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Re: Fluoride - Demand AARP Take Action

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1.  No, Bill, I did not ask “for any peer-reviewed evidence fluoride at 0.7-1.4 ppm” whatever in the world you deem that to mean.

 

2.  The US DHHS did not lower anything, nor find anything unsafe, in regard to water  fluoridation.  These are yet more false claims to add to your ever growing list of such.

 

3.  A FAN claim as to what NHANES data has shown does  not constitute  proper evaluation of this data by any qualified, reliable entity.

 

4.  Yes, the 2006 NRC Committee on Fluoride in Drinking Water considered severe dental fluorosis to be an adverse effect.  This is of no relevance to optimally fluoridated water.  As this same committe clearly stated in its final report, severe dental fluorosis does not occur in communities with a water fluoride content below 2.0 ppm.  Water is fluoridated at 0.7 ppm, one third that level.

 

5.  Neither you, nor anyone else, has provided any valid, peer-reviewed scientific evidence that anyone, anywhere, is being “harmed by the addition of fluoride in public water”.  Your inexplicable unsubstantiated personal opinion to the contrary obviously does not qualify as such evidence.

 

Steven D. Slott, DDS

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1322 of 1,448

Steve,

 

Have you considered taking some anger managment courses.  Wow.  Calm down.  

 

You have provided some studies reporting a benefit of fluoridation.  Thank you.  Yes, I have read them.  Yes they have value, but limited.

 

None of them are prospective RCT studies.  And yes, quality of study is important.    

 

None of them controled for nor mentioned the unknown which crushed dental caries prior to fluoridation.  

 

Studies of small subsets of the population are valid if the treatment is targeted to those subsets of the population.  

 

Fluoridation is treatment of the entire population, not a subset.

 

And evaluation of hospitalizations is important, but I think we agree there are multiple causes for caries.  And hospitalization is a major factor for socioeconomics.  

 

A friend took the 1986 NIDR survey of dental caries which included fluoride concentration, magnesium concentration and calcium concentration in the public water of each child.  The graph below is most interesting.  It is three snap shots of data with variations in those three elements, fluoride, magnesium and calcium.

 

The graphs clearly show caries rates vary with all three chemical concentrations and they are interdependent.  The software is cool because a person can adjust any one of the three chemicals higher or lower and see what it does to the dental caries rates.

 

Take the first graph where I chose 0.1 ppm fluoride in the water.  I then chose a low magnesium concentration and a low calcium concentration where caries were optimally low.   This is similar to soft water in Seattle.  If all three are at their "optimal" concentration for caries, the caries rate is 1.7 cavities per child.

 

The second graph I chose 0.7 ppm fluoride and and the third graph I chose 1.0 ppm F.    Those concentrations of fluoride also resulted in 1.7 cavities per child.

 

In other words, when the magnesium and calcium concentrations in the water were controlled, caries rates were the same regardless of fluoride concentrations at 0.1, 0.7 or 1.0 ppm.  

 

However, we can see a change in concentration of magnesium or calcium does make a huge difference and increased fluoride exposure over 1 ppm increased caries.   Any study which does not report magnesium or calcium exposure has limitations.

 

When total fluoride exposure increases, caries increases.  Excess total fluoride exposure as reported with increased dental fluorosis is a serious concern.   

 

NIDR large-001.jpgNIDR 1986Bill Osmunson DDS MPH

 

 

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1323 of 1,448

Bill,

 

How about we stick with clinical dentistry for the present moment Bill.  And perhaps a bit of evidence-based science thrown in.

 

1.  You stated in your testimony in Cortland, NY, that you place veneers over teeth that are showing fluorosis from CWF.  You did not show any before or after pictures.  You know that the only fluorosis attributed to CWF is very mild to mild.  Why don't you show pictures of before and afters of patients you've treated from CWF that needed veneers?  I'd like to see them.  Please refer to the CDC figure below:

Normal
Image of normal tooth with semi-translucent structure and smooth, glossy, pale cream color.
Questionable
Image of questionable fluorosis. Teeth show some slight differences from normal translucent appearance. Some white spots are apparent but not enough to warrant a diagnosis of very mild fluorosis.
Very mild
Image of very mild fluorosis. Teeth with small, paper-white opaque spots over a small area.
Mild
Image of mild fluorosis. Teeth show white opaque areas covering an extensive portion, but not as much as 50%, of the total surface.
Moderate
Image of moderate fluorosis. All surfaces of teeth affected with opaque areas and teeth show marked wear and brown staining.
Severe
Image of severe fluorosis. All enamel surfaces of teeth are affected and the teeth do not exhibit normal development. The teeth are pitted and brown staining is also apparent.

https://www.cdc.gov/fluoridation/faqs/dental_fluorosis/index.htm

 

2.  The US Community Preventive Services Task Force stated that severe fluorosis does not occur from CWF.  The literature review that they undertook was reviewed by the Cochrane Oral Health Group (COHG), the same COHG that published their report in 2015 on CWF.  They gave their stamp of approval to the studies used.

 

The USCPSTF findings:

Task Force Finding (April 2013) The Community Preventive Services Task Force recommends

1. community water fluoridation based on strong evidence of effectiveness in reducing dental caries across populations.

2. Evidence shows the prevalence of caries is substantially lower in communities with CWF.

3. In addition, there is no evidence that CWF results in severe dental fluorosis. Evidence indicates the economic benefit of CWF is greater than the cost.

4.In addition, the benefit-cost ratio increases with the size of the community population.

https://www.thecommunityguide.org/sites/default/files/assets/Oral-Health-Caries-Community-Water-Fluo...

 

Lastly, your mixing of facts and snippets of information based on the typical anti-fluoridation 101 handbook should be somthing left to a person that is outside of our profession, especially someone with an MPH after their name.  Stick with the facts.

 

Show me before/afters of the last 10 patients that you treated with veneers that were required by fluorosis that you relate to CWF.  It's time to become a dentist here, Bill.  Let the other non-dental commentors use the double talk that you are putting out.  Let's make this about clinical experiences.

 

Respectfully,

 

Johnny Johnson, Jr., DMD, MS

Pediatric Dentistry

Diplomate American Board of Pediatric Dentistry

Life Fellow, American Academy of Pediatric Dentistry

President, American Fluoridation Society

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Re: Fluoride - Demand AARP Take Action

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Message 1324 of 1,448

Invoking “religion” again, I see, Bill.  I fail to understand the constant attempt of antifluoridationists to mingle religion into water fluoridation, however, to each his own, I guess.

 

1.  Your personal opinion of what constitutes “unprofessional and unscientific” is obviously irrelevant and meaningless.

 

2.  Again, as I have clearly demonstrated, the cost savings and safety of water fluoridation are without question.  Constant  attempts by antifluoridationists to create “controversy” and “question” with unsubstantiated claims, false assertions, misrepresented science, and misinformation, does not constitute “good scientists”.

 

Steven D. Slott, DDS

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Re: Fluoride - Demand AARP Take Action

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Message 1325 of 1,448

Stop your childish whining, Bill.  Attempting to divert attention from exposure of your false claims and misinformation, with groundless, kindergarten complaints of “bullying” is a transparent tactic frequently employed by antifluoridationists who become frustrated with the facts and evidence, having nothing with which to counter them.  Now, please refrain from such tactics and stay with facts and evidence you can provide.

 

1.  “Stick with” whatever you please.  You asked for scientific evidence to support my claim that a zero level of arsenic is undesirable.  I provided it.  Live with it.

 

2.  Fear-mongering about arsenic is yet another diversionary tactic which has no merit.  The amount of arsenic in water at the tap which has been fluoridated with HFA is not even detectable unless 10 times the manufacturer’s recommended single use amount of HFA is utilized in order to get some sort of reading. 

 

Neither arsenic, nor any other contaminant in fluoridated water at the tap is in an amount to be of any concern, whatsoever.

 

http://www.nsf.org/newsroom/nsf-fact-sheet-on-fluoridation-chemicals

 

3.  Yes, as I have been stating, your constant speculation and unsubstantiated personal opinions are valid evidence of nothing.    At some point you need to understand that science is evidence-based, not Bill Omunson personal opinion-based.

 

4.  The precautionary principle applies when there is no scientific consensus of the safety of an initiative.  Water fluoridation has been in effect for 73 years, hundreds of millions having ingested optimally fluoridated water during this time, with no proven adverse effects.  The public health benefits of fluoridation are publicly recognized by the US CDC, the US National Academy of Medicine, the American Dental Association, the American Medical Association, the World Health Organization, the American Academy of Pediatrics, and over 100 more of the most highly respected healthcare and healthcare-related organizations in the world.  There is not one credible organization in the world which opposes fluoridation. Clearly there is scientific consensus of the safety of this initiative.

 

Obviously, the precautionary principle does not apply to fluoridation.

 

Steven D. Slott, DDS

 

 

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1326 of 1,448

Bill

 

1.  Apparently unbeknownst to you, the cause and preventive factors involved in dental decay are myriad.  Attempts to assess the overall and cost-effectiveness of but one preventive measure, fluoridation, based on nothing but comparison of raw data on dental decay incidence which controls for none of the myriad other variables involved in this process....is obviously ludicrous.

 

2.  Your obsession with RCTs is indeed bizarre, however, as  I have explained previously, randomized controlled trials are not necessary to assess the effectiveness of broad public health initiatives such as water fluoridation.  

 

Your unsubstantiated personal opinion of what constitutes valid evidence of cost-savings, is unqualified and irrelevant.

 

Peer-reviewed science demonstrating cost-effectiveness:

 

a.  “On the basis of the most current data available on the effectiveness and cost of fluoridation, caries increment, and the cost and longevity of dental restorations, we find that water fluoridation offers significant cost savings.”

 

J Public Health Dent. 2001 Spring;61(2):78-86.

An economic evaluation of community water fluoridation.

Griffin SO, Jones K, Tomar SL.

 

b.  “These results clearly indicate that there is an association between

adequacy of water fluoridation and hospitalization due to dental infections
among children and adolescents. This effect is more prominent in populations of
lower socioeconomic status.”

 

Hospitalizations for dental infections
Optimally versus nonoptimally fluoridated areas in Israel

Amir Klivitsky, MD; Diana Tasher, MD;
Michal Stein, MD; Etan Gavron, BSc;
Eli Somekh, MD

https://doi.org/10.1016/j.adaj.2015.01.014

 

c.  “Compared with the predominantly fluoridated counties, the mean number of restorative, endodontic, and extraction procedures per recipient was 33.4% higher in less fluoridated counties. The mean number of claims per child for caries-related services was inversely correlated with the extent of fluoridation in a county (Spearman's correlation coefficient = -0.54, p < 0.0001), but claims for non-caries related services were not.”

 

Kumar J.V., Adekugbe O., Melnik T.A., “Geographic Variation in Medicaid Claims for Dental Procedures in New York State: Role of Fluoridation Under Contemporary Conditions,”

Public Health Reports, (September-October 2010) Vol. 125, No. 5, 647-54.

 

d.  “We estimated that Colorado CWFPs [community Water Fluoridation Programs] were associated with annual savings of $148.9 million (credible range, $115.1 million to $187.2 million) in 2003, or an average of $60.78 per person (credible range, $46.97 to $76.41).”

 

Brunson D, O’Connell JM, Anselmo T, Sullivan PW. Costs and Savings Associated With Community Water Fluoridation Programs in Colorado. Preventing Chronic Disease. 2005;2(Spec No):A06.

 

 

Steven D. Slott, DDS

 

 

 

 

 

 

 

 

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1327 of 1,448

Steve,

 

I would like to look at some research which is powerful questioning support of fluoride ingestion.  The Figure 1 reproduced from the CDC Oral Health Division web page is an example of cherry picked evidence.  In dental school I was shown the early renditions which were used to convince me fluoridation caused caries to decline.  

Evidence settled, some might say.  However, look and think about the evidence.  Caries declined from 4 DMFT to just over 1 DMFT.  Very impressive, 75% reduction in caries.  The graph seems to claim the huge decrease resulted from an increase in about 17% of the ENTIRE USA population fluoridated.   Not possible.  Even a halo from heaven could not do that.  Fluoride would have to have been targeted on the 17% of the population most at risk, not randomly added to public water in various cities.  The CDC knows their evidence is bogus, an exageration and simply cherry picked science.  But they persist in telling lies.

00001.jpgCDC Web Page 2017

Now lets look at a longer time frame as presented in the graph below which includes the CDC timeline with the same decline.  However, a longer timeline helps put perspective on fluoridation.  Caries declined from over 11 cavities for a 12 year old in 1930, to about half by the time fluoridation became significant.  

 

What cause the huge decline in caries prior to fluoridation and fluoride toothpaste?   Please answer Steve?   

 

Once you know what caused the decline, based on research, then explain how that huge caries crushing cause all of a sudden stopped when fluoridation started and the credit for caries reduction can be given to fluoridation.

 

Any benefit from fluoridation, based on the population at large is simply pipe smoke speculation and assumptions.  

 

Yes, two events happened but the evidence does not show common cause.  Any study comparing two groups may simply be comparing the random decline which we could say is a natural ebb and flow of all diseases.   

 

00001.jpgColquhoun 1997 ISFRAnd please, stick to the evidence.

 

Bill Osmunson DDS MPH

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Re: Fluoride - Demand AARP Take Action

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Message 1328 of 1,448

"Nations who are using fluoridation should feel ashamed.” - Dr. Arvid Carlsson 

 

July 1, 2018 New York Times Obituary:

Arvid Carlsson, Who Discovered a Treatment for Parkinson’s, Dies at 95

Dr. Arvid Carlsson, a Swedish scientist whose discoveries about the brain led to the development of drugs for Parkinson’s disease and earned him a Nobel Prize, died on Friday. He was 95...... 

 

... Dr. Carlsson was an outspoken critic of fluoridating water supplies to prevent cavities. He said that fluoride produces side effects, such as mottled teeth, and that fluoridation was contrary to the principles of modern pharmacology because there was no way to regulate the amount of fluoride individuals received. He argued that individualized preventive care was a better approach.

 

Note: Dr. Carlsson was a world-renowned scientist who specialized in neurodegenerative diseases that primarily affect senior citizens. He was one of thousands of scientists who oppose fluoridation based on evidence of harm. His country of Sweden, like most of Europe & the world, is unfluoridated because of his integrity & courage

 

 

 

 
 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1329 of 1,448

Steve,

 

Your response to CarryAnne does not really make "judgment" sense.

 

You say skeletal fluorosis is "not a conern."  

 

Yet provide research saying skeletal fluorosis in the USA is "extremely rare."

 

I consider rare cases of disease still a concern.  Many diseases are extremely rare and a serious concern for the person with the disease.

 

I agree overt severe crippling skeletal fluorosis is extremely rare.   Early cases are difficult to diagnose because they resemble arthritis like symptoms.   Science has much to learn.  With huge increases in dental fluorosis, I am concerned for skeletal fluorosis.

 

The lack of benefit and lack of cost effectiveness of adding more fluoride to the diet is a serious concern.

 

Bill Osmunson DDS MPH

 

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Re: Fluoride - Demand AARP Take Action

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Message 1330 of 1,448

Last year, the European Union adopted a regulation banning amalgam use for children under age 15, pregnant women, and breastfeeding mothers beginning 1 July 2018.  Now that day is here!  

 

The amalgam manufacturer had a warning on its label with essentially the same warning 20 years ago.  

 

Steve,  scientists are more and more concerned about the mercury coming off of fillings and harming people.  You have suggested fluoride ingestion evidence is "settled" and many thought the same for amalgams.  But we are learning more and obviously the evidence on both is not settled.

 

Camping on speculation is risky.

 

Bill Osmunson DDS MPH

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