at least look. But, shame on you. Activists for the most part, do look at both sides. The pushers, don’t.
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ASWLA – I have put you under moderation and will not allow any future posts from you which are personally abusive or use childish name-calling of the sort you used in your previous post.
Come on, we are adults here and such name calling does not support your argument.
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ASWLA
. Richard Sauerheber, PhD. Sauerhaber is the “scientific consultant” for “Attorney Deal” in his class-action stirring attempts. A look at Deal’s website will show Sauerhaber and his opinions plastered all over it. What fees Sauerhaber may or may not receive for his fluoride “consulting” is anyone’s guess.
So now I suppose you will try and tell me he is the Tea boy and has no input into the court cases
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ASWLA
I have a question, I see in the news that chlorine gas has been used in Syria, Now if that is the case you made a big thing about fluoride being a poison when it was connected to sarin, now what are you going to do about chlorine?? The same rules apply ,are you going to start a movement to stop this so called poison too. It is added to water the same as fluoride
Or is it selective. I think the answer has a lot to do with credibility ,dont you
I look forward to your answer.Then we will see how committed your are to pure water
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ASWLA
table salt (NaCl) can be a food preservative, a nutritional mineral, a prescription medication, an over the counter medication.
Equally clearly fluoride ions can be a natural mineral, a mineral nutrient, a water additive, an over the counter medication, a prescription medication, an industrial chemical (including extremely pure forms), an industrial pollutant, a fumigant, and a rat poison.
All of these are true and there are important, critical distinctions between each use, each concentration, and the purity standards which define the various incarnations of “fluoride.”
The willful refusal to acknowledge these clear and easily understood distinctions is an important element in anti-fluoridation propaganda.
Courts around the country have uniformly ruled that fluoridation is not medication and further that water districts have both the right and the obligation to determine the chemical composition of their product. Individual citizens do not have the right to demand an specific chemical composition of the drinking water.
Clearly fluorophobes will bear some inconvenience and expense avoiding 0.7 ppm fluoride but that inconvenience is trivial compared to the little preschool children who have operations they wouldn’t have needed, kids and adults who have more tooth decay, and old folks whose teeth are lost to root cavities they would not have suffered if the water were fluoridated.
It is incredibly self centered to insist on water your way when the entire legitimate medical, dental and public health expert communities agree that CWF is safe, effective, inexpensive, and properly regulated as a water additive.
Fluoridation simply prevents cavities. It is straightforward.
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Chris, you can boil out chlorine. Fluoride concentrates. Chlorine is used to treat the water. Fluoride is used as a treatment of people. Ethics of choice are removed when such measure are put in place. Ken, we note you have put ASWLA’s comments under moderation ie. that you will cherry pick which comments you want to post. However, we have saved our comments, and will get them out to our lists. Lets see how ‘fair’ you are in this debate; or, like all promotors, choose to remove the truth, as it is shown.
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See, ASWLA, you can use people’s correct names. But I am going to continue moderation and hold back any posts where you continue to use derogatory names in this childish manner.
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Chlorine is used to treat the water. Fluoride is used as a treatment of people.
So…?
Have you any argument based upon the difference between the two chemicals based on this observation?
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Fluoride cannot be removed from drinking water easily, unless by expensive whole house and reverse osmosis filters; or time intensive distillation process that many cannot afford; so avoiding fluoride is difficult. But Chlorine can be removed easily – it can be filtered out by even simple charcoal filters even on shower heads; or, putting drinking water in the sunlight. Both chemicals are toxic, yes. Fluoride is way harder to remove/avoid.
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BTW Chris, we think you are confused – ASWLA has made no comment about Sarin gas – where on earth did you cook that idea up from? ie. you have said in your post that, “you made a big thing about fluoride being a poison when it was connected to sarin, now what are you going to do about chlorine??” – these are your thoughts, and has nothing to do with anything that ASWLA has written.
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Are you saying they are both drugs, right? but there is no problem with chlorinated town supplies because it’s easy to remove and there is a problem with fluoridated supplies because it’s harder to remove?
That it’s just a matter of degree in difficulty in removal?
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Bill,
“Again, deflect and dodge the issue. Attack the messenger instead of the message. Refuse to protect infants.”
Nice try, but, obviously, the only one here who is deflecting and dodging is you. I have repeatedy requested that you provide valid, peer-reviewed evidence of any adverse effect on infants by water fluoridated at the optimal level. You have provided none. Your “concern” for infants amounts to nothing more than a transparent reprehensible exploitation of emotion.
You seriously should get some help for whatever is this hangup you have for religion. Your continued references to it are indeed bizarre.
What a shock that you agree with Sauerber. With his bias and gross conflict of interest, he has no creddibility on this issue.
Steven
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ASWLA
It’s always comical when antifluoridationists refer to my “ilk”. A clear sign of their frustration. Not sure what an “ilk” is, but it has a good ring to it. “Milk” minus the “M” maybe? A misspelling of “ink”, maybe? I don’t know, but comical just the same.
Excellent rant!! Sometime when I have time to waste and am in need of a good laugh, I may even read it.
Steven D. Slott, DDS
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Steve,
“I have repeatedy requested that you provide valid, peer-reviewed evidence of any adverse effect on infants by water fluoridated at the optimal level. You have provided none.”
I have responded:
First. I have repeatedly responded that Federal and state laws require the manufacturer of the substance used with the intent to prevent disease to gain FDA CDER approval which would require valid peer-reviewed evidence. FDA CDER has rejected all applications due to lack of evidence. In other words, it is not the patient who is to provide the research to prevent the legal intermediary or manufacturer from forcing the substance into the patient. Proof is in the lap of the manufacturer.
Second. Mother’s milk.
Third. FDA 0.05 mg/Kg/day BW
Fourth. EPA 0.06 mg/Kg/day BW
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Bill,
“First. I have repeatedly responded that Federal and state laws require the manufacturer of the substance used with the intent to prevent disease to gain FDA CDER approval which would require valid peer-reviewed evidence. FDA CDER has rejected all applications due to lack of evidence. In other words, it is not the patient who is to provide the research to prevent the legal intermediary or manufacturer from forcing the substance into the patient. Proof is in the lap of the manufacturer.”
This is valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level? Uh….no. Your skewed “interpretation” of the law can certainly be argued in court if you wish, but obviously, is evidence of nothing but your skewed “interpretation” of the law.
“Second. Mother’s milk”. Uh….no, again. We’ve already discussed the absurdity of this “argument”. Obviously not valid evidence of any harm to infants.
Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of “concern” for their health.
Steven D. Slott, DDS
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Bill
“Regardless of a purchaser asking for affidavits or not, the FDA is in charge of all drug substances used for ingestion in the U.S. All drugs require clinical trials testing for FDA approva and require prescriptions. Next January all manufacturers of those materials sold for ingestion purposes must be State licensed for that purpose”.
So if this is the case How come your partners in crime ,the natural health industry fought tooth and nail to stop any testing on their “drugs’
On June 7, 1991, Henry Waxman introduced the Food, Drug, Cosmetic, and Device Enforcement Amendments, which “authorized any district court to order the recall of a food, drug, device, or cosmetic which is in violation of the [law] if the violation involves fraud or presents a significant risk to human or animal health.” The word most important to Waxman and Kessler [the FDA commissioner]—and that most frightened the supplement industry—was fraud. The FDA knew that claims of safety and effectiveness by supplement manufacturers were either unsubstantiated or wrong;
Four of the industry’s top thirty manufacturers—Weider, Nutraceutical Corporation, Nature’s Way, and Nu Skin International—were located in Utah. (It was the only state with its own supplement trade association: the Utah Natural Products Alliance.) … Utah benefited from several billion dollars in profits from supplement sales. Hatch’s campaigns also benefited…. Between 1989 and 1994 Herbalife International gave Hatch $49,250; MetaboLife, $31,500; and Rexall Sundown, Nu Skin International, and Starlight International a total of $88,550. In addition, according to his financial disclosures for 2003, Hatch owned 35,621 shares of Pharmics, a Utah-based nutritional supplement company. In the early 1990s,
The failure of the FDA to regulate natural products appropriately can be attributed not only to the actions of powerful senators such as Orrin Hatch of Utah and Tom Harkin of Iowa, but also to prominent physicians and scientists who stumble in rebutting their agendas. Dr. David Kessler, as commissioner of the FDA, was grilled by Hatch during Senate hearings about regulation of the supplement industry.
So if the drugs made by the Natural health industry do not need testing ,Why do you keep saying fluoride is poison,and needs testing, It comes under the same description You call it a drug the same as hundreds of non regulated ‘poisons’ sold by your partners like Mercola
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Chris,
You simply can’t hold a professional conversation, can you. You suggest I have “partners” in the “natural health industry.” Did you have to spit the words out in disgust? I’m sorry you are so angry with your paper tiger.
I don’t take any supplements, probably should. I don’t have any partners. Stick to the facts, if that is possible.
Look up the legal definition for a highly toxic substance, poison.
Sodium fluoride is a highly toxic substance, poison, based on legal terms.
Highly toxic substances are exempt from highly toxic substance and poison laws when regulated as pesticides or drugs. Dilution of the substance does not exempt the substance from jurisdiction.
Your reasoning seems flawed. The intent of use determines whether it is a drug regardless of concentration, efficacy or safety. I know natural supplement manufacturers who have been shut down by the FDA because of claims of intent without FDA approval. They need to get FDA approval.
Please name one of the supplement ingredients which is a poison.
Fluoride is stronger and more toxic than any of those ingredients, to my knowledge.
Please name one of those “natural” supplements or ingredients which I am forced to ingest without my consent?
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Steve,
You state, “Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of “concern” for their health.”
Go to this link and read each of the sections. They are short and explain drugs in clear simple terms.
http://www.fda.gov/cosmetics/guidanceregulation/lawsregulations/ucm074201.htm
Read the FDA CDER drug approval process and history of the process. You have flipped jurisdiction on its head, reversed jurisdiction.
It is not the consumer who is to provide evidence of safety or efficacy. That job is the manufacturer.
It is not your job or my job to determine the safety of substances intended to prevent disease. That is the job of the FDA CDER.
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The possibility of harm caused by natural products … isn’t theoretical. Blue cohosh can cause heart failure; nutmeg can cause hallucinations; comfrey, kava, chaparral, Crotalaria, Senecio, jin bu huan, Usnea lichen, and valerian can cause hepatitis; monkshood and plantain can cause heart arrhythmias; wormwood can cause seizures; stevia leaves can decrease fertility; concentrated green tea extracts can damage the liver; milkweed seed oil and bitter orange (Citrus aurantium) can cause heart damage; thujone can cause neurological damage; and concentrated garlic can cause bleeding….And it’s not just the supplements themselves that might be harmful, but what’s contaminating them. In 2004, researchers at Harvard Medical School tested Indian (Ayurvedic) remedies obtained from shops near Boston’s City Hall. They found that 20 percent contained potentially harmful levels of lead, mercury, and arsenic….And you may argue about the toxicity of this list ,but it is the same as fluoride, It is all in the dose
The difference with fluoride is it is covered by a highly controlled set of standards to guarantee safety, where as your mates natural products have no such control, and they dont want it ,wonder why?
No one is forced to ingest anything, It is your choice ,and as justice Hanson said at a recent court case in NZ, {You should know all about them, being Attorney Deals right hand man}
Justice Hansen made this argument in his recent judgment on the fluoridation issue [Hansen 2014]
“Providing it does not have consequences for public health, a person has the right to make even the poorest decisions in respect of their own health. But where the state, either directly or through local government, employs public health interventions, the right is not engaged. Were it otherwise, the individuals right to refuse would become the individuals right to decide outcomes for others. It would give any person a right of veto over public health measures, which it is not only the right, but, often the responsibility of local authorities to deliver”
You say you have no ties to the Natural Health industry in your work [and stopping fluoride in drinking water is you job, and you are doing it here so this is work} well that seems to be false, as in 2012 this was released by FANN
the Fluoride Action Network (FAN) joined the Health Liberty Coalition, formed by Mercola.com, the National Vaccine Information Center (NVIC), the Institute for Responsible Technology (IRT), the Organic Consumers Association (OCA), and Consumers for Dental Choice.
The purpose of forming the nonprofit partnership was to advocate and actively campaign for the freedom of individuals to make personal health decisions, and to increase access to unbiased and accurate health information.
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Bill,
“You state, ‘Once again, please provide valid, peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, or cease the transparent facade of ‘concern’ for their health.”
“Go to this link and read each of the sections. They are short and explain drugs in clear simple terms.”
1. There is no peer-reviewed scientific evidence of any harm to infants from water fluoridated at the optimal level, in the literature to which you provide a link.
2. Fluoride at the optimal level is not a “drug”. It is simply a mineral identical to that which has existed in water since the beginning of time.
3. The US EPA has full jurisdiction and regulatory authority over all additives to drinking water, not the FDA.
4. “You have flipped jurisdiction on its head, reversed jurisdiction”
I have not “flipped” anything. I have no authority to determine jurisdiction of fluoride, or anything else.
5. “It is not the consumer who is to provide evidence of safety or efficacy. That job is the manufacturer.”
In the case of fluoride or any other additives to drinking water it is not the consumer or the manufacturer who is to provide evidence of safety and efficacy. It is the job of the EPA to provide evidence of safety of additives to drinking water. It does so by requiring all drinking water from the tap to meet the stringent Standard 60 certification requirements of the National Sanitary Foundation.
6. “It is not your job or my job to determine safety of substances intended to prevent disease. That is the job of the FDA CDER”.
You are correct. It is not your job or my job to determine the safety of substances intended to prevent disease. If you are referring to optimal level fluoride in drinking water, however, this is the job of the EPA, not the FDA.
Steven D. Slott, DDS
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STEVE,
Like you, I once thought the EPA was in charge of the addition of fluoride to water. First I read the law:
“No national primary drinking water regulation may require the addition of any substance for preventive health care purposes unrelated to contamination of drinking water. ” 42 USC 300g-1(b)(11):
Next I contacted the EPA with an FOI request and they responded:
“The Safe Drinking Water Act prohibits the deliberate addition of any substance to drinking water for health-related purposes other than disinfection of the water.”
FOIA Request HQ-FOI-01418-10
Then I talked to an EPA official for confirmation and they said the NSF is in charge of substances added to water.
When I have time, I will respond to your other statements. Look up the Relative Source Contribution Analysis done by the EPA and the Dose Response Analysis. Read those. Especially the chart, I believe it is 8-1.
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Bill,
Facts are facts. The EPA has jurisdiction and regulatory authority over fluoride additives to drinking water, not the FDA.. If you believe this to be an error on the part of the US government, then go argue your case in court.
Steven D. Slott, DDS
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Steve, You allege,
“Facts are facts. The EPA has jurisdiction and regulatory authority over fluoride additives to drinking water, not the FDA.”
That’s what I thought also, until I read the law and talked to lawyers and talked to the EPA and FDA.
I have a choice:
A. Believe what the FDA, CDC, laws, HHS, Congress actually say.
OR
B. Believe Steven D. Slott DDS.
Facts are not “faith based.” Facts are hard data, words, numbers.
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I forgot to add NSF to the list.
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Where does the FDA exempt a drug due to concentration or dosage?
FDA uses “intent” not dosage to determine whether a substance is a drug.
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Bill,
“Steve, You allege,
“Facts are facts. The EPA has jurisdiction and regulatory authority over fluoride additives to drinking water, not the FDA.”
That’s what I thought also, until I read the law and talked to lawyers and talked to the EPA and FDA.
I have a choice:
A. Believe what the FDA, CDC, laws, HHS, Congress actually say.
OR
B. Believe Steven D. Slott DDS.”
I don’t “allege” anything. I state facts.
Apparently you are under the delusion that I have any concern whatsoever what you “believe”. That’s entirely up to you. I simply expose the fallacies of your comments.
Again, if you want to believe that the US government is in error over jurisdiction of additives to drinking water, that’s certainly your prerogative. But, you should probably take your arguments to court. It is highly doubtful that the laws will change because you repeatedly keep posting the same nonsense on this website.
If you believe there to be some sort of conspiracy, coverup, or corruption within the US government, then you should report this to the appropriate authorities.
Steven D. Slott, DDS
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Steve,
For some bizarre reason, you think I disagree with the jurisdiction of artificial fluoridation being with the FDA CDER. Why would I go to court when I agree with the law and these agencies that the FDA CDER has jurisdiction.
Of course I would not take the EPA to court when the EPA does not have jurisdiction over the ADDITION of fluoride to water. EPA has jurisdiction over the EXISTING fluoride in water. Their MCLG is not protective, but that is a different subject.
Steve, you fail to give any legal reference or notice from the EPA that the EPA has jurisdiction over the ADDITION of fluoride to water with the intent to prevent dental caries.
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Wow, this a long comment stream. I just got thru part of it and found this quote from dentist Steve Slott: “The reasons that European countries may or may not fluoridate their water systems are myriad, few, if any, related to effectiveness or health concerns of optimal level fluoride. They are also irrelevant to that which is done by New Zealand, the US, or any other countries, in the best interests of their respective citizenries.”
Ok, so where can I read about European countries and their experience with fluoridation? Where can I find out about the myriad real “reasons?” And please don’t tell me to ask the ADA or consult their “Fluoridation Facts.” The ADA no longer answers questions from the public. Years ago I exposed their lie that “60 nations practice water fluoridation” The next edition of “Fluoridation Facts” took that false statement out. They knew that statement was false but printed it anyway.
In the current “Fluoridation Facts” it says “Many fluoridation systems that used to operate in Eastern and Central Europe did not function properly and, when the Iron Curtain fell in 1989-90, shut down because of obsolete technical equipment and lack of knowledge as to the benefits of fluoridated water.3” That actually is an insult to the engineers and public health people in those countries. This implies that the engineers were too stupid to fix fluoridation equipment. Or It implies that the country is too poor to fix equipment. As for the “lack of knowledge as to the benefits” what happened? Did they forget why they were adding fluoride to water? Did they see a lack of effectiveness in their country when they were supposed to ignore that? Another insult.
And the ADA still lies about Europe, stating that: “No country in Europe has banned community water fluoridation.” and “Political actions contrary to the recommendations of health authorities should not be interpreted as a negative response to water fluoridation. For example, although fluoridation is not carried out in Sweden and the Netherlands, both countries support World Health Organization’s recommendations regarding fluoridation as a preventive health measure, in addition to the use of fluoride toothpastes, mouthrinses and dietary fluoride supplements.138,350”
Of course political actions can be a negative response to water fluoridation. Just like they can be a positive response to a proposal to add fluroide to water. I expect this section to be re-written in the next edition of “Fluoridation Facts” which I think should be out fairly soon.
So in the Netherlands they had fluoridation and then said it was no longer allowed. They banned it. They changed laws, they had court decisions. In Sweden the legislature said no. If the what the ADA said was true, then we must believe that any water system in the Netherlands or Sweden could start up fluoridation if it wanted to. But none have done so in the many decades since it was banned. Why not? There are plenty of people in those countries who support fluoridation, but the ADA story says these public health officials chose voluntarily on their own to stop fluoridation and never start up another fluoridation scheme anywhere. For some unexplained reason they supposedly did that.
But of course that is not what most of the world believes about fluoridation in the Netherlands and Sweden. I find it incredible that the ADA would make these statements. Most of the world agrees that fluoridation is banned in those countries.
There has been something fishy about statements regarding European fluoridation for a long time now. I’m not going to accept what Steve Slott said about Europe until I can see something significant and specific that supports him. I know it is hard to gather the historical data on fluoridation around the world, but the British Fluoridation Society eventually did a fair job of it. Their first attempt had errors and misleading stuff, but they made an effort to fix it after I complained. The BFS never claimed that there were “60 nations practicing fluoridation.” And I bet the BFS would never make the claim that “No country in Europe has banned fluoridation.”
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