Tag Archives: District Health Board

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

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.”

and

“ . . 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

Similar articles

When politicians and bureaucrats decide the science

The current seperation of responsibility for water treatment (local body councils) and community health policy (District Health Boards) is a problem when considering fluoridation. This was illustrated by the Hamilton City Council’s suspension of  fluoridation of the city’s water supply. In the end the City Council neglected its real responsibility (to find out and reflect the views of its citizens) and instead took over the health Board’s responsibility for public health policy.

The council set itself up as a “tribunal” to make judgements on the science – a task they were clearly not equipped for.

The “tribunal” process

Tegan McIntyre, the Hamilton City Council’s Strategy and Research Unit manager, recently revealed a little of the process used by the council in its judgment of the science around fluoridation. She released “a list of the key research papers referenced during the submission and tribunal process.” She also described the “in-house evaluation” of that research. This evaluation appeared to find the research acceptable if it was “validated (peer reviewed) and/or published in an acknowledged peer-reviewed journals.”

You can download Tegan’s list –Scientific research supporting the stopping of fluoridation. The research seems to have been chosen using some sort of popularity index – she says “Please note, this list does not cover all the reports referred as this was extensive but focuses on the ones most frequently cited.”

So, the unrepresentative nature of submissions is a bit of a problem to start with – the summary of submissions says – ”

“Of the 1,557 submissions received 1,385 (89%) seek Council to stop the practise of adding fluoride to the Hamilton water supply. 170 (10.9%) seek Council to continue the practise of adding fluoride and 2 (0.1%) submitters did not indicate a stance.”

submissions

This in a city which showed 70% support for fluoridation at its 2006 referendum!

The validity of scientific research determined by this sort of popularity contest. Or by the way the councillors and council bureaucrats kept referring to “experts on both sides” as if it was simply a matter of weighing the submissions without any proper evaluation of the validity of claims made by the “experts.”

This approach is not acceptable for scientists who are used to critical consideration and in depth analysis of published research.

However, maybe it’s a natural way for bureaucrats without the scientific background necessary to make sense of a large number of submissions. I am sure the anti-fluoridation activist organisations realise this and I can understand why they use the approach of swamping such hearings with unrepresentative numbers of submissions, basically repeating the same message.

I will comment below on the documents in the list and the validity of the Council’s assessments. Sorry for the inevitable length of these comments. You can download a pdf to read at your leisure.

1: Public Health Investigation of Epidemiological data on Disease and Mortality in Ireland related to Water Fluoridation and Fluoride Exposure by Declan Waugh.

Declan Waugh is a darling of the anti-fluoridation movement. He also made presentations (written and by Skype from Ireland) to the “tribunal” so I am not surprised to find it top of the list. Apparently the Council evaluated the document highly because it was a “literature review collated by environmental scientist/consultant.”

I haven’t had time to critically consider this specific document but in the scientific world Declan Waugh’s work is not so highly regarded. The Irish Expert Body on Fluorides and Health evaluated Waugh’s previous report – which he considers his “main Report” – (Human Toxicity, Environment Impact and Legal Implications of Water Fluoridation)  and found it was “not reliable.” That while the “report is expertly produced and is impressive in size and appearance. However, in spite of its presentation, its content is decidedly unscientific” (see Appraisal of Waugh report – May 2012). Among specific points it made are these (see Executive Summary of Appraisal of Waugh report – May 2012):

  • “The allegations of ill health effects are based on a misreading of laboratory experiments and human health studies, and also on an unfounded personal theory of the author’s.
  • There is an absence of reporting of the bulk of the scientific literature which points to the lack of harmful effects from fluoridation.
  • The views of authoritative bodies such as the World Health Organisation, the European Commission and others are significantly misrepresented.
  • There is a misunderstanding of the evidence of benefits to oral health and with regards to enamel fluorosis.
  • The view that there is a build up of fluoride in the environment is unfounded and not supported by the evidence.”

Anyone willing to spend a little time can make their own evaluation of Declan Waugh’s scientific integrity simply by checking his approach to citations.

Two examples:

On page 74 of his “main report” we find the claim:

“Fluoride is known to be an inhibitor of enzymatic activity and research has identified fluoride as an inhibitor of homocysteine hydrolase.363

The cited paper is:

Mehdi S, Jarvi ET, Koehl JR, McCarthy JR, Bey P. The mechanism of inhibition of S-adenosyl-L-homocysteine hydrolase by fluorine-containing adenosine analogs. J Enzyme Inhib. 1990;4(1):1-13.

Waugh is citing work about “fluoride-containing adenosine analogs” to make the claim about the fluoride anion. Extremely sloppy!

On Page 75 he claims:

“Current research has also identified the link between fluoride and atherosclerosis.370

The cited paper is:

Li Y, Berenji G R, Shaba W F, Tafti B, Yevdayev E, Dadparvar S. Association of vascular fluoride uptake with vascular calcification and coronary artery disease. Nucl Med Commun. 2012 Jan;33(1):14-20.

Those familiar with the claims made by anti-fluoridation propagandists will recognise this paper. It concluded “[18F]fluoride PET/CT might be
useful in the evaluation of the atherosclerotic process in
major arteries, including coronary arteries. “ Fluoride does not cause atherosclerosis but because fluoride is associated with calcium containing products of atherosclerosis – fluoride is only along for the ride – the authors proposed the technique for detecting atherosclerosis.

Waugh uses citations like a drunk uses a lamp post – for support rather than illumination. And this causes him to use the citations dishonestly – as evidence for claims that they actually don’t support. Try checking out a few citations yourself.

2:  Ethics of Artificial Water Fluoridation in Australia by Niyi Awofeso

This appears to be an academic discussion of the ethical issues involved and comes out in opposition to fluoridation. Effectively it balances  health equity against individual autonomy – a values/political judgement. The Council evaluated the document highly because it was “Published in a peer-reviewed international journal.”

I could not get the full text of this document so can’t really comment on it – except to conclude from the abstract that no scientific issues seem to be discussed.

3: Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis by Anna L. Choi, Guifan Sun, Ying Zhang,and Philippe Grandjean

If you are familiar with the fluoridation debate you will recognise this paper – it is one of the most quoted by anti-fluoridation commenters on the internet.  The Council evaluated the document highly because it was “Published in a peer-reviewed research and news journal published with support from the National Institute of Environmental Health Sciences.”

The study often seems to be quoted alongside outrageous claims like the Nazis used fluoride in the concentration camps to placate inmates. Or the US government adds fluoride to water to keep the population from revolting (see Fluoridation and conspiracy theories).

Because of the study’s misuse to attack fluoridation the authors warned in a press release:

“These results do not allow us to make any judgment regarding possible levels of risk at levels of exposure typical for water fluoridation in the U.S. On the other hand, neither can it be concluded that no risk is present. We therefore recommend further research to clarify what role fluoride exposure levels may play in possible adverse effects on brain development, so that future risk assessments can properly take into regard this possible hazard.”

One problem is that the effects on IQ were seen at high fluoride intakes (studies were of Chinese localities with a range of fluoride in drinking water from both natural and industrial pollution sources). The “control” ‘low fluoride exposure” groups in this study are often exposed to fluoride concentrations comparable to that achieved by community water fluoridation schemes. Andrew Sparrow illustrated this with the following infogram:

neuro

Another problem is that no causal link between fluoride and IQ levels was sought or found. The fact that some of the locations suffered from industrial and coal pollution means these IQ effects, if real as social factors were not elimated, could have been caused by any number of pollutants.

This work should not have been considered relevant to the question of fluoridation of Hamilton’s water supply – despite its popularity with anti-fluoridation submitters.

4: Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water by SCHER

The Council evaluated the document highly because it was “Published by one of the independent non-food Scientific Committees which  provides the European Commission with scientific advice.

This review is often cited by both sides. Reasons for anti-fluoridation citing could include the clear assertion that fluoride “is not an essential element for human growth and devlopment.” But the review does make clear the fluoride is beneficial for oral health. Misunderstandings often revolve around precise usage of words like “essential.”

Another reason could be the vague comparsion between “topical fluoride application” and “systemic” intake of fluoride. This could enable anti-fluoridationists to claim fluoridated water is ineffective. However, the report does refer to the effectiveness of maintianing “a continuous level of fluoride in the oral cavity.” Fluoridated water does do this.

Again this illustrates the need for careful and critical evaluation of the scientific literature and the need to avoid simple claims which may incorrectly cite that literature. I just don’t think politicans and bureaucrats can be relied on for that.

5: Estimated Dietary Fluoride Intake For New Zealanders by Peter Cressey, Dr Sally Gaw and Dr John Love

The Council evaluated the document highly because it “was prepared as part of a Ministry of Health contract for scientific services.”

It is a straightforward desktop study of the “dietary fluoride intakes for a range of age and gender sub-populations based on New Zealand data.” There are no surprises in the data, although the interest for anti-fluoridationists was probably their findings for  formula-fed infants:

“The estimates for a fully formula-fed infant exceeded the UL [upper level of intake] approximately one-third of the time for formula prepared with water at 0.7 mg fluoride/L and greater than 90% of the time for formula prepared with water at 1.0 mg fluoride/L. However, it should be noted that the current fluoride exposure estimates for formula-fed infants are based on scenarios consistent with regulatory guidelines, rather than on actual water fluoride concentrations and observed infant feeding practices.”

They conclude “the very young appear to be the group at greatest risk of exceeding the UL.” However:

“the rarity of moderate dental fluorosis in the Australia or New Zealand populations indicates that current exceedances do not constitute a safety concern, and indicates that the UL may need to be reviewed.”

Anti-fluoridationist have made some mileage out of this, taking advantage of parent’s’ understandable concerns about their children. They (and the Hamilton City Council in their initial advice to ratepayers) advised parent not to use fluoridated water to make up formulae when infants are  fully formula-fed.

While the current expert advice is a little confusing it does take account of the need for review of current UL’s and considers use of fluoridated water safe for fully formula-fed infants. However, they also advise that if parents are concerned they should use non-fluoridated water for part of the feeding – a peace of mind matter.

Again, I question if the “tribunal” really understood the complexity of the situation for fully formula-fed children. Even though health experts had explained the situation during the hearings they apear to have simply accepted the anti-fluoridationist’s interpretation of this research.

Maybe it was the loudest, or more frequently presented, message which prevailed?

6: Fluoride in Drinking Water: A Scientific Review of EPA’s Standards by National Research Council Of  The National Academies Committee on Fluoride in Drinking Water.

The Council evaluated the document highly because the national research council is a “government funded research entity.”

This report usually get cited by both supporters and opponents of fluoridation – however, it actually does not have direct relevance to fluoridation of water supplies at the concentrations used in New Zealand (0.7 – 1.0 ppm) or in the US (0.7 to 1.2 ppm). “The charge to the committee did not include an examination of the benefits and risks that might occur at these lower concentrations of fluoride in drinking water.”

The NRC’s task was to evaluate the scientific evidence to determine if the Environmental Protection Agency’s maximum recommended levels of 4 ppm F should be lowered. They concluded it should be lowered to below 2 ppm to avoid any severe fluorosis. Anti-fluoride activists very often cite this report because of its thorough discussion of the negative effects of fluoride observed at high concentrations. They rarely admit that these effects are not reported for the concentration range used in public water fluoridation. This sort of scare-mongering often comes up in political debate but I would expect a critical evaluation of the report would have recognised that it is not relevant to the Hamilton situation.

But then again, why should we expect politicians and bureaucrats to be capable of such critical consideration.

7: Water Fluoridation: a Review of Recent Research and Actions by Joel M. Kauffman

The Council evaluated the document highly because although the “journal  is not listed as an academic journal but as a professional association journal. [It]Has a double-blind peer-review process.”

This was published in the Journal of American Physicians and Surgeons which really has no scientific standing. Issuepedia says “the journal does not appear to be considered respectable by the scientific establishment because:

  • It is not listed in the major literature databases ( MEDLINE/PubMed nor the Web of Science).
  • The World Health Organization found that a 2003 article on vaccination published in the journal had “a number of limitations which undermine the conclusions drawn by the authors.” 
  • Quackwatch lists it as an untrustworthy, non-recommended periodical. 

Investigative journalist Brian Deer described the journal as the:

“house magazine of a right-wing American fringe group, the Arizona-based Association of American Physicians and Surgeons, which campaigns against US vaccination policies. The association is also vocal in opposing moves to combat fraud by private doctors, and medical professional efforts to reduce deaths from domestic firearms. In 2005, Time Magazine reported that the association had only 4,000 members. Although cited by Private Eye in stories attacking MMR, the association’s journal – recently renamed from the Medical Sentinel, presumably for the purpose of attempting to give its ideologically slanted material the aura of science – is barely credible as an independent forum for such material. No objective medical scientist with important information of any standard would submit it to such a publication, unless they couldn’t get it published anywhere else.”

So much for the Hamilton City Council high evaluation. But the paper itself is not at all convincing. It’s claims are poorly supported. It relies heavily on citation of sources from anti-fluoridation activists. Much of the citation is to just one book Fluoride: Drinking Ourselves to Death by Barry Groves – a staple anti-fluoridationist manual. Kauffman’s ideological motivation are obvious.

8: Prevention and reversal of dental caries: Role of low level fluoride  by J. D. Featherstone.

The Council evaluated the document highly because it was in a “ranking academic journal.”

This paper is often cited by anti-fluoridationists as support for their claim that the “topical mechanism” of protection of existing teeth means that fluoridated water is ineffective. Yet the paper clearly includes “fluoride in drinking water” (as well as in “fluoride-containing products”) as operating via the topical mechanisms. Featherstone has also stressed drinking water in recent descriptions of the “topical mechanism” (Topical Effects of Fluoride in the Reversal and Prevention of Dental Decay). I can only conclude that some people have the wrong impression through superficial reading and their conclusions have been adopted by others without any checking. The Fluoridation Action network NZ (FANNZ) website even claims, incorrectly, that a topical effect of fluoridated water on teethis contradicted by Featherstone.”

Again, and again, I find this website very misleading in their use of citations.

The Hamilton City Council repeated this incorrect interpretation of topical mechanisms in their information leaflet for citizens (see Topical confusion persists) – a serious mistake which has been strongly criticised by health professionals. Did Council bureaucrats simple take the anti-fluoridationist use of this citation at their word – without any checking?

9: Why I changed my mind about water fluoridation by J. Colquhoun.

The Council evaluated the document highly because it was in a “Peer-reviewed academic journal published by Johns Hopkins. Author: former dental officer in New Zealand during the 1970s and early 1980s”

This is really a memoir, and not a high quality review. I found that it generally gave a lot of emphasis to longitudinal studies which show improvement in oral health over time for both fluoridated and unfluoridated areas. This may have suprised researchers at the time but is well recognised today and, by itself, is not evidence against the effectiveness of fluoridation. He also seems to be very selective, some would say cherry-picking, in referring to studies where comparison have been made between fluoridated and unfluoridated areas. The all appear to show either no effect, or that oral health was better in the non-fluoridated areas! (Anti-fluoridations regularly do such cherry-picking today).

Colquoun presented the “topical” mechanism as an argument that fluoridated water is ineffective – a suprising interpretation for someone familiar with the literature. However, I guess his committment to the anti-fluoridationist cause when he wrote this memoir might explain the faulty interpretation.

10: The mystery of declining tooth decay by Mark Diesendorf

The Council evaluated the document highly because it was published in “Nature [which] is a prominent interdisciplinary scientific journal. Ranked the world’s most cited. “

Although Diesendorf is an environmental scientist he is also an anti-fluoridation activist. In this paper he relies heavily on longitudinal studies, where oral health was found to improve in both fluoridated and unfluoridated areas over time. This is a well accepted observation, explained by improvements in diet and care of teeth, as well as availability of fluoridated toothpaste. I believe some of this improvement is also due to changes in dental practice involving less fillings.

Such research does not invalidate the also well recorded difference in oral health between fluoridated and unfluoridated areas observed in many good studies. However, the longitude observations still get trotted out as evidence against fluoridation by the anti-fluoridation activists.

Despite the high standing of Nature, this paper does come across as somewhat one-sided, maybe partly because of its age (1986).

Conclusions

The mistaken approach of the Hamilton City Council in its “tribunal” judgement of the science behind fluoridation illustrates the problems of the current situation where councils effectively make decisions about fluoridation because they manage water supplies. This can force them into a role for which they have neither the skills nor the training – making scientific and health judgements. Anti-fluoridation activists have taken advantage of this anomaly with a certain amount of success.

The Medical Association has called the debate on fluoridation to be raised to a national level. “Medical Association chairman Dr Mark Peterson says it’s not ideal for it to be discussed at a regional level and not nationwide.” This could be a way of avoiding the problems illustrated by the actions of some councils – including the Hamilton City Council.

The way scientific research was evaluated by the Hamilton City Council and its bureaucrats shows what can happen when such evaluations are not done critically by people with expertise in research and some understanding of the issues involved. Discussion and decision of the fluoridation issues at the natioanl level could help ensure such evaluations are done by bodies better equipped for the job.

See also:

Similar articles on fluoridation
Making sense of fluoride Facebook page
Fluoridate our water Facebook page
New Zealanders for fluoridation Facebook page

Welcome counter to scientific and health misinformation

Anti-fluoridation activists work very hard to propogate their misinformation. Letters to the editor, Facebook, Twitter and blog comments. At times their material will dominate google searches. No wonder the layperson can be confused, or even influenced by some of this information.

So I welcome the announcement of a new website dedicated to correcting the misinformation. This will provide New Zealanders a place to go for information on fluoride and fluoridation when they or their communities are faced with questions or even decisions. Interestingly, it is probably fairly unique in New Zealand – on-line action by authorities to counter misinformation about science and health.

Here is the media release about the new website from the Minister of Health Tony Ryall.


CWF

A new website, www.fluoridefacts.govt.nz will help local communities make informed decisions on water fluoridation, Health Minister Tony Ryall says.

The most recent nationwide New Zealand survey into oral health showed 40 percent less tooth decay on average for children living in fluoridated areas compared with non-fluoridated areas, Mr Ryall says.

“Some information circulating about community water fluoridation is either confusing or misleading. This website, which is supported by the Ministry of Health, district health boards and the New Zealand Dental and Medical Associations, contains evidence-based information, backed-up by research.”

New Zealand’s Chief Science Advisor, Professor Sir Peter Gluckman is among the several health professionals, scientists and community leaders who feature in a video series on fluoride also on the website. Professor Gluckman says: “It’s absolutely clear that the levels of fluoride that are put into New Zealand’s water supply – and are clearly regulated – are safe. They have real health benefits and there are no health risks.”

Mr Ryall noted that fluoride occurs naturally in water but New Zealand, like several other countries, has low levels. “Many countries in similar situations supplement fluoride to optimum levels for dental health benefit by adding it to the community water supply, or in some cases milk or salt.”

In New Zealand the levels of fluoride used in community water fluoridation are carefully monitored and within the guidelines of the World Health Organization and other public health agencies.

Mr Ryall says tooth decay, which is less likely in individuals when fluoride is added to the water supply, is painful and costly when fillings are needed to treat it. Community water fluoridation is effective, safe and an affordable way to provide the dental health benefits to everyone in a community.”

“People should refer to www.fluoridefacts.govt.nz  and come to their own conclusions when deciding to support community water fluoridation.”

For further information, including videos from Chief Science Advisor, Professor Sir Peter Gluckman, Chief Medical Officer of Health Dr Don Mackie, Chief Dental Officer Dr Robyn Haisman-Welsh and Children’s Commissioner Dr Russell Wills, along with other health experts and community leaders, see: www.fluoridefacts.govt.nz.


Further information also available from www.Health.govt.nz and www.nfis.org.nz the National Fluoride Information Service.
In New Zealand community water fluoridation is endorsed by the following organisations:

Ministry of Health
District Health Boards
New Zealand Dental Association
New Zealand Medical Association
Public Health Association of New Zealand
New Zealand Nurses Organisation
Te Ao Marama – the Māori Dental Association
Toi Te Ora – Public Health Service
Office of the New Zealand Children’s Commissioner
New Zealand College of Public Health Medicine
NZ Dental and Oral Health Therapists Association
NZ Society of Hospital and Community Dentistry
NZ Oral Health Clinical Leadership Network Group
Royal New Zealand Plunket Society
Cancer Society of New Zealand
The Royal Australasian College of Physicians
Royal Australasian College of Dental Surgeons

See also:

Similar articles on fluoridation
Making sense of fluoride Facebook page
New Zealanders for fluoridation Facebook page

Scientists, political activism and the scientific ethos

The recent decision of the Hamilton City Council to stop fluoridating its water supply caused a bit of discussion among New Zealand scientists. Discussion of the ethical and practical questions related to scientist involvement in political activism.

The Hamilton City council had been exposed to large numbers of submissions from anti-fluoridation activists. Most of them misrepresented the science and gave misleading, often incorrect, information. Scientists could have corrected these mistakes and distortions, but the job was left to a few representatives of the District Health Board and the Ministry of Health.

Many scientist think, as do others in the community, that they must play a greater role countering distorted information and pseudo-science. But the scientific ethos of objectivity, evidence-based debate and peer review conflicts with the political nature of such activism.

It’s a problem that scientists, especially younger scientists, will have to face increasingly in the future. Quite a few of us have solved the dilemma for ourselves by blogging – a sort of half way point between ivory tower science and political activism.

But here is something to think about. Climatologist James Hansen has thought about this issue throughout his life. Sometimes he has opted for pure science, these days he is opting for pure activism. Here’s an excellent video of one of his talks from February 2012 explaining his motivations and history on this issue. It’s also a simple and clear explanation of the climate change problems we are facing now and in the future.

James Hansen: Why I must speak out about climate change 

Hansen has also written about these issues in his book   Storms of My Grandchildren: The Truth About the Coming Climate Catastrophe and Our Last Chance to Save Humanity. Have a look at  Global climate – and your grandchildren for my review of the book.

See also: Fluoridation

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