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Ms. Butterfly - Systematic reviews are the most reliable category of information for evidence based medicine.
Random quotations from individuals with no mention of expert qualifications isn't even on the list of information sources considered for quality.
All systematic reviews published in the last two decades have concluded that fluoridation doesn't cause cancer. The most definitive and profound analysis was in 2011 when the California Carcinogen Identification Committee decided by unanimous vote that fluoride doesn't cause cancer in ANY concentration.
"Follow the money" you say! Conspiracy theories like this are a standard part of science denying gospel. Those denying the importance of vaccination, the reality of human caused global warming, that cigarettes cause cancer and biologic evolution use similar rhetorical devices: fake experts, logical fallacies, impossible research demands and expectations, cherry picking scientific literature and conspiracy theories.
"Following the money" creates no trail to America's pediatricians, registered dental hygienists, clinical nutritionists or any of the other 140 organizations which support community water fluoridation:
Acad for Sports Dentistry
Acad of Dentistry InterNatl
Acad of General Dentistry
Am Acad of Family Physicians
Am Acad of Nurse Practitioners
Am Acad of Oral & Maxillofacial Pathology
Am Acad of Orthopaedic Surgeons
Am Acad of Pediatrics
Am Acad of Pediatric Dentistry
Am Acad of Periodontology
Am Acad of Physician Assistants
Am Assn for Community Dental Programs
Am Assn for Dental Research
Am Assn for Health Education
Am Assn for the Advancement of Science
Am Assn of Endodontists
Am Assn of Oral & Maxillofacial Surgeons
Am Assn of Orthodontists
Am Assn of Public Health Dentistry
Am Assn of Women Dentists
Am Cancer Society
Am College of Dentists
Am College of Physicians-Am Society of Internal Medicine
Am College of Preventive Medicine
Am College of Prosthodontists
Am Council on Science & Health
Am Dental Assistants Assn
Am Dental Assn
Am Dental Education Assn
Am Dental Hygienists' Assn
Am Dietetic Assn
Am Hospital Assn
Am Institute of Nutrition
Am Legislative Exchange Council
Am Medical Assn
Am Nurses Assn
Am Osteopathic Assn
Am Pharmaceutical Assn
Am Pharmacists Assn
Am Public Health Assn
Am School Health Assn
Am Society for Clinical Nutrition
Am Society for Nutritional Sciences
Am Student Dental Assn
Am Veterinary Medical Assn
Am Water Works Assn
America's Health Insurance Plans
Assn for Academic Health Centers
Assn of Am Medical Colleges
Assn of Clinicians for the Underserved
Assn of Maternal & Child Health Programs
Assn of State & Territorial Dental Directors
Assn of State & Territorial Health Officials
Australia New South Wales Dept of Health
Australian Dental Assn ADA
Australian Health Ministers' Conference
Australian Natl Health & Medical Research Council
British Dental Assn
British Fluoridation Society
British Medical Assn
Canadian Assn of Dental Public Health
Canadian Dental Assn
Canadian Dental Hygienist Assn
Canadian Medical Assn
Canadian Nurses Assn
Canadian Pediatric Society
Canadian Public Health Assn
Center for Science in the Public Interest
Centers for Disease Control & Prevention
Child Welfare League of America
Children's Dental Health Project
Coalition Of Physicians for Social Justice
Consumer Federation of America
Consumer Federation of America
Council of State & Territorial Epidemiologists
Delta Dental Plans Assn
Dental Assn for disabled people
European Organization for Caries Research
Federation of Am Hospitals
Food & Drug Administration FDA
Food & Nutrition Board
Fédération Dentaire InterNatle FDI
Great Britain Ministry of Health
Health Insurance Assn of America
Health Resources & Services Administration HRSA
Hispanic Dental Assn
Indian Dental Assn U.S.A.
Indian Health Service
Institut Natl de santé du Québec
Institute of Medicine
InterNatl Assn for Dental Research
InterNatl Assn for Orthodontics
InterNatl College of Dentists
March of Dimes Birth Defects Foundation
McGill University Faculty of Dentistry
Montreal Children’ Hospital Child Development Program
Montreal Children’s Hospital Council of Community Pediatricians
Montreal Public Health Dept
Montreal Research Centre on Social Inequalities in Health
Montreal, Laval, Laurentides et Lanaudiere
Natl Acad of Science
Natl Assn County & City Health Officials
Natl Assn of Community Health Centers
Natl Assn of Dental Assistants
Natl Assn of Local Boards of Health
Natl Assn of Social Workers
Natl Cancer Institute
Natl Council Against Health Fraud
Natl Dental Assistants Assn
Natl Dental Assn
Natl Dental Hygienists' Assn
Natl Down Syndrome Congress
Natl Down Syndrome Society
Natl Eating Disorders Assn
Natl Foundation of Dentistry for the Handicapped
Natl Head Start Assn
Natl Health Council
Natl Health Law Program
Natl Healthy Mothers, Healthy Babies Coalition
Natl Institute of Dental & Craniofacial Research
New Zealand Ministry of Health
Oral Health America
Pan Am Health Organization
Public Health Assn of Australia
Quebec Assn of public health dentists
Quebec Federation of family physicians
Quebec Order of dentists
Quebec college of physicians
Quebec dental Acad
Quebec Dept of environment
Quebec Dept of health & social services
Quebec order of dental hygienists
Quebec order of pharmacists
Québec Assn of Pediatricians
Robert Wood Johnson Foundation
Royal College of Physicians London
Society for Public Health Education
Society of Am Indian Dentists
Special Care Dentistry
St-Justine Hospital Dept of pediatics
St-Justine Hospital university center
The Children's Health Fund
The Dental Health Foundation of California
U.S. Public Health Service
U.S. Surgeon General
U.S. Dept of Defense
U.S. Dept of Veterans Affairs
University of Montreal Dept of social & preventive medicine
Water Fluoridation: An Analysis of the Health Benefits & Risks
World Federation of Orthodontists
World Health Organization
Water Fluoridation: An Analysis of the Health Benefits and Risks
Scientific Advisory. Institut national de santé publique, Quebec
June 2007, p 47.
Indeed, the difference between FAN and CDH is significant. Carefully examine the research references of FAN and CDH?
For example, both quote and agree with the Bashash study that fluoride lowers inteligance. However, the "judgment" of CDH and FAN are significantly different.
CDH and FAN AGREE that the study found "a 0.5mg/L increase in prenatal urinary fluoride was associated with 3.15-point drop in GCI scores (p=0.01, N=287)." and GCI and IQ have significant correlation.
CDH recommends further studies, as all good studies recommend further studies.
CDH fails to put the pieces of the puzzle together, as FAN has done, adding the other 50 human studies and animal studies to make a reasonable judgment. We have plenty of studies for judgment on fluoridation.
CDH takes the position that we need more studies.
FAN takes the position that since mothers with higher fluoride concentration have children with lower intelligence, and those urine fluoride concentrations are similar to those found in the fluoridation population, and the Bashash study did not find a "lower limit" or "safe" urine fluoride concentration, and the Bashash study is consistent with more than 50 human studies, then from a public health and individual policy, we must cut back on our total fluoride exposure.
The best place to reduce total fluoride reduction in the population at large is fluoridation cessation.
Charles, need I tell you that dentists and public health officials do not treat IQ?
Brains are more important than teeth?
Your comment on cancer will be touched on next.
Bill Osmunson DDS MPH
“Fluoride is a carcinogen by any standard we use.” - Dr. Wm. Marcus (1998)
"Follow the money." - Deep Throat (1972)
“Children with dental fluorosis were burdened more by dental disease and had more treatment needs (dental caries, fluorosis, periodontal disease and gingivitis) when compared to those without dental fluorosis.”
- Mildred ndoti Mavindu, Gladys N Opinya, Richard Owino and Edith Ngatia. Oral Hygiene Habits and Dental Treatment Needs of Children with Dental Fluorosis and Those Without .... Mod. Approach to Dental Oral Hygiene. 2(2)-2018.
- Study of 248 teens in Kenya, matched for age and gender with 1:1 ratio for with:without dental fluorosis. Most children were consuming 1 ppm concentration in water, some less and some more. All children had similar brushing patterns of twice a day.
- Over half of American teens have dental fluorosis and one in five has moderate to severe fluorosis (Wiener et al. 2018). Children & the elderly are among the 'vulnerable subpopulations' for fluoride intoxication (chronic posioning).
Since lawsuits are expensive and given the way fluoridation is set up (there are no deep pockets to sue), they typically have other complicating issues. Elite whistleblower attornies Stephen & Michael Kohn won a lawsuit against the EPA in the 1990s on the wrongful termination of senior EPA scientist and toxicologist Dr. Wm. Marcus who wrote a memo about management interference for manipulation of cancer data in order to disappear the evidence of carcinogenicity in a fluoride study.
The ADA and friends who have no liability for fluoridation even though they aggressively promote it, frequently threaten and sometimes bring lawsuits against vocal opponents. I especially like the story told by medical correspondant and NYC celebrity dentist, Dr. Gerry Curatola. Apparently, he made a comment against fluoridation as ineffective and unsafe and the ADA got it into its head to either threaten or to actually bring a lawsuit against him in order to shut him up. Well, Dr. Curatola has money and wasn't going to be intimidated. He stood up to the fluoridationist bullies. He paid his legal fees and provided science to document that fluoridation was ineffective and harmful and demanded the ADA provide science to document their claims against him. The ADA backed down. I don't know if that particular story is in any of Dr. Curatola's many recordings on YouTube, but he tells it in various venues.
- Kohn & Marcus et al. (64 min): http://fluoridegate.org/about-dr-kennedy/
- Dr. Curatola (5 min): https://www.youtube.com/watch?v=QE4hre_PCiE
- FAN TV collection: http://fluoridealert.org/fan-tv/
Dr. Saueheber - - you make a number of allegations which if true, surely would have actionable legal consequences.
The current EPA is clearly "mindful of the public health significance of reducing the incidence of dental caries in the U.S. population." This quotation is from the EPA rejection of the FAN petition to apply section 21 of the Toxic Substances Control Act to "prohibit the purposeful addition of fluoridation chemicals to U.S. water supplies."
The undeniable fact is that in 2014 74.7% of US citizens on community water supplies drink fluoridated water. Quite obviously none of your points have ever successfully challenged this very important public health program in any court room. No state mandated fluoridation obligation has ever been withdrawn for these reasons.
Since you believe fluoridation to be illegal, my advise is for you to bring suit against New York City. If you were to prevail, one action would cease fluoridation in our largest city. Isn't it a bit inappropriate to argue legal views which, to the extent they have been formally contested, have always been rejected by US courts?
Thank you for your suggestion to attend a dental public health Conference.
I have. They had a class on fluoridation and I had previously asked to participate. They refused.
At the end they had question/answer and I asked one question, "Please provide one study of MEASURED evidence reporting significant cost savings in the public at large from water fluoridation."
Yes, many claim fluoridation is cost effective, but the dental speakers looked at the back wall and did not respond. Finally an insurance speaker said something like, "this is the type of question we need the experts." and he looked at the dental speakers at the table and they sat silent looking at the back wall. Finally someone in the audience (a student) shouted Maupome. I responded, "yes indeed, measured evidence of cost effectiveness of fluoridation in the community at large. And did you note the cost savings was enough to pay for equipment repairs? Not enough to pay for chemicals or equipment installation, dental fluorosis treatment, promotions, or operations. Just enough to pay for equipment repairs. And did you note that comparing the children in the two largest groups, those without fluoridation actually had lower dental treatment costs?" The speakers were silence. And then they took the next question.
Yes, there are a great deal of public health professionals who promote fluoridation, but they don't look at the research which does not support their position.
Charles, I took my MPH prior to dental school. I almost walked out of my MPH program during the last week of school, I was so disgusted with Public Health. The professor told us it was not our job as pubic health professionals to evaluate the science. We were to promote policy, not review science. I raised my hand and asked, "what if my boss tells me to promote tobacco smoking?" The professor paused, several students turned around and glared at me. The professor said, "you are to promote tobacco smoking, but don't do it to the best of your ability." At that point I knew public health was not a profession I could be comfortable with.
30 years later, the Dean of my public health school visited Portland and we had alumni meet him and come to support the school. I told him about my experience and he said he recognized the problem and they were trying to change that practice of being blind obedient servants of policy.
I was speaking with a public health dentist on the phone about 10 years ago regarding fluoridation. He said, "we will promote fluoridation until a judge tells us otherwise." I asked about scientific evidence. He responded, "I don't care about science and I don't care if it is right or wrong, I only care if a judge tells me the policy is wrong."
Obviously, I do not have much respect for that type of blind obedience, unquestioned loyalty to policy, because sometimes policy is flawed. And if a policy is flawed, it may take generations to change, or a judge to order a change.
My other profession, dentistry, is only marginally better. Dentistry at least claims to go with science and promotes science. Indeed, tradition and policy rule, but as individual clinicians, we can step out and protect patients even if our profession refuses to change their flawed policy and recommendations.
Now to your second point on purity of chemicals. Most of the chemicals added to make fluoridated water are industrial waste products of the phosphate mining industry, not pharmaceutical grade. Many are concerned with the contaminants. Personally, I do not think the contaminants pose the greatest risk. They are a problem, but not the big problem. Fluoride is the big problem.
So I called up the National Sanitation Foundation after reading their criteria for chemical safety. They require chemicals to not have contaminants in them which will increase the concentration of the contaminant more than 10% of the EPA's Maximum Contaminant Level. My question to the NSF was, "the MCL for the contaminant fluoride is 4 ppm. 10% of 4 ppm (the MCL) is 0.4 ppm. However, fluoridation is at 0.7 ppm
Why does NSF permit fluoride to be added to public water in greater concentration than 10% of the MCL? The person I talked to said they would get back to me. And to their credit they did. The response was, "NSF regulates the contaminants in the contaminant added to water, but they don't regulate the contaminant itself." I responded, so if we called the hydrofluorosilicic acid or sodium fluoride by any other name, NSF would pull their approval because the concentration of contaminant would be above 10% of EPA's MCL. But since the name is fluoride, then more than 10% can be added. The NSF person said, "yes, that's about right." Since then, my understanding NSF has rewritten their guidelines to give fluoride an exemption.
And do you know how the the statement came to be that fluoridation was one of public health's greatest achievements of the 20th Century? I've heard it was by three people at the Oral Health Division. Good marketing, but lacks facts, evidence and science.
I consider fluoridation to be one of dentistry's darkest hours and one of public health's greatest blunders of the 20th Century. Fluoridation started about the same time as the Tuskegee study of syphilis on black men and their families. The ethics of public health back then was not good and if the idea of fluoridation were to come up today, I'm proud to say the policy would be blocked for lack of ethics.
Bill Osmunson DDS, MPH
The U.S. FDA has opposed water fluoridation since its first incepton in 1945 under the direction of officials from the U.S. military. U.S. Sugeons General in the CDC have historically recommended the practice since that time. The original material used was industrial waste sodium fluoride but the starting material since 1985 has been fertilizer industry waste fluosilicic acid, after Rebecca Hamner of the EPA wrote that this use in public water supplies would be an ideal solution to dilute the waste material, assuming it would have dental benefit to consumers.
Again, the FDA will not approve the oral ingestion of fluoride, ruled that fluoride added into water is an uncontrlled use of an unapporve drug, forbids the use of fluoridated water in kidney dialysis wards, and banned the sale of all fluoride compounds intended for ingestion by pregnant women. The FDA requires Good Manufacturing Practices for all consumed materials used to treat human tissue, but GMP rules are not followed by fertilizer production faciltiies that generate the waste used to fluoridate consumers through water supplies. Please read the Journal of Enviornmental and Public Health 439490 for details: https://www.hindawi.com/journals/jeph/2013/439490/
Fluoridationists at the CDC rely on the EPA MCL to claim the intentional infusions are somehow legal, but the EPA only regulates contaminants, not nutrients or drugs purposely added into water to treat humans. The EPA consistently states that fluoridation is the legal responsibility of the FDA since it it is added intentionally to treat humans, rather than its presence in a chemical spill or when present naturally as a contaminant in water. The current FDA staff has no understanding how to enforce FDA rulings on fluoridation of water supplies. Critics argue that the FDA has no "rights" to regulate water supplies, but the FDA is the only Federal agency approved by Congress to regulate any substance intended for ingestion to treat humans, regardless of how the ingestible substance is disseminated. Fluoride promoters will not voluntarily follow the law and, as seen here, have no interest in following GMP regulations or existing FDA rulings.
R. Sauerheber, Ph.D.
Sirpac . .
It is sad that someone so utterly unaware of the subspecialty of oral public health can make claims like this. Even more tragically some will be persuaded..
You should attend a National Oral Health Conference
or the American Public Health Association annual meeting
so you could understand who the advocating professionals are and why they are credible and legitimate sources of information.
Clearly you have no idea the exact nature of the "chemicals." They are water additives that are highly regulated for purity and physical characteristics. They have more specifically stringent criteria for purity from heavy metal contamination that do medications. National Sanitation Foundation water testing shows that the actual arsenic from water additives is less than 0.1% of that which EPA deems protective of human health.
Here's a graphic representation of how utterly unimportant fluoridation water additive contaminants are -
The daily arsenic intake from fluoridation is 0.14 micrograms a day, the daily intake from normal, healthy food is 56.3 micrograms per day. The truth about these claims that somehow the drinking water is contaminated from fluoridation is illustrative of the abysmal falsehoods so often used to oppose what the CDC considers one of the great public health accomplishments of the 20th Century.
It is truly horrific that these noted governmental agencies and some doctors, who are not research scientists and who have no time to truly study fluoridation, are enforcing this practice of dumping industrial waste into the public water supply. Here are the CDC links to NIOSH specifications of hydrofluorosilicic acid and sodiumhexafluorosilicate, which are the most commonly used fluoridation compounds in the United States:
If any of these ‘enforcing’ doctors actually understood what these chemicals are, then this crime against the masses is on them!
The difference between FAN and the Campaign for Dental Health (CDH) could not be starker.
CDH is the organization behind ilikemyteeth.org and is part of the American Academy of Pediatrics which in turn is composed of many thousands of practicing pediatricians. The mission of CDH and their web site is to promote dental health, especially children's.
The EPA suit is reminiscent of the action FAN and collaborators brought to the California Carcinogen Identification Committee claiming this would be the end of fluoridation. In fact a unanimous vote found that fluoride is not related to cancer at any concentration.
FAN predicted and promoted the National Toxicology Programs planned animal studies as "finally" showing low fluoride exposures to harm developing brains. No effect at all was found. The promotion before the fact of the EPA suit seems similar.
The EPA suit decisions thus far have been strictly on procedural grounds. The merits of the suit have not been considered. The monograph the EPA published in the Congressional Record contains core arguments and issues which will be judged if the case proceeds to full trial. I'm betting that if FAN et al loose in Federal Court they will just look for the next set of claims. Courts are hesitant to over-rule scientific decisions made by venerable and responsible bureaucracies. While I am reasonably confident, we will just have to wait and see how it turns out.
Your picture of pounding on the table is incredibly out of step with reality of Federal Court proceedings.
To return to the point of these many posts, it is not reasonable for AARP to oppose well established and widely supported public health programs for any the points in your last message.
“If the facts are against you, argue the law. If the law is against you, argue the facts. If the law and the facts are against you, pound the table and yell like hell!” - Carl Sandburg
It makes little difference if a group is an advocacy group like the AFS and "I Like My Teeth" or an activist group like FAN. What matters are the facts of the matter, not opinions, endorsement of policy or well-funded marketing campaigns. What also matters are integrity and good behavior.
FAN provides a database of ALL fluoride science mostly listed in PubMed for ease of use by those not familiar with scientific research, while AFS and friends specialize in loudly singing the praises of endorsements most of which originated in the 1950s as part of organizational policy statements and have been rubber stamped for decades. The fluoride advocates also simultaneously and aggressively denigrate any who disagree with them. They also offer questionable selections of science and politics pretending to be science.
For example, AFS member Chuck Haynie just pointed to the EPA 2017 response to a citizen's petition from six organizations including FAN. That EPA response was so poor that a judge in a federal lawsuit brought against the EPA threw it out. The judge essentially said that the EPA arguments lacked common sense, were contrary with their agency mission and regulations, and were internally inconsistent. The TSCA lawsuit will be heard in federal court in August 2019. Like the petition, the lawsuit is specific to neurotoxicity science.
I expect the EPA will pound the table and yell like crazy in defense of their fluoride MCL, while the plaintiffs who include FAN will argue the facts. Much like what has been happening on this thread the past few days.