Misinformation of Fluoridation

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FANNZ has released this statement:

“Informed, Courageous Dentists do indeed say “No” to Fluoridation
Press Release
Fluoride Action Network NZ
fannz.org.nz
Wellington, 7 September 2013

The NZ Dental Association is about to implement rules to stifle dissent amongst dentists over water fluoridation – only a few months after Chief Executive David Crum denied they put pressure on dissenters. From November, dentists who state a view against fluoridation will have to qualify that by saying they are stating a minority view. But worldwide those who support fluoridation are in the minority. Will the NZ Dental Association qualify all its public statements with that fact?

Even in New Zealand, the Dental Association (NZDA) has no real proof of what the majority view is. But more worrying is why is the Dental Association so hell-bent on promoting fluoridation, against the overwhelming weight of scientific evidence, that it will issue veiled threats to dentists not to discuss the issue openly?

It also seems that those dentists who support fluoridation are highly uninformed, according to a study published in the New Zealand Dental Journal in June this year. It found that just over half the dentists that responded to a survey either did not know, or did not agree, that drinking fluoridated water could cause dental fluorosis – white spots or marks on the teeth indicating that a child has been over-exposed to fluoride .

This is absolutely astounding and shows that many dentists are completely uninformed about the effects of fluoridation. According to the Ministry of Health 44% of New Zealand children have some form of dental fluorosis. NZ studies published since 2005 show twice as many children in fluoridated areas have fluorosis compared to children in non-fluoridated areas.

If they are that uninformed about dental fluorosis, it is likely that many of them still do not know that fluoride does not need to be swallowed – it works by surface action on teeth. This has been known since 1999, yet many dentists still tell local councils that fluoride works by being incorporated into tooth enamel while the teeth are forming. That was the unsubstantiated theory until 1999.

The survey of dentists was carried out three years ago. Only 465 responded (20% of the total number of dentists registered with the Dental Association). Therefore, the NZDA cannot claim that the majority of dentists agree with fluoridation as it is likely that dentists who did not agree would have been reluctant to complete the survey. Views may also have changed in the last three years with the issue gaining more attention.

“Codes of practice” have been used to suppress dissent throughout the history of fluoridation, as shown by published sociological research.

We invite the Dental Association to participate in an open, public, scientific forum discussion on fluoridation when world expert Dr Paul Connett is here in February 2014. Science, not suppression, is the only way this controversial issue will be resolved.”

A couple of thoughts on this FANNZ statement.
They seem to have gotten confused about the difference between the NZ Dental Council and the NZ Dental Association.
NZDC is based in Wellington and makes the rules for dentists.
NZDA is based in Auckland and is the professional association.

Drinking optimally fluoridated water alone is highly unlikely to cause fluorosis. What is more likely to cause fluorosis is toothpaste. One study reported that 80% of F intake among small children comes from toothpaste:
http://www.ncbi.nlm.nih.gov/pubmed/17244138

There is a recommendation for only a smear of toothpaste for small children. That’s because the amount of toothpaste a child swallows directly relates to the amount put on the brush.

Some fluoride will come from fluoridated water, but alone it isn’t enough. At the levels dental fluorosis occurs in NZ, it isn’t a public health problem. The real problem is that in NZ around 34,000 per year children have had a tooth removed, including a great many that have decay so bad that they had to be treated under general anaesthetic.

What makes Paul Connett a “world expert” scientist on this subject? His book “The Case against Fluoride”? That was not put in a scientific journal. When it comes to the science that it is safe and it works – there isn’t a controversial issue here. If there was, you would expect one of the major health organisations would be against it.

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“Dental Council is aware that various oral health practitioners have been requested to make submissions or provide advice to the councils on this matter.
Recent survey results published by the New Zealand Dental Association indicate that the majority of oral health professionals support community water fluoridation.
However, a small number of practitioners take a dissenting view. The difficult question for practitioners holding a dissenting view is how to reconcile their beliefs against a majority opinion, and what advice they offer to patients, local councils and other stakeholders involved.
A significant body of research exists about water fluoridation. The published research is peer-reviewed, presented in journals to a broad audience and is therefore exposed to wide critique. From this wide critique, the consensus of opinion across the oral health profession is that the benefit of water fluoridation outweighs the potential side effects.
Practitioners advising stakeholders and decision-making bodies have a professional and ethical responsibility to critically analyse available research, and to ensure the breadth and depth of the evidence they use to formulate their position is appropriate. The information presented should be impartial, not selected or edited to support one particular view. If your personal belief differs from the majority view, then there is an onus on you to inform your audience on the extent to which your view has, or does not have, the support of the majority of oral health practitioners.
Oral health promotion is a key competency of all oral health professionals, and practitioners are encouraged to embrace the opportunity to participate in this very important debate, but simultaneously must act in a responsible and professional manner as the outcome of these decisions impact on our communities.”

http://www.dcnz.org.nz/assets/Uploads/Publications/Newsletters-pre-2014/AUG2013.pdf

So if an oral health practitioner continued to give out misinformation on fluoridated water, they could be pulled in front of a Professional Conduct Committee if someone complained to the Dental Council.
http://www.dcnz.org.nz/i-practise-in-new-zealand/competence-reviews/
http://www.dcnz.org.nz/i-practise-in-new-zealand/dentists-and-dental-specialists/codes-of-practice-for-dentists-and-dental-specialists/

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