An extraordinary press release from Fluoride Free NZ highlights the inconsistency of the group’s position on science – and then attempts to re-write local history.

The release this week cites the new data from the highly-respected Dunedin longitudinal study showing that exposure to lead in the ‘70s reduced children’s IQ by about 4 points.

The lobby group’s release attempts to compare the danger of lead to exposure to water fluoridation – yet the group has repeatedly rejected the same Dunedin study’s finding that water fluoridation has no effect on IQ and in fact improves lives by reducing the burden of tooth decay.

“It’s ridiculous that FFNZ is trying to have it both ways,” says Making Sense of Fluoride president Daniel Ryan. “You can’t accept the results you like from a study and then turn around and dismiss the ones you don’t, especially when the data is from the same source.”

The dangers of lead poisoning have been known since the 19th century, though lead was slow to be recognised as a hazardous fuel additive. The FFNZ release goes on to make a further remarkable claim: that the Royal Society of NZ supported opposition to lead’s removal from petrol – when in fact, the Society commissioned its own study and in 1986, recommended removing all lead from gasoline (which occurred in 1996).

“Perhaps FFNZ has made this claim because they’ve never accepted the Royal Society’s 2014 review finding that fluoridation is safe and effective,” says Mr Ryan. “Once again, they are misrepresenting data and even history to support their opposition to fluoridation. It’s time they faced reality.”

For more information please contact:

Dr Ken Perrott, Science adviser, MSoF

[email protected]

Daniel Ryan, President, MSoF

[email protected]

The post Fluoride Free NZ makes astonishing claim appeared first on Making Sense of Fluoride.

Two more rulings released today find Fluoride Free New Zealand is not a reliable source of information – and MSoF president Daniel Ryan is urging Whakatane District Councillors to pay
attention to the rulings when they revisit the issue of fluoridation tomorrow.

The decisions by the Advertising Standards Authority relate to an information leaflet distributed by fluoridation opponents during November’s referendum in Thames and to their newspaper advertising at the time.

The leaflet made a number of claims such as ‘fluoride is harmful to health’ and ‘fluoridation does not reduce dental decay’, which the ASA found to be misleading and alarmist, while parts of the newspaper ads were found to unjustifiably play on consumers’ fears.

‘Fluoride Free NZ has no qualms about spreading false information,’ says Ryan. ‘This is just the latest in an ongoing series of successful complaints against FFNZ which in fact currently ranks as the 12th worst organisation in NZ for successfully upheld or settled ASA complaints; quite an achievement when taking into account the small scale of their advertising.’

Ryan says it’s disturbing that before voting narrowly in late January to remove fluoridation in the Whakatane District Council water supply, one of only four parties invited to address the council was FFNZ.

‘FFNZ is simply not a reliable source. The Advertising Standards Authority is a neutral body and it has demonstrated that you don’t need to be a scientist to see when a statement is an opinion rather than a fact.’

‘It appears some of the councillors take FFNZ’s information at face value,’ Ryan adds. ‘To be fair, opponents are slick at making their information look convincing which makes it challenging for councillors. It’s why we and so many other public health advocates keep calling on central government to give responsibility for fluoridation to the Ministry of Health.’

Meanwhile, MSoF calls on Whakatane District Councillors to be mindful of today’s ASA decisions, along with the overwhelming scientific consensus on the safety and effectiveness of fluoridation, when they meet to reconsider their decision tomorrow.

Full ASA decisions:
http://msof.nz/wp-content/uploads/ASA-complaint-15470.pdf
http://www.asa.co.nz//backend/documents/2016/02/10/15503.pdf

For more information please contact:

Dr Ken Perrott
Science advertiser, MSoF
[email protected]

Daniel Ryan
President, MSoF
[email protected]

The post More Strikes Against the Credibility of Fluoride Free NZ as Whakatane Councillors reconsider their decision appeared first on Making Sense of Fluoride.

When Thames Coromandel District Council began to review fluoridation back in 2012, I assumed it was prompted by new information. Yet when I examined the alarming claims, not a single one stacked up. I became quite annoyed with the avid misrepresentation of a such a significant public health programme, so similar to the anti-vaccine lobby.

Fast forward 2 years through local public hearings where continuing fluoridation (in the Thames water supply since 1971) was twice upheld, to the dismay of committed opponents. But with at least a couple of councillors on their side, they kept unrelenting pressure on the council and almost a year ago, the mayor in particular appeared to throw up his hands in exasperation. And so a referendum was ordered for 2015, a stand-alone single issue postal ballot, usually the perfect vehicle for passionate campaigners to achieve their aim. And let’s be honest, among the general public, only the opponents are passionate about fluoridation. It wasn’t looking good.

Our small voluntary group of not-passionate-but-peeved fluoridation supporters (with a couple of health promoters added later) knew the antis would be tireless and highly visible. Fluoride Free NZ targeted Thames hard, with everything from free film nights to glossy magazines and with deep pockets for local advertising.

We worked hard too to maximise our limited resources using some advertising, social media and personal networking. With a significant ‘worried middle class’ as well as a thriving alternative community in Thames, we were far from overconfident. We also knew that while even a slight majority was enough to win, it wouldn’t be enough to stop the opponents.

Once balloting began, the TCDC website posted a vote tracking tool that showed how many ballots were returned each day. Predictably, the highest number was received early in the 3 week voting period, which had Labour weekend in the middle. I fretted in the closing days as the number of votes coming in gained momentum, rather than reducing to the trickle I expected.

Click to enlarge

It appears however, that during this time, our messages were not only sinking in, they were galvanizing voters, aided no doubt by the visible zealotry of the opposition foot soldiers.

We made a point of reminding the community the referendum was unnecessary because the antis had already had a fair go with 2 hearings. We had strong, unified support from the Children’s Commissioner, local identities, health professionals – including the crucial iwi-based health provider – and all Thames dentists. We had a powerful local story to tell in that Thames children barely feature in the 150 cases treated last year for severe tooth decay at Thames Hospital under general anaesthesia (only 8 from Thames addresses). And of course there is also the overwhelming scientific consensus.

The campaign felt very long, receiving a boost in its final hours from an Advertising Standards Authority ruling that the ‘toxic’ signs were misleading and scaremongering.
The entire town probably never wants to hear the word fluoridation again. And thanks to the resounding and highly gratifying results of the referendum, they won’t have to – and can just get on with reaping the benefits.

(Final results: 73% of voters supported continuing fluoridation with 57% of eligible voters casting a ballot.)

 

The post The Thames Referendum Experience appeared first on Making Sense of Fluoride.

The website looks at all ASA complaints made since 2008. You can see the top complainants, most complained about companies, complaints by product and complaints by media, amongst other statistics.

Fluoride Free New Zealand (FFNZ) aka Fluoride Action Network NZ is ranked 13th in organisations having the most successful complaints made against them, with 8 successful (upheld or settled) complaints. These successful complaints make up 73% of all complaints made against FFNZ and puts them just below Jetstar (12th) and above Air New Zealand (14th). Given how few adverts Fluoride Free NZ have released compared to the likes of Jetstar and Air NZ, it is disappointing to see that so many were found by the ASA to be infringing.

In total 1,013 companies in NZ have had successful ASA complaints made against them.

Mark Atkin, who was the science and legal advisor for FFNZ, has made four complaints against the Ministry of Health, Waikato District Health Board and Fluoridate Our Water – and every complaint he made was rejected by the ASA.

The post Fluoride Free NZ ranks 13th worst NZ organisation by ASA complaints appeared first on Making Sense of Fluoride.

Teresa Goodin, a First Light Flower Essence practitioner, presented a submission on fluoridation at New Plymouth Council’s 3rd June Council Meeting. She was talking on behalf of Stan Litras from the Fluoride Information Network for Dentists (FIND) and represented Fluoride Free NZ and Fluoride Free Taranaki. This is the second discussion on the meeting, the first being “Health experts talk about fluoridation“.

Here I address some of the points she made about water fluoridation, and correct the misinformation and the confusion she presented on this issue.

What fluoride is in the water?

Drinking water contains only fluoride ions. It doesn’t matter what the source of the fluoride is, as added chemicals like fluorosilicates hydrolyse on dilution and end up exactly like naturally occurring fluoride ions that are already present in the water supply. Natural calcium fluoride doesn’t exist in drinking water, as it dissociates into calcium and fluoride ions when it dissolves. Adding Hydrofluorosilicic acid (HFA) into the water supply is just a method of adjusting these levels of fluoride.

Nobel Prize winners

Teresa claimed ’14 Nobel prize winners object to fluoridation’, which, while superficially impressive, is really just an argument from authority and a fairly trivial figure. Most of those listed people are dead, so it’s difficult to gain personal confirmation of their stance. There is also no differentiation made between the number of the 14 who had some reservations about fluoridation, and those who were opposed. There have been many hundreds of Nobel Prize winners. The only reliable inference that can be made from the data of Nobel Prize winners’ opinions is that many of them supported fluoridation or had no firm viewpoint.

See “Nobel Prize winners and fluoridation” blog article for more information.

US lowering fluoride levels

The US has recently lowered their recommendation of the amount of fluoride that is ideal in water to 0.7ppm – this is to reduce levels of mild fluorosis. The decision was not an admission of harm being caused by higher levels of fluoride. “Mild” and “very mild” fluorosis have no effect on the appearance, form or function of teeth. In fact, it has been demonstrated that mildly fluorosed teeth are more resistant to decay.

The 2009 New Zealand Oral health Survey found very little difference in fluorosis between fluoridated and non-fluoridated areas. Any increase in fluorosis due to Community Water Fluoridation (CWF) would be in this “very mild” to “mild” fluorosis range.

Thousands to repair fluorosis?

While it may cost thousands of dollars to repair severe fluorosis, we do not see this kind of fluorosis at optimal levels of fluoride. If one wanted to reduce mild fluorosis, even though it is the kind of effect that most likely only dentists would notice, it is a relatively cheap and easy procedure.

IQ

The best study in the world on IQ and fluoride, when ingested in NZ’s recommended range of fluoridation, shows no effect of fluoride on IQ.

The studies brought up by Teresa are mainly found published in obscure Chinese scientific journals. China’s water is not artificially fluoridated, and the studies in question involved well water with high levels of naturally occurring fluoride – levels far above the recommended level of 0.7ppm.

See “Myth-busting fluoridation and IQ” article for more information.

Other countries don’t do it

Teresa claimed that some countries don’t artificially fluoridate their water supplies. It could equally be stated that 1.1 billion people do not have access to an improved source of drinking water, while another 2.6 billion lack basic sanitation.

Just because some countries don’t utilise certain public health measures, this doesn’t mean that other countries shouldn’t. However, 377.7 million people in 25 counties have access to artificially fluoridated water supplies, and a further 57.4 million people in 28 countries have naturally fluoridated water supplies that are already at the optimal level. This is no small number.

Countries such as Jamaica, Costa Rica, Mexico, Uruguay, Colombia, Switzerland, France and Germany use salt fluoridation as an alternative to water fluoridation. A number of these countries make sure that this salt gets added to school meals and baked into commercial breads.

Countries such as Bulgaria, Thailand and Chile use milk fluoridation, with 800,000 children in five countries participating in milk fluoridation programs.

Israel is already looking into reinstating fluoridation, after only a year of having removed it from their water supply, to reduce the harm to children.

See “‘Other countries don’t do it’ excuse” blog article for more information.

Referenda are not the way to determine health policy

This point myself and many others would agree with – that councils, instead of using a referendum, should listen to both the experts in the field and their own local health boards on this matter.

US cities have removed fluoride

There have been cities in the USA that have removed fluoride, but to say that is to ignore half of the story – the number of people receiving fluoridated water in the USA has actually increased. The US Department of Health and Human Services’ (HHS) Healthy People 2020 initiative has set a goal of serving eighty percent of Americans with community water systems with optimally fluoridated water by 2020.

Fluoridated areas have more cavities?

One can’t use raw data when comparing fluoridated to non-fluoridated areas. Instead, one must look at the entirety of peer-reviewed papers to come to the best conclusion possible, even better if systematic reviews are used. For example:

The Water fluoridation Health monitoring report for England in 2014 reported: “In fluoridated areas there are 45% fewer hospital admissions of children aged one to four for dental caries (mostly for extraction of decayed teeth under a general anaesthetic) than in non-fluoridated areas.”

Health effects of water fluoridation: A review of the scientific evidence concluded: “A large number of studies and systematic reviews have concluded that water fluoridation is an effective preventive measure against tooth decay that reaches all segments of the population, and is particularly beneficial to those most in need of improved oral health.”

Water fluoridation for the prevention of dental caries key results showed: “Data suggest that the introduction of water fluoridation resulted in a 35% reduction in decayed, missing or filled baby teeth and a 26% reduction in decayed, missing or filled permanent teeth. It also increased the percentage of children with no decay by 15%.”

Effectiveness of Fluoride in Preventing Caries in Adults concluded in the abstract: “The prevented fraction for water fluoridation was 27% (95%CI: 19%–34%). These findings suggest that fluoride prevents caries among adults of all ages.”

The post Selling fluoride misinformation to council members appeared first on Making Sense of Fluoride.

They will speak at meetings organised by Fluoride Free NZ (FFNZ) – a local activist group affiliated to FAN – in Thames (Tuesday 24th February) and Taupo (Wednesday 25th February).

FFNZ will also promote these meetings, and their anti-fluoride message, via media releases and media interviews with Drs. Connett and Hirzy while they are in New Zealand.

Making Sense of Fluoride (MSoF) provides the following background information for news media covering this visit.

Background information on speakers and organisations.

1: FAN is the main U.S. based activist group and is very active in promoting an anti-fluoride message within the US and internationally. It is affiliated internationally to anti-fluoride groups throughout the world, including in Australia and New Zealand.

FAN is organisationally linked to the “natural” health/alternative medicine industry and the anti-vaccination movement through Mercola LLC’s Health Liberty Coalition. It is, at least in part, funded by the “natural’ health industry through the Mercola LLC company. This company also helps fund the anti-vaccination movement.

Mercola LLC reportedly brought in about $7 million in 2010, and has received three warning letters from the U.S. Food and Drug Administration for violations of U.S. marketing laws, two of which charged Mercola with making false and misleading claims regarding the marketing of several natural supplemental products, which violated the Federal Food Drug and Cosmetic Act.

FAN promotes its anti-fluoride message through media links to “natural” health/alternative medicine publications and websites and general press releases and articles via its network. It is also very active in reviewing and misinterpreting scientific publications

2: Speaker details:

A: Dr. Paul Connett has a PhD in chemistry. Now retired, he previously worked as a lecturer at St. Lawrence University, USA.

Although presented by his organisation and its local affiliates as “the world expert on fluoridation,” Dr. Connett has no research background in fluoride or fluoridation. His book, articles and presentations are based on his own interpretation (or misinterpretation) of the scientific work of others as presented in the scientific literature. (For example, in 2005 Professor John Spencer of Adelaide University said, “Dr. Connett misrepresents (my) study as an analysis of the benefits of water fluoridation, which it was not.  He also misinterprets the study’s indirect evidence on the benefits of water fluoridation on decay.”). He uses these misinterpretations to provide apparent authority to his anti-fluoride message.

Dr. Connett’s only relevant publications in peer-reviewed scientific journals are two letters to the editor and one, as junior author, of a review paper. The senior author of that paper, Anna Strunecká, is an Advisory Board member of FAN.

B: Dr.William Hirzy has a PhD in chemistry. Now retired, he formerly worked as a union official in the US Environmental Protection Agency (EPA)?

Dr. Hirzy has made statements and submission on fluoride and fluoridation in his role as a union leader. Unfortunately these are often disingenuously presented as representing the EPA and its scientific staff. They do not.

Hirzy’s only publications on fluoride or fluoridation in peer-reviewed scientific journals are two from 2013. The first argued that it is cost-effective to replace fluorosilicic acid as a fluoridating agent with sodium fluoride. The second paper effectively withdrew the conclusions of the first – admitting to a simple arithmetic error producing a 70-fold error in calculated costs which lead to a reversal of his conclusions.

3: Tactics of anti-fluoride activists.

Activist organisations like FAN and FFNZ target local body councils with campaigns to halt community water fluoridation or prevent its introduction using mass submission campaigns with templates provided by organisers. Submissions usually contain cherry-picked and misrepresented scientific citations which can impress and influence councillors who have little scientific background.

These organisations target newspapers with letter writing campaigns which usually attempt to discredit scientific and health organisations and experts.

Dr Paul Connett has made annual summer visits to New Zealand as part of these campaigns.

4: MSoF and contacts for comment

“Making Sense of Fluoride” is an incorporated society, whose main aim is to counter much of the misinformation on the internet and printed media related to community water fluoridation. We are a combination of students, academics and medical professionals advocating that this significant public health initiative be maintained in Australasia given the longstanding scientific consensus on its safety and efficacy.

For comments on the visit of Drs. Connett and Hirzy contact:

Dr. Ken Perrott

Email: [email protected]

5: On-line resources

Review by Royal Society of NZ and the Office of the Prime Minister’s Chief Science Advisor – Health Effects of Water Fluoridation: a Review of the Scientific Evidence

NZ Community Water Fluoridation is Safe and Effective: A critique of Fluoride Free NZ’s criticisms of the NZ Fluoridation Review by Dr Ken Perrott

The Fluoride Debate – Paul Connett and Ken Perrott

Jason M Armfield “When public action undermines public health: a critical examination of antifluoridationist literature“

The post Press release: facts on Fluoride Action Network’s visit to NZ appeared first on Making Sense of Fluoride.

Personally, I see this choice of words disgusting and sounds like they have no idea on the traumatic effects.

Edit: The original comment from the Fluoride Free group has now been quietly deleted.

The post Fluoride Free NZ Hamilton Coordinator posts “fluoride is rape” appeared first on Making Sense of Fluoride.

While the NZOHS said “it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be considered a fluoridation study as such”; the anti-fluoridationists like to repeat this and say that this is an invalid study for fluoridation. This is far from the truth; the statement was taken in the context that the NZOHS did not take into consideration lifetime fluoride exposure, as it was a cross-sectional study. People moving from non-fluoridated to fluoridated areas would have been likely as well as the opposite. This would tend to increase the risk of underestimating the extent of the benefits from fluoridation.

The full ASA complaint from M. Atkin who was listed as the “Science and Legal Advisor” for FFNZ.

The post Attacks continue on the “40% less tooth decay” statement appeared first on Making Sense of Fluoride.

Rita’s original paper here. My first response here. Rita’s first response here.

You can read the PDF version here.

Compulsory Water Fluoridation: Second Response To Rita Barnett-rose

Written by Daniel Ryan

Introduction

This is my second response to Associate Professor Rita Barnett-Rose to her paper “Compulsory water fluoridation: justifiable public health benefit or human experimental research without informed consent”. It is a response to her document “RE: CWF Working Paper Article” (hereafter referred to as “Rita’s reply.”). I wish to thank Rita for acknowledging in that papers should be referenced accurately by using citations to the original sources rather than simply referencing activist sources. I am also pleased she is getting experts to review the science in her paper and am interested to know who the independent reviewers are.

In this response I have collected a number of comments to consider under separate headings.

Objectively looking at the science.

Rita’s reply:

“…you object to my failure to include contrary studies that reaffirm the (English speaking countries’) public health agencies’/dental lobby positions on the safety and benefits of compulsory water fluoridation.”

“…with respect to your complaint or desire that I cite to contrary (i.e., pro-fluoridation) studies in addition to (or in lieu of) the published studies that I cite that tend to weigh against fluoridation”

“It is not meant to be an exhaustive examination of all studies on fluoridation and is specifically and accurately identified for what it is”

“…you are just as guilty of ‘cherry picking’ your sources and your studies as you suggest I am.”

“I am not interested in a battle of the studies debate”

“These reasons would remain even if compulsory water fluoridation were proven to be entirely safe, which it most definitely has not, despite the presumed “majority” view in the English speaking countries”

My reply:

Rita implies I only use ‘pro-fluoridation’ or ‘English speaking countries’ papers. This is incorrect – I cite papers which provide the best weight in regards to evidence. Science doesn’t take sides (good papers are neither “anti-fluoridation” nor “pro-fluoridation”, they present data and reasoning) and these are international. To clarify, my issue is not that Barnett-Rose (2014) was not using ‘pro-fluoridation’ papers, it was the quality of the studies themselves. Reviewers of the science should attempt to understand and evaluate the quality of the research.

I also look at the quality of journal. And I try to cite papers which are in high quality journals more as those journals attract the best scientific papers. Journals use a metric called “impact factor” that basically states how many times an average paper is cited by other papers. It is an independent, objective method to judge the quality of published research.

The hierarchy of scientific evidence in the literature is also important I illustrate this in the image below.

Secondary reviews published in peer-reviewed, high-impact journals and high quality randomised controlled trials with definitive results should be the preferred sources. For consideration of human health effects I consider that animal studies would be placed above “expert opinion” in this hierarchy.

Overall one needs to approach the literature intelligently and critically – considering the evidence provided in the individual papers and also considering other published material.

Instead I saw that Barnett-Rose (2014) did not evaluate the evidence well, only selecting evidence of harm in order to persuade the audience to accept her position. There is no reason to use low validity papers when there is plenty of high quality papers but unfortunately this happens when trying to “price” a preconceived idea.

An example of this is Barnett-Rose (2014) used an opinion article from the Scientific American many times as her source. This is not a scientific paper, it is not peer-reviewed or in a research journal; furthermore the writer is not a scientist and definitely not an expert on the subject. This type of evidence would come below “expert opinion” on the image above. I hope such problems would be given as feedback from the independent reviewers.

Rita accuses me of cherry picking but fails to back this up. I do try to use only the best sources of evidence – usually systematic reviews. A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question.

The evidence shows

Rita’s reply:

“However, what I do believe is that the burden of proving safety and effectiveness lies with the pro-fluoridation side”

“It also appears to me that the pro-fluoridation side is playing “whack a mole” with the studies weighing against CWF – often trying to hammer down/marginalize the opposition each time a negative study pops up, rather than trying to consider the evidence objectively.”

“However, to me, if even one strong study exists, then the entire compulsory practice must be re-evaluated.”

My Reply:

The scientific consensus is that fluoridation works, it is safe and it is cost effective. We have evolved with fluoride and had it adjusted in our water for over 60 years in some countries. Developed countries where natural fluoride levels are low but choose not to use community water fluoridation (CWF) generally use other methods such as milk and salt fluoridation, which again are both safe and effective, or have very effective public health and dental systems. Over 5,500 papers have been systematically reviewed and no consistent association between fluoridation and illness has been found that has been confirmed through later research.

Using the latest evidence: Public Health England just released their water fluoridation review this month – “Water fluoridation Health monitoring report for England 2014” and it concluded:

“This monitoring report provides evidence of lower dental caries rates in children living in fluoridated compared to non-fluoridated areas. Similarly, infant dental admission rates were substantially lower. There was no evidence of higher rates of the non-dental health indicators studied in fluoridated areas compared to non-fluoridated areas. Although the lower rates of kidney stones and bladder cancer found in fluoridated areas are of interest, the population-based, observational design of this report does not allow conclusions to be drawn regarding any causative or protective role of fluoride; similarly, the absence of any associations does not provide definitive evidence for a lack of a relationship.”

Last month a review “Health effects of water fluoridation: A review of the scientific evidence” written on behalf of the Royal Society of New Zealand and the Office of the NZ Prime Minister’s Chief Science Advisor concluded:

“Councils with established CWF schemes in New Zealand can be confident that their continuation does not pose risks to public health, and promotes improved oral health in their communities, reducing health inequalities and saving on lifetime dental care costs for their citizens. Councils where CWF is not currently undertaken can confidently consider this as an appropriate public health measure, particularly those where the prevalence and severity of dental caries is high. A forthcoming study from the Ministry of Health is expected to provide further advice on how large a community needs to be before CWF is cost-effective (current indications point to all communities of 1000+ people).

It is recommended that a review such as this one is repeated or updated every 10 years – or earlier if a large well-designed study is published that appears likely to have shifted the balance of health benefit vs health risk.”

Looking at the many other systematic reviews you will find a similar pattern. CWF is shown to be safe and effective. So the “burden of proof” really is on those claiming evidence of harm. They need to produce well supported and peer-reviewed studies which back up their claims.

If there is a strong evidence for health risks of fluoridation then I totally agree with Rita that it needs to be re-evaluated. Every year many studies are written on fluoridation and continued monitoring of the scientific findings occurs in many countries with the precautionary principle of being alert to any possible negative effects.

Health organisations

Rita’s reply:

“Please also note that any and all of your cites to the ADA lobby, or to the CDC (which, though its oral health division, works hand in hand with the ADA promoting fluoridation and thus has a serious conflict of interest/credibility problem) are unpersuasive to me – as they should be to anyone conducting even a minimum level of research into the history of and politics behind fluoridation (some of which is chronicled in my article, including the story of the EPA’s NTEU battle).”

“it does not take long to discover how politically motivated many “public health agencies” and “professional dental associations” are — or how willing they are to obscure, minimize, or bury contrary evidence or to marginalize the anti-fluoridation messengers, regardless of the evidence or the credentials of those messengers (e.g., Waldbott, Taylor, Marcus, Mullenix, Bassin, Hirzy).”

My reply:

I think Rita is placing her own bias on these judgments. One could equally say: “It does not take long to discover how politically motivated Dr Paul Connett and FAN are — or how willing they are to obscure, misinform, or bury contrary evidence or to marginalise the pro-science messengers, regardless of the evidence or the credentials of those messengers.”

If Rita has a specific problem with the CDC or the ADA, I can use some of the many other hundreds of health organisations around the world. They all have similar conclusions about fluoridation. As I said in my first response, there is not one reputable health organisation that is against fluoridation. We already have Dr Paul Connett suggesting a massive conspiracy, I hope you do not agree with his accusations as this is generally the last resort for people who cannot find reasonable faults in the evidence but still refuse to believe it.

NRC Report

Rita’s reply:

“However, I believe that its review of fluoride toxicology is highly relevant to exposures from fluoridated water (and its exposure data itself suggests that some people drinking fluoridated water can, indeed, receive doses that can cause adverse health effects, including severe dental fluorosis and bone fractures).”

“In addition, in a number of health risk areas, the NRC panel concluded that there was not enough data, and/or that more research needed to be conducted, before definitive statements could be made with respect to other potential adverse health effects due to excess exposure to fluoride.”

My reply:

I will not repeat what I said in my earlier reply. The review itself said that it was not relevant to exposures to concentrations used for fluoridated water and to say it is “highly relevant” is spreading misinformation. The NRC report furthered shows the safety of fluoridation. As for the “more research needed”, that is always the case with science. That is why responsible public health agencies continue to monitor research findings.

Ethics

Rita’s reply:

“I would genuinely be interested in knowing why you feel so strongly that imposing this practice on everyone is ethically justifiable.”

“Thus, I am very curious as to why there appears to be such an aggressive campaign on the pro fluoridation side to impose this practice on the world – and why anyone believes that personal liberties and rights to bodily integrity should be sacrificed for a public health practice addressing a non-contagious disease.”

“I would also be interested in understanding where you personally believe compulsory public health practices should begin and end (e.g., do you believe governments should mandate compulsory flu shots? What about the HPV vaccine that the Governor of Texas tried to mandate for girls? Where should the personal right to bodily integrity begin and end, in your opinion? And how comfortable are you with public health officials mandating what is good for you?…)”

My reply:

I don’t see how you conclude that I “feel so strongly that imposing this practice on everyone”. I, myself, could say I am strongly against misinformation. The MSoF society is here to help explain what the actual scientific evidence shows to the public, not to advocate for CWF at any cost. It is up to the communities if they want to use CWF and we, the MSoF Society, support their democratic right to decide.

But regarding ethical aspects, you might be interested in what the Nuffield Council on Bioethics decided. It:

• Rejected the prohibition of water fluoridation based on the argument of mass medication and restricting personal rights.
• Affirmed that water fluoridation should be accepted based on the quantified risks and benefits, the potential alternatives, and, where there are harms, the role of consent.

They also used a ‘stewardship mode’ to analyse the acceptable degree of state intervention to improve population health, concluding that water fluoridation can be justified based on its contribution to the goals of stewardship: the reduction of health inequalities, the reduction of ill health, and the concern for children, who represent a vulnerable group.

The New Zealand High court this year ruled that fluoridation of the water supply:

• is not a medical treatment,
• does not violate the right to refuse medicine,
• is not in breach of the Bill of Rights,

And that

• the Council was thoughtful and responsible in making their decision to begin fluoridation, and had no obligation to consider “controversial factual issues” (anti-fluoride propaganda).

You could say there is an aggressive campaign on both sides, but people are pushing for fluoridation simply because it works – reducing up to 40% of caries over a whole population.

Dental caries is a serious chronic disease, it makes no difference if it is contagious or not. The Royal Society Review pointed out that

“…tooth decay (dental caries) remains the single most common chronic disease among New Zealanders of all ages, with consequences including pain, infection, impaired chewing ability, tooth loss, compromised appearance, and absence from work or school. Tooth decay is an irreversible disease; if untreated it is cumulative through the lifespan, such that individuals who are adversely affected early in life tend to have pervasive decay by adulthood, and are likely to suffer extensive tooth loss later in life. Prevention of tooth decay is essential from very early childhood through to old age”.

The Royal Society Review also suggested that removing fluoridation would have direct and indirect costs to society.

“Tooth decay is responsible for significant health loss (lost years of healthy life) in New Zealand. The ‘burden’ of the disease – its ‘cost’ in terms of lost years of healthy life – is equivalent to 3/4 that of prostate cancer, and 2/5 that of breast cancer in New Zealand. Tooth decay thus has substantial direct and indirect costs to society.”

I am all for protecting the vulnerable. If individuals do not consent, they can simply choose not to partake of the community water supply (bottled water, filters, rain water, etc.). I feel this is starting to head slightly off-topic but to answer your question, if the vaccine given out is safe and effective for the general public then I have no problems with compulsory shots for children. While choice is nice thing to have, you cannot always get it, especially if it is going to lower the quality of life in children.

The New Zealand High court summarised some ethical aspects in the decision I referred to above:

“Provided it does not have consequences for public health a person has the right to make even the poorest decisions in respect of their own health. But where the state, either directly or through local government, employs public health interventions, the right is not engaged. Were it otherwise, the individual’s right to refuse would become the individual’s right to decide outcomes for others. It would give any person a right of veto over public health measures which it is not only the right but often the responsibility of local authorities to deliver.”

The World Health Organization

Rita’s reply:

“Data published by the WHO suggests that the decline in dental caries is similar in both fluoridated and unfluoridated countries, and I have heard of no massive outbreak of a worldwide dental carie epidemic that has been attributed to a lack of fluoridated water (rather than to poverty, poor nutrition, or a lack of access to proper dental care).”

My reply:

Petersen & Lennon (2004), a WHO funded study showed dental caries remain a major public health concern, affecting 60–90% of schoolchildren and the vast majority of adults. While fluoride is not a silver bullet, it is just part of the problem, it should not be ignored when it can clearly help very effectively. Their study goes into a number of suggestions for alleviating tooth decay, one being fluoridation.

“Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages particularly for subgroups at high risk of caries. Alternatively, fluoridated salt, which retains consumer choice, can also be recommended. WHO is currently in the process of developing guidelines for milk fluoridation programs, based on experiences from community trials carried out in both developed and developing countries.”

As for the similar DMFT decline between fluoridated and unfluoridated countries Rita claims this needs to be considered critically. Fluoride occurs naturally everywhere and it is very hard to compare one country to others because of the many other contributing factors such as; history, culture, ethnic differences, as well as differences in health services, dental practice and assessments. The graphical evidence FAN promotes on their website and elsewhere they do not account for naturally occurring fluoride or other programs (fluoride vanish, mouth rinse programs, etc.) and different history and social practices. Their graphs also use only 2 data points for each country. There is no consideration of also changing fluoridation amounts over time and their graph is very confusing. It does not enable proper consideration of different DMFT declines in different countries. The stats show Denmark having the lowest DMFT and FAN marked them as not fluoridated, but they actually have high levels of naturally occurring fluoride.

If you look at the WHO data in more detail (graph left does this for the Irish Republic using the same WHO data) you will find that fluoridated areas show faster declines in DMFT than unfluoridated areas.

Making Sense of Fluoride

Rita’s reply:

“…you complain about FAN not being a legitimate source of credible scientific information, but your organization is also a political advocacy (pro-fluoridation) group”

“I urge you to conduct such a battle with a more appropriate sparring partner, such as FAN-NZ.”

My reply:

Like yourself, I am not a scientist – I am a software developer; my responses get checked by scientists but I would always look into the evidence in scientific studies. I avoid political or activist organisations (legitimate or not). The Making Sense of Fluoride society is not a pro-fluoridation group, we are a pro-science group. We will go with what the scientific consensus says and will spread warnings, if for example: sometime in the future, CWF was really found to be harmful.

The objectives of the MSoF incorporated society are:

1. To foster awareness and dispel misinformation regarding fluoride with a focus on CWF.
2. Use the scientific method as the foundational platform upon which this awareness is promoted.

FANNZ, now known as Fluoride Free NZ (and a close partner of FAN), will always be anti-fluoride no matter what the evidence shows. For that reason it is usually not fruitful debating them. Their incorporated society main purposes make clear their opposition to CWF irrespective of the science:

1. To bring about the permanent end to public water fluoridation (“fluoridation”) in New Zealand.
2. To provide resources, both personal and material, to others opposing fluoridation in New Zealand.
3. To provide a central contact point for those opposing fluoridation in New Zealand.

Apology

Rita’s reply:

“This statement about “mounting scientific evidence” at the start of my paper (near fn. 2) actually references an entire section of my article – (“See discussion infra Sec. II-B”) — and not an opinion piece by Colquhoun, which is only referenced – appropriately – at footnote 65 (referring to “formerly avid fluoride proponents” who have changed their minds). I have no desire to engage with insincere zealots, so I hope that you simply made a mistake there.”

My reply:

I apologise for mistaking you and any offense it may have caused you. It was clearly a simple mistake that anyone could have made and I had no intention to twist your words.

Wrapping up

Rita’s reply:

“After this exchange, however, I am only interested in a private discussion with you, which is something you may not be interested in as it may not advance your organization’s agenda”

“However, your Facebook posting has generated some contact to me by a few rude (and seemingly unbalanced) pro fluoridation folks”

My reply:

MSoF is always happy to have private discussions if you are willing to listen to our feedback. A lot of our work is outside of what the public sees but we always up for public exchanges to share to our followers.

You will find that your paper got sent all over Facebook and the media; because it was publicised in a press release from FAN. That is how I found out about it. It is a pity you were subjected to insults because of that publicity. That said I was also hit with insults on Fluoride Free NZ Facebook pages because of my response to you. These insults are common and something I have gotten used too; in either case it is a shame that people feel it best to engage in debate in disrespectful ways. Fluoridation is an emotional topic for some – personally I do my best to stick with the science and keep my emotions out.

Thank you Rita for making time in reading our feedback and responding to us.

The post Discussion – Compulsory Water Fluoridation: Second Response To Rita Barnett-rose appeared first on Making Sense of Fluoride.

Also for those who haven’t listen to the last episode, Skepticism Today interviewed Mark Hanna who talked about our ASA wins against Fluoride Free NZ in Episode 2 at 42:24.
Listen to the episode here.
He goes into detail on why they lost against our 5 complaints regarding their quizzes. You can read our initial press release here.
FFNZ also lied in their follow-up press release about the ASA not actually finding anything wrong, but that is to be expected.

The post Skepticism Today podcast: Chat on fluoridation and ASA complaints appeared first on Making Sense of Fluoride.