Category Archives: Health and Medicine

Fluoridation not associated with hip fracture, heart attacks of osteosarcoma – new study


A new Swedish study confirms fluoride does not increase risks of hip fracture, myocardial infarction, or osteosarcoma.

Community water fluoridation appears to have no association with increased risk of hip fracture, myocardial infarction or osteosarcoma.

That’s the conclusion from a new Swedish study. And these conclusions agree with most findings from earlier studies.

Peggy Näsman describes this new study in her PhD thesis:

Näsman, P. (2016). Epidemiological studies of fluoride exposure and hip fracture , myocardial infarction and osteosarcoma.

She used Swedish nationwide population-based registers for her investigations.

Sweden does not use community water fluoridation but its drinking water contains fluoride at various levels, including optimum or even higher concentrations. So Swedish population data are ideal for looking at possible links between the level of fluoride intake and specific health effects.

Näsman found no association between fluoride exposure level and risk of hip fracture using a  cohort of 452,824 eligible people with an exposure to the same drinking water source from birth. The drinking water fluoride levels  ranged between <0.1 and 2.7 mg/L . Similarly, she found no association between fluoride level and the risk of osteoporotic (low-trauma) hip fracture.

However, stratified analyses suggested that fluoride exposure in people younger than 80 years of age was, in fact, associated with a decreased risk for hip fracture.

There was also no association between fluoride exposure level and risk of myocardial infarction using a cohort of 455,619 eligible people with an  exposure to the same drinking water source from birth.  The drinking water fluoride levels  ranged between <0.1 and 2.7 mg/L . There was also no association with fatal and non-fatal myocardial infarction.

Finally, Näsman found no association between drinking water fluoride exposure and risk of osteosarcoma using a case-control study consisting of 363 eligible osteosarcoma cases identified in the Swedish Cancer Register, and 1,815 control subjects randomly selected from the Total Population Register. Here the drinking water fluoride levels ranged between 0.03 and 2.75 mg/L.

Anti-fluoridation campaigners often cite cherry-picked studies based on unreliable work or small numbers of subjects to argue that community water fluoridation is harmful. They have specifically claimed fluoridation causes increased risks of hip fracture,myocardial infarction, and osteosarcoma. However, the bulk of the scientific literature does not support these claims and this study once again confirms that.

Näsman is publishing her findings in three scientific publications:

Näsman P, Ekstrand J, Granath F, Ekbom A, Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study. J Dent Res. 2013 92(11):1029-34.

Näsman P, Granath F, Ekstrand J, Ekbom A, Sandborgh-Englund G, Fored CM. Natural fluoride in drinking water and myocardial infarction: a cohort study in Sweden. Science of the Total Environment. 2016 562:305-11.

Näsman P, Granath F, Ekstrand J, Ekbom A, Sandborgh Englund G, Naimi- Akbar A, Fored CM. Natural fluoride in drinking water and osteosarcoma: a case-control study in Sweden. [Submitted]

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Anti-fluoridation activist Paul Connett has a senior moment about our debate

Paul Connett, from  the US anti-fluoride group, the Fluoride Action network, was interviewed today on the Radio new Zealand’s Jesse Mulligan programme. You can listen to the interview at Complaints against anti-fluoride ads not upheld.


Jesse Mulligan interviewed Paul Connett about his anti-fluoride views

Unsurprisingly, Paul presented the same  tired old arguments against community water fluoridation. And I can understand why he should once again promote his own anti-fluoride book. After all, it has 80 pages of references (most of them broken links to Fluoride Action Network web pages)! And it is surely natural for an author to be proud of their book.

But he seems to suffer from senior moments, or at least memory blocks, when he claims that the arguments in his book have never been confronted. That people refuse to debate with him about these arguments.

Has he really managed to eradicate all memory of our rather long on-line debate about those very arguments? He specifically required that our debate have the format of him advancing arguments from his book and that I would respond to them.

The full debate is available here (see Fluoride Debate) or it can be downloaded as a pdf document (see The fluoride debate). It’s a useful document – about 212 pages long – fully referenced and Paul’s arguments are presented completely unedited – just as he presented them.

I know Paul was unhappy at how the debate went. Since then he has asked me never to contact him again and I was immediately banned from commenting on all the local anti-fluoride websites and Facebook pages. I have also been blocked from commenting on the US Fluoride Action Network’s Facebook page.

OK, I can understand Paul may have felt disappointed with his response to my debunking of his claims – but to pretend the debate never happened?

Interestingly, this is not an isolated behaviour by anti-fluoride activists. Local anti-fluoride people have also made similar claims that no one will debate with them. However, they seem to run quickly in the opposite direction when they do get a response to their offer to debate. Stan Litras is one example where time and time again I have critiqued his anti-fluoride claims and offered him a right of reply. He always refuses but still publicly claims that no one will debate with him.

Paul lost it a bit in his interview today when Jesse mentioned the NZ fluoridation review carried out by the Royal Society of NZ and the office of the Prime mInister’s Chief Science Advisor. He made a few ill-advised disparaging comments which came across as shrill when compared with the explanations from Sir Peter Gluckman, the Prime Ministers Chief Science Advisor, who was given the opportunity to respond to Paul’s criticisms.

The Interview and Sir Peter’s response is worth listening to. You can download it or listen to it at Jesse Mulligan, 1–4pm.

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Shyness of anti-fluoride election candidates

Why do anti-fluoride candidates standing for District Health Boards (DHBs) shy away from proper discuss of community water fluoridation? After all, they have usually raised the issue themselves – and often claim that those supporting CWF avoid the discussion.

In my article Fluoridation & democracy: Open letter to DHB candidate Andrew Buckley I raised this with Andrew Buckley who is standing for the Waikato DHGB. Despite writing an article on the issue on his webpage he refused to allow any proper discussion of the issue there. He allowed slavishly anti-fluoride comments but nothing from anyone who specifically disagreed with his (often incorrect) claims. My open letter to him  was an attempt to get that discussion going. I even offered him the right of reply and space here – but he refused. He effectively ran away from an issue he had raised himself.

Now this is also happening with Stan Litras, a candidate for Capital and Coast DHB. Stan is a well-known anti-fluoride campaigner – often producing anti-fluoride press releases from his astroturf one-man group “Fluoride Information Network for Dentists” (FIND). He is clearly standing on an anti-fluoride ticket and the discussion on his campaign Facebook page makes that clear.

For example:


Notice specifically his claim of knowing the subject and claiming he can “defend” his “opinion.” Also, notice his claim that supporters of CWF “cannot defend their views in an open discussion with any reliable evidence.”

That is completely misleading. I have often critiqued his claims and have particularly taken issue with his misrepresentation and distortion of the science. I have always offered him a right of reply and he has always rejected it. If he can “defend” his “opinion” why does he run away from such discussions?

This post of his is typical of the way he distorts the science:


Preventing discussion and banning critics

Far from welcomin g discussion of their claims these candidates actually do everything to prevent proper discussion. Andrew Buckley banned any comments from me (and presumably anyone else critical of his claims) on his page. And now Stan Litras has done the same. He removed some comments taking issue with his claims (one of them was mine) and has presumably banned the commenters. Hehas certainlyy banned me from further comments.

This is how he justifies his actions.


So he is backing  away from claims that are still on his page and labelling anyone critical of his misinformation as a “pro-fluoride zealot!”

And isn’t it hypocritical for him to label others as “pseudoscientific” and blame them for the fact that he is standing specifically as an anti-fluoride candidate?

Oh, here are some of my articles on Stan’s misrepresentations and distortions – and I have always offered him the right of reply to these:

Anti-fluoridation campaigner, Stan Litras, misrepresents WHO
Cherry-picking and misinformation in Stan Litras’s anti-fluoride article
Anti-fluoride campaigners cherry-pick irrelevant overseas research but can’t find relevant New Zealand research
Anti-fluoridation cherry-pickers at it again
Misrepresentation of the new Cochrane fluoridation review
Fluoride Free NZ report disingenuous – conclusion
A challenge to anti-fluoridationers to justify their misrepresentation of New Zealand research
Fluoridation: News media should check press releases from anti-fluoridationists

Have you voted yet?

I know how confusing it is so hope you haven’t been fooled by any of these anti-fluoride candidates.

A Spinoff article Quack hunt: Our vital tool for stopping anti-science crackpots infiltrating your DHB is useful guide to the candidates for DHB positions.

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Flogging a dead horse – anti-fluoridationists lose in court again


This certificate should be awarded to New Health NZ, the NZ Health Trust and the anti-fluoridation movement for not knowing when to give up on the “fluoridation is medicine” myth.

The NZ Court of Appeal has rejected the latest legal attempt by New Zealand anti-fluoridation campaigners to hinder community water fluoridation. You can read a summary of the ruling in the Court’s press release – New Health v South Taranaki District Council. The full Court of Appeal ruling can also be downloaded.

Of course, you might find it boring – it is full of legalese. The appeals (there were three and all were rejected) themselves were  about details – the definition of a medicine and the right of governments to make regulations. But readers might want to reflect on who took the legal action and who paid for it.


New Health NZ took the High Court actions and appeals. It is an incorporated society set up in 2005 by the The New Zealand Health Trust. This Trust is the lobby group for the “natural”/alternative health industry in New Zealand and is financed by that industry. So, in effect, this legal action was taken by the alternative health industry – and paid for by this industry – which is big business.

We can get some idea of the costs involved from the financial statements of the NZ Health Trust (strangely registered as a charity) and New Health NZ (statements available on the society’s register). Unfortunately, the latest statements only provide information for the 2014 and 2015 financial years – but the legal action is several years old so you can get an idea of the money flows involved.

The NZ health Trust appears to receive grants in the hundreds of thousands per year from the alternative health industry($250,000 in 2014 and $190,000 in 2015). In its turn, it distributed “grants & donations” in the hundreds of thousands (125,000 in 2014 and $130,000 in 2015).


New Health NZ received grants of around $100,000 per year ($100,00 in 2014 and $95,000 in 2015). It paid out similar amounts in “Professional and Consultancy Fees” ($95,156 in 2014 and $95,124 in 2015).


These amounts are of the order required for the legal actions taken by this group.

So here we see a money flow from the “natural”/alternative health industry, through the New Zealand Health Trust to New Health NZ to pay for legal attempts to halt community water fluoridation.

At least, this time, New Health NZ was ordered to pay costs – a sure sign that the court believes their legal actions no longer have any community value.

A sign that they should stop promoting their myth that community water fluoridation is a medicine – they should stop flogging that dead horse.

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Fluoridation & democracy: Open letter to DHB candidate Andrew Buckley

Community water fluoridation looks like becoming a hot topic in October’s elections to District Health Boards. Anti-fluoride candidates should stop preventing open discussion and critique of their unscientific claims.

Legislation transferring fluoridation consultation and decision-making tasks from councils to district health boards (DHBs) will probably be introduced into New Zealand’s parliament next year. Anti-fluoride activists are preparing for this by transferring their attention from councils to District Health Boards. In particular, they are standing candidates for elections to DHBs in October’s elections.


Andrew Buckley is standing for the Waikato District Health Board. He calls for open debate on the fluoridation issue but will not allow any critique of his claims in his web page discussion.

Andrew Buckley is a retired osteopath who is standing for the Waikato DHB. He is making community water fluoridation a central issue of his campaign and presented his views in a blog article – Fluoridation and democracy – and in a press release.

I welcome candidates who make their views clear on issues like this during their campaign where they can be discussed. But the problem with Andrew is that he does not seem to either want to discuss his claims or allow any discussion of them in the comments on his article. I contributed a comment which dealt with his claims point by point but he has not allowed it to appear – despite showing supportive comments from many of the usual anti-fluoride brigade.

This anti-democratic behaviour is ironic given that he was arguing for democracy and open debate on the issue. It is also deplorable that he prevent this open debate during an election campaign where he is making community water fluoridation a central issue.

As he won’t allow proper discussion on his web page I have put my comments into an open letter to Andrew. I, of course, offer him the right of reply here and welcome any contribution he can make to the discussion here.

Hi Andrew,

I welcome your declarations that you are “not pro- or anti-fluoridation as a matter of principle”  and decisions about community water fluoridation (CWF) “simply cannot and should not be made on the basis of hearsay and urban legend.”  However, the claims you make in this article (Fluoridation and democracy“) suggest you may have succumbed a few urban legends and been influenced by hearsay yourself.

Let’s consider some of your claims:

Hamilton City Council’s fluoridation fiasco

You claim the “Hamilton City Council councillors voted unanimously to stop” CWF – but that is just not true.

In June 2013 the council voted 7 to 1 (with several imposed abstentions) to stop CWF. There was public opposition to this decision as it ignored polling and a previous referendum result showing community support for fluoridation. A new referendum held along with the October 2013 local body elections again showed overwhelming public support for CWF and in March 2014 the council voted 9 to 1 in favour of reinstating CWF.

You claim the Hamilton City council “delivered a scathing commentary on the practice of fluoridation.” Could you identify that document and link to it? I am completely unaware of such a document despite having followed the issue closely at the time and having discussed the scientific basis of CWF with several councillors. My impression was that individual councillors were incapable of discussing the issue and, in fact, several councillors were very hostile towards science and scientists and very rude to correspondents as a result. I thought that highly disturbing for councillors in a city which houses several very reputable scientific institutions. But it seemed their stance, and emotive response, had more to do with pre-election political infighting than any appreciation of the science.

Are anti-fluoride claims validated?

You claim “validated claims of the multitude of opponents to water fluoridation [are] not refuted by sound supportive evidence in public debate.” Again not true.

Anti-fluoride activists like Paul Connett, Stan Litras, etc., often claim this but refuse to debate the issue themselves. I had one on-line debate with Paul Connett in 2013/2014 where (I believe) every claim he made was soundly refuted. You can find the record of that debate on my blog (Fluoride debate) or a pdf version of Fluoride Debate  from my publications on ResearchGate . This is quite substantial and covers most issues that are raised by opponents of CWF.

The claims made by opponents of CWF have not been scientifically validated and are often based on misinformation or distortions of the science. It is telling that since my debate with Paul Connett he has simply refused every opportunity I have offered him for a right of reply to my articles where I have critiqued his claims (see for example Misrepresenting fluoride science – an open letter to Paul Connett“). Similarly, Stan Litras has refused my offers of a right of reply in similar situations.

What about this “multitude?”

You are incorrect in using the word “multitude” as recent referenda have shown in New Zealand. This was confirmed in more detail by the NZ oral health survey as reported in this paper:

Whyman, R. A., Mahoney, E. K., & Børsting, T. (2015). Community water fluoridation: attitudes and opinions from the New Zealand Oral Health Survey. Australian and New Zealand Journal of Public Health.

I discussed date from this paper in my article Anti-fluoride propagandists get creative with statistics. The graph below summarises the data:

While support for CWF may not appear as massive as recent referenda results show (which don’t record the undecided), the fact that only about 10% of people are strongly opposed (and another 5% somewhat opposed) to CWF in the survey. This does suggest your use of the word “multitude” is an exaggeration.

The opponents of CWF may be very organised and vocal (a fact which has led councils to see the fluoridation issue as a poisoned chalice) but they basically represent the minority ideological and commercial interests of the alternative health industry – which in many cases funds their work and give avenues for their propaganda.

WHO data misrepresented

You claim “according to the World Health Organisation, [there is] an equal reduction of dental caries in countries throughout Europe, irrespective of whether there is water fluoridation or not” is just not true. You have blindly accepted a popular anti-fluoride urban legend.

In fact, the WHO data show different reductions of dental caries for different countries. The reductions are just not equal. Here is the graph that anti-fluoride activists often use to promote this urban legend:

Slide from Paul Connett’s 2016 New Zealand presentation

There is actually very little data for each country in this graphic (hence the predominance of straight lines). The bigger problem is that no sensible comparison can be made between countries without taking into account the multitude of factors which influence tooth decay and which vary from country to country and year to year. Surely that is obvious?The more sensible and scientifically accepted approach is to compare fluoridated and unfluoridated areas within countries. I discussed this in my article

The more sensible and scientifically accepted approach is to compare fluoridated and unfluoridated areas within countries. I discussed this in my article Misrepresenting fluoride science – an open letter to Paul Connett and illustrated it with the WHO data for Ireland where fluoridated and unfluoridated areas are compared:

People like Paul Connett and his followers promote this urban legend again and again – despite having been shown why it is wrong (for example in my debate with Connett). They are knowingly promoting a distortion of the facts.

CWF a “medicine?”

You ask “Why was fluoride removed from the medicines list . . ?” but CWF was never on a “medicines list” as you would be aware if you had read the High Court ruling in the case brought by the “natural”/alternative health industry lobby group New Health NZ against the South Taranaki District Council.

I refer to this in my article Corporate backers of anti-fluoride movement lose in NZ High Court but you could also read Justice Hansen’s  judgment. This was confirmed in Justice Collin’s ruling on the subsequent appeal (see Another legal defeat for NZ anti-fluoridation activists).

The concentrations of fluoride used in CWF are below that required for listing. As Justice Collins determined:

“when fluoride is added to domestic water supplies within the maximum allowable concentration of 1.5 mg/l the concentration of fluoride in domestic water supplies will be well below the concentration threshold required for fluoride to be a medicine in Schedule 1 of the Regulations.”


“ . . fluoride would be a medicine under the Act if it was added to domestic water supplies in concentrations of 10 mg/l or more.”

The only change to regulations was to introduce a clause clarifying that when chemicals like sodium fluoride, fluorosilicic acid or sodium fluorosilicate are used for CWF they are not considered a medicine. A clarification, not a change.

Why transfer decision and consultation on CWF to DHBs?

You ask why the Minister of health has “decided to take the decision away from local authorities and give it to DHBs to decide?”

As you are a candidate for election to a  DHB you have a responsibility to consult the official documents outlining reasons for the proposed changes. I suggest you read Proposed legislative changes: decision-making on the fluoridation of drinking-water supplies,  Transferring decision-making on the fluoridation of drinking-water from local authorities to district health boards the cabinet paper Decision-making on the fluoridation of drinking-water supplies).

I also suggest you refer to discussions at the Local Government NZ conferences and individual council statements requesting that central government take responsibility for CWF decisions and consultations away from councils. As they have often argued, they do not have the expertise to consider the science involved and feel that they are unfairly exposed to a highly organised minority of ideologically and commercially motivated activists.

Questions for you, Andrew

Do you think a body like the elected DHB or local body councils are the appropriate place to make decisions about the science of health issues like CWF? After all, they do not have the expertise and surely such scientific decisions are not made by the board on other health issues relevant to all the procedures carried out in a hospital. Don’t you think that DHBs and Councils should instead rely on the best up-to-date reviews of the science by a body like the Royal Society of NZ?For example:

For example:

Eason, C., & Elwood, JM. Seymour, Thomson, WM. Wilson, N. Prendergast, K. (2014). Health effects of water fluoridation : A review of the scientific evidence.

Surely the task for board member on this issue is to receive such up-to-date reviews, together with data from staff on the oral health issues in the area and the feasibility and likely efficacy of CWF. On top of that, they should take into account the balanced views of the community – using polls or referenda. This should then allow them to make an informed decision about any proposal for or against CWF in their region.

Getting bogged down with the activist claims and counter claims and their propaganda based on misinformation and distortions of the science (as happened initially with the Hamilton City Council) is certainly not a responsible approach.

Andrew, you criticised the democratic processes of the DHB for which you are standing. I cannot judge if your complaints are sincere as I have not see the full picture. But I certainly support your conclusion about this issue:

“I believe we must follow democratic process and proper debate.”

So, why have you denied the democratic process with your blog article Fluoridation and democracy? You did not allow my comment, which covered the areas above, while at the same time allowing comments from known anti-fluoride activists slavishly praising you for your article?

Does this illustrate the sort of rejection of open and democratic discussion you will follow if you are elected?

I believe voters have a right to know how you have purposely acted to prevent open discussion while hypocritically calling for it.

Surely that is a reason not to vote for you in the October elections?

Finally, Andrew, I offer you a right of reply to my open letter. I am willing to post a reply for you here. After all, I do support open discussion of the CWF issue and, particularly, I am keen that these “urban legends” and “hearsay” be properly debunked and their promoters exposed.

I look forward to a fruitful good-faith discussion.

Kind regards,

Ken Perrott

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Dissecting pseudoscientific and political propaganda

Tactics used in anti-science and pseudoscience propaganda are essentially the same as used in political propaganda.

Everyone has their own ideological and political starting points – and none of us are really rational, even when we think we are. So we shouldn’t be surprised to find we are fully  in agreement with some people on one issue but on the opposite sides of the fence with the same people on other issues.

I often find this  in my on-line discussions . Some of my “allies” in the fight against pseudoscience (for example, in debunking anti-fluoride propagandists) will become my “opponents” when I discuss issues like the war in Syria. (I use quote marks because I do not feel any enmity towards discussion partners when the discussion is civil).

Nevertheless, I do not consciously separate my approaches to science and politics (and I guess my discussion partners would make the same claim). People can often be more resistant to anti-science propaganda because claims can be tested against reality. This is sometimes harder to do with political issues but if we don’t try we can be fooled by political propaganda. So, a recent article –  Dissecting the Propaganda on Syria – appealed to me as I immediately recognised that the tactics used by propagandists against the Syrian government are essentially the same as those tactics used by anti-fluoridation propagandists.

The article identifies three propaganda tactics:

1: Demonise the enemy

Those pushing pseudoscience do this continually. Scientists are claimed to be only in it for the money. How often do we hear the chant “follow the money” (and how hypocritical is this considering many of these propagandists are making money out of the “natural”/alternative health industry.


Anti-fluoride campaigner Paul Connett regularly charges NZ scientists with fraud – but he fraudulently distorts the evidence to do so.

Honest scientists are accused of fraud and researchers whose work contradicts the propaganda are personally attacked.

On Syria, we continually hear about the Syrian “regime” and its “brutal dictator” – despite the fact that the Syrian government and president have been elected. Words like “regime” instead of “government” are a way of demonising.

Responsibility for all the deaths in this war is often attributed solely to President Bashar al-Assad. This is absurd as these deaths also include those fighting on the government’s side. As the article says:

This propaganda “deems Assad responsible for everything, including the killing of Syrian soldiers by the armed opposition. This opposition, which is financed and armed by Saudi Arabia, Qatar, Turkey and the U.S., includes extreme jihadist groups, including Al Qaeda’s longtime affiliate and the Islamic State. Yet, none of the leaders supplying these rebels – in defiance of international law – bears any blame for the death and devastation of Syria, according to” the propaganda.”

This demonisation of Assad is part of the interventionist strategy of “regime change.” We saw it before in Iraq and Libya. Liberal intervention to correct a wayward government appeals to many, and fools even more. After all, it is easy to find fault with the governments and leaders in these countries. But those who want regime change in Syria do everything to protect the regimes and leaders of other countries, like Saudi Arabia, with far greater violations of human rights. And the “regime change” doctrine violates the fundamental rights of people to decide their own government and leaders.


What better way to demonise advocates of community water fluoridation than to compare them to Hitler?

In a parallel way those anti-fluoride propagandists who demonise honest scientists can easily be found to be guilty of the very charges they lay against others. Aren’t these propagandists often paid shills for big business – the “natural”/alternative health industry? And don’t they frequently misrepresent and distort the science? Are they not the ones who should be charged with fraud?

2: Romanticise the opposition

Anti-fluoride propagandists continually describe themselves as fighters for truth who have “done their research.” They are fighting for natural, pure, food and water and against the wicked big business “fluoride industry” which is disposing their contaminated waste by dumping it in our water supply. And how often do we get the David vs Goliath analogy – even when it is the anti-fluoride activists who have dominated submissions to local bodies?

On Syria, our mainstream media

“portrays the conflict as a “civil war” which began with peaceful democracy-loving Syrian revolutionaries who were ruthlessly repressed by a brutal regime.

In reality, there was a violent faction from the start. In the first protests in Deraa, seven police were killed. Two weeks later there was a massacre of 60 security forces in Deraa.

In Homs, an eyewitness recounted the situation: “From the start, the protest movements were not purely peaceful. From the start I saw armed demonstrators marching along in the protests, who began to shoot at the police first. Very often the violence of the security forces has been a reaction to the brutal violence of the armed rebels.”

In the first two months, hundreds of police and security forces were killed. Yet, . . . the West’s mainstream media, ignores this reality because it clashes with the desired image of white-hatted protesters being victimized by a black-hatted government.”


Violence against the Syrian government occurred even during the early demonstrations.

This romanticisation is hardly suprising when we realise that most of our information on the Syrian war is coming from rebel or terrorist sources – or sources sympathetic to antigovernment fighters. Al Jazeera has reporters embedded in  “rebel”/”terrorist” militia forces. And so often our news reports cite “activists” or sources like the Aleppo Media Center, White Helmets, or the Syrian Observatory for Human Rights which are sympathetic to the rebels.

Similarly, anti-fluoride propagandists very often cite sources from their own anti-science side. Their hope is that their reliance on sources such as “NaturalNews”, The Health Ranger, the Fluoride Action Network and Mercola, and continuous promotion of articles from those sources, can be translated into a similar acceptance by our mainstream media.

3: Attack anyone who questions the dogma

Many health professionals who recognise community water fluoridation as a safe and effective social health measure refuse to speak up in its defence because this can lead to personal attacks. A dentist who recently took issue with the misinformation being promoted by an anti-fluoride group was told in an anonymous personal letter:

“How dare you try to shut the truth down, people like you are a total insult to the art of Dentistry.”

And that is a mild example. How often are people who attempt to inject some logic and fact into this argument accused of being “shills?” Or attacked in a memes on social media – almost always from behind a wall where they are banned from participating in the discussion or answering their critics.

Similarly, those who attempt to debate the “party line” on Syria are often accused of being “Asad supporters” or worse. I was recently described as being a “fanatical follower of the Soviet camp” when I attempted to argue that there are child casualties in the government-held west Aleppo as well as in the “rebel”terrorist” held east Aleppo. (Some readers may object to my use of the word “terrorist” in this context – but the fact is the anti-government “Army of Conquest” which unites all the “rebels forces” in the current battle for Aleppo is led by Al Nusra – officially recognised as a terrorist organisation by the Russian Federation, USA and the United Nations).

Such attacks are simply a way of shutting down honest discussion of this conflict. A way of preventing information undesired by our political leaders from getting through the propaganda we are exposed to. Such attacks are really just a neo-McCarthyist tool in the information war.

Anti-fluoride propagandists and their allies in the “natural”/alternative health industry use exactly the same tactic. By attacking and labelling honest scientists and others who attempt to debunk the pseudoscience propaganda they hope to intimidate people and raise doubts about the science. We have seen this before from climate change deniers and creationists. They also use such attacks to raise doubts about the science of evolution and the findings of climate scientists.


This article quotes a leader of the US Veterans of Peace:

The U.S. peace movement has been demobilized by disinformation on Syria.”

I think he is correct. The tactics of demonising the Syrian government and president, of romanticising the “rebels” by selective reporting of history and current events, and of attacking anyone who speaks out against such propaganda, has been very effective in muting opposition to this war and encouraging “regime change.”

While the same tactics being used by the anti-fluoride and similar pseudoscientific or anti-science movements has been less effective for the population at large it still resonates with many.

Such propaganda tactics need to be resisted.

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An anti-fluoride trick: Impressing the naive with citations

One way to make an article look impressive is to use citations – the more you use, the more impressive. Well, so some people think.


Some of the over 140 references in Geoff Pain’s article. These references impress some people but are irrelevant to Pain’s arguments.

Again and again I find anti-fluoridation campaigners refer to the number of references in an article or book as a sign of scientific credibility. Paul Connett often promotes his anti-fluoride book by referring to its 80 pages of references. And in a recent on-line discussion where I criticised an article by the anti-fluoride campaigner Geoff Pain I was told that it contained over 140 references, as if that was the end of the story – his article must be valid!

Pain’s article is Fluoride causes heart disease, stroke and sudden death.” It’s one of series of propagandist articles which he has placed on the Researchgate we site. That website also impresses the anti-fluoride people as they think it gives the articles the scientific credibility of publication in a scientific journal. But anyone can belong to Researchgate and upload their articles. There is no peer review or any other form of quality control.

Geoff Pain has uploaded a screed of anti-fluoride propagandist articles with titles like :

  • Fluoridation Causes Cancer, so does the Fluoride content of Tea
  • Fluoride causes Death and Disease
  • Toxicity of Fluoride
  • What do you know about Fluoride?/
  • Impact of Fluoride on Women, the Unborn and Your Children
  • Fluoride is a bio-accumulative, endocrine disrupting, neurotoxic carcinogen – not a nutrient
  • Plumbosolvency exacerbated by Water Fluoridation
  • Fluoride Causes Diabetes
  • NHMRC = Politics, Not Science. Australians – Victims of Tragic Fluoridation Experiments
  • Fluoride doped hydroxyapatite in soft tissues and cancer. A literature review.

So you get the idea. With titles like this you will not be surprised to find his Twitter tag is @FluoridePoison. Although he describes some of these articles as “conference papers” they are, of course, talks given to anti-fluoride meetings. He describes the other articles as “technical reports.”

He is a consultant with a science degree and claims to specialise in analytical chemistry. But there is no credible science in his “technical reports” and “conference papers” on fluoride.

Literature trawling

Pain uses the technique of literature trawling that Declan Waugh has made famous in his anti-fluoride articles. This involves searching the scientific literature for any reference to fluoride and possible toxic effects. A technique which produces mostly irrelevant articles – but so what. They just bung the citations into their articles and make unjustified claims. They rely on their readers never to check the references anyway The committed anti-fluoridation person is only impressed by the number of references  – not their relevance.

No-one has the time or interest to completely debunk such articles by going through every single claim and checking every single citation. Nor are such articles worthy of such attention.

So let’s settle for a “partial debunking.” Here I will just take a single central claim in Pain’s article linked to above and check the relevance of his supporting citations. This should be sufficient to show how he misuses citations and misrepresents the science. Readers can draw their own conclusions about the rest of this article and about his other articles.

The claim

He claims a literature search shows “numerous examples of evidence relevant to cardiovascular damage by Fluoride” and cites “[Houtman 1996, Tyagi 1996, Artru 1997, Johnson 1998, Maheswaran 1999, Jehle
2000, Kousa 2004, Bogatchera 2006 and references therein].” So let’s see how relevant those citations are and if they actually support his claim.

Let’s see how relevant those citations are and if they actually support his claim.

Houtman 1996 reported:

” In general, the elements selenium, copper, zinc, chromium, and manganese seem to counteract the development of cardiovascular diseases, whereas cadmium and may be lead seem to stimulate it. Effects of arsenic, silicon and fluorine are unclear and for cobalt absent.”

So no evidence of fluoride causing cardiovascular damage there.


The organic phenyl methyl sulfonyl fluoride does not contain fluoride.

Tyagi et al., 1996 (Post-transcriptional Regulation of Extracellular Matrix Metalloproteinase in Human Heart End-stage Failure Secondary to Ischemic Cardiomyopathy“) used the metal chelators  phenanthroline and phenyl methyl sulfonyl fluoride in laboratory identification of bands identified in immunoblot analysis of proteinases extracted from heart tissue. This has absolutely nothing to do with fluoridation or the fluoride anion. Phenyl methyl sulfonyl fluoride is an organic compound and does not contain the fluoride anion.


Artru et al 1997 investigated use of anaesthetics sevoflurane and isoflurane and their effect on intracranial pressure, middle cerebral artery flow velocity, and plasma inorganic fluoride concentrations in neurosurgical patients. There was no investigation of cardiovascular damage. The plasma fluoride was derived from breakdown of the anaesthetics – there was no fluoridation involved.

4 ami

4-amidinophenylmethanesulfonyl fluoride

Johnson et al., 1998 does deal with heart-related matters – atherosclerosis, infarction and stroke. But there is no mention of fluoride or fluoridation. Pain has picked up this article in his literature trawling purely because the study used the protease inhibitor 4-amidinophenylmethanesulfonyl fluoride as a reagent. Again, this is an organic chemical – it does not contain the inorganic fluoride species. The study has no relevance to fluoridation.

Maheswaran 1999 (“Magnesium in drinking water supplies and mortality from acute myocardial infarction in north west England“) investigated the relationship between magnesium and cardiovascular problems and found none. Yes, fluoride and other ions were considered as possible confounders but the paper specifically states:

“Calcium and fluoride appeared to have no significant association with mortality from acute myocardial infarction.”

So Pain’s literature trawling has found  a paper mentioning fluoride and cardiovascular problems but it does not support his claim they are related.

Jehle 2000 did research the human coronary artery but again it was produced by Pain’;s literature trawling simply because the investigation used the protease inhibitor reagent phenylmethylsulfonyl fluoride (see comments on Tyagi 1996). Nothing here to do with fluoridation or the inorganic fluoride species used in community water fluoridation.

Kousa 2004 (“Geochemistry of ground water and the incidence of acute myocardial infarction in Finland“) obviously is related to cardiovascular problems and, yes, fluoride was one of the chemical species in water considered. But what do the authors say:

“Fluoride concentrations of around one mg/l in household water may be beneficial . . . In this study one mg/l increment in the fluoride concentration in the drinking water was associated with a 3% decrease in the risk of AMI [acute myocardial infarction ]. “

And they concluded that their findings suggested fluoride played a protective role.

So a success for Pain’s literature trawling – a reported relation between fluoride and cardiovascular problems – but the opposite to what Pain claim. And he didn’t bother mentioning  this, did he? How honest is that?

Bogatchera 2006 does not seem to relate at all to cardiovascular issues, but sodium fluoride was used to stimulate bovine cells. The concentration of sodium fluoride used was 20mM – equivalent to 380 ppm fluoride. Well above concentrations found in drinking water and the recommended optimum level of 0.7 ppm. Not at all relevant to community water fluoridation and it simply does not support Pain’s claim.

Well, that’s enough. I am not going to search Pain’s “references therin.” Nor will I bother with any of his other claims or cited references. I think you get the picture.


Geoff Pain

Anti-fluoride campaigners always promote people like Paul Connett and Pain as “renowned” or “world experts.” They aren’t

People like Geoff Pain promote themselves as “renowned” experts on community water fluoridation – but they simply aren’t. Surely the dishonest way Pain has used citations in the article considered here illustrates this. And we can be sure that he has approached his other fluoride articles in the same way.

So there is a warning. Just don’t be impressed by large numbers of references. Check them out – or at least check some of them out. If you find the references you check do not support the claims being made, or are maybe even completely unrelated to the claims, then draw the obvious conclusions.

NOTE: I am contacting Geoff pain to offer him the right of reply here and a chance to enter into any discussion.

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Does community water fluoridation reduce diabetes prevalence?


Maybe community water fluoridation reduces the prevalence of diabetes?

You will be seeing headlines claiming a link between community water fluoridation (CWF) and diabetes. Or even that fluoridation can predict an increase in the prevalence of diabetes. But they are misleading

These articles report results from a recently published study indicating that in the majority of situations CWF is linked to a decrease in diabetes prevalence. But many of these articles, and especially those from anti-fluoride activists are making opposite claims.

Why the confusion? Well, the study used modelling to relate a number of factors to the prevalence of diabetes. According to the model’s prediction CWF using fluorosilicic acid and sodium fluorosilicate is related to a decrease in diabetes prevalence. However, the saving clause for anti-fluoride activists is that the model predicts an increase in diabetes prevalence when the least common fluoridation chemical, sodium fluoride, is used.

A 1992 survey found that only 9% of the US population received water fluoridated with sodium fluoride – compared with 63% for fluorosilicic acid and 28% for sodium fluorosilicate. I got the latest figures from a fluoridation engineer at the US Center for Disease Control. The current figures are 75% for fluorosilicic acid, 13% for sodium fluorosilicate and 7% for sodium fluoride.

In New Zealand only on water treatment plant for a small community uses sodium fluoride.

So this subheading by the Fluoride Action Network (FAN) is completely  misleading – “Regression analyses suggest association between increases in consumption of fluoridated water and type 2 diabetes.” The only way anti-fluoride propagandists can make mileage out of this study is by deliberately ignoring the results indicated for over 90% of the population!

Perhaps supporters of CWF should be the ones reporting and promoting this study – arguing that CWF could reduce diabetes prevalence! However, I would not push that idea on the basis of a single report. This study has a number of deficiencies – and recommendations should not be based on individual cherry-picked studies anyway.

This is the paper reporting the study:

Fluegge, K. (2016). Community water fluoridation predicts increase in age-adjusted incidence and prevalence of diabetes in 22 states from 2005 and 2010. Journal of Water and Health.

Here are some of the problems I see with it.

Insufficient consideration of confounders

It is a modelling study looking for correlations between selected parameters. Such studies often suffer from little or no consideration of important confounders. Statistically significant correlations can disappear when such confounders are later included. For example, consider my criticism of the Malin and Till (2015) ADHD study – see ADHD linked to elevation not fluoridation and ADHD link to fluoridation claim undermined again.

Fluegge included obesity prevalence and leisure time physical inactivity as confounders but more could have been considered.  One that sticks out like a sore thumb to me is the community size. It could be that the sodium fluoride data he used could be acting as a proxy for community size as these days sodium fluoride is usually only considered for small water treatment plants.

Adjustment of fluoride exposure data

Fluegge compared his model prediction for diabetes prevalence using two different measurements of fluoride exposure – drinking water fluoride concentration (ppm) and an adjusted estimate of fluoride intake (mg/day). His estimation was made from per capita domestic water deliveries per county. I find this questionable as the proportion of water consumed will vary by location where there are different requirements for things like lawn and garden watering, car washing, swimming pools etc.

Whereas the drinking water fluoride concentration showed a negative correlation with diabetes prevalence (the prevalence decreased with increasing fluoride concentration), the adjusted exposure values showed a positive correlation (the prevalence increased with increasing fluoride concentration). He declared the second correlation more “robust” but his reasons seem more related to confirmation bias than any proper analysis.

Confused discussion

Fluegge seems completely unaware that sodium fluoride is now only rarely used as a fluoridating chemical. He even suggests a possible policy outcome of his research could be switching from sodium fluoride to fluorosilicic acid!

He refers to Hirzy et al. (2013) claiming it showed cost savings from using sodium fluoride but critiques Hirzy for not including consideration of effects on diabetes prevalence. He seems completely unaware that Hirzy’s paper was discredited and he had to withdraw its claims about cost savings.

This suggests to me that Fluegge is not familiar with fluoridation research. In fact, his very brief publication history indicates his interest is more associated with cherry-picking various health measures to find fault with by using statistics and modelling.

How reliable is the modelling?

I have drawn attention to possible problems with poor selection of confounders and lack of familiarity with the fluoridation literature. But there may also be problems with the modelling methods used.

I do not have the modelling skills or time to delve into his model in any depth but note there has been some controversy about another modelling paper he was involved in.

He co-authored a paper with his brother claiming a link between glyphosate and ADHD. This created some controversy because it was rejected by the journal and then published by mistake. So the journal had to retract the paper. You can read about it at Retraction Watch – A mess: PLOS mistakenly publishes rejected ADHD-herbicide paper, retracts it.

The paper was rejected because it did not satisfy the standards of experimental and statistical analysis required, or describe these in enough detail. Also because the conclusions were not presented in an proper way or supported by the data.

OK, we should not discredit future work because an earlier paper was rejected, even for the given reasons. Authors can learn from their mistakes. But it does ring warning bells. With this history, I would prefer a deeper critique of the methods used and the reliability of his conclusions.

These questions just underline my warning that one should never base policies, or final interpretations, on single papers – especially cherry-picked ones. Conclusions should be based on a more complete reading of the scientific literature.


So, always take headlines with a grain of salt. In this case they will be completely misleading – especially if promoted by anti-fluoride activists.

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“Filtering” out fluoride

filter TWBTFLPB1

Systems for removing fluoide from tap water can cost less than $300

Many anti-fluoride campaigners and their sympathisers use “filters” to remove fluoride from their tap water. Despite this, they will often claim the procedure is “too expensive” for the ordinary person – or that it is ineffective.

Fluoride Free Nelson (FFN) combined both reasons in this exchange on their Facebook page.

fluoride size

But she is wrong on both counts. Suitable water filters can be relatively cheap (just do an on-line search  to check this out) and they just do not work by filtering out particles. The argument that fluoride “is so small most filters do not remove it at all” is naive. FFN does not understand how these systems work and her advice is completely unreliable.

Firstly, The word “filter” is commonly used but is technically not correct for “filters” that remove fluoride. Filtration is usually understood to involve removing particulate matter, and not soluble ions. The actual mechanism of fluoride removal is not by filtration of particles.

Yes, some “filters” do not work with fluoride – because they are not intended to. Activated charcoal is great for removing organic matter and tastes – but is not mean to remove anions like fluoride.

Apart from distillation, there are three ways for the ordinary consumer to remove fluoride and similar anions from tap water – anion exchange, surface adsorption and reverse osmosis. Here is a brief description of each method but readers can also refer to a useful local report:

National Fluoride Information Service (2012). Household water treatment systems for fluoride removal.

Anion exchange

This involves attraction of negatively charged anions like fluoride by positively charged surfaces. Water is passed through a bed of anion exchange material which has positive charges on its surface balanced by negatively charged anions like chloride (Cl) or hydroxide (OH).

Anion exchanger

Anion exchange particle. Positive surface charges are balanced by negatively charged ions.

Anions like fluoride in the tap water replace the existing charge-balancing anions on the exchanger. For example:


Fluoride anion in tap water replace chloride anions on the surface of the anion exchanger.

Of course, these anion exchange cartridges eventually become saturated with fluoride or other anions being removed, and their efficiency drops. They are then replaced or recharged by flushing with the proper salt solution.

Surface adsorption

Interaction of fluoride anions and anion exchangers is basically a physical electrostatic one. But some filters rely on a chemical interaction where the fluoride anion reacts with the surface to form a chemical bond. Absorbents like bone char and alumina are common.

Bone char is made from cow bones and is a high surface area, porous calcium phosphate (apatite) providing active calcium for reaction with fluoride. Alumina provides a surface containing active aluminium which reacts with fluoride.

The chemical reactions occurring at the surface of these materials are of the form:

surface reaction


alumina F

Schematic of a water filter using alumina. Source: National Fluoridation Information Service.

The efficiency of both the anion exchange and surface adsorption methods can be improved by the way the filter is set up, the use of pre-filters, etc. And by regular recharging or replacement of cartridges.

Reverse osmosis

This relies on the ability of certain semi-permeable membranes to allow transport of water molecules but not ions like fluoride. So much for the naive concept that fluoride anions are too small to be filtered out of water.

It gets its name from the phenomena of osmosis which is probably familiar to most school children. Remember the experiment where pure water would pass through a membrane into a solution of sugar or salt – but water from the sugar or salt solution could not pass through into the pure water.

reverse osmosis 1

A semi-permeable membrane is a membrane that only allows through molecules of a certain size or smaller. The cell membranes of plants and animals are semi-permeable membranes, they let water molecules pass through while keeping out salts. Image credit: Solar-Powered Desalination Plants.

That creates an osmotic pressure. Reverse osmosis involves applying pressure to the sugar or salt solution (or whatever solution needs purifying). This causes pure water to flow through the membrane and the contaminants to stay behind providing a way of removing ions and molecules from the original water.

This schematic animation shows how reverse osmosis works in practice – although the membranes are rolled into cylinders to provide a greater surface area and increased efficiency.


Image credit: Reverse Osmosis Works

Consumers can use either of these methods to remove fluoride from tap water if they choose. While the equipment varies in price and sophistication, like any household appliance, relatively cheap systems are available.

These do work – just beware of claims made about low efficiency as often measurements are made with inappropriate “filters” like activated charcoal, or on systems that have been used for a time and need recharging.

That “freedom of choice” we keep hearing about is available and it is relatively cheap.

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Fluoridation – freedom of choice

forced water

This sort of image springs to mind when I see claims of forced fluoridation. Aren’t activists like “Forced Fluoridation Freedom Fighters” misrepresenting the real situation? Credit: FALUN DAFA MINGHUI.ORG – enacting claimed forced feeding in Chinese camp.

I think the “freedom of choice” argument is the most reasonable argument that anti-fluoride campaigners can use. Unfortunately for them, they usually only resort to it after their “science-based” arguments have been exposed as misleading or completely false. And even then, they usually present their “freedom of choice” argument in a naive and hostile way.

Have a look at this discussion from a local anti-fluoride Facebook page.

Freedom of choice

Here an opponent of community water fluoridation (CWF)  has declared she doesn’t want fluoridation – fair enough. She has also declared that she doesn’t drink fluoridated water. Also fair enough.

I would say she has exerted her freedom of choice – she doesn’t drink fluoridated water so must have made other arrangements.  And I am all for people exerting that right – even when they refuse to partake of a safe and effective social health policy.

But, in the next breath, she declares that she doesn’t have freedom of choice!

How does that work? It is as illogical as someone who votes on election day and then declares to everyone that they have been denied their right to vote!

“Forced fluoridation”

Some campaigners are even worse – declaring that they are being forced to drink fluoridated tap water!

That brings up a picture of someone being held down and water being forced down their throats. But we know that does not happen. Worse – we also know that most of the people making this claim do not even drink unfiltered tap water. The serious anti-fluoride person almost always uses a system to remove fluoride from the tap water, or finds a different source of water to consume.

When New Zealand councils provide “fluoride-free” public taps they get very little use. This suggests that the anti-fluoride campaigners (who may have lobbied for the taps) have already made their alternative arrangements (see Fluoridation: Freedom of choice – and responsibility).

So, I just don’t buy this naive “freedom of choice” argument – especially when presented in such aggressive ways. The fact is that where most social policies are concerned they are not forced on people – there is usually a chance for objectors to avoid the policy or use alternatives. No one is forced to send their kids to secular schools or to use free hospitals. There are alternatives in such cases.

A community’s freedom of choice

Anti-fluoride campaigners should just stop using this argument at the personal level – it just discredits them. Where it does have validity is at the community level. Because it is a controversial issue there is usually some level of public consultation when health authorities recommend the introduction of fluoridation.

The public has a right to feel aggrieved when they are denied their freedom of choice if decisions to start or stop fluoridation are just imposed on them by officials. But that “freedom of choice” argument is an argument for democracy – not an argument for or against a social health policy.

The freedom to deny others their freedom of choice

Unfortunately, many anti-fluoride campaigners will still advance their personal “freedom of choice” arguments even when decisions have been made democratically by using referenda or some other method of polling voters opinions. It’s like a voter who supported a minority party in a general election claiming their rights are being violated by the party or parties with the most votes actually got elected!

So what “freedom of choice” are these die-hard anti-fluoride campaigners really thinking about?

If they have already exerted their own personal freedom of choice by use of tap filters or alternative water supplies, and they have been given a chance to express their views or take part in a democratic referendum, what freedom do they think they have lost.

I can only conclude the freedom that really concerns them is their perceived freedom to prevent others from taking advantage off a safe and effective social health policy.

And that attitude is hardly democratic.

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