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View Diary: Pub Hlth Officials Lie about Fluoridation Safety (65 comments)

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  •  Ummm, I did... (2+ / 0-)
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    The link goes to the MMWR (that's the Morbidity and Mortality Weekly Report, from the CDC) Recommendations and Reports, August 17, 2001/50(RR14);1-42, entitled  Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. The block quote is from the conclusion.

    -5.12, -5.23

    We are men of action; lies do not become us.

    by ER Doc on Sat Mar 14, 2009 at 06:56:52 AM PDT

    [ Parent ]

    •  Same Place I took quotes (0+ / 0-)

      My quotes came from the same source

      What I mean is what are the peer-reviewed scientific studies that support the CDC's claim that fluoridation is safe?

      If you look to the American Dental Associations newly launched website about evidence-based-dentistry, you'll see the only systematic review of fluoridation science is done by Pizzo, "Community water fluoridation and caries prevention: a critical review" who actually found
      contrary to belief, fluoridation is damaging
      teeth with little cavity reduction.

      Fluoridation 101 News Releases

      by nyscof on Sat Mar 14, 2009 at 07:08:24 AM PDT

      [ Parent ]

      •  Sorry, don't have time to beat this dead horse (3+ / 0-)

        The MMWR recommendation has a total of 270 references, which I do not have time to review now. The article from Pizzo et al is an Italian study taken from a population with far better access to quality dental care than a large portion of the US population which either cannot afford or chooses not to spend the money necessary to care adequately for their teeth.
        The ADA site also includes a review article from C.A. Yeung entitled A systematic review of the efficacy and safety of fluoridation. It concludes:

        RECOMMENDATIONS: Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride. It is recommended (see also that water be fluoridated in the target range of 0.6-1.1 mg/l, depending on the climate, to balance reduction of dental caries and occurrence of dental fluorosis.n particular with reference to care in hospital for those following stroke.

        The ADA site does not include any specific "clinical recommendations" with respect to water fluoridation, but within its recommendations for "Professionally Applied Topical Fluoride" I note the recurring remark, for each age group discussed:

        Patients whose caries risk is lower, as defined in this document, may not receive additional benefit from professional topical fluoride application.(Fluoridated water and fluoride
        toothpastes may provide adequate caries prevention in this risk category. Whether or not to apply topical fluoride in such cases is a decision that should balance this consideration with the practitioner’s professional judgment and the
        individual patient’s preferences.)

        This hardly represents a strident challenge to the continued practice of fluoridation.

        -5.12, -5.23

        We are men of action; lies do not become us.

        by ER Doc on Sat Mar 14, 2009 at 07:46:27 AM PDT

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        •  CDC ref is a belief (0+ / 0-)

          The only reference to fluoridation safety in the CDC MMWR report you reference is based on belief - not science.

          1. Bratthall D, Hänsel Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci 1996;104:416--22.

          Fluoridation 101 News Releases

          by nyscof on Sat Mar 14, 2009 at 07:57:29 AM PDT

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          •  That is completely specious! (1+ / 0-)
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            That reference, by the way, doesn't appear to address safety at all! It addresses "Reasons for the caries decline". Links are not provided, but roughly a fourth of the references in the MMWR report appear to address safety and side effect issues, including at least most of these:

            #  Fejerskov O, Manji F, Baelum V. The nature and mechanisms of dental fluorosis in man. J Dent Res 1990;69(special issue):692--700. # Avery JK. Agents affecting tooth and bone development. In: Avery JK, ed. Oral development and histology. 2nd ed. New York, NY: Theime Medical Publishers, 1994:130--41. # DenBesten PK, Thariani H. Biological mechanisms of fluorosis and level and timing of systemic exposure to fluoride with respect to fluorosis. J Dent Res 1992;71:1238--43. # Evans RW, Stamm JW. Dental fluorosis following downward adjustment of fluoride in drinking water. J Public Health Dent 1991;51:91--8. # Dean HT. The investigation of physiological effects by the epidemiological method. In: Moulton FR, ed. Fluorine and dental health. Washington, DC: American Association for the Advancement of Science, 1942;19:23--31. # Fejerskov O, Manji F, Baelum V, Møller IJ. Dental fluorosis---a handbook for health workers. Copenhagen: Munksgaard, 1988. # Kaminsky LS, Mahoney MC, Leach J, Melius J, Miller MJ. Fluoride: benefits and risks of exposure. Crit Rev Oral Biol Med 1990;1:261--81. # Clark DC, Hann HJ, Williamson MF, Berkowitz J. Aesthetic concerns of children and parents in relation to different classifications of the Tooth Surface Index of Fluorosis. Community Dent Oral Epidemiol 1993;21:360--4. # Dean HT. Endemic fluorosis and its relation to dental caries. Public Health Rep 1938;53:1443--52. # Clark DC. Trends in prevalence of dental fluorosis in North America. Community Dent Oral Epidemiol 1994;22:148--52. # Szpunar SM, Burt BA. Trends in the prevalence of dental fluorosis in the United States: a review. J Public Health Dent 1987;47:71--9. # Brunelle JA. The prevalence of dental fluorosis in U.S. children, 1987. J Dent Res 1989;68(special issue):995. # Heller KE, Eklund SA, Burt BA. Dental caries and dental fluorosis at varying water fluoride concentrations. J Public Health Dent 1997;57:136--43. # Pendrys DG, Katz RV, Morse DR. Risk factors for enamel fluorosis in a fluoridated population. Am J Epidemiol 1994;140:461--71. # Osuji OO, Leake JL, Chipman ML, Nikiforuk G, Locker D, Levine N. Risk factors for dental fluorosis in a fluoridated community. J Dent Res 1988;67:1488--92. # Pendrys DG, Katz RV. Risk for enamel fluorosis associated with fluoride supplementation, infant formula, and fluoride dentifrice use. Am J Epidemiol 1989;130:1199--208. # Pendrys DG. Risk for fluorosis in a fluoridated population: implications for the dentist and hygienist. J Am Dent Assoc 1995;126:1617--24. # US Department of Health, Education, and Welfare. Public Health Service drinking water standards, revised 1962. Washington, DC: US Public Health Service, Department of Health, Education, and Welfare, 1962; PHS publication no. 956. # Galagan DJ, Vermillion JR. Determining optimum fluoride concentrations. Public Health Rep 1957;72:491--3. # CDC. Engineering and administrative recommendations for water fluoridation, 1995. MMWR 1995;44(No. RR-13):1--40. # US Environmental Protection Agency. 40 CFR Part 141.62. Maximum contaminant levels for inorganic contaminants. Code of Federal Regulations 1998:402. # US Environmental Protection Agency. 40 CFR Part 143. National secondary drinking water regulations. Code of Federal Regulations 1998;514--7. # US Department of Health and Human Services, Food and Drug Administration. 21 CFR Part 165.110. Bottled water. Federal Register 1995;60:57124--30. # US Food and Drug Administration. 21 CFR Part 355. Anticaries drug products for over-the-counter human use. Code of Federal Regulations 1999:280--5. # American Dental Association. ADA guide to dental therapeutics. 1st ed. Chicago, IL: American Dental Association, 1998. # American Academy of Pediatric Dentistry. Special issue: reference manual 1995. Pediatr Dent 1994--95;16(special issue):1--96. # American Academy of Pediatrics Committee on Nutrition. Fluoride supplementation for children: interim policy recommendations. Pediatrics 1995;95:777. # Singer L, Jarvey BA, Venkateswarlu P, Armstrong WD. Fluoride in plaque. J Dent Res 1970;49:455. # Dabeka RW, McKenzie AD, Lacroix GMA. Dietary intakes of lead, cadmium, arsenic and fluoride by Canadian adults: a 24-hour duplicate diet study. Food Addit Contam 1987;4:89--102. # Kramer L, Osis D, Wiatrowski E, Spencer H. Dietary fluoride in different areas of the United States. Am J Clin Nutr 1974;27:590--4. # Osis D, Kramer L, Wiatrowski E, Spencer H. Dietary fluoride intake in man. J Nutr 1974;104:1313--8. # Singer L, Ophaug RH, Harland BF. Fluoride intake of young adult males in the United States. Am J Clin Nutr 1980;33:328--32. # Ophaug RH, Singer L, Harland BF. Estimated fluoride intake of average two-year-old children in four dietary regions of the United States. J Dent Res 1980;59:777--81. # Ophaug RH, Singer L, Harland BF. Estimated fluoride intake of 6-month-old infants in four dietary regions of the United States. Am J Clin Nutr 1980;33:324--7. # Singer L, Ophaug RH, Harland BF. Dietary fluoride intake of 15-19-year-old male adults residing in the United States. J Dent Res 1985;64:1302--5. # Pang DTY, Phillips CL, Bawden JW. Fluoride intake from beverage consumption in a sample of North Carolina children. J Dent Res 1992;71:1382--8. # Levy SM, Kohout FJ, Guha-Chowdhury N, Kiritsy MC, Heilman JR, Wefel JS. Infants' fluoride intake from drinking water alone, and from water added to formula, beverages, and food. J Dent Res 1995;74:1399--407. # Levy SM, Kiritsy MC, Warren JJ. Sources of fluoride intake in children. J Public Health Dent 1995;55:39--52. # Johnson J Jr, Bawden JW. The fluoride content of infant formulas available in 1985. Pediatr Dent 1987;9:33--7. # Dean HT, Jay P, Arnold FA Jr, Elvove E. Domestic water and dental caries. II. A study of 2,832 white children, aged 12--14 years, of 8 suburban Chicago communities, including Lactobacillus acidophilus studies of 1,761 children. Public Health Rep 1941;56:761--92. # Dean HT, Arnold FA Jr, Elvove E. Domestic water and dental caries. V. Additional studies of the relation of fluoride domestic water to dental caries experience in 4,425 white children, aged 12 to 14 years, of 13 cities in 4 states. Public Health Rep 1942;57:1155--79. # Galagan DJ. Climate and controlled fluoridation. J Am Dent Assoc 1953;47:159--70.


            -5.12, -5.23

            We are men of action; lies do not become us.

            by ER Doc on Sat Mar 14, 2009 at 08:13:37 AM PDT

            [ Parent ]

            •  Look again (0+ / 0-)

              Don't you find it odd that the only reference the CDC could dig up to prove fluoridation reduces tooth decay is based on belief

              This from the text:

              "Today, all U.S. residents are exposed to fluoride to some degree, and widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries in the United States and other economically developed countries (1)

              1. Bratthall D, Hänsel Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci 1996;104:416--22.

              By the way Burt and Eklund in their dental textbook "Dentistry, Dental Practice and the Community."

              also concede that fluoridation based on belief and that its beneficial effect has not been proven scientifically.

              I can see you also have an unshakable belief based on shaky science.

              Fluoridation 101 News Releases

              by nyscof on Sat Mar 14, 2009 at 08:34:36 AM PDT

              [ Parent ]

        •  Australian Report Biased (0+ / 0-)

          A careful reading of this report indicates that at best, it is a work of professional incompetence or, at worst, an example of scientific fraud, in which scientific information is manipulated to support a preordained conclusion. There are six fundamental problems with this report.

          1. The NHMRC's failure to make it clear that very little original work has been done investigating the health of fluoridated communities in Australia.

          I think the average reader of a governmental report on fluoridation in a country which has been fluoridating its water for over 50 years would expect to read studies performed in their own country. However, virtually no health studies have been done in Australia on any organ or tissue other than the teeth. This is a particularly egregious omission because a previous review form this same agency over 17 years ago (NHMRC 1991) actually recommended that some health studies be done. This included recommending that fluoride bone levels be measured so that there would be a better handle on epidemiological studies on the bone. Not only were these bone levels not obtained, but no epidemiological studies on the bone were done either. The NHMRC (1991) also recommended that the many anecdotal reports that some citizens are particularly sensitive to fluoride be investigated scientifically. This also has not been done. The guiding principle in Australia - as well as other fluoridating countries - seems to be "if you don't look, you don't find." Which also means that when you apply systematic reviews to the literature - no matter how sophisticated the analyses might be - it is highly likely that there will be no damage to report.

          1. The dominant interest in the report is on one organ: the teeth.

          Of the 183 pages in the report, only a few pages in the text are devoted to health concerns.
          26 pages to dental caries
          23 pages to dental fluorosis
          6 pages to bone fractures
          7 pages to cancer
          6 pages to other possible health effects

          In other words more pages were devoted to both dental caries and dental fluorosis than all the other health issues combined. Once again we are reminded that the whole issue of water fluoridation, especially the money spent on research, has been captured and controlled by the dental lobby.

          1. The NHMRC's cavalier dismissal of the relevance of the NRC (2006) report.

          Even though citizens in Australia had requested that the NHMRC panel pay special attention to the NRC (2006) report, the authors dismissed this landmark 507-page report by the National Research Council: Fluoride In Drinking Water: A Scientific Review of EPA's Standards, (NRC 2006, referred to as "NAS, 2006 below") in just two sentences:

             "The reader is also referred to recent comprehensive reports regarding water fluoridation published by the World Health Organization (WHO, 2006) and the National Research Council of the National Academies (NAS, 2006). The NAS report refers to adverse health effects from fluoride at 2 - 4 mg/L, the reader is alerted to the fact that fluoridation of Australia's drinking water occurs in the range of 0.6 to 1.1 mg/L."

          Such a dismissal of this important review - which took the panel 3.5 years to write - is unbelievable. The reason they give betrays a very poor understanding of toxicology.

          First, for most toxic substances regulatory bodies are forced to use high dose animal experiments to extrapolate to concerns about low doses for humans. In the case of fluoride we have the luxury of being able to use dozens of relatively low dose human studies from India and China to inform our judgments.

          Second, unless the study involves a very large number of subjects, when extrapolating to a "safe" level for a whole population, it is necessary to apply a safety factor (a margin of safety) to take into account the very large range of sensitivity to any toxic substance we can expect in a human population (intra-species variation). The factor usually chosen for this purpose is 10. Thus to dismiss findings of health effects reported in studies involving a small number of subjects consuming water between 2 and 4 ppm as irrelevant to a whole population consuming water at 1 ppm, is ridiculous.

          Third, some of the studies reviewed in the NRC (2006) found or estimated effects at lower than 2 ppm (for example, Lin, 1991; Xiang, 2003).

          Fourth, the NRC panel did an extensive exposure analysis (chapter 2) and concluded that some subsets of the population are already exceeding so called "safe" doses in drinking water fluoridated at 1 ppm. These include bottle-fed infants; above average water consumers like athletes, outdoor workers in hot climates, military personnel and people with diabetes; people with impaired kidney function and people who are borderline iodine deficient, which is a common problem in Australia.

          1. The NHMRC's over-reliance on the York Review.

          Instead of using the NRC (2006) review as their starting point the NHMRC panel went back to the York Review (McDonagh et al., 2000). However, they did this without acknowledging the caveats issued by those associated with this report. In particular, see the letter from professor Trevor Sheldon to the House of Lords. In fact, much of the NHMRC review is simply duplicating large parts of the analysis in the York Review! Like the York Review they spent much of their time on teeth, bones and cancer and bundled all the other health issues into one section. This section consisted of less than 6 pages, much of it being material reproduced from the York Review. They virtually ignore the issue of a possible relationship between fluoride exposure and the lowering of IQ in children (see point 6 below) as well as fluoride's impact on the thyroid and other parts of the endocrine system. These issues were extensively covered in the NRC (2006) report which they chose to ignore.

          1. The NHMRC's questionable downplaying of the Bassin osteosarcoma study.

          The NHMRC downplayed the important finding by Dr. Elise Bassin that young boys exposed to fluoridated water between their 6th and 8th years had a 5 to 7-fold increased risk of succumbing to osteosarcoma by the age of 20 using a "letter." So here we have a panel being extremely particular about what papers qualify for their analyses, but are willing to downplay a well conducted case-control study using a yet to be published study promised in a letter! Moreover, just in case people don't read the full text of the NHMRC review, the authors use exactly the same device and verbage in their Executive Summary.

          Worse, the letter they use comes from none other than Professor Chester Douglass whose position on this whole matter is highly suspect. First, he is a co-author of a previous report which expressed concerns that a positive finding on osteosarcoma could threaten the fluoridation program (JADA 122:39-45, April 1991); second he has received government funding of over $1 million for his research on osteosarcoma and yet has published virtually nothing on the subject for over 18 years; third he is a consultant for Colgate, a manufacturer of fluoridated dental products and fourth he concealed Bassin's work from his peers, the public, the NRC panel and his funders for the three years between the successful defense of her thesis and its discovery in the rare books section of a Harvard library. Moreover, the Douglass study which is supposed to rebut Bassin's work - promised for the Summer of 2006 - has yet to appear in print. More significantly, the methodology Douglass has used is unlikely to challenge her finding since he is comparing osteosarcoma rates with bone levels of fluoride. As these levels are taken after the cases have been identified they give only a cumulative measure of fluoride exposure: i.e. these bone concentrations give no information on what levels of exposure the victims had to fluoride between the critical 6th to 8th years.

          1. The NHMRC's failure to adequately cover the most recent literature indicating health problems, especially the studies relating fluoride exposure to the lowering of IQ in children.

          In the small section in the NHMRC report which reviews other harms from fluoridation (pp 105-110), one of the York Review tables identified two IQ studies (Lin et al., 1991 and Zhao et al., 1996). However, the NHMRC search appears to have found no more. This is strange since had they actually read the NRC (2006) review, rather than dismissing its relevance, they would have found a whole chapter devoted to the brain, and in this they would have found three more IQ studies: Li et al., 1995; Lu et al., 2000; Xiang et al., 2003.

          To make matters even worse, the NHMRC panel handled one of the two studies they do cite in a critically misleading fashion. They state:

             "Lin (1991) found a significant association of combined low iodine and high fluoride with goiter and mental retardation." (my emphasis).

          However, the level of fluoride in this study was not high at all, it was 0.88 ppm - i.e. less than 1 ppm! So not only did the NHMRC authors not take advantage of the research in the NRC (2006) review, which revealed the three extra IQ studies, but they haven't even read (or poorly read) one of the two IQ studies they actually do cite!

          It should also be pointed out that the single sentence I have quoted above is the only reference they make to the fact that fluoride might damage the brain!

          They state in their methodology that they only reviewed the literature in English published between 1996 and December 2006 so that gives them a possible excuse for ignoring the following studies: Seraj et al, 2006 (only the abstract was in English, the rest was in Persian); Trivedi, 2007; and Wang, et al., 2007. Even if they missed the chapter on the brain in the NRC (2006) report they should have been tipped off that this was an issue by the study by Zhao et al, 1996 (cited by the York Review) and listed in a table they reproduce. This study was published in the journal Fluoride. Serious researchers would have searched the archives of this journal - which are readily available on the internet - to see if this journal had published any more IQ studies since 1996 - and they have. They could also have found references to many of these studies had they bothered to visit our website. Under Health Studies, FAN has a whole section on fluoride and the brain - and it has been there for several years.

          To have missed so much in the literature - and all the clues that it was there - would have been bad if we were talking about a term paper written by an undergraduate, but for a body on which a whole country is relying for health advice this is extremely shoddy research. But the more serious question is whether the handling of this issue by the NHMRC was a product of academic incompetence or a deliberate attempt to mislead the public. Which is easier to believe?

          However, whatever excuses people care to make to explain the NHMRC panel on this matter, this ignorance should go no further. Those who glibly cite this NHMRC review as an authority on fluoridation's safety should be warned that there are now TWENTY THREE published studies which indicate that fluoride lowers IQ in children and these have been subjected to two systematic reviews, Connett and Limeback (2008) and Tang et al. (2008).

          Nor does the matter end there. There are other Chinese studies which show that fluoride damages the fetal brain, as well as altering behavior of neonates and workers in the aluminum industry. Moreover, 12 Chinese studies on the brain (11 newly translated) have been reproduced in the journal FLUORIDE, so there is no excuse for government fluoridation promoters to continue to ignore this large body of Chinese work. In a future bulletin we will give a full citation list for all these studies on the brain, along with links where the full papers can be accessed.

          Meanwhile, this NHMRC (2007) review is still being cited by fluoridation promoters in Canada (Dr. Peter Cooney, Chief Dental Officer), the UK (Dr. Barry Cockcroft, Chief Dental Officer) and the US (Dr. William Bailey at the CDC' Oral Health Division) as evidence that fluoridation is "safe." They will doubtless continue to do so, despite what I have written above, because, sadly like health authorities in Australia their agenda is to promote water fluoridation whatever the cost to public health.

          by Paul Connett, PhD, Executive Director, Fluoride Action Network

          Fluoridation 101 News Releases

          by nyscof on Sat Mar 14, 2009 at 08:26:27 AM PDT

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