Fluoridation: What’s happening with the New Zealand legislation?

The second reading of the fluoridation bill is now on the order paper for the current parliament. Public submissions have been heard, the Health Committee has reported back to the House and the Ministry of Health (MoH) has provided its own responses to submissions.

Of course, we don’t know yet what the final Act will be like exactly. But the submissions, the committee report, and the MoH responses give us some idea of likely changes to the original bill.

Submissions

I have described before how the anti-fluoride activist groups organise to deluge consultation processes with their submissions. This was certainly the case here and their submissions accounted for most of those opposed to the Bill.

However, because the legislation is about the decision-making process and not the scientific or ethical validity of social health policies simple opposition to fluoridation was irrelevant  – outside the scope of the bill. This was true of most submissions (85%) and these should be considered a waste of every bodies time.

I am surprised the anti-fluoride organisations organising this submission campaign chose to take such an irrelevant approach. Surely if they had put a bit of thought into their efforts they could have directed their submission at relevant aspects such as the consultation process, the decision-making body and the question of referenda.

That said, a small number of the anti-fluoride submissions did address aspects of the bill and these were considered by the Health Committee and the MoH.

Putting aside the anti-fluoride submissions which did not address the bill, 20% percent supported the Bill and 80% opposed to the Bill as currently drafted. Most supported extending fluoridation cover, but disagreed with specific parts of the Bill and suggested changes.

The legislation does not mandate fluoridation

This is a common misunderstanding promoted by anti-fluoride campaigners – obviously attempting to use scare-mongering to motivate their supporters. For example, Fluoride Free NZ formally names the legislation the Mandatory Fluoridation Bill which is dishonest – the correct name of the bill is Health (Fluoridation of Drinking Water) Amendment Bill.”

The bill transfers decision-making from local bodies to District Health Boards (DHBs) – but it does not require DHBs to make a decision about fluoridation. That is up to local DHBs and local conditions such as dental health, likely advantages and establishment costs.

Consideration of other health factors

A number of submitters expressed concern that while the bill requires DHBs to consider dental health effects, consideration of other possible health issues is not provided for. However,  the response from the MoH to this is:

“While DHBs are required to consider the evidence in relation to oral health, DHBs are not prevented from considering other factors, including the effect of fluoridation on overall health. However, officials do not consider it necessary for the Bill to require DHBs to consider these other factors.”

So, consideration of other health factors will depend on specific situations, the board members or public interest. Importantly, DHB’s are not prevented from considering wider health aspects.

Considering the science

I was interested to see that:

” The Ministry of Health is currently exploring options for the ongoing monitoring and assessment of research on fluoridation within the Ministry to align with the implementation of the Bill.”

The MoH sees this as carrying on the role formerly played by the now disbanded National Fluoridation Information Service. But this also goes some way to satisfying a suggestion in my own submission that the assessment of research on fluoridation is carried out by some sort of central expert body (see Fluoride, coffee and activist confusion). My concern was that the DHBs are not really suitable bodies for making expert reviews of the literature and evaluating the current state of the science. Handing this over to a central body could also prevent boards being deluged with misinformation and unsupported claims about the science – a feature of local body consultation which caused so much trouble to councils.

It was the pressure of submission campaigns including misrepresentation and false claims about the science which drove local bodies, who do not have the expertise to consider the science, to request a change to the legislation. DHBs will confront the same situation unless they can direct scientific consultation to a central expert body.

Community consultation

Many submitters (12%), both for and against fluoridation, suggested the bill should specifically require DHBs to consult the community about fluoridation decisions. While the bill did not make such specific requirements it also did not prevent such consultation.

In practice, public consultation will depend on the level of demand for it. It is up to DHBs to decide when consultation is appropriate and there is already a regulatory requirement for DHBs “to foster community participation in health improvement” which could cover that.

There is also provision for the Minister to describe a fluoridation decision as a “significant service change” which would require DHBs to undertake community consultation on regional service plans including fluoridation.

So, the anti-fluoride activist claims of denial of community consultation is wrong. While consultation is not specifically required it is not prevented by the bill and will depend on the level of public interest.

Engagement with local authorities

The health committee is recommending the bill be amended to explicitly require DHBs to consider the views of the drinking water supplier. This accommodates suggestions made by some local bodies who feared the imposition of decisions without considering their local situations.

However, the committee also suggested an amendment to make clear that engagement with local authorities does not require them to consult communities. The DHB which makes the ultimate decision would have that responsibility where necessary.

The Committee also suggested “the Government consider whether
it intends to contribute funding towards the costs of establishing fluoridated water supplies” because there is a “moral hazard arising from the DHBs making a decision that will impose costs on local authorities and ratepayers.”  It looks like the Government has accepted this point as they have already made $12 million dollars available to local bodies setting up new fluoridation systems (see Government commits $12m to help councils cover costs of fluoridation in water supplies.).

Provision of non-fluoridated alternatives

Some local bodies have already introduced “fluoride-free” taps at the request of local anti-fluoride campaigners., The MoH is suggesting an amendment to the bill to make clear that “DHBs can direct local government water supplies in their region on a supply by supply basis if they wish.”

This could make it possible for specific local supplies, like Petone in the Hutt region or some supplies in Christchurch to remain unfluoridated if their communities demand it even if a decision is made to fluoridate a region.

The DHB or the director general of health?

Many of the submitters opposed to the bill in its present form suggest that the decision-maker should not be the DHBs but the Director-General of Health or central government. This is because of the likely low expertise of DHB members, low voter turnout for DHB elections and concerns of legal challenges to DHB decisions. There was also the expressed belief that the anarchic and dishonest coordinated submission campaigns previously experienced by local bodies would simply be transferred to the DHBs.

Some submitter proposed that fluoridation be mandatory thereby removing the need for an elected body to be responsible for the decision making.

The committee report and response from the MoH show that parliament will probably stick with the DHBs as the decision maker. There are some advantages in this (the DHB have responsibilities in health areas) and the proof of the pudding will be in the eating. Will the DHB approach to consultations be able to successfully give more credence to credible and peer-reviewed science than the misinformation and distortions of science promoted by anti-fluoride campaigners?

Possibly. I hope so.

Conclusions

Despite the anti-fluoride campaigns and the resulting deluge of misinformed or misleading submissions, the submission process has been successful. Problems in the current wording of the bill were identified and reasonable solutions to these problems have been advanced.

We should now see how MPs react to the bill and the recommended changes in the second reading. Anti-fluoride activists have carried on an intensive campaign of emails, letters and representations aimed at MPs. On the whole, this will have been counterproductive as MP are surely aware this bill is not about the science or ethics of fluoridation but simply the decision-making process.

I am picking that these campaigns have produced more heat than light and will have little influence on the progress of the bill. However, I do expect a lot of teeth-grinding, hairpulling, garment rending, lamentations that democracy doesn’t work or that various MPs should be shot or otherwise disposed of from anti-fluoride campaigners. This is already happening and will no doubt intensify when the final bill is passed into law.

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26 responses to “Fluoridation: What’s happening with the New Zealand legislation?

  1. No mention of Maori whatsoever! Total disregard for protection, partnership and participation. More BS pro-poison propaganda.

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  2. No mention of LGBT whatsoever! Total disregard for protection, partnership and participation. More BS pro-poison propaganda.

    No mention of Muslim minorities whatsoever! Total disregard for protection, partnership and participation. More BS pro-poison propaganda.

    No mention of Disabled community whatsoever! Total disregard for protection, partnership and participation. More BS pro-poison propaganda.

    (yawn)

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  3. Pretty disappointing article. The author lumps everyone together who don’t think the fluoride used for fluoridation is a safe or effective intervention.
    And calls them all “activists” and anti-science.
    Id be willing to bet that the author of this book isn’t even fully aware of the actual nature of the chemicals used. Because most people aren’t.
    Im no activist or member of any anti-fluoride group. Im pro-science.
    And ive looked in detail on pubmed and at the pear reviewed science over a number of years. Ive had correspondence with council members in Wellington and many scientists, biologists and recently DHB staff.
    You would be amazed how many of these people recently based on good scientific evidence are opposed to fluoridation but will not speak up publicly about it because they quite simply don’t want to lose their jobs. The stubbornness of the establishment to stick to their guns on the safety of fluoridation despite knowing otherwise is incredible.
    If you read many of the submissions, they were from caring medical experts, biologists and scientists in many cases who really quite simply spelled out the problems with the current methods of fluoridation.
    Yes its not what the bill was focused on but you need to understand the whole basis for fluoridation is on such shakey ground in reality, that so man y want to speak out and this was the way many chose to do that. Have their say. The author is correct that this isnt a man date bill.. its a change that doesnt look good for many of us however. Even taking away the “activists” it was pointed out that submissions were still 80% against.
    But that aside also.. The biggets problem I have with all of this. speaking as a normal citizen, is that the public and many officials also, have no idea what is actually been used a fluoride too put in the water.
    Quite simply it is environmental toxic waste, that is expensive and difficult to dispose of.. unless of course you dilute it into a water supply..
    Which when you learn the truth is insanity.
    Its called HFSA, its hydrofluorosilicic acid. Its extremely corrosive. Its highly immuno toxic, toxic to all biological life and biological processes.
    It actually leaches lead out of copper piping and puts lead into the water supply. It is itself contaminated with lead from the aluminium smelters where we get it from. Its a toxic waste product sourced from the aluminium smelters and also the phosphate fertilizer industry.
    This stuff is contaminated with lead, arsenic, aluminium and various other petrochemicals.
    In fact it forms Aluminium Fluoride which is a compound that is 10x more neuro-toxic than aluminium or fluoride.
    we all need to understand what this stuff is. Its not like the fluoride you get in toothpaste. Its not a pure clean product made with health in mind.
    Its a frigging industrial waste product loaded with industrial chemicals.. watered down to make it somehow safe.
    When people actually let this sink in and realise this. Then you ask them.. would you knowingly contaminate good drinking water with industrial waste if it was diluted sufficiently to make it “safe”. I think most people would say no.
    That’s just stupid. Its poor science and makes no sense.
    This is what the situation is here. I’m no activist and I consider this article in insult to peoples intelligence who have been following this fluoride debate for years. But I have to assume the author simple wasn’t aware of the actual type and compounds been used.
    I have correspondence from Gear Island treatment plant that supplies water to Wellington stating that the number one contaminant in the HFSA used to treat wellingtons water is Lead.
    The WHO and the EPA say that lead should be eliminated from all water supplies worldwide and all sources of lead should be removed wherever possible. So how does adding lead, along with aluminium and arsenic and other highly corrosive elements constitute a health intervention?
    Maybe just maybe if were lucky, these new DHB processes might actual uncover the actual scientific truths about fluoridation and maybe even finally put a stop to it? That would be amazing but I doubt it.
    I spoke with Julie Anne Genter in person about this shortly after she signed the first reading of this bill. She wasnt even aware of what was been used as fluoride in New Zealand. She didnt even know the composition or the source of the fluoride. It’s not even fluoride. We should stop calling it that.
    its a corrosive acid that contains fluoride along with aluminium, silica, lead, arsenic and other chemicals. This is a way for industry to dispose of toxic waste. there is no plant in NZ that can dispose of HFSA. Thats why we use it in NZ. Its a bloody disgrace and almost none of the public know this.

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  4. Jay, I do not know what book you are referring to. But if your comments are about my article here are some things for you to consider.

    1: I am aware of the nature of the chemicals used. I am a retired research chemist and actually did some research with fluorosilicic acid produced by local fertiliser manufacturers. Exactly the same chemical that is most commonly used for community water fluodiation in New Zealand.

    I was really amazed at how low the level of contaminants in the samples I analysed was – but this is most probably because differential distillation of heavy metal fluorides improves their removal from the chemical.

    My actual analytical experience with this chemical was one reason I came to conclude that anti-fluoride activists were actually telling porkies about it.

    2: The fluorosilicic acid used in obviously not a waste – by definition. Waste products are not used, they are disposed of. The food you buy in the supermarket are not waste products – but they do become waste products when they are unsold and disposed of.

    Fluorosilicic acid is an important by-product of the phosphate industry and, in more industrially developed countries, can be used as a source material for the production of many fluorochemicals. In the US fluorosilicic acid actually commands a higher price when sold to the fluoride industry than when sold for water treatment.

    3: Yes, in its concentrated form fluorosilicic acid is toxic – as are most concentrated chemicals. When used in water treatment it is very highly diluted and decomposes to form the hydrated fluoride anion and silica – exactly the same as the forms of these chemicals which exist naturally in waterways. Here is an article for you explaining some of the chemistry – Fluoridation: Some simple chemistry.

    4: Fluorosilicic acid is not “contaminated with lead, arsenic, aluminium and various other petrochemicals.” Contaminant levels are extremely low – certificates of analysis provided by the manufacturers show this. When the extreme dilution of fluorosilicic acid is considered the contribution of any of its contaminants to the concentrations in your drinking water is actually in most cases less than 1% of the contribution coming from the pure water source. This is the case for the lead so I suggest you have misinterpreted your correspondence from Gear Island. I explain this here – Chemophobic scaremongering: Much ado about absolutely nothing.

    So, sadly, I conclude you have been misinformed – or at least have not understood the articles you read in your research.

    If you feel that I am wrong or you have an article which supports the claims you make please identify and link to it. I am always happy to discuss the science, especially involving chemistry.

    But, of course, this requires specific claims and specific articles or links to them.

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  5. Hiya Ken

    Thanks so much for your quick and detailed reply.
    Its very useful information. Id like to make a few comments and ask a few follow up questions as you seem to be quite knowledgeable on the subject.
    And in no particular order as it comes to mind.
    So point 3 of yours ypou say it decomposes to form fluoride ions and silica. But does that happen while its in the water? or later as its decomposing in soil for example.
    I mean are you saying it breaks down in the human body to form these or are you saying by the time it reaches the human organism its fully broken down and there is no HFSA as such entering the human body?
    Im asking this because are you aware that no safety studies, double blind, placebo or any other kind have been done on HFSA to asses its safety on humans or animals in general.
    Also what about the contaminants like aluminium, arsenic and lead. I guess the combined actions of these compounds are not considered because the are well below the MAFS?
    For example aluminium fluoride, which is pretty toxic stuff.
    Also there have been studies (i need to find those again) doen in the states which show that HFSA can leach lead out of brass pipes and fittings and increase the overall quanities of lead in the water at the other end of the supply. IE: At residents homes.
    You say the HFSA you tested was fine. However the HFSA used often is from aluminium smelters and not fertilizer industry and has higher levels of things like aluminium and arsenic.
    If what you say is true about the levels of contanimamnts been around 1% of whats naturally occuring then that is encouraging. But surely there are differences between naturally occuring elements and industrial ones. Like arsenic in shist rock. And what about organic vs inorganic for example organic forms of arsenic also contain carbon, but inorganic forms do not.
    Do you know if councils rely entirely on certifications provided by the suppliers or do they do their own tests as well?
    What do you mean by differential distillation. Are you saying the testing process involved distillation and also may have reduced the levels of contaminants? Whata re you saying here?
    Is distillation occuring with the water treatment process also?
    You say Fluorosilicic acid is an important by-product of the phosphate industry.
    Yes but byproducts of industry are usually as you say used to make other materials in manufacturing. Saying this does not make it sound better for drinking water just because its important. But I get your point, that its valuable and putting it in water supply isnt just a way to get rid of it.
    Interestingly research conducted on the reason fluroridation started in the states at the very beginning shows that a huge amount of fluoride is used in neuclear industry.
    It appears that fluoride pollution was one of the biggest legal worries facing key U.S. industrial sectors during the Cold War. A group of corporate attorneys, known as the Fluorine Lawyers Committee, whose members included U.S. Steel, Alcoa, Kaiser Aluminum, and Reynolds Metals, commissioned research at the Kettering Laboratory at the University of Cincinnati to “provide ammunition” to those corporations who were then fighting a tidal wave of citizen claims for fluoride injury. The research was directed by Dr. Robert A. Kehoe, more famous for his lifetime defense of the safety of leaded gasoline. When the half million dollar medical study showed that fluoride poisoned lungs and lymph nodes in laboratory animals, the research was buried.
    Harold Hodge was a biochemist whose specialty
    was the study of bones and teeth at the University of Rochester.
    Harold Hodge’s role as gatekeeper at the wartime crossroads of law and
    medical science was spelled out in a 1944 letter introducing the Rochester
    scientist to the DuPont company. The letter, stamped ” confidential, ” again
    lays out a fundamental scientific bias in the Manhattan District ‘ s medical
    program—a bias against workers and communities, and in favor of
    corporate legal interests.
    ” The Medical Section has been charged with the responsibility of
    obtaining toxicological data which will insure the District ‘ s being
    in a favorable position in case litigation develops from exposure to
    the materials”.
    Dr. Hodge had an idea for calming the citizen panic. His prescription
    gives an early meaning to the term spin doctor—and provides a clue that
    the promotion by the U.S. government of a role for fluoride in tooth health
    has a powerful national-security appeal. ” Would there be any use in making
    attempts to counteract the local fear of fluoride on the part of residents of
    Salem and Gloucester counties through lectures on F toxicology and
    perhaps the usefulness of F in tooth health? ” Hodge inquired of Colonel
    Warren. 32 Such lectures, of course, were indeed given, not only to New
    Jersey citizens, but to the rest of the nation throughout the cold war
    In summary many people died of fluoride exposure during the Manhattan Project and Harold Hodge was the guy responsible for promoting fluoride for teeth as a spin-doctor hired by the government to provide a positive spin on fluoride at that time in an attempt to reduce the amount of cpourt cases against the govt at the time.
    This is where the whole idea of using fluoride in water supplies came about.
    I think its worth noting this. It wasnt some public health intervention. It was government spindoctors during the manhattan project.
    Its worth reading HOW THE MANHATTAN PROJECT SOLD US FLUORIDE in chapter 5 of the book you can download here:
    http://www.bibliotecapleyades.net/archivos_pdf/fluoride_deception%20.pdf

    I just included the above for your interest. I feel its important to know where this “public health intervention” all started from in the first place.

    Anyway thanks again Ken for your time.
    cheers Jay

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  6. 1: Fluorosilicic acid decomposes on dilution – when added to water. By the time water reaches your tap it is effectively completely decomposed. If you require scientific citations showing this just ask, or search yourself.

    2: No, of course, there are no safety studies for fluorosilicic acid – any more than there are for concentrated sulphuric acid, hydrochloric acid or nitric acid. But there are a lot of safety studies for fluoride (which is the species pre3sent when diluted) as there are for chloride, sulphate and nitrate).

    We don’t do safety studies for concentrated chemicals – studies are made on the concentrations relative to dietary uptake.

    3: I discussed the levels of contaminants in my last comment. The contributions from fluoridating chemicals are infinitesimal – the contractions in the original water source are far more relevant.

    4: My reference to differential distillation simple refers to the different boiling points of the heavy metal fluorides. This means that one can separate fluorosilicic acid from these contaminants simply by choosing appropriate temperatures for evaporation and condensation.

    My comments on by-products were to correct the misleading description of fluorosilicic acid as a waste product. It clearly isn’t and that term is used by anti-fluoride campaigners to imply there is something wrong with the chemical and councils are using devious means to dispose of it. If the question of disposal comes up that is possible provided the environmental regulations are followed. I understand fertiliser plants have considered disposal by pumping out to the sea (the concentration of F in seawater is relatively high naturally).

    5: Fluorine is a valuable industrial chemical. Yes, it is used in the nuclear industry but also in many more industries – including the pharmaceutical industry where it plays an important role in improving the power of drugs at a lower dose. That is why there is an interest in using rock phosphates as a source mineral as the more commonly used Fluorite mineral is declining in availability.

    6: The role of fluoride in helping prevent tooth decay came from the observation of lower incidence of decay in areas where dietary intake was high (and where teeth usually showed symptoms of dental fluorosis.) Since then the optimum concentration in drinking water (the main dietary source) has been established by balancing the beneficial effects against the harmful effects at high concentration.

    Dental and skeletal fluorosis are are still a problem in areas of endemic fluorosis in countries like India, Iran, Mexico and China. It is not a problem where community water fluoridation is used.

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  7. Thanks again.. it’s helpful to know your perspective.
    For me personally I would never knowingly ingest fluoride to reduce tooth decay. It seems science can agree that the benefit for an average adult is a reduction of 1.5 tooth surfaces over an average lifetime. Which for all the effort is pointless to me. Also the difference between a “useful” dose and s dose that starts to show problems like cognitive deficits in children, IQ and in rat cognition show that even as low as 1.5ppm is noticeable unfavorable effects which to me makes the whole thing stupid. 1ppm is the safety margin and it’s too narrow a margin. The studies on rat behaviour done in recent years and studies on Chinese children show that clearly to me. Natural levels of fluoride are sold as a good thing. But fluoride is not needed by the human organism any more than mercury or aluminium. Less is better.
    It’s only the commonwealth and USA that uses fluoride like this. The rest of the developed world has decided the risks are greater than the benefits. Many science committees in europe have made it clear fluroide ingestion is a flawed intervention. Topical is much safer.
    Plus as I’ve already pointed out I believe the reason fluroide was proposed for water supplies was more political than health motivated as even the benefits are so small.. measurable but hardly worth the effort on their own. There is a bigger picture here. I thank you for your time. I feel I have a more balanced understanding now. And will also say there is no way I would be a champion for fluoridation considering the narrow safety margin and minimal benefit. It’s still adds up to a bad idea for the developed world. Dietary sources of fluoride are plenty already.. also the negative effects on babies and young children are magnified through a blanket fluoridation.. it was a interesting idea that was politically motivated and ultimately stupid.
    In this modern are where cancer and diseases of autoimmune etc are higher then ever before in the population, where use of pesticides and chemicals is also at an all time high.. adding a chemical like fluoride which as you already pointed out is used in pharmaceuticals to make drugs stronger. I magnified the effects of other chemicals.. fluoride is a catalyst.. and it also magnified the negative effects of toxins. This is well known. Fluoride is harmful to biological processes, that’s why it’s useful against bacteria, both good and bad bacteria, enzymes and biological life in general. So considering all these factors I feel it’s really stupid to put it in drinking water.

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  8. Jay, you say”

    1: ” It seems science can agree that the benefit for an average adult is a reduction of 1.5 tooth surfaces over an average lifetime.” Could you provide a reliable citation for this – it conflicts with a large number of studies and reviews. For example the recent Cochrane review:

    “Data suggest that the introduction of water fluoridation resulted in a 35% reduction in decayed, missing or filled baby teeth and a 26% reduction in decayed, missing or filled permanent teeth. It also increased the percentage of children with no decay by 15%. These results indicate that water fluoridation is effective at reducing levels of tooth decay in both children’s baby and permanent teeth.”

    And the NZ oral health survey found about 40% reduction in tooth decay.

    2: Your reference to IQ and cognitive effects – there has been absolutely no evidence of cognitive effects at the concentrations used in community water fluodiation. Anti-fluoride campaigners rely on brief studies from areas of endemic fluorosis where people suffer a whole range of problems – IQ deficits is actually well down the list.

    3: You refer to rat experiments – “rat cognition show that even as low as 1.5ppm is noticeable unfavorable effects which to me makes the whole thing stupid.” Have a look at my post on the recent very authoritative and complete rat study which was planned to overcome the deficiencies exposed in previous studies. – Not just another rat study. This used concentrations of 10 and 20 ppm – no effect.

    4: Natual levels of F are not sold as a good thing – the natural level in areas of endemic fluorosis causes all sorts of health problems.
    |
    5: You say “fluoride is not needed by the human organism” but this is just not true. it is not considered an “essential” elements as this category is used for elements involved in biochemical reactions. But it is a natural component of bioapatites – our bones and teeth. None of these are pure apatites – and it is just as well. F is usually desribed as a beneficial microelement.

    6: You say “The rest of the developed world has decided the risks are greater than the benefits. Many science committees in Europe have made it clear fluoride ingestion is a flawed intervention.”

    This is just not true (try finding a credible scientific organisation that says this). Name some of these “science committees” which make the claim you attribute to them. Please – I do not know of any.

    You, of course, are welcome to your own beliefs and values and also welcome to live your life according to those. I do exactly the same (and yes I have some unscientific hangups). But you should not make claims that cannot be supported – especially scientific claims. That is dishonest.

    The experts disagree with you – they see value in fluoridating drinking water in many instances. The benefits are clear and if the people want it then it should not be denied them.

    You can make your own arrangements to avoid this social health policy that the experts have found safe and effective.

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  9. Jay, this is what I don’t get about the anti water fluoridation position. (I don’t know, maybe you haven’t thought it through.)

    Your quote: ” Many science committees in europe have made it clear fluroide ingestion is a flawed intervention. Topical is much safer.”

    First of all, as Ken has said, there are no science committees in Europe who have said this.

    But more to my point – “Topical is much safer.”

    Ok, let’s think this through. Topical mean brushing your teeth with toothpaste. Toothpaste has about `1500 parts per million of fluoride in it. That is about 2000 times more fluoride than optimally fluoridated water.

    So, when you brush your teeth with toothpaste you spit it out. Nevertheless, only a few drops at 2000 times the concentration of fluoridated water, not spit out, are bound to be swallowed.

    Moreover, consider that Nitroglycerin is absorbed into the body through the thin lining of the mouth. It stands to reason that even the fluoride in toothpaste (with its high concentration of fluoride), when brushed around in the mouth, can easily be absorbed into the body through that thin skin in the mouth.

    I always laugh when I hear anti fluoridation people say, “Fluoride is more toxic than lead, and only slightly less toxic than arsenic.” It’s a commonly repeated myth.

    If true, then it would be safer to brush your teeth with a substance containing 1500 ppm of lead in it . . and only slightly less safe to brush your teeth with a substance containing 1500 ppm of arsenic, than it would be to use toothpaste.

    I always ask people to brush their teeth twice a day with a substance containing that much lead in it for a year . . I’ll brush my teeth with toothpaste, and let’s see who is in better health after a year. I’ve been using toothpaste at least twice a day, “topically,” for over 50 years, and I feel fine.

    Simple common sense disproves most of the anti-fluoride rhetoric that you seem to be repeating, if you just think about it.

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  10. David,

    “Moreover, consider that Nitroglycerin is absorbed into the body through the thin lining of the mouth. It stands to reason that even the fluoride in toothpaste (with its high concentration of fluoride), when brushed around in the mouth, can easily be absorbed into the body through that thin skin in the mouth.”

    Erm, no, it doesn’t stand to reason.

    Nitroglycerin, or GTN, can be absorbed through the skin of the mouth, or even through intact skin anywhere on the body (as shown with medical use of GTN cream or patches, or even earlier accidentally in armament workers during WWI).

    GTN is an exception. For almost everything else, like fluoride or even water, we need the complex length of the entire gastrointestinal tract in order to incorporate a substance into our body.

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  11. Thank you, Stuartg, I never take anything for granted that I’ve come to believe, and I’m always glad to check something out.

    Chemicals administered into the body through the thin membrane beneath the tongue is called Sublingual administration. This method has several advantages over gastro-intestinal administration. “Being more direct, it is often faster,[quantify] and it ensures that the substance will risk degradation only by salivary enzymes before entering the bloodstream, . .”

    While some pharmaceuticals are specifically designed for sublingual administration, like nitroglycerin, “Almost any form of substance may be amenable to sublingual administration if it dissolves easily in saliva. Powders and aerosols may all take advantage of this method. However, a number of factors, such as pH, molecular weight, and lipid solubility, may determine whether the route is practical. Based on these properties, a suitably soluble drug may diffuse too slowly through the mucosa to be effective.”
    https://en.wikipedia.org/wiki/Sublingual_administration.

    I see that not only nitro, but psychoactive drugs like LSD, allergens, therapeutic peptides and proteins, and vaccines are taken via sublingual administration. And we do know that fluoride is water soluble, since we find it in fluoridated water . . indeed in almost all water on Earth.

    Moreover, I think this discussion has lent credence to the validity of the idea that fluoride is absorbed beneath the tongue when one brushes teeth with 1500 ppm toothpaste. And I thank you for that.

    In light of this discussion, when someone says that ‘fluoride used topically is safer,’ (at 1500 ppm) than drinking optimally fluoridated water, the sheer nonsense of the statement becomes apparent.

    What was your source of information, Stuart, for saying, “For almost everything else, like fluoride or even water, we need the complex length of the entire gastrointestinal tract in order to incorporate a substance into our body?” Because it appears that your comment is not correct.

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  12. I understand that most membranes have a mechanism to prevent the transfer of the fluoride anion and reviews usually say there is no evidence of transfer through the skin. The anti-fluoride claim that fluoride gets into one’s body while showering has always struck me as silly as these same people seem to have not trouble swimming in the ocean where fluoride concentrations are higher.

    When fluoride is consumed the fluoride anion is converted into the HF species in the stomach because of the low pH, anmd this can transport across membranes. Of course, when in the blood the HF converts to the fluoride anion again.

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  13. Ken, some of what you’ve said is correct, some appears not to be.

    First: “I understand that most membranes have a mechanism to prevent the transfer of the fluoride anion and reviews usually say there is no evidence of transfer through the skin.”

    Skin on your hand is not the same thing as the membrane under your tongue. You can’t take LSD by rubbing it on your hand. There is a reason vaccines are not administered by rubbing them on your hand.

    The ” the connective tissue beneath the epithelium (which) contains a profusion of capillaries,” is not the same thing as the back of your neck upon which your shower sprays.

    However, upon further looking, I see that one source has said because the fluoride in toothpaste is either Stannous Fluoride, or Sodium Fluoride, it will not be readily absorbed beneath the tongue. (I don’t think this would apply to CWF per your argument.)

    Nevertheless, that doesn’t diminish the argument that when you brush your teeth you are putting 1500 parts per million of a substance, that anti-fluoridation claim is more toxic than lead, into your mouth. And you do swallow what you don’t spit out.

    So, if everyone is so sure that nothing is absorbed into the mouth by brushing your teeth with a substance containing 1500 ppm of something the antis say is more toxic than lead . . . then prove it. Brush your teeth with something containing 1500 ppm lead, and after a year compare your health with most normal people who brush their teeth twice a day.

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  14. David, this is outside my expertise and I am just going on what I have read in reviews that intake does not occur through the skin. It would be interesting to see what has been published regarding membranes under the tongue – but I think if these allowed much in the way of access then dietary intake of toothpaste F would be much higher.

    Although the chemistry of stannous fluoride is more complex sodium fluoride in saliva contains the hydrated fluoride anion -exactly the same as CWF. It is this anion that most membranes seem to prevent the transfer of. Although, I have read that transfer of F- across the membranes of the lower intestine may be another mechanism of uptake.

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  15. David,

    There’s no need for me to to cite a source.

    Let’s instead try a practical experiment. Get your stopwatch ready.

    You hold a mouthful of water, or saliva, or peanut butter sandwich, or really anything else, in your mouth without swallowing. See how long it takes to be absorbed by the body.

    Meantime, whilst you are starving, or dehydrating, or whatever, I’ll eat a peanut butter sandwich with a glass of water and have it incorporated into my body within 2-3 hours, using my gastrointestinal tract for the purpose it evolved.

    Some medications, like GTN spray, are specifically manufactured to be able to be absorbed sublingually. Some are even designed to be absorbed rectally, using the mucosal surfaces at the other end of the GI tract. Some are designed to be injected. But most are just swallowed and use the GI tract for the purpose it evolved.

    By the way, how long do you leave the toothpaste residue in your mouth before rinsing? Hours? Even GTN, designed to be absorbed by the oral mucosa, takes a couple of minutes to be absorbed and can be rinsed out before significant absorption takes place.

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  16. David,

    Your use of GTN is not a good example to compare with fluoride. As Ken pointed out, and you acknowledged, the fluoride anion is not absorbed through intact skin. But GTN is. It is absorbed through the skin of the neck and the palms of the hands. There’s a reason it is supplied as transdermal patches.

    Try something more comparable to sodium fluoride for your comparison. Say sodium chloride. How well is that absorbed through the skin?

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  17. David,

    Thinking a little more, apart from being able to absorb some lipophilic substances, the oral mucosa acts more like a semipermeable membrane than anything else.

    As far as I am aware, and don’t have the resources in an overseas hotel room to check, there is minimal or no active transport of substances across the oral mucosa. Active transport occurs much further down the GI tract.

    There is some transfer of water across the oral mucosa – down the osmotic gradient. So pure water in the mouth would have some absorption of water into the body, down the osmotic gradient, but a 1-2% solution of sodium chloride (or sodium fluoride) in the mouth would have water leave the body by the same mechanism.

    So – I suspect that you would have to swallow the toothpaste in order to change blood levels of fluoride within the body. And don’t manufacturers say not to swallow toothpaste?

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  18. Richard Christie

    Stuart,

    I recently spent time in intensive care following organ transplant. One of the immunosuppressant drugs I was given was administered sub-lingua . I distinctly recall the specialists explaining to nursing staff that the drug was absorbed more efficiently that way than by ingestion (i.e. GI tract). These days I take the same drug in tablet form.

    I conclude that relative absorption efficiency of two methods isn’t cut and dry.

    By the way, I follow a dental surgeon’s advice to brush with fluoride toothpaste and spit but not rinse the slurry from mouth upon completion.

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  19. Richard,

    On a quick count, I professionally use/prescribe medications given by at least fifteen routes. GTN is usually given by at least four routes in at least five preparations. Fluoride in toothpaste is applied topically to teeth (and that’s not one of the fifteen routes).

    I’m just objecting to someone comparing transdermal/sublingual administration of GTN to topical administration of fluoride to teeth and by doing so implying that fluoride is absorbed through oral mucosa in the same way that GTN is.

    The rates of absorption are not the same through the buccal mucosa, in the same way that the rates of absorption are not the same through intact skin.

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  20. Ken, you blandly state that the NZ oral health survey found about 40% reduction in tooth decay with fluoridation without acknowledging the fact that the report itself clearly states that this survey was not designed as an in-depth fluoridation study.
    It is, however, interesting to note from an Official Information Act disclosure of the 987 children ages 2 to 17 surveyed that at ages 16 and 17, of the 52 fluoridated children surveyed the average decayed, missing or filled teeth (dmft) was 2.46 and of the 55 non-fluoridated children the average dmft was lower at 2.39.
    Regarding your reference to the Cochrane Collaboration, widely regarded as the gold standard of scientific rigor in assessing effectiveness of public health policies, which reviewed every study done on fluoridation that they could find, only three studies since 1975 were identified that addressed the effectiveness of fluoridation on tooth decay in the population at large. In addition to your quoted data these papers determined that fluoridation does not reduce cavities to a statistically significant degree in permanent teeth.
    The latest oral health statistics from the New Zealand school dental service for 12-year-olds (2016) show statistically insignificant differences between fluoridated and non-fluoridated cohorts.
    The 26,207 children fluoridated were 64.29 per cent caries free with a mean of 0.80 dmft and the 21,120 non-fluoridated children 60.58 per cent caries free with a mean of 0.97 dmft. That is, less than four per cent difference in caries free and with decayed, missing or filled teeth the difference is less than one fifth of a tooth.
    Gertrude Clark’s 2017 thesis, Supervised tooth brushing in Northland, submitted in fulfilment of the requirements for the degree of Master of Community Dentistry at the University of Otago Dunedin, concluded that the aim of the study, which was to improve the oral health of Northland children, had been successfully achieved with a supervised tooth brushing programme.
    Her programme has been the first large-scale, fully evaluated tooth brushing programme to be set up and run successfully in New Zealand. It showed improved caries outcomes at one year for children involved and reinforced the need for policy to consider other than existing approaches to improve children’s oral health in communities that experience high caries and poor oral health.
    Imposed fluoridation via an enacted Health (Fluoridation of Drinking Water) Bill will involve tens of millions of dollars expenditure for capital supply requirements, ancillary requirements and ongoing operating costs
    I’m sure Gertrude Clark’s supervised brushing teeth approach applied nation-wide is likely to be more successful and orders of magnitude cheaper than fluoridation – which incidentally won’t reach many needy communities.

    Liked by 1 person

  21. Stuartg, There’s no need for you to cite a source? That’s code for you are just making it up.

    Let’s try another practical experiment. Get your calendar ready.

    Brush your teeth with a substance containing 1500 ppm cyanide, or 1500 ppm arsenic, or 1500 ppm mercury, . . . lead, . . polonium, or any other toxic substance. Brush your teeth with it and then spit it out. Do it twice a day for a year.

    Meanwhile, I will brush my teeth with a substance containing 1500 ppm of fluoride. After a year, let’s compare our health. On your deathbed, perhaps you will admit your error.

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  22. David,

    I suspect that you’ve swallowed or spat out the mouthful that you were trying to absorb through your oral mucosa, in your sleep if nothing else.

    Meantime, I’ve eaten, and absorbed, several excellent meals and drinks by utilising the entire of my gastrointestinal tract for the purpose it evolved.

    If you continue claiming that significant amounts of fluoride from toothpaste, or indeed any other substance, is absorbed through the oral mucosa, then it’s up to you to provide proof. It’s not the job of others to prove you wrong. That’s why I don’t need to cite a source; I did more than was required of me by suggesting that practical experiment. (How long was that mouthful present without you absorbing it, by the way?)

    In general, sublingual or buccal administered medications require careful design to function. They are an exception that proves the rule, the rule being that the entire gastrointestinal tract is needed to absorb substances into the body. (Yes, I’m ignoring gaseous exchange…)

    You continue to hold that mouthful of whatever and see how long it takes to be absorbed merely by using the oral mucosa. I’d guess you’ll absorb about as much sustenance from that mouthful as breatharians do from theirs.

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  23. Stuartg says, “If you continue claiming that significant amounts of fluoride from toothpaste, or indeed any other substance, is absorbed through the oral mucosa, then it’s up to you to provide proof.”

    Response: Stuart, if you would learn to read, you would see that I don’t have to provide proof of anything.

    My comment: “However, upon further looking, I see that one source has said because the fluoride in toothpaste is either Stannous Fluoride, or Sodium Fluoride, it will not be readily absorbed beneath the tongue. https://openparachute.wordpress.com/2017/06/12/fluoridation-whats-happening-with-the-new-zealand-legislation/#comment-116022

    That’s the problem with fanatics like you . . you don’t know how to read.

    Nevertheless, you were still wrong when you said, “. For almost everything else, . . . we need the complex length of the entire gastrointestinal tract in order to incorporate a substance into our body.” Every source I’ve looked at confirms the incorrectness of your statement.

    You only happened to be correct about toothpaste by chance.

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  24. David,

    Obviously I can read. But I wouldn’t class myself as a fanatic. I just get concerned when people who are manifestly unable to use the scientific method pretend to do so. And no, I’m not aiming that statement specifically at you.

    Perhaps you could re-read your own comment, the one I first objected to: “Moreover, consider that Nitroglycerin is absorbed into the body through the thin lining of the mouth. It stands to reason that even the fluoride in toothpaste (with its high concentration of fluoride), when brushed around in the mouth, can easily be absorbed into the body through that thin skin in the mouth.”

    As I said, it does not “stand to reason”. There was no logic behind your statement. It read more like a statement of belief/faith from an antifluoridationist. That’s why I contend that you have to provide the proof for your assertion rather than have others demonstrate why you are wrong. You made the statement, so it’s up to you to provide the proof of that statement. Or you could simply acknowledge that you are wrong as a scientist would.

    I stated: “For almost everything else, like fluoride or even water, we need the complex length of the entire gastrointestinal tract in order to incorporate a substance into our bodies.” If I am wrong with this statement, then please explain how you personally manage to assimilate the food and drink that consist the “almost everything else” I mentioned. Are you a breatharian, believing that you can survive only on air and sunlight? Do you hold the food and drink in your mouth until it is absorbed by the oral mucosa? (Long wait for that…) Do you administer nutritional enemata and bypass the small intestine? Have you had surgical excision of your large and small intestine and now live on total parenteral nutrition administered via an AV shunt? Or do you eat and drink like the rest of us, using the complex length of your entire gastrointestinal tract to absorb food and drink into your body?

    Every reputable source I’ve ever looked at, from year 8 science textbooks to advanced university texts in anatomy, physiology, biochemistry, medicine, pharmacology, evolution, and all the rest of the biological sciences, confirms that normal healthy human beings, like all mammals, use the entire of their gastrointestinal tracts to absorb the food they eat and the fluids they drink.

    “Every source I’ve looked at confirms the incorrectness of your statement.” All I can say is that you must have some very strange sources…

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  25. Stuartg, you’re an idiot and you are wasting my time and Ken’s space.

    Science, in case you didn’t know, never assumes to have all the answers. That is its genius. It adapts to empirical evidence which becomes available over time.

    So, sure, I made a statement that began, “It stands to reason . . ” Upon further research I discovered my initial comment was wrong . . and you are still harping on my original comment which even I disavowed.

    So now you’re making the outrageous claims. You are claiming that only a few select, pharmaceutically engineered, substances are capable of
    sublingual administration. That is dead wrong. Now it’s up to you to prove your outrageous claims.

    Get out your stopwatch. Try this practical experiment. Brush your teeth with strychnine, rinse your mouth with it, then spit it out. According to you, you should be fine. (You’ll need the stopwatch, because if you are honest enough to video your suicide, we would all be interested in knowing how long it took for you to make the world a nicer place.)

    As I said . . You’re a fuckin idiot and you’re wasting everybody’s time and space

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  26. David,

    You’re getting angry to no purpose.

    Read what I said, not what you imagine that I said: “For almost everything else, like fluoride or even water, we need the complex length of the entire gastrointestinal tract in order to incorporate a substance into our bodies.” The operative words are “almost everything else”, which you appear to read as “everything else”. I’m curious as to why you still believe that statement is incorrect and if you have anything other than breatharian sources to back up your belief.

    If you don’t absorb your own food and drink (the “almost everything else” in my statement) through your gastrointestinal tract, like the rest of us, I’m genuinely interested in how you obtain sustenance.

    Contrast my actual words: “there is minimal or no active transport of substances across the oral mucosa. Active transport occurs much further down the GI tract” and “In general, sublingual or buccal administered medications require careful design to function” with your interpretation: “You are claiming that only a few select, pharmaceutically engineered, substances are capable of sublingual administration.” I made no such claim, so why get angry and call me an idiot when it’s your own interpretation of my words that is faulty?

    Look through the British National Formulary, or the NZ MIMS, and you’ll see perhaps a couple of dozen readily prescribed medications available for sublingual or buccal administration. To avoid misinterpretation, I don’t have either book available so that number is informed guesswork. Most, if not all of those medications, have been specifically engineered for that route of administration.

    GTN is an exception; it was known to be absorbed through intact skin surfaces anywhere on the body well before sublingual or indeed any other therapeutic formulations were developed. So GTN is not a good choice, really, to use when comparing the absorption of anything else into the human body.

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