Anti-fluoridationists misrepresent new dental data for New Zealand children

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Another whopper from the anti-fluoridation movement in New Zealand.

They claimed yesterday that “data released by the Ministry of Health today confirm that water fluoridation is having no noticeable effect in reducing tooth decay” (see DHB Data Show No Benefit From Water Fluoridation).

Yet a simple scan of the data (which can be downloaded from the MoH website) shows this to be patently untrue.

Here is a graphical summary of the New Zealand-wide data for 5-year-olds and year 8 children. It is for 2014 and I have separated the data ethnically as well as presenting the summary for all children (“total”).

DMFT and dmft = decayed, missing and filled teeth.

2014_5_years

214---8-yrNow – don’t these figures show the press release headline and the first sentence  are completely dishonest?

The data for all children (“total”) Maori and “other” show children in fluoridated areas have a higher percentage of caries-free teeth and a lower mean value of decayed, missing and filled teeth. The data for Pacifica are less definite – because the vast majority of Pacific children live in fluoridated areas. I discussed this further in my last post A challenge to anti-fluoridationers to justify their misrepresentation of New Zealand research.

Cherry-picking

So the headline and main message of the anti-fluoridationists press release were outright lies. However, they will fall back on the claim that the press release does contain some facts.  But these are just cherry-picked snippets taken out of context to confirm the bias of the anti-fluoride mind.

For example, comparing data for Christchurch and Nelson-Marlborough with those for  Auckland and Counties-Manukau is just disingenuous if the ethnic differences (which we know clearly play a role in oral health) are not considered. Similarly, reference to the 2o14 “overturning” of the Hamilton Council decision to stop fluoridation is just silly considering that there are no separate data for the city and the Hamilton Council fiasco over water fluoridation overlapped the period the data covers.

Of course, this press release has been processed through the international anti-fluoridation – “natural”/alternative health media channels so expect to be bombarded with international reports based on these lies.

The lesson from this little story – don’t take claims made by anti-fluoridation campaigners, or similar activists with an anti-science agenda, at face value. Always check them out.

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18 responses to “Anti-fluoridationists misrepresent new dental data for New Zealand children

  1. Shouldn’t you be comparing groups of a similar age at different points in time?
    Ie. 5 year olds and 8 year olds in 1980 and 2014 (or whatever years pre and post fluoridation) and not two different ages in the same year?

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  2. Depends on what you are looking at.

    The relevant question is – do we see any effect of fluoridation? In this case, we should use a cross-sectional approach and compare the same age group as the same time for fluoridated and unfluoridated areas.

    Inception of fluoridation, of course, varies from region to region and in some places like Hamilton stopping and starting confused things.

    But, in general, fluoridation commenced well before the first points on these plots. So pre and post-fluoridation comparisons are not possible.

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  3. This is an email sent April 19th 2016. I am unaware of corrections or replies that were made.

    ‘To the team leader in the Dental team,

    I left you a message today to let you know that the 2016 School Dental Statistics that have recently been uploaded are seriously wrong. The children in non-fluoridated Christchurch have been entered under the fluoridated data and vice versa.

    It is astounding that an error like this could be made for the first time in all the years these statistics have been produced, and given it must have been reviewed by many people. As fluoridation is currently in the lime light and there are claims that children in non-fluoridated Canterbury have more tooth decay than the children in fluoridated Canterbury it is appalling that these figures have been switched.

    This information needs to be corrected asap. There really is no excuse for it not to be.

    Regards’

    Also I see that this article is bringing up 2014 statistics in response to 2016 data.

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  4. Tobias – I can not understand your claim that “this article is bringing up 2014 statistics in response to 2016 data.” I didn’t refer to 2016 data (or did I make a mistake somewhere – I can’t find it.)

    I have let the article stand as is because the mistake seems to be in the Canterbury data and, if so, will not have much influence on the graphs I presented.

    You refer to claims the “children in non-fluoridated Canterbury have more tooth decay than the children in fluoridated Canterbury.” One can not make this comparison because the number of fluoridated children is less than 1% of the total. Comparisons end up being silly as I explained in my later article “Do the math” – a bit like “Do the research!” Choose your year and you will confirm whatever bias you want to.

    The MoH has been aware of their mistake for a while and withdrew the spreadsheets. Please remember these are just records of treatments – they don’t have the ranking of peer-reviewed papers, there are all sorts of problems with the data and the website contains a disclaimer. Really such data needs some intelligent analysis befiore drawing eany conclusions and the anti-fluoride people have just resorted to cherry-picking to confirm their bias. Very badly at that.

    However, despite the withdrawal of the 2014 data, it is easy enough to make comparisons using the existing data from 2005 – 2013. Whether 2014 data is included or not makes no difference.

    hey, waht about pernmitting me to comment on you Facebook page where you are commenting on my article?🙂

    Fair is fair.

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  5. To quote the article here…
    “Here is a graphical summary of the New Zealand-wide data for 5-year-olds and year 8 children. It is for 2014 and I have separated the data ethnically as well as presenting the summary for all children (“total”).”

    As has been established, the 2014 data this article refers to has been removed from the MOH database. So it seems the data that the graphs in this article are drawn on has been withdrawn.

    I feel that the fact very much still stands that we have seen next to no evidence to support fluoridation, in comparison with the mountains of reasons to consider not using it. Especially not for the entire population.

    The 1% of Japans population that drinks fluoridated water uses calcium fluoride because their research finds the industrial by-products used in NZ ineffective.

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  6. Tobias – could you post a link or citation to the use of CaF2 in Japan? I am really surprised as I can not see how CaF2 could be used as a fluoridating agent. Similarly, the research they have done on “industrial by-products used in NZ ” showing them ineffective. I am not aware of such Japanese studies so really need the proper links/citations.

    Yes, I acknowledged that my article used the 2014 data (I did not refer to 2016 data) – as I said, if the mistake was in the Canterbury figures I(and that appears to be the case) this will not make any significant difference. In fact, the posted spreadsheet already drew notice to problems with the Canterbury data. I will wait for the corrected data to be posted before amending – if at all.

    You must remember this article was written in response to the misrepresentation of the data by San Litras – he has not withdrawn his comments yet.

    I simply cannot agree with your claim:

    I feel that the fact very much still stands that we have seen next to no evidence to support fluoridation, in comparison with the mountains of reasons to consider not using it. Especially not for the entire population.”

    There is plenty of evidence of the efficacy of CWF and no convincing evidence for any problems except a possible increased risk of mild dental fluorosis. I have been writing articles here for 3 years now dealing with the scientific aspects of this and I cannot see how anyone can make that as an honest claim.

    Have you not read the NZ Fluoridation Review?

    But, please, don’t forget. Links/citations for the Japanese research you referred to.

    And what about allowing comments on your facebook posts about my article?🙂

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  7. Firstly, to enter Canterbury’s non-fluoridated children into the fluoridated statistics, regardless of how many people are on fluoridated water, could greatly alter the stats. Canterbury has good dental health and no fluoride. This is taking pennies from bowl A and putting them in bowl B.
    “I will wait for the corrected data to be posted before amending – if at all.”
    In the meantime the stats in this article are pretty much fictional.

    “Have you not read the NZ Fluoridation Review?”
    The reviews are wishy washy. When you write a report with the outcome already decided, it is easy to cherry pick data from anywhere to match what you want. I could easily say, with more certainty, that Canterbury and Nelson are proof that effectiveness of water fluoridation is very questionable. Seriously, how much water do kids hooked on fizzy and lollies drink?

    “There is plenty of evidence of the efficacy of CWF and no convincing evidence for any problems except a possible increased risk of mild dental fluorosis.”
    This is blatently untrue. Once fluoride is swallowed it actually has no effect on teeth and instead causes skeletal fluorosis. No effect on teeth at all. It only works topically.
    This is a report from The Lancet, one of the most repuatable medical journals that strongly links multiple studies of lower iq scores in children that ingest fluoride.
    http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/
    The effects of fluoride being absorbed into bones is still largely unknown. There is plenty to suggest that it is a concern beyond iq. This was a link to an OHEAA report that has been removed in the last few days about possible links to bone cancer.
    http://oehha.ca.gov/prop65/hazard_ident/pdf_zip/FLUORIDE070811.pdf
    It has also been linked to thyroid disorders and is apparently more of a risk to diabetics and women with osteoporosis.

    “Tobias – could you post a link or citation to the use of CaF2 in Japan? I am really surprised as I can not see how CaF2 could be used as a fluoridating agent”
    Less than 1% of Japan practices water fluoridation. Instead, as of March 2010, a total of 7,479 schools and 777,596 preschool to junior high school children were participating in school-based fluoride mouth-rinsing programme (S-FMR), with an estimate of 2,000,000 children participating in 2020.
    I cannot be stuffed trawling through Japanese research papers right now. By all means, take a look for yourself. The Japanese finding HFA and similar chemicals ineffective is out there. And they now use mouth rinse for obvious reasons, fluoride only works topically and is a listed neurotoxin.

    In my mind, there is nothing solid enough in favour of fluoridated water to justify arrogant dismissal of research from such souces as The Lancet. The rest of the world is taking out the fluoride and we want to put it in? I could use the exact same data as was used for the nz fluoridation review and make a case as solid against fluoride. There is definately a bias towards supporting fluoridation here in NZ. Just look at this article. The graphs are drawn on fictional data. Every ingestable fluoridated product, even with fluoride in lower levels than fluoridated tap water, states ‘do not consume while pregnant’ on the label. Not to mention the ethincs of forcing a medication on people. A medication that only works topically and should not be ingested.

    I’m a why asker… What I have come to is this. One group, Water NZ, is responsible for consultation of installation of equipment, providing the fluoride, and they also started their journey as New Zealand Water and Wastes Association i.e. they dispose of industrial waste. They also most likely set up private investors into buying New Zealand water but we’ll get to that another day.
    The chemicals used in NZ are not food grade products. They are by-products that need disposal. They are currently supplied by Ravensdown Fertilizer.
    Information received from the Invercargill District Council shows the Council was buying its fluoridation chemicals in 2009 from the Chinese company Shanix, but had to stop because of discolouration and the presence of rust and bits of wood.

    “And what about allowing comments on your facebook posts about my article? :-)”
    I set my profile to open comments last night but just changed it back. Seriously, if you want to come onto my personal profile and start a debate it will just make the case for fluoridation look kind of desperate. This is a public forum, it is not your personal wall and you did kind of call out people to come debate with you… If you feel what I have written on my wall about this article is unfair I am happy to edit it. I’m sure if I were to look on your wall I will find something I feel disrespectful or untrue…

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  8. Tobias, I suggest you actually take the data from, say 2013, and see what effect inclusion or exclusion of Canterbury data have on the mean values. I have done that and that is why I am saying that when the corrected spreadsheet is available there will be very little difference to the conclusion I have shown.

    If, in fact, there is a major difference I will of course post an article acknowledging that. But let’s wait and see, eh?

    It is not clear if your comment acknowledges that any comparison of fluoridated and unfluoridated Canterbury is meaningless because of the very small fluoridated numbers – as I said pick your year according to your bias.

    Also, you do not acknowledge the influence of ethnic composition on the data – that in fact when like is compared with like Canterbury has slightly poorer dental health than in the Waikato? As I said, any intelligent conclusions from the data requires taking such factors into account. It is meaningless to compare apples with oranges.

    Could you please make the specific criticism of the NZ Fluoridation review on which you base your wishy-washy condemnation? Or am I to conclude that you have got the term from FFNZ As I have heard it so often without any backup.

    Seriously, I would like to hear your specific criticism of the Royal Society Review. Just repeating FFNZ slander is not acceptable.

    Also, provide your data for Nelson and Canterbury so we can discuss your claim. That is the way scientific discussion works – we consider evidence.

    Your refusal to respect my request for links or citation for your claims re Japanese research is unacceptable. My only conclusion is that there is nothing to back up your claim. It is an invention.

    I maintain a close watching brief on fluoride research and have not seen anything along these lines. And as a chemist I cannot see how calcium fluoride can practically be used for CWF. Your refusal to back up your claims means In the absence of any other evidence I will stick with my current conclusions and, unfortunately have to accept you are telling porkies on this one. : -)

    I will comment on your other claims in a separate comment with links for you to read.

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  9. “There is plenty of evidence of the efficacy of CWF and no convincing evidence for any problems except a possible increased risk of mild dental fluorosis.”

    This is blatently untrue.

    Helloooo, Tobias, anyone at home?

    Name a single scientific, medical or dental association that rejects the mainstream scientific consensus that properly managed CWF is a safe and effective means of improving community dental health.

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  10. Tobias, allowing comments on your facebook page is of course up to you. But it is consistent with a trend I have noted. Since just after the conclusion of my on-line debate with Paul Connett every single anti-fluoride internet site internationally I have attempted to comment on has banned me – the latest being Methven Fluoride Facts yesterday. I can only conclude that the order went out from headquarters.

    Of course, it could just be that anti-fluoride propagandists in general just refuse to allow scientific discussion.🙂

    However, I think it cowardly when people make a criticism of my articles but refuse to allow my comments.

    But I do congratulate you for bringing your comments here where they should have originally been made anyway.

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  11. “I tis not clear if your comment acknowledges that any comparison of fluoridated and unfluoridated Canterbury is meaningless because of the very small fluoridated numbers”

    Oh wow, this needs some emoticons or something.
    The non fluridated stats were entered as fluoridated and vice versa. So the large population with good teeth and no fluoride were entered as having fluoride.

    “I maintain a close watching brief on fluoride research and have not seen anything along these lines. And as a chemist I cannot see how calcium fluoride can practically be used for CWF”
    The Lancet classified fluoride as a neurotoxin a long time ago, and can we not get hung up on Japan having calcium fluoride for CWF, it may occur naturally on quick look.
    It is beside the main points I made that you didn’t mention in your reply. We since established that Japan has a school programme for fluoride mouth rinses. Brilliant idea. Since fluoride works topically and is a listed neurotoxin. To further this point I’ll repeat my question from before, how many kids hooked on fizzy and lollies drink water?

    To quote you…
    “As I said, any intelligent conclusions form the data requires taking such factors into account”

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  12. Tobias – re you claim that CWF is not effective I will just link to a couple of my articles mentioning recent papers showing that your claim is silly:

    Korean community water fluoridation supported by new evidence
    Water fluoridation effective – new study

    Of course, I could cite many studies – these are just recent examples. And all reviews do report CWF effective.

    I have written several articles ion the systemic and “topical” or surface mechanism underlying CWF effectiveness – I suggest you search for those words on my blog for the articles. But the fact is that ingestion of fluoridated water and food is a very effective way of maintaining fluoride concentration in saliva which we know provides a positive role against acid attack with existing teeth.

    Regarding Grandjean’s Lancet paper – have you even read it? I find most people who cite it haven’t.

    I made comments on it at the time – Repeating bad science on fluoride

    You are in a bad way to have to rely on that review paper for your stand on CWF in NZ.

    Enough for now. As I have said your refusal to back up your claims about Japan disappoint me. I can understand you have drunk the Kool Aid from FFNZ – but I would have thought you could have at least had the confidence to back up a claim like that.

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  13. Thanks, Tobias, you have admitted your mistake about calcium fluoride. I can now rest with the confidence that my chemical understanding was not wrong.

    Yes, mouth rinses are a good alternative if CWF is not feasible – it is what was used in Cuba – a fact people like Connett refuse to mention when he uses that case to claim that CWF is ineffec tive – I most recently commented on this in Fluoridation cessation studies reviewed – overall increase in tooth decay noted.

    The protective action of mouth rinse programmes relies on the same mechanism as that for CWF with existing teeth.

    Fluoride is not a listed neurotoxin. In fact, it couldn’t be as it is not produced by living organisms (implies by the word toxin). Now if you provide the official designation that fluoride is neurotoxicant (the correct term) we can discuss it. The Lancet paper is not an official designation.

    This “neurotoxin” claim is simply a big lie that FAN promotes.

    Regarding the Canterbury and 2014 data story – if you have any confidence that my figures are misleading then please do the analysis I suggested with the 2013 data and report it here to prove me wrong.

    Regarding sugar – yes an intelligent analysis does require taking such factors into account. The MoH data is not meant to be a research paper (and you really should read the disclaimer) but I suggest you read the following paper which found that the protective role of fluoride persists even when confounders like sugar consumption are included in the statistical analysis:

    Blinkhorn, A. S., Byun, R., Mehta, P., & Kay, M. (2015). A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia. International Dental Journal.

    It is really not hard to understand – there are many factors influencing dental health. Sugar consumption is an important one. Fluoride deficiency another. One should attempt to correct both.

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  14. Tobias, my comment on the Canterbury data and the silliness of making comparisons between fluoridated and non-fluoridated areas relates to the graphs I presented over the years between 2005 – 2013 – not 2014. In “Do the math” – a bit like “Do the research!”. I suggest you look at that.

    I thought that was clear.

    Do you really think it is possible to make a meaningful comparison with such data?

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  15. Tobias – further to my suggestion you check out thew 2013 data. I have plotted the data for %caries-free 5-yerar-old – with and without the Canterbury data. The figures show no practical effect of removing the Canterbury data.

    I think this confirms my point.

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  16. “The protective action of mouth rinse programmes relies on the same mechanism as that for CWF with existing teeth.”
    Again, we need some emoticons. Why would we want to put a toxic chemical in our drinking water (unless it needs disposal), when it would be cheaper to have mouth rinses of food or lab grade fluoride in schools. This would also solve the problem that sugar addicts don’t drink water.
    There is so many sources of repuatable information strongly suggesting that ingesting fluoride could have very real health concerns. I see you have still not adressed issues like skeletal fluorosis and osteoporosis. If the research hasn’t been properly conducted or reviewed then why not? Why do you feel it is ok to simply dismiss this?

    As for the revised 2013 data graphs…
    The relevant associations were told of the error about 3 weeks ago and they haven’t been able to put up the corrected figures even though it should just be a simple swap.
    So the 2013 data cannot be viewed by the public. Very strange. Looks like there is possibly more ‘mistakes’.

    The 2005 – 2013 graphs?
    Look at them, that green line jumps around like 5 year old bugs bunny on a three day coke binge. I think there might be more ‘mistakes’ somewhere in there mate.

    Also, here is a Nelson Mail poll from 22/07/2014 showing a vote against fluoride.
    http://www.stuff.co.nz/nelson-mail/10293033/1m-fluoride-saving-seen-on-tap

    Here is a Stuff.co.nz poll from 01/08/2014 showing the same result.
    http://www.stuff.co.nz/marlborough-express/news/10335375/More-against-fluoridation-than-for-poll

    Here is a screenshot of a one day Paul Henry poll showing 64% to 36% vote against water fluoridation.
    http://postimg.org/image/5kwzl4gpd/

    So as well as the science being full of holes, full of questions without answers, it seems the majority don’t want it. Sorry but I’m going to have to quote you again here, spelling mistake and all…
    “As I said, any intelligent conclusions form the data requires taking such factors into account”

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  17. Tobias – you say the science is full of holes – but you cannot seem to cite a single one!

    Suggests you haven’t looked at the science.

    You say the Royal Society report is “wishy-wahy” – yet when asked for specifics you can not relate any.

    Suggests you have not read the report and are simply repeating FFNZ’s bad-mouthing.

    All the research shows fluoride at the concentration used in CWF is not toxic. You haven’t provided a single piece of evidence to back up your belief it is. It is just silly to talk about skeletal fluorosis – which results from high fluoride intake which just doesn’t occur with CWF.

    I cannot dismiss something you do not even produce evidence for.

    You accept that the non-fluoridated data “jumps around.” – Great – but can you not understand this is exactly what you expect from very small samples. Nothing to do with mistakes – that is simply the nature of small samples. And you should by now realise it is foolish to attempt to compare data for fluoridated and unfluoridated Canterbury areas when there is such a large variation (inevitable with small sample sizes).

    That is basic statistics.

    You put all your faith in internet polls – which we all know are skewed – while ignoring completely the actual referenda in places like Hamilton, Whakatane, Hastings and Thames in recent years which clearly show a majority support for CWF.

    You do not seem to be capable of “intelligent conclusions” because you are cherry-picking data and sources, covering up other data and sources and letting your biases get in the way.

    And the 2013 data is still available on the MoH website.

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  18. soundhill1

    “mouth rinses of food or lab grade fluoride in schools. This would also solve the problem that sugar addicts don’t drink water.”

    It would seem interesting to see DMFT rates in unfluoridated areas where the sugar or sweetener drinks are imported made with fluoridated water.
    High acid would also need to be controlled for.

    Like

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