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    Water Fluoridation Safety, Efficacy And Value In Oral Health
    By News Staff | March 21st 2014 10:02 AM | 63 comments | Print | E-mail | Track Comments

    During the 43rd Annual Meeting&Exhibition of the American Association for Dental Research, held in conjunction with the 38th Annual Meeting of the Canadian Association for Dental Research,  Stephen H. Abrams of Cliffcrest Dental Office in Toronto chaired a symposium titled "Water Fluoridation: Safety Efficacy and Value in Oral Health Care."

    Community water fluoridation (CWF) and other fluoride modalities historically have been and remains the cornerstone for the prevention and control of dental caries. There is extensive evidence on the efficacy and cost‐effectiveness of these interventions as well as assessments of the risks associated with fluoride ingestion.

    In 2006, the National Research Council identified severe fluorosis as the only documented health effect of fluoride at 2 – 4 mg/L in drinking water. Concentrations recommended for CWF and current dosage schedules for other modalities ensure safety. Systematic reviews on fluorides have identified gaps in knowledge or the need to replicate some of the previous studies under current widespread use of fluorides.

    Yet some controversy remains. What used to be the domain of right-wing John Birch Society members has now been adopted by people on the left who are also suspicious of vaccines, food science and energy.

    The symposium covered the linkage between caries rates and water fluoridation, it reviewed the research on the safety and value of water fluoridation and described how community water is fluoridated.

    The four presentations were:

    • Effectiveness of Fluorides: Findings of Evidence-Based Reviews, E. Angeles Martinez-Mier, Indiana University School of Dentistry, Indianapolis, USA.

    • The Health Assessment of Fluoride in Drinking Water: Conclusions from the National Research Council and Subsequent Scientific Assessments By EPA, Jayanth Kumar, New York State Department of Health, New York City, USA.

    • Community Water Fluoridation: Translating Evidence into Public Health Practice, Barbara F. Gooch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

    • Gaps in Scientific Knowledge Regarding Water Fluoridation and Other Fluoride Modalities, Gary Slade, University of North Carolina Chapel Hill, Chapel Hill, USA.




    Comments

    The world has learned the truth that fluoridation is ineffective for teeth and dangerous to health, so only 5% of the world and only 3% of Europe fluoridate their drinking water, more in the U.S. than the rest of the world combined. The tooth decay rate in Europe is as good or better than any fluoridated country including the U.S.

    Chicago, fluoridated for 58 years, reports that 64% of third graders have tooth decay. Similar reports occur in most fluoridated states (over 60 years) and other cities like Cincinnati, Boston, Detroit and Washington D.C., etc. Hawaii has the least fluoridation and the best dental decay rate of all states.
    It is time to get this toxic waste out of our drinking water.

    Fortunately, intelligent civic leaders in the United States understand the fallacy of attempting to assess the effectiveness of one dental decay preventive measure, water fluoridation, based on nothing more than a snapshot of data which controls for none of the myriad other causative and preventive factors of this disease. Would that healthcare was that simplistic.

    Steven D. Slott, DDS

    That which other countries elect to do in regard to water fluoridation is irrelevant to that which our leasers in the United States choose to do in the best interests of the health and well-being of our citizenry. Fluoridation is increasing in the United States. According to the latest CDC report, 74.6% of the U.S. was fluoridated in 2012, increased from 73.4% in 2011.

    For anyone who may be interested in the various reasons that other countries may or may not fluoridate, the following is an outline of the situation with fluoridation throughout the world taken from a recent issue of the newsletter of the New Zealand National Fluoride Information Service. It gives a pretty detailed picture:

    Countries with widespread water fluoridation programmes include Australia, the United States of America, Canada, the United Kingdom, Ireland, Spain, Israel, Brazil, Brunei, Chile, Argentina, Colombia, Hong Kong, South Korea, Singapore and Malaysia. Countries with limited water fluoridation programmes include Vietnam, Fiji, Papua New Guinea, and South Korea.

    Several countries are unable to introduce water fluoridation programmes due to technical, financial or sociocultural reasons. As an alternative, both salt and milk have been found to be reliable and convenient vehicles for increasing fluoride intake to an optimal level for hard to reach and low socio-economic communities. Studies have found them to be as effective as community water fluoridation schemes.

    Some European, Latin American, and Caribbean countries, including France, Switzerland, Germany, Costa rica, Colombia and Jamaica currently use fluoridated salt schemes. Mexico and most Latin American and Caribbean countries (apart from Argentina, Brazil, Chile and French Guyana) have or have had salt fluoridation programmes.

    A smaller number of countries currently have fluoridated milk programmes, including Bulgaria, Chile, China, Peru, Russia, Thailand and the United Kingdom

    Some country regions have optimal amounts of naturally occurring fluoride which provides good protection for oral health. examples of countries supplied with naturally fluoridated water at or around the optimum level needed to prevent dental decay include the United Kingdom (estimated 329,000 people), United States of America (estimated 10,078,000 people) Canada (estimated 300,000 people) and Australia (estimated 144,000 people).

    It is estimated that 39.5 million people around the world have access to naturally fluoridated water at the optimal level although variations from one community to another over time make it difficult to calculate an accurate total.

    Steven D. Slott, DDS

    Jwillie's reference to Hawaii ignores the data. A Pew report found "children in Hawaii continue to exhibit among the highest rates of dental caries in the nation." (Feb. 2010)

    Hawaii's 50/50 fluoridation rate hurts kids' oral health. State officials conducted exams of 9,100 public school students & found that 27% needed "urgent or acute dental treatments." (Maui News, 8/5/12)

    Fluoridation clearly is not the only variable causing cavities. While fluoridation is not a silver bullet cure, it clearly blunts the poor oral health burden those with socioeconomic disadvantage, especially these disadvantaged children.

    The most impressive benefit is the avoidance of 2/3rds of the operations necessary for little preschool kids.

    see: Water Fluoridation & Costs of Medicaid Treatment for Dental Decay. MMWR. CDC 09/03/1999

    This benefit alone returns 150% in lower dental bills.

    Done under anesthesia these procedures include extractions root canals & stainless steel crowns & cost up to $15,000. These happen more often where water fluoride is too low for optimal health.

    This result has been confirmed in Scotland, Australia, Texas, New York and Oregon.

    see for example: http://photos.oregonlive.com/photogallery/2013/09/far_fewer_operations_w...

    Citizens should read the long list of prestigious organizations representing thousands of medical, dental & public experts & many health advocacy organizations like the Pew Charitable Trust whose only goal is to better the common good.

    Jwillie's views harm the community's oral health, especially the kids. Arguing against is arguing for increased pain suffering & life-long disadvantages.

    This is a very BIG deal!!

    Dr. J. Kumar of the NYS Dep't of Health published data within a a study which shows fluoridation fails to reduce tooth decay (July 2009 Journal of the American Dental Association)

    Attempting to prove that fluorosed teeth have fewer cavities, Kumar uses 1986-1987 National Institute of Dental Research (NIDR) data which, upon analysis, shows that 7- to 17-year-olds have similar cavity rates in their permanent teeth whether their water supply is fluoridated or not (Table 1).

    Kumar divided children into four groups based on their community's water fluoride levels:

    Less than 0.3 mg/L where 55.5% had cavities

    From 0.3 to 0.7 mg/L where 54.6% had cavities

    Optimal 0.7 to 1.2 mg/L where 54.4% had cavities

    Over 1.2 mg/L where 56.4% had cavities

    The purpose of the Kumar study was to assess the association between dental fluorosis and dental decay resistance of teeth.

    "Background. The authors assessed the association between enamel fluorosis and dental caries to determine if there is any beneficial effect of enamel fluorosis in U.S. schoolchildren."

    The results of the study did indeed suggest that mildly fluorosed teeth are, more resistant to dental decay. The implications of this study were that any concerns with mild dental fluoorisis should be weighed against the dental decay resistance of those teeth.

    "Results. Permanent maxillary right first molars with fluorosis consistently had lower levels of caries experience than did normal molars. Adjusted odds ratios for caries prevalence in molars with fluorosis were 0.71 (95 percent confidence interval [CI], 0.56–0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74–1.06) in communities with water at or above optimal fluoridation levels.

    Conclusion. This study’s findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis.

    Clinical Implications. The results highlight the need for those considering policies regarding reduction in fluoride exposure to take into consideration the caries-preventive benefits associated with milder forms of enamel fluorosis.

    -----The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren
    Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH

    Steven D. Slott, DDS

    The reason that fluoridation enjoys such overwhelming professional support is because it does exactly what it is supposed to do, it just prevents cavities.

    Both jwillie and NYSCOF egregiously cherry pick stats to their favor.

    NYSCOF quotes from Kumar's analysis of the NHANESII data published by Brunelle and Carlos in 1990. Kumar found that the mild (and less) degrees of fluorosis from fluoridation are positively beneficial, preventing cavities.

    NYSCOF is carrying on the tradition of antifluoridationist John Yiamouyiannis. Yiamouyiannis who first used the insensitive measure, DMFT, which when averaged nationwide shows no improvement with fluoridation oppose community water fluoridation (CWF). Because Kumar's paper analyzes the same data it same subterfuge.

    In case readers aren't' aware, Dr. Yiamouyiannis was a PhD who believed that AIDS isn't caused by a virus. He died from potentially curable colon cancer after seeking alternative treatments in Mexican Clinics rather than going to his local board certified surgeon.

    Firstly, Yiamouyiannis averaged the whole country, so the areas where the Halo Effect was active (opposite to the Pacific Region) decreased the differential. Secondly he averaged the entire population by age. The age examined was 5-17. Five year olds don't have very many adult teeth yet they counted as a subject for a statistical "average." Thirdly he chose an insensitive measure (DMFT - Diseased Missing or Filled Teeth). Then he had courage to state that fluoridation doesn't work. It is a little tough to find the Yiamouyiannis paper today, because it was not published in a journal with sufficient quality to deserve indexing in the National Library of Medicine database.

    Antifluoridationists NYSCOF, Connett and Osmunson in citing Kumar's recent paper are merely repeating Yiamouyiannis's trick.

    That they completely fail to recognize the core finding of Kumar's new paper, that enamel fluorosis prevents cavities, is classic cherry picking so typical of fluoridation's opponents.

    J Am Dent Assoc. 2009 Jul;140(7):855-62. The association between enamel fluorosis and dental caries in U.S. schoolchildren. Iida H, Kumar JV.
    http://www.ncbi.nlm.nih.gov/pubmed/19571049

    To better understand the improperness of guaging fluoridation's effectiveness using DMFT in young school children imagine a vaccine which converts the near uniformly fatal Ebola virus hemorrhagic fever to a mild cold-like illness. Using the Yiamouyiannis, Connett, Osmunson and NYSCOF approach to effectiveness measurement (only disease prevalence counts) that vaccine would be judged worthless.

    Legitimate tests of fluoridation's effectiveness occur with experimental and epidemiological studies designed to test for that effectiveness, not with the listing of random factoids and opinions.

    One prays that the American voter will soon more widely understand the political swindle arguments like the DMFT listed here. Voters everywhere should listen to their local and trusted public health, dental and medical professionals.

    More Kumar Research Shows Fluoridation Creates More Harm Than Good

    A New York State Department of Health study shows that children in fluoridated Newburgh, New York, have no less tooth decay but significantly more dental fluorosis than children from never-fluoridated Kingston, New York. Newburgh and Kingston's children have been examined periodically, with results published since 1945, in order to demonstrate that fluoridation reduces tooth decay. This research shows the experiment has failed.

    Published in Community Dentistry and Oral Epidemiology, June 1999, New York State Department of Health dentist, Dr. J. V. Kumar, and associates report that "continuous exposure to water fluoridation had an observable effect on dental fluorosis." Dental fluorosis is white, yellow or brown permanent tooth stains; in severe cases teeth actually crumble. In fact, they report that three children with unusually large amounts of decay also had severe fluorosis -- the worst fluorosis category. Kumar previously reported this data in the New York State Dental Journal and the American Journal of Public Health in 1998. Kumar found the risk of dental fluorosis is even greater in African-American children.

    Kumar's data corroborates published research ("A Re-examination of the Pre-eruptive and Post-eruptive Mechanism of the Anti-Caries Effects of Fluoride: is there any anti-caries benefit from swallowing fluoride?" by Dr. Hardy Limeback, Community Dentistry and Oral Epidemiology, 1999) that shows fluoride's decay preventing effects are mostly topical (on the outside of the tooth) and that very little, if any, swallowed fluoride incorporates into teeth as a shield against decay, as has been theorized since fluoridation began. But swallowed fluoride builds up in the teeth and bones which can lead to disfiguring dental fluorosis or crippling skeletal fluorosis.

    Dr. Kumar advised that dentists and physicians to cut back on fluoride and to prescribe fluoride based upon a patient's total fluoride exposure. But that advise isn't broadcast too loudly

    NYS Health Officials Disregard Own Fluoride Cautionary Advice

    In 1990, the New York State Department of Health (DoH) published a study, “Fluoride: Benefits and Risks of Exposure,” alerting officials that fluoride can be harmful to kidney patients, diabetics and those with fluoride hypersensitivity even at “optimal” levels.(1) But the advice went unheeded, research left undone and today’s claims of safety ring hollow.

    Kaminsky et. al report: "The available data suggest that some individuals may experience hypersensitivity to fluoride-containing agents” and " …individuals with renal insufficiency who consume large quantities of fluoridated water are at an increased risk of developing skeletal fluorosis.” Research in these two areas were advised but never conducted.

    Further, dental fluorosis was reported in diabetics who consume large volumes of water containing 0.5 to 1.0 mg fluoride/liter, the latter equal to NYS’s fluoridated water supplies.

    Malfunctioning kidneys may not adequately filter fluoride from the blood allowing toxic fluoride levels to build up in and damage bones. Symptoms of skeletal fluorosis include bone pain, tenderness and fractures, according to the EPA.(3)
    The National Kidney Foundation (NKF) withdrew its fluoridation endorsement in 2007, with advice that “individuals with CKD [Chronic Kidney Disease] should be notified of the potential risk of fluoride exposure.”(4)

    The landmark 2006 National Research Council fluoride report stated, “Early water fluoridation studies did not carefully assess changes in renal [kidney] function...Several investigators have shown that patients with impaired renal function, or on hemodialysis, tend to accumulate fluoride much more quickly than normal."

    Bone changes in advanced kidney patients are similar to bone changes found in individuals with skeletal fluorosis, . This raises the possibility that some individuals with kidney disease are suffering from undiagnosed skeletal fluorosis. “

    We know almost half of US kids are fluoride-overdosed as evidenced by their fluoride-discolored teeth, or dental fluorosis What has fluoride done to their bones, glands and organs known to collect fluoride? Are they fluoride-hypersensitive? Without such critical studies, claims that fluoridation is safe for everyone are unproven and groundless

    There can no longer be excuses from anyone (primarily dentists) promoting fluoride who simply refuses to read the truth.

    The Fluoride Action Network has recently organized a  FAN Study Tracker, the most up-to-date and comprehensive source for fluoride health research, including studies investigating how fluoride affects the brain (e.g., IQ scores), the bones/joints (e.g., arthritis), the cardiovascular system, the kidneys, and the thyroid gland. 

    This database  makes the science on fluoride toxicity more readily available than ever before.
    Features of the Study-Tracker include:
    •    Over 1,500 abstracts and over 400 full-text studies. 845 studies since 2000, including 181 studies since 2013.
    •    Filters that enable 80+ years of research to be organized by health category/subcategory, study type, and date. •    237 studies on the brain, including 95 studies on cognitive function.

    http://fluoridealert.org/studytracker/?effect=cancer-2&sub=bone-cancer&t...

    jwillie, you mean FAN's Study-Deceptor

    Those who promote this toxic waste fluoride in drinking water do not like to see the truth easily available for the public.
    They certainly do not want to read the hundreds of scientific studies showing the dangers which are listed in my above reference, so watch how they try to criticize them.

    jwillie, you mean FAN's Study-Deceptor

    The FAN "study tracker" site contains but a fraction of the volumes of fluoride information easily obtainable from far more reliable and respected, primary sources on the internet than is an antifluoridationist website. Interestingly enough, however, as can be seen from the "tracker" studies below, even FAN's own site contradicts the nonsense disseminated by these people.

    1. CONCLUSIONS: The findings from this study provide no evidence that higher levels of fluoride (whether natural or artificial) in drinking water in GB lead to greater risk of either osteosarcoma or Ewing sarcoma.

    ———-———Is fluoride a risk factor for bone cancer? Small area analysis of osteosarcoma and Ewing sarcoma diagnosed among 0-49-year-olds in Great Britain, 1980-2005.

    2. CONCLUSION: Our ecological analysis suggests that the water fluoridation status in the continental U.S. has no influence on osteosarcoma incidence rates during childhood and adolescence.

    ———-Fluoride in drinking water and osteosarcoma incidence rates in the continental United States among children and adolescents

    3. The results of this study do not support the hypothesis that osteosarcoma incidence in the island of Ireland is significantly related to public water fluoridation. However, this conclusion must be qualified, in view of the relative rarity of the cancer and the correspondingly wide confidence intervals of the relative risk estimates.

    ————-Drinking water fluoridation and osteosarcoma incidence on the island of Ireland

    Steven D. Slott, DDS

    Nyscof, the "Media Relations Director" for the New York antifluoridationist group FAN, has presented an array of half-truths here in regard to the public health initiative of water fluoridation. Let's now take a look at the whole truth in regard to her claims.

    In regard to kidneys and water fluoridation:

    "Because the kidneys are constantly exposed to various fluoride concentrations, any health effects caused by fluoride would likely manifest themselves in kidney cells. However, several large community-based studies of people with long-term exposure to drinking water with fluoride
    concentrations up to 8 ppm have failed to show an increase in kidney disease."

    ------https://www.kidney.org/atoz/pdf/Fluoride_Intake_in_CKD.pdf

    "People exposed to optimally fluoridated water will consume 1.5mg of fluoride per day. Available studies found no difference in kidney function between people drinking optimally fluoridated and non-fluoridated water. There is discrepant information in studies relating to the potential negative effects of consuming water with greater than 2.0ppm of fluoride."

    "Available literature indicated that impaired kidney function results in changes in fluoride retention and distribution in the body. People with kidney impairment showed a decreased urine fluoride and increased serum and bone fluoride correlated with degree of impairment; however, there was no consistent evidence that the retention of fluoride in people with stage four or stage five CKD, consuming optimally fluoridated water, resulted in negative health consequences."

    -----Ludlow M, Luxton G, Mathew T. Effects of fluoridation of community water supplies
    for people with chronic kidney disease. Nephrol Dial Transplant 2007; 22:2763-2767

    In regard to skeletal fluorosis and water fluoridation:

    The United States is 74.6% fluoridated. Given the hundreds of millions of people who have been ingesting fluoridated water over the 70 year history of this public health initiative, any association of fluoridation with skeletal fluorosis would have manifested itself in massive epidemics by now.

    "Several of the more recent reviews on the safety of fluoride intake have discussed skeletal fluorosis, which is extremely rare in the United States. Epidemiological studies in the U.S. of communities with naturally occurring fluoride in the water 3.3 to 8 times the amount in optimally adjusted water supplies found no evidence of skeletal fluorosis. Pages 45-47 of the 1991 Department of Health and Human Services document Review of Fluoride: Benefits and Risks discusses the topic of skeletal fluorosis topic in more detail and provides references. Only 5 cases of skeletal fluorosis have ever been reported in the U.S. In these cases, the total fluoride intake was 15 to 20 mg./fluoride per day for 20 years."

    Dixie E. Snider, M.D., M.P.H.
    Assistant Surgeon General
    Associate Director of Science
    Centers for Disease Control and Prevention
    -------http://aspe.hhs.gov/infoquality/request&response/1d.shtml

    In regard to the National Kidney Foundation:

    On September 18, 2007, the Board of Directors of the National Kidney Foundation was presented with an unconscionable threatening letter from an antifluoridationist attorney, Robert E. Reeves. The letter threatened "legal action" against the then current and past members of the NKF Board of Directors, and/or employees. Rather than using its limited resources as a charitable foundation to pay what would have surely been astronomical legal fees, win or lose, and subject its Board members and employees to protracted legal processes and costs, the Board elected to simply remove the NKF from the list of fluoridation endorsers. However, neither the NKF, nor any other respected organization in the world has ever expressed any opposition to fluoridation.

    In regard to the 2006 National Research Committee on Fluoride:

    After a three year, exhaustive, detailed review of all relevant literature on fluoride, the NRC Committee made but one recommendation, to lower the EPA primary MCL flr fluoride down from its current 4.0 ppm. The sole stated reasons for this recommendation were that the Committee deemed 4.0 ppm to be inadequately protective of the public against severe dental fluorosis and bone fractures, with chronic consumption of water with a fluoride concentration at or above 4.0 ppm. Had the Committee deemed there to be concerns about any other adverse effects, it would have stated so in this final recommendation. It did not.

    The NRC Committee was also charged with evaluating the adequacy of the EPA secondary MCL of 2.0 ppm fluoride, in protecting the public against adverse effects. The Committee made no recommendation to lower the secondary MCL of 2.0 ppm. Water is fluoridated at 0.7 ppm, one third the level of this secondary MCL.

    -----Fluoride in Drinking Water: A Scientific Review of
    EPA's Standards
    Committee on Fluoride in Drinking Water, National Research Council

    Dental fluorosis:

    The only dental fluorosis in any manner attributable to water fluoridation, is mild to very mild. This barely detectable effect of the teeth causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. demonstrated mildly fluorosed teeth to be more decay resistant, many do not even consider this effect to be undesirable, much less adverse.

    ----The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren
    Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH

    In assessing the validity of claims made by nyscof, or any other antifluoridationists, it is important to realize their propensity for providing half-truths, out-of-context information, misinterpreted study conclusions, and misinformation in attempts to intentionally deceive the public. Valid science clearly demonstrates water fluoridation ti be safe and effective. It is simply a matter of accessing accurate information from reliable, respected, and primary sources of information.

    Steven D. Slott, DDS
     

    We already know that Harvard University published an article showing that fluoride reduces IQ.
    http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-gran...

    This month LANCET, one of the most respected medical journal in the world, published an report this which adds FLUORIDE to the list of chemicals that causes Neurobehavioural effects (damage to the central nervous system and the brain).

    “Neurobehavioural effects of developmental toxicity”
    Since 2006, epidemiological studies have documented six additional developmental neurotoxicants—manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene, and the polybrominated diphenyl ethers.
    http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70278-3/abstract

    The "Lancet" article reports nothing new. Fluoride is one of 200 substances on the EPA list of toxins. This classification makes no differentiation in concentration levels. Also on the list are such commonly ingested substances as aspartame. ethanol, salicylate, caffeine, and nicotine. Attempting to alarm and induce fear about neurotoxicity with the ingestion of fluoridated water is akin to fear of brain damage when a package of artificial sweetener is added to tea or coffee, worries about a drop in IQ when one drinks a beer or other alcoholic beverage, or a loss of brain function with the morning cup of coffee. In other words.....it is ridiculous. There is no substance known to man which is not toxic at improper levels, including plain water. Concentration is the difference between safety and toxicity of ALL substances. Fluoride at the optimal level of 0.7 ppm is not toxic, neuro or otherwise. Neither the "Lancet" article nor any other respectable source claims otherwise.

    As far as the Harvard Review and IQ......simply yet one more "red herring" attempted by antifluoridationists to cast doubt where none exists. The Harvard study was actually a review of 27 Chinese studies found in obscure Chinese scientific journals, of the effects of high levels of naturally occurring fluoride in the well water of various Chinese, Mongolian, and Iranian villages. The concentration of fluoride in these studies was as high as 11.5 ppm. By the admission of the Harvard researchers, these studies had key information missing, used questionable methodologies, and had inadequate controls for confounding factors. These studies were so seriously flawed that the lead researchers, Anna Choi, and Phillippe Grandjean, were led to issue the following statement in September of 2012:

    "--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."

    --Anna Choi, research scientist in the Department of Environmental Health at HSPH, lead author, and Philippe Grandjean, adjunct professor of environmental health at HSPH, senior author

    As it seems there have been no translations of these studies into English by any reliable, objective source, it is unclear as to whether they had even been peer-reviewed, a basic for credibility of any scientific study. These studies were so flawed that NOTHING could be "concluded" from them.

    Steven D. Slott, DDS

    Fluoridation apologists are so good a shoveling manure, they really ought to be advising us on organic gardening. It would certainly be a more positive contribution to public health and the dental profession.

    Thank you Ima. You provide yet one more excellent example of the antifluoridationist mindset, and denial of the science. Decision makers should take note and understand that this is typical of the ignorance with which they are dealing when according any credence to the antifluoridationist "arguments".

    Steven D. Slott, DDS

    You've got an answer for everything, don't you Dr. Steve? If a fluoridation objector said "Chickens can't fly" you'd post 20 paragraphs documenting how they actually can fly. Talk about mindsets! Rant on, Doc, rant on. It's all recorded in "the cloud" for your future embarrassment.

    Ima, it is not I who has an answer for all your objections to fluoridation, it is science.

    As clearly evidenced by your comments, objections of antifluoridationists are not grounded in science, they are grounded in personal ideology. Therefore it makes no difference how much valid science is presented to them, as long as it does not agree with their ideology, they will reject it. Your comment about "shoveling manure" is an excellent example. The science does not agree with your ideology, thus you consider it to be "manure".

    Please do record my comments. Post them on the front page of the New York Times if you wish. I don't post for with the delusional expectation of changing any antifluoridationist mindsets. That will never happen. I simply correct the mounds of misinformation posted by these uninformed zealots, such that intelligent readers of these comments, who honestly seek accurate information, will not be deceived into believing that the half-truths, and misinformation posted by antifluoridationists, are in any manner representative of the truth.

    Steven D. Slott, DDS

    "Science" is a slippery concept, Dr. Slott. It is a particular way of seeking and postulating knowledge that is always evolving, frequently in dispute--both with regard to hypotheses and to experimental design--and always incomplete. It's not Truth with a capital T.

    Science is also amoral. No amount of science can justify unethical behavior. The limitations of science, are, however, one compelling reason why fluoridation is unethical: There is no way that your science or anyone's science can ever PROVE or guarantee that fluoride added to the common water supply will not harm anyone.

    Now, I know you are so committed, so wedded, so completely entranced by the belief that fluoridation is the dental profession's greatest gift to humanity, that your mind goes bonkers when someone says something like that and you immediately go into denial. I also know that your grasp of scientific concepts is limited and that you actually rely on the say-so of others you consider to be authorities and that those authorities have a policy of deliberately misleading and strong-arming trusting health professionals like you.

    Some day, some way, maybe you will be emboldened to take a peak outside shuttered mental box you live in, because science is dynamic and things once thought to be true are frequently discovered not to be. And beyond that, no science, accurate or not, is justification for you to treat anyone with any substance without their informed consent.

    Basic scientific principles discredit fluoridation.

    Ima, you are correct about this outdated practice.

    It is illegal for a doctor or a dentist to force anyone to take a drug or a chemical.
    In fact, failure to get informed consent is the number one reason for malpractice lawsuits.
    Uninformed consent should be illegal for the government as well, particularly for the toxic waste fluoride (hydrofluorosilicic acid) which is more poisonous than LEAD and only slightly less poisonous than ARSENIC. That's why it is very effective in rat poison, roach poison and pesticides.

    The solution for the fluoridation issue is very simple.
    SIMPLE SOLUTION:
    1. Take the toxic waste fluoride chemical out of the drinking water.
    2. It is still legal and available, so those who wish to take it can then put fluoride in their own glass of water.
    3. Leave the rest of us out of it, giving everyone the freedom of choice.
    PROBLEM SOLVED FOR EVERYONE.

    As I said, Ima, antifluoridationists are science-deniers. There is no "my science", or "your science", just science. There is no valid science which supports opposition to fluoridation. That's a simple fact. If you want to continue to deny this, then provide valid, peer-reviewed scientific evidence to support your opinions. Otherwise they are nothing more than meaningless nonsense.

    Steven D. Slott, DDS

    Oh, "just science" But you say it can be valid or not valid. That's two kinds of science isn't it?

    Fluoridated organic vegetables are good for you.

    Jwillie

    Transparent fear-mongering about non-existent legal "threats" is a typical, yet meaningless antifluoridationist tactic. Antifluoridationists have repeatedly attempted the frivolous "forced medication" gambit in U.S. courts. They have been rejected each and every time.

    Fluoride is not a drug, and it is not "forced" upon anyone. Fluoride is a mineral which the FDA must classify as a drug for the sole reason of its stated use in water as a therapeutic rather than as a disinfectant. No other reason. As the EPA regulates all mineral additives to water, it is the EPA, not the FDA, which controls and regulates fluoride in water. Fluoridated water meets all NSF Standard 60 certification requirements as mandated by the EPA. There are no dosage requirements, or requirements for "informed consent", for fluoride, nor is there any need for such, any more than is there any need for them in regard to chlorine in water.

    Just to educate you, fluoride and hydrofluorosilic acid are not the same. HFA is the compound utilized to increase the existing level of fluoride in water systems up to the optimal level. HFA, as are all substances known to man, is toxic in improper concentrations. However, as it is recovered specifically for use in fluoridation, it is a mystery why anyone would mislabel it as "waste". "Waste" is not used productively. HFA and phosphoric acid are co-products of the same process. Phosphoric acid is utilized in soft drinks we consume and in fertilizers that become incorporated into the foods we eat. The fact that you deem one co-product of this process to be "toxic waste" and not the other, exposes the fallacy and hypocrisy of your claims.

    Actually, the current active ingredient in rat poison is Warfarin. Warfarin, under the brand name "Coumadin", is prescribed to millions of people who have cardiovascular disease. Why do suppose physicians, worldwide, would prescribe rat poison for their patients?

    Your fear-mongering about HFA is totally without merit. HFA does not exist in fluoridated water at the tap. Once introduced into water, HFA immediately and completely dissociates into fluoride ions identical to those which already exist in water, and trace contaminants in barely detectable amounts that fall far below the EPA mandated maximum levels of safety. Once hydrolyzed, HFA no longer exists in that water. It does not reach the tap. It is not ingested. Thus, it is of no concern, whatsoever.

    Science denial, fear-mongering, and intentional dissemination of misinformation. Part and parcel of antifluoridationist tactics. These are the types of people in whom decision makers are placing their trust, when according credence to antifluoridationist "arguments".

    Steven D. Slott, DDS

    Yakaty Yak ------ no one can keep up with the extensive verbiage of someone who appears to be employed to spread the mainstream line. There is a great money at stake from the industries profiting form selling their waste product.
    They simply have no answer to the immorality and unethical practice of forcing everyone to consume the drug/chemical, hydrofluorosilicic acid, which is a toxic industrial waste added to our drinking water.

    Very simply, it is illegal for doctors or dentists to force anyone to take a drug/chemical. It should be illegal for governments as well. The chemical is still legal and available for those who want to consume this poison. Why do they resist a plan to satisfy everyone? PROFITS must be the answer.

    Of courswe they are ,why would FANN join up with Mercola ,one of the biggest woo saleman in the U S A If money was not involved think of all the fluoride suppliments he can sell if fluoride is stopped and FANN will be in on the gold rush

    Jwillie

    I personally am unaware of any fluoridation proponent, certainly including myself, who receives compensation of any kind for his/her efforts in this regard. Just to demonstrate your hypocrisy, however, let's take a look who actually is profiting from keeping this issue alive:

    1.  Paul Connett, the Director of the antifluoridationist group, Fluoride Action Network (FAN), long time antifluoridationist zealot, and your mentor- Paul's non peer-reviewed book, which he pushes at every conceivable opportunity, sells for $25 per copy.  Paul claims that he donates all royalties he receives from his book sales, to his non-profit group, FAN.  Given that FAN presumably pays all or part of Paul's fluoride chasing trips all over the United Stated, to New Zealand, Australia, Europe, and anywhere else he chooses to visit, this "donation" would seem to be little more than a tax strategy.

    Additionally, both Paul and his wife receive monthly payments of $1,000 each from the umbrella organization under which FAN operates.

    2.  William Hirzy- the long time antifluoridationist, and close Connett affiliate, Hirzy, is the paid lobbyist for Connett's group, FAN.

    3. Attorney James Deal- close Connett affiliate, and donor  to FAN, Deal, maintains a website devoted soley to attempts at stirring up  class-action lawsuits against fluoridation, from which he would presumably profit in the delusionary dream that he would ever succeed. 

    4.  Richard Sauerheber, PhD- Richard is the "Scientific Consultant" for Attorney Deal in Deal's fluoride lawsuit seeking activities.  Sauerheber and his opinions may be found all over Deal's website.  What, if anything, Sauerheber may be paid by Deal for his "consulting" services, is anybody's guess.  Sauerheber has failed to disclose this information, in spite of repeated requests to do so.

    5.  Alex Jones- Connett  affiliate, and syndicated, controversial radio host, Jones, of "Infowars" infamy, is now pushing, for $39.95  a solution called "FluorideShield"

    According to Jones' website:
    "Introducing Fluoride Shield™, an Infowars Life exclusive blend of key herbs and ingredients specifically infused within the formula to help support the elimination of toxic forms of fluoride and other dangerous compounds like mercury, chlorine, and bromine from within the body."

    ------http://www.infowarsshop.com/Fluoride-Shield_p_1223.html

    6.  Whatever may be paid to Connett's son, Michael, for his "services" to FAN as well as to any other Connett family members and/or friends.

    As FAN operates under the umbrella of another non-profit organization, the FAN financials lack the transparency as would normally be expected of any such non-profit organization dependent on public donations, and exempt from federal income taxes.  

    Steven D. Slott, DDS

    It is absolutely silly to say fluoride is not a drug, when it is added to drinking water to affect the teeth. .That is the definition of a drug, to treat a part of the body. Also dentists prescribe it for some children. It cannot be purchased over the counter. Again, that is the definition of a drug.

    Ask your pharmacist whether fluoride is a drug. They will confirm that you have to have a prescription to acquire it.
    It is the only drug on the market not approved by the FDA. The reason: it was grandfathered in when the FDA was formed because it was already used in rat and roach poison. It is still used in these poisons and in pesticides today. Just go look at the rat and roach poisons on the shelves at Home Depot.
    I don't wish to consume fluoride, and neither should you.

    Well, tell you what jwillie, I'm sure that once the FDA, the EPA, and the U.S.court system understand that you deem fluoride at the optimal level to be a drug, the lightbulb will go on and they will instantaneously yield to your wisdom.

    Steven D. Slott, DDS

    No likely that government agencies will act in the public interest regarding fluoride. There is too much profit made by selling this toxic waste fluoride to communities. You recall that some years ago several thousand scientific EPA employees partitioned the agency to change the fluoridation rules. That didn't work.
    All the industries selling this waste have lobbyists in Washington to ensure compliance. It doesn't surprise that it will take some time to overcome the big money, but it is happening.

    Several hundred cities have rejected fluoridation in the last few years, including Wichita, Kansas; Portland, Oregon: Santa Fe, New Mexico; Windsor, Ontario; Fairbanks, Alaska; Calgary, Alberta; and over 17 regions in Queensland, Australia, etc., etc. The people have learned the truth that it is ineffective for teeth and dangerous to health. The trend is clear and fluoridation is on the way out.

    See the full list of several hundreds of cities rejecting fluoridation here:
    http://www.fluoridealert.org/content/communities/.

    Opponents have repeatedly cited the EPA Union of Scientists as an organization that shares their views. This is not the EPA, which has no official position on fluoridation other than citing the CDC's position, which is the governing agency on health matters. William Hirzy and Robert Carton, who were members of the EPA Union, are frequent sources of anti-fluoride writings and pushed for a vote of support from their union. I have found that of their 1,500 union members, there were only 12 present when they passed a resolution to oppose fluoridation, and not all of them voted. Shortly after this vote, the EPA union went out of business, and has since become part of the National Treasury Employees Union 2020, which has no record of a position on fluoridation. Mr. Carton no longer works for the EPA, and Mr. Hirzy is a full-time union representative and no longer has any laboratory duties.

    The EPA union appears to be a non-existent paper tiger, and a flimsy source to base public health decisions. With the worst decay rates in the state, Western Maryland has paid a dear price following the counsel of fringe groups such as these. When the voters of Cumberland reconsider fluoridation in May, I hope they consider the source.

    Wake up, you are mistaken with this: "This is not the EPA, which has no official position on fluoridation"

    The EPA has the responsibility for setting the maximum fluoride content in drinking water. Their maximum is 4.0 ppm,
    They also refuse to read the current science, so they continue to hold on to a dangerous number which is 65 years old.
    Because 99% of the toxic waste fluoride goes directly into the environment (people drink 1%), it is now into so much food that scientist estimate that children get about double that in water. That is one reason the the CDC reports that 60% of children have enamel damage (dental fluorosis). Lowering IQ, thyroid damage, and bone cancer are other more severe health problems.

    Jwiilie

    Your opinion on that which the EPA reads or does not read, is , obviously, irrelevant.

    The only dental fluorosis which may, in any manner, be attributable to water fluoridated at the optimal level, is mild to very mild. This barely detectable effect causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many do not even consider this to be undesirable, much less adverse.

    As far as the litany of disorders with which you attempt to fear monger, there is no valid evidence, whatsoever, to support your claims in this regard. In the 69 year history of water fluoridation, there have been no proven adverse effects....none.

    Steven D. Slott, DDS

    Jwillie

    Fluoridation in the United States is increasing. The latest CDC report shows that the US was 74.6% fluoridated in 2012. This was increased from 73.4% in 2011.

    Steven D. Slott, DDS

    The enamel damage from fluoride, dental fluorosis, will now be exposed in court. This type of lawsuit was inevitable. How can companies and governments cause such damage to children and not even pay for it?
    Pictures of the tooth damage is shown in the newspaper ad, in the second site below.

    "Legal Community Awakens as Federal Fluoride Harm Case Proceeds to Oral Arguments"
    The Washington D.C.-based law firm Public Justice has joined other plaintiff firms to help argue the case. Public Justice has more than 3,000 affiliated attorneys.

    “There are a lot of harmed people out there that were not told the facts about fluorides, nor have they seen documentation of what dental leaders knew and admitted amongst themselves about fluorosis,” says attorney Chris Nidel.

    “Fluoride providers and promoters are now under the microscope as the Fluoridegate scandal unfolds,” he says. “In their own publications, dentists warned of a day when fluoride litigation would arrive.”

    Nidel’s law firm and the firm of Paulson and Nace have been with the case from the beginning. Public Justice is adding its expertise to argue that defendants in the case cannot use federal laws to preempt state legal actions on fluoride harm.
    http://publicjustice.net/what-we-do/case-stories/NemphosvNestleWaters
    In another development, advertisements seeking students with dental fluorosis are beginning to appear in newspapers at universities, such as The Hoya newspaper at Georgetown University.
    http://issuu.com/the_hoya/docs/issuu_3.4.14/7?e=3568114/6958776

    Steven,

    To suggest that fluoride is not a drug at the levels at which it is added to drinking water is utterly misleading. From the Food, Drug and Cosmetic Act:

    (1) : a substance recognized in an official pharmacopoeia or formulary (2) : a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease (3) : a substance other than food intended to affect the structure or function of the body (4) : a substance intended for use as a component of a medicine but not a device or a component, part, or accessory of a device.

    If it shows a measureable positive effect on preventing tooth decay and is being used with this purpose in mind then it clearly meets this definition and hence is a drug. If it is a drug then medical ethics should apply and consent is required. Regardless of your views on its efficacy, adding fluoride to the domestic water supply is a serious breach of medical ethics. This usually leads to cries of “Oh, but think of the children,” so let’s do exactly that.

    As another commenter pointed out, introducing fluoride into the water supply at “optimal levels” ensures that it gets into everything and that intakes are much higher than levels in drinking water alone would suggest, especially when retention from toothpaste and mouthwash are added into the equation. This also means that you can’t avoid fluoride by drinking filtered water as food is prepared using mains water and crops are watered with it so it builds up in the soil. Here in Hong Kong where water is fluoridated at around 0.45 mg/litre, typical daily intake for a 20 kg child is a little over 1 mg. Admittedly, we drink a lot of tea, which is very rich in fluoride, but in more heavily fluoridated areas it would not be unusual for the same child to have an intake 4 times as high. An acute probable toxic dose for an adult is 1 mg/kg, for children data is limited, but doses as low as 0.3 mg/kg have produced toxic effects in accidental overdoses. So, the aforementioned child in Hong Kong is receiving roughly 5-15% of an acute toxic dose on a daily basis.

    A potentially chronic toxic dose is typically set at 10mg/day for an adult, so about 3mg/day for the 20 kg child, although this figure is well out-of-date as studies are suggestive of toxicity at lower levels in vulnerable individuals and fluoride bio-accumulation in bones and some endocrine glands has now been shown. As a naïve measure, pound for pound sodium fluoride has a similar toxicity to soluble lead compounds, but acceptable levels of fluoride in drinking water are orders of magnitude greater than lead compounds in order to accommodate fluoridation. Fluoride is a topical treatment. Like after-sun, it is best applied to the surface in need of care rather than swallowed. It belongs in toothpaste, not tap water.

    So where do I stand? Do I believe that the anti-fluoridationists have a watertight case? No, but I believe that they have a good enough case to suspend this unethical practice, enough evidence and gaps in our knowledge existing to cast a reasonable doubt on its safety. I realise that a lot of studies show no ill-effects, but this has been true for a significant number of drugs that have then been shown to be unsafe; oddly enough this typically happens around the time the patent expires. Increasingly, the “science” is all about collecting data that supports the conclusion that has been written in advance by those funding it, an increasing number of us having experiences that shatter our trust in “the experts” who all too often engage in cover-ups. Men shouting down at us from ivory towers don’t help.
    The only way to restore confidence is to remove the coercion and let people choose freely. Mass medication with no control of individual dosage, no effective monitoring or aftercare and without the consent of the patient is an unsavoury practice straight from 1984. Fluoride may or may not be a problem, but it opens the door to mass medication with other drugs, as has been suggested on a number of occasions. If it is acceptable to mass medicate for tooth decay then surely it is fine to do it for something really serious like heart disease, hypertension or mental illness? Where do you want to draw the line?

    Raphe

    As far as fluoride at the optimal level being a "drug", you are certainly free to present your personal opinion on that to the EPA, the CDC, the FDA and the U.S. court system.....but i don't much like your chances. Antifluoridationists have repeatedly attempted the "forced medication " gambit in U.S. courts, and have had it rejected eadh and every time.

    Fluoride at the optimal level is not a drug, and it is not "forced" upon anyone. Fluoride is a mineral which the FDA must classify as a drug for the sole reason of its stated use in water as a therapeutic rather than as a disinfectant. No other reason. As the EPA regulates all mineral additives to water, it is the EPA, not the FDA, which controls and regulates fluoride in water. Fluoridated water meets all NSF Standard 60 certification requirements as mandated by the EPA. There are no dosage requirements for fluoride, nor is there any need for such, any more than is there any need of dosage requirements of chlorine in water.

    The Institute of Medicine has established the daily upper limit of fluoride, before advetse effects will occur, at 10 mg for everyone over the age of 8 years. The CDC has estimated that of the total daily fluoride intake from all sources, including dental products, 75% comes from water and beverages. The average daily water consumption for adults is 2-3 liters. Even if you double that to an excessive 6 liters per day, the daily fluoride intake from all sources is only slightly more than half of the daily upper limit. Before this limit could be attained, water toxicity would be the concern, not fluoride.

    For infants and children 0-8 years, the daily upper limit is considerably less, but only due the risk of development of mild to very mild dental fluorosis during those tooth developing years, no other reason. Mild to very mild dental fluorosis is a barely detectable effect of the teeth which causes no adverse effect on cosmetics, form, function, or health of teeth. As Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many do not even consider this effect to even be undesirable, much less adverse.

    Your distrust of expert opinions and authoritative sources is unfortunate, but irrelevant. The same is true for your opinions on the best manner of provision of fluoride protection to the teeth.

    The only lack of confidence in fluoridation is amongst antifluoridationists. They have historically disseminated unsubstantiated claims about this public health initiative then claimed there to be a "controversy" based on these claims. There is no controvery within respected science and healthcare about fluoridation. It has been demonstrated effective in countless peer-reviewed scientific studies, with no proven adverse effects in its entire 69 year history.

    "Drawing the line"' in terms of content of public water supplies is entirely in the hands of local officials, within the parameters of state and federal regulations and statutes.

    Steven D. Slott, DDS

    As the lawyer says in preparing the latest lawsuit, which I note in an above comment. Dentists knew of the enamel damage. They should have been more truthful.
    Why are families forced to pay for this damage and not the companies or governments which have forced fluoride on everyone?

    “There are a lot of harmed people out there that were not told the facts about fluorides, nor have they seen documentation of what dental leaders knew and admitted amongst themselves about fluorosis,” says attorney Chris Nidel.

    “Fluoride providers and promoters are now under the microscope as the Fluoridegate scandal unfolds,” he says. “In their own publications, dentists warned of a day when fluoride litigation would arrive.”

    Jwillie

    Yes, just another frivolous lawsuit like all the other frivolous lawsuits attempted by antifluoridationists. More funds needlessly expended, more court time wasted on what will be the inevitable same result.....rejection.

    Steven D. Slott, DDS

    The definition of a drug that I gave is not my opinion, it’s from US statute. It makes no mention of levels; a substance is either a drug at any intake level or it is not a drug at any level. Fluoride cannot be added to water in levels able to disinfect as this would definitely prove toxic, so to bring up this possibility is misleading. Whilst there are no dosage requirements for fluoride, there are limits set on levels in drinking water, which to all practical purposes amount to the same thing. Your argument against it being a drug is simply special pleading. Either the courts accept established legal definitions and we have the rule of law or, as many suspect, they work for those who can pay for the most expensive lawyers.

    Severe accidental overdoses do occur with fluoride, including that added to drinking water, so to argue that it be exempt from regulation as a drug is irresponsible, especially when it is a drug that the public cannot avoid. The size of the therapeutic window for fluoride is tiny and it should be treated accordingly. The courts in some European countries take a far less tolerant line than those in the US, The Netherlands ruling that the practice is unjustified as fluoride does not improve water safety and further finding that it amounted to force as consumers have a right to water but cannot change their water supplier. Also, the US is unusual in its widespread acceptance of fluoridation, accounting for more fluoridated drinking water than the rest of the world combined. Here in Hong Kong I don’t believe that there has been a recent legal challenge, but then the authorities have a history of monitoring and responding to concerns, cutting fluoride levels back in 1967, 1978 and 1988, leaving them at roughly half of where they began and well below US levels. The city of Canton experimented with fluoridation and ultimately ditched the program, in part in response to public pressure.

    The CDC figure of 75% needs some error bars as it just doesn’t add up when the full range of intake levels is considered. Intakes of 6 mg/day are not unusual in the most heavily fluoridated areas, depending very much on dietary choices. Tea, grape juice, dried fruit and wine can all raise fluoride intake by a substantial margin and if tap water is fluoridated then foods like rice and dried pasta also deliver a significant extra dose. It is impossible for an individual to effectively manage their intake and so on this basis alone the practice is unethical. The figure of 10 mg/day for chronic toxicity is out of date, vulnerable individuals showing signs of joint damage at around 6-7 mg/day of sustained exposure. It is also based on an intake over a 10 year period, not lifelong exposure. In areas that fluoridate, the typical fluoride intake is a significant percentage of the dose known to cause acute toxicity based on admissions to hospital following overdose. If we were discussing lead or organophosphates then these intake levels as a proportion of the toxic dose would be way over maximum exposure limits, but for fluoride the “safe” intake limit for adults is around one-fifth of the level that would probably put them in hospital and far less for small children. This strikes me as imprudent and I would like to keep my intake well below these “safe” levels.

    Thank you for pointing out the irrelevance of my opinions. I have grown tired of closed-minded men in ivory towers telling me to “Shut up and do as you’re told, you’re too ignorant to get it,” the same people who I know from experience will go to any lengths to avoid an admission of ignorance or of having made a mistake, and who increasingly twist the scientific method to breaking point whenever it is in their interest to do so. It’s only science if the conclusion follows the data, not the other way around. For the record, I was a medicinal chemist for some years and so would consider myself conversant in basic toxicology, but I will not hide behind my authority or the “respect” that people have for my profession. Respect is a two way street. I make no claim to your body and have no wish to medicate you against your will, just as you have no claim on me and so should respect my right to refuse the medication you would have me take. The officials that you trust to make decisions concerning fluoridation answer to the people, not the other way around, and where these officials have deigned to offer a referendum on fluoridation they frequently lose. There is a controversy, and to suggest otherwise whilst telling members of the public that their opinions are irrelevant is simply a tactic aimed at shutting down debate. It gets used a lot by authority figures. You point to the evidence, but there is enough credible material that contradicts the status quo position to suggest that a significant problem may exist. Relying on the courts to ride roughshod over those who dissent is pure arrogance and will only convince people that self-interest is at work and that compassion is stone-dead.

    I don’t know where to go from here. As far as the effects of fluoride go, I am concerned enough to want an end to water fluoridation but not as concerned as I am about, for example, the air quality here. What concerns me far more is the possibility of the precedent set by fluoridation being used to add something more sinister to the water supply against the wishes of a significant part of the population. What has me outraged is the casual dismissal of accepted ethical boundaries by the medical profession whenever it suits their ends, the increasing contempt that is displayed for anyone who dissents, the authoritarian attacks on the right of individuals to make their own life choices and the tendency to view adverse consequences in terms of statistics rather than patients. I believe that despite being an “anti” my position is quite moderate and yet we seem to be poles apart. Neither camp will completely sway the other in the near future and the public appears fairly evenly split, so either it’s court cases at dawn until one side is exhausted or some compromise on fluoride needs working out.

    Raphe

    It makes no difference how many times you reiterate your opinion that fluoride at the optimal level is a "drug" it still remains simply your opinion. If you want to argue your case in court, feel, free, but again, antifloridationists have attempted the "forced medication gambit" in U.S. Courts repeatedly, and have had it rejected each and every time.

    No one is forced to do anything in regard to water fluoridation. If someone has held you down and poured fluoridated water down your throat, then report them to the authorities. The only ethical question concerns are those of self-absorbed factions who seek to deny whole populations a simple dental decay preventive based on their own personal ideology and/or irrational phobia of ingesting a mineral they have, in all likelihood, been ingesting their entire lives, whether their water is fluoridated or not.

    You are certainly free to take your personal opinion on total daily fluoride intake to the CDC. They generally require valid evidence upon which to base their decisions, but who knows, maybe they will make an exception for you and simply allow your opinion to suffice.

    If you have any valid evidence of adverse effects of fluoride at the optimal level, then properly cite it. Otherwise, you are simply espousing meaningless personal opinion.

    Steven D. Slott, DDS

    I almost didn’t bother to respond because clearly no one wants to open their mind and discuss this issue. Steven, I’ve done my best to answer your points, but clearly you have no interest in answering mine, you simply dismiss the language of your own Congress as my “opinion”. Ethical issues that cannot be answered by citing papers you dismiss as irrelevant when to many they are far more relevant than any damage that fluoride may or may not be doing. You love to mention US court cases and legislation, but ignore the rest of the world. Okay, you’re from the US, but I’m from Hong Kong and yet I know of what has happened in the courts of the US and other places too because this issue interests me, it’s one I understand well and I have an open mind. I’m concerned by it, like to discuss it and have learned a great deal from pro-fluoridationists, which in part is why I would love to explore a compromise rather than demanding that the use of therapeutic fluoride be banned. Instead I’m met by entrenched self-interest, hostility and shockingly poor “logic”.

    Your argument that no one is holding me down and forcing fluoridated water down my throat is simplistic beyond belief. I’m going to break it down, as clearly you have read my words but have not understood them.
    1. Is it reasonable to expect a domestic water supply in your home in a developed country?
    2. Can I change my water supplier and so choose not to receive fluoridated water?
    3. Is an alternative water source of appropriate quality available?
    4. How efficient are fluoride filters?
    5. Will a fluoride filter on my taps remove the excess fluoride in irrigated crops, processed foods and restaurant food?
    6. So can I effectively avoid the excess fluoride in the water supply?
    7. If my consent has not been sought, I object to it and yet can’t avoid it then could I reasonably consider it a use of force? Do please bear in mind that democracy is not supposed to be the same thing as the tyranny of the majority and safeguards certain individual rights. The argument that “My gang’s bigger than your gang” belongs in the playground…oh hang on, that’s just an opinion and can be dismissed out of hand, especially given that I have no formal qualifications in politics.

    I don’t expect a reply, all I want you to do is suppress your-all-too human reflex to lash out and really deeply think about each question. When I posted my original comment I was curious. I would love to know what you think about the undeniably tiny therapeutic window of fluoride, but you ignore it. Perhaps you know of alternatives to water fluoridation that have been tried and failed or just proved unworkable? You could explain why the mainstream medical community is so confident of the safety of fluoridation despite the incredibly poor signal to noise ratio in so many of the studies (rather like the debate). When I ask people how mass medication fits in with democracy and the rights of the individual I get a different answer from everyone, some of which are enlightening, but all I’m getting here is a rehash of a very tired story that clearly I no longer accept (I used to), otherwise I wouldn’t be asking these questions. I wanted to learn, to take the debate forward and to think, but an opportunity has been missed. I should be angry about wasting my time, but instead I’m just sad.

    Every claim that I have made is supported by scientific evidence that I consider reasonable. Yes, this is my “opinion”, but I also qualify as an “expert” on this, so it is an “expert opinion” that you claim to prize so highly. Write it off if you can’t see the contradiction, it’s your loss. The evidence is out there for those with the interest to look, but I don’t believe that you have any interest in actively seeking opinions that contradict your own. Of course, this is based solely on our exchange here and I happily concede that I’m probably wrong, but thus far I have definitely been wasting my time trying to get you to open up. A few years ago I was in that place, one of the new and infallible high-priests of science, self-entitled, egotistical, holier-than-thou, utterly lost in confirmation bias and incapable of saying the words “I don’t know” or “I might be wrong”. Then I was ripped from my ignorance and have managed to avoid reburying my head in the sand despite it being tempting to be intellectually dishonest and return to the status quo ante.
    I’m not going to get into a cite-fest with you as I’ve been there before and it is a total waste of time unless citations are chosen carefully, read thoroughly, understood and discussed, which of course never happens as having a d**k-waving contest is far more intellectually satisfying. Instead I’m going to provide these links and I hope you learn from them.

    https://www.youtube.com/watch?v=RDjCqjzbvJY
    https://www.princeton.edu/~achaney/tmve/wiki100k/docs/Confirmation_bias....
    http://www.informationisbeautiful.net/visualizations/rhetological-fallac...

    This is farewell as I feel I can achieve more by chatting to my wife and walking my dog. Thank you for reading my comments and for keeping it reasonably civil. If you respond with something that adds to the discussion then of course I’ll reply, but otherwise I leave the last word to you. Oh, and don’t knock conspiracy theorists; you might want to find out where the term originated.

    Raphe

    Your personal opinion that you are an "expert" is, like the rest of your claims, simply your opinion. Perhaps when you go to court to try to impose your opinion that fluoride at the optimal level is a "drug", you might mention that you deem yourself to be an "expert". I'm sure the court will be duly impressed....

    Your claim to have an "open mind" on this issue is as comical as is your self anointment as an "expert". It is obvious that you are an antifluoridationist trying your utmost to rationalize the same irrational "arguments" as does every other antifluoridationist.

    There is a distinct difference between inconvenience and force, regardless the degree of inconvenience. No one is forced to do anything in regard to fluoridation. The "forced medication" gambit is a staple of antifluoridationist tactics, but has been understandably rejected as having no merit.

    Steven D. Slott, DDS

    Raphe:
    Thank you for a very reasonable opinions on reasons to reject fluoridation. Your professional background adds weight to all you express. The one area you did not discuss is the profit motive to continue this outdated practice, particularly important in the U.S. All of the industries producing and selling their toxic waste fluoride have lobbyists in Washington, D.C. to ensure that the practice continues. Foundations are established to fund communities to start fluoridation and to encourage those already on board. It is similar to the scheme some companies use to give away the razor so you have to purchase their razor blades thereafter. The other funding to national and state organizations is not known, but certainly appears to be active.
    It is true that when referenda are held, promoters lose 80% of the time. The internet has allowed the truth to spread everywhere.
    It will be sad if the fluoridation practice must be stopped by class action litigation, but that is now underway. It would be far better to acknowledge the science from the last 25 years and voluntarily stop in the best interest of all people.
    So, for now expect the promoters to resist vigorously; however, several hundreds communities have rejected fluoridation in the last couple of decades and this movement will continue as the truth spreads.

    Raphe

    You now have jwillie with his conspiracy nonsense, in agreement with you. That should tell you something about the credibility of your position.

    Steven D. Slott, DDS

    Raphe:
    It appears that the poison promoters are out of ammunition.
    They don't even try to refute the individual issues raised anymore.
    Jus as well I guess.

    Jwillie

    Your conspiracy nonsense refutes itself, and you present no issues which haven't been refuted countless times by facts supported by valid science. That you keep copy/pasting the same comments verbatim on new sites does not mysteriously endow them with new-found credibility. If you truly have an interest in properly educating yourself on this issue, then I would suggest you cease trying to deceptively steer readers to "fluoridealert" and other such antifluoridationist websites, and begin accessing accurate information from reliable, respected, and primary sources.

    Steven D. Slott, DDS

    Steven D. Slott, DDS

    This report below (159 pages & 560 scientific references), shows that fluoridation causes 450% more early onset dementia, 300% sudden infant deaths, 100% more osteoporosis, and significant increases in cancer, diabetes, rheumatoid arthritis and Downs syndrome and much more.
    Everyone should read the study, located here:

    http://www.enviro.ie/Feb2013.pdf.
    Look at pages 6,10 and 12. These 3 graphs will give you a good overview of the study.

    Jwillie, thank you. You provide yet one more example of your ignorance of science, and total lack of integrity.

    As you well know, the "study" to which you deceptively attempt to steer readers is that of Declan Waugh, an Irishman who has no degree higher than undergraduate college. His "study" has not been peer-reviewed, a very basic requirement for credibility, nor been published in any respected scientific journal. Waugh's own Irish government has, through its Irish Expert Body on Fluorides and Health, totally refuted Waugh's "study" , point by point. That you would even attempt to purport this "study" as having any semblance of credibility is clear evidence of the depths to which antifluoridationists will sink in order to further their own, personal ideology.

    The Irish government's refute of Waugh can be found:

    http://www.fluoridesandhealth.ie/download/documents/Appraisal_of_Waugh_r...

    Steven D. Slott, DDS

    Jwillie

    As you well know, the report to which you provide a link is that of Declan Waugh. Waugh is an Irishman who has no degree higher than undergraduate college level. His "study" has not been peer-reviewed, and has not been published in any respected scientific journal. His own Irish government, through its Irish Expert Body on Fluorides and Health, has totally rebuked this "study" point by point.

    That you would even attempt such deception as citing information from this "study" shows the depths to which you will sink in order to further your personal ideology. Truth and honesty are, obviously, nothing more to you than an annoyance to be discarded whenever they get in your way. The void of integrity and ignorance of science you exhibit is astounding, yet, typical of the antifluoridationist mindset. Hopefully, local decision makers will take note of this, and understand the type of persons with whom they are dealing when they accord any credence to antifluoridationist "arguments".

    Steven D. Slott, DDS

    Try to recover your composure. Maybe a dose of your prescription would help.
    It is apparent that you go off the level when reports disagree with your preconceived positions.

    Mr. Waugh, a senior environmental scientist in Ireland, has over 20 years of experience in his field. He was employed as a senior researcher by the EPA. Everyone should go read his report. It was important in Israel's decision to ban fluoride.

    The report by Declan Waugh, a senior environmental scientist in Ireland, was directly involved in the battle against fluoridation in Israel. In August 2013 the Israeli Supreme court read his it and ruled that all councils in Israel stop fluoridation by 2014. Quoting them: "because it presents health dangers and its benefits are no longer widely accepted."
    Israel has now joined the 95% of the world which bans water fluoridation. Ireland will probably be next to take this action, as the people are becoming more informed of the truth.

    Jwillie/James Reeves

    You seriously have no comprehension of the difference between respected, peer-reviewed science, and the "junk science" such as Waugh's "study", do you? Exactly the problem with the factions of fringe activists who answer to no one, who, obviously, have no integrity or respect for truth and honesty, and who do everything they possibly can to intentionally deceive and confuse. This is the true antifluoridationist mindset, and the caliber of individuals with whom local leaders are dealing when they accord any credence to these despicable individuals.

    For those readers who wish to read the point-by-point rebuke of Waugh's "study" by his own Irish government, it can be found:

    Http://www.fluoidesandhealth.ie/download/documents/Appraisal_of_Waugh_re...

    Steven D. Slott, DDS

    The rest of us have other work to do. We present the truth but not full time.
    And we are not employed to do so.
    Goodnight.

    Jwillie

    Fortunately, the truth is the truth, not what jwillie desires it to be. Doubtful you will ever understand this simple concept. If it is your desire to be "employed" to present your nonsense, this is certainly not surprising. You should talk to Connett. He does profit from keeping this issue alive, and would perhaps be willing to share a piece of this with you.

    Steven D. Slott, DDS

    How can you call fluoride a drug when you know full well it is a natural mineral, found in all water ground and air, Show me a peer reviewed paper that says fluoride is dangerous to human health at the .7PPM range.

    Chris:
    You must be trying to put us on. Many natural substances are used as drugs. For example Digitalis comes from Foxglove, a perennial, shrub. Just like fluoride, a prescription is required to obtain it.
    Why is this so hard for some of you to understand what a drug is?

    I have referenced above several hundred scientific studies to show the dangers of this toxic waste fluoride added to drinking water (hydrofluorosilicic acid).
    One example: we already know that Harvard University published an article showing that fluoride reduces IQ in children.
    http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-gran...

    This month LANCET, one of the most respected medical journal in the world, published an report this month which adds FLUORIDE as one of six newly recognized “developmental neurotoxicants,” or chemicals that can cause damage to the central nervous system and the brain. Fluoride and the other listed neurotoxicants are likely behind the increase in neurodevelopmental disabilities seen in children— including autism, attention-deficit hyperactivity disorder (ADHD) and dyslexia.
    http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(13)70278-3/abstract

    "Gish gallop", jwillie6.............................

    Gish Gallop - RationalWiki rationalwiki.org/wiki/Gish_Gallop.

    "The Gish Gallop, named after creationist Duane Gish, is the debating technique of drowning the opponent in such a torrent of half-truths, lies, and straw-man arguments that the opponent cannot possibly answer every falsehood in real time. The term was coined by Eugenie Scott of the National Center for Science Education. Sam Harris describes the technique as "starting 10 fires in 10 minutes."

    The formal debating term for this is spreading. It arose as a way to throw as much rubbish into five minutes as possible. In response, some debate judges now limit number of arguments as well as time. However, in places where debating judges aren't there to call on the practice (like the internet) such techniques are remarkably common.

    Here's a 72 second You Tube video that explains the Gish gallop technique. Enjoy!

    http://youtu.be/12nYRa8PTzo

    When one runs out of science and facts, they resort to presenting this type of rubbish.

    The Harvard study you reference was actually a review of 27 Chinese studies found in obscure Chinese scientific journals, of the effects of high levels of naturally occurring fluoride in the well water of various Chinese, Mongolian, and Iranian village. The concentration of fluoride in these studies was as high as 11.5 ppm. By the admission of the Harvard researchers, these studies had key information missing, used questionable methodologies, and had inadequate controls for confounding factors. These studies were so seriously flawed that the lead researchers, Anna Choi, and Phillippe Grandjean, were led to issue the following statement in September of 2012:

    "--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."

    --Anna Choi, research scientist in the Department of Environmental Health at HSPH, lead author, and Philippe Grandjean, adjunct professor of environmental health at HSPH, senior author

    As it seems there have been no translations of these studies into English by any reliable, objective source, it is unclear as to whether they had even been peer-reviewed, a basic for credibility of any scientific study. These studies were flawed that NOTHING could be "concluded" from them.

    The Harvard study you reference was actually a review of 27 Chinese studies found in obscure Chinese scientific journals, of the effects of high levels of naturally occurring fluoride in the well water of various Chinese, Mongolian, and Iranian village. The concentration of fluoride in these studies was as high as 11.5 ppm. By the admission of the Harvard researchers, these studies had key information missing, used questionable methodologies, and had inadequate controls for confounding factors. These studies were so seriously flawed that the lead researchers, Anna Choi, and Phillippe Grandjean, were led to issue the following statement in September of 2012:

    "--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."

    --Anna Choi, research scientist in the Department of Environmental Health at HSPH, lead author, and Philippe Grandjean, adjunct professor of environmental health at HSPH, senior author

    As it seems there have been no translations of these studies into English by any reliable, objective source, it is unclear as to whether they had even been peer-reviewed, a basic for credibility of any scientific study. These studies were flawed that NOTHING could be "concluded" from them.