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Re: Fluoride - Demand AARP Take Action

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I do recall the following sweeping statement made in the Cochrane review.:

"We had concerns about the methods used, or the reporting of the results, in the vast majority (97%) of the studies."  The report also concluded that there is zero evidnece proving that caries are reduced by water fluoridation in adults.

Many studies indeed found caries were reduced in children, but just  like modern studies by Kumar and others who make the same claim, the observation error and bias are problems, coupled with the fact that again humans cannot be put in cages to control candy eating, teeth brushing, diet, etc. Kids with dental fluorosis are typically embarrassed by it and naturally brush their teeth more than kids without fluorosis, in an attempt to help their disfigured teeth. So it would not be surprising to see fewer caries in fluoridated areas because brushing is not controlled between the groups.

This has everything to do with brushing and fluorosis, and has nothing to do with any intrinsic ability of fluoride to somehow reduce caries. There is no known mechanism for fluoride to reduce caries. Enamel is too hard for fluoride to penetrate into its matrix.

Again, humans cannot be caged, and this is largely why 97% of the studies making these claims of effectiveness have no power. 

 

Richard Sauerheber, Ph.D.
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Re: IAOMT is a highly respected Professional Dental Academy

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Hi William,

 

I have been a bit busy and unable to keep up with your frequent posts.

 

Your post about the NTP is lacking in accuracy.  The first phase found mild to moderate confidence in the data that they reviewed.

 

The second phase, which was the definitive and rock solid phase of their evaluation, showed no neuorological effects from fluoride ingestion of regular chow, low fluoride chow, or 0ppm, 10ppm, or 20ppm fluoride in the water fed to the pregnant rats during the 6th day in utero and testing of the offspring male rats to adulthood.  This is where the train runs off the track with the anti-fluoride group's arguement with the NTP's  methodology.

 

For a full response to the letter that was sent to the main author of the NTP Report, please click on the link below.  The NTP was an authoritative study which measured both intakes of all foods and liquids ingested.  The outcomes of these intakes were evaluated at the highest level that this group always performs. Yet, you didn't like the results.   Opinions do not equate with facts:

https://americanfluoridationsociety.org/1363-2/

 

Warm regards,

Johnny

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Re: More Irrelevant Distractions

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BillO – Apparently I need to ask short, specific questions in hopes of obtaining specific replies.  I have actually examined the evidence responsible for the scientific consensus that fluoridation is safe and effective, and I am shocked that fluoridation opponents (FOs) can manipulate it with no regard for accuracy.

 

Q1) Do you apply your libelous “circular referencing” “They are lemmings, followers, part of a herd, not scientists.” critiques (07-09-2018 09:09 PM) to all the other 100+ organizations and their members who support CWF and don't accept the anti-F opinions as legitimate? 

 

Q2) Do you accept the concept of scientific consensus as the collective judgment, position, and opinion of the community of scientists in a particular field of study?  If so, how do you recognize and accept a scientific consensus?

 

Q3) Do you accept the scientific consensus that disinfection is a safe and effective public health measure to protect the health of citizens and the "DOSE" of residual disinfectants and DBPs is sufficiently regulated to protect the health of those who drink the treated water?

 

Q4) If you accept the scientific consensus that disinfection is safe and effective, how do you dismiss the scientific consensus that CWF is a safe and effective public health measure and the "DOSE" of fluoride ions is sufficiently regulated to protect the health of those who drink the treated water??  Fluoride ions actually have a health benefit while there are no health benefits (only risks) from ingesting DBPs. 

 

Q5) If a water treatment process is effective at protecting the health of citizens, why does it matter whether the treatment chemicals added are called poisons or medicines or additives or water treatment chemicals? 

 

Q6) You complain that “CDC did not assess the evidence, they rely on reviews and report which allegedly assess the evidence.”  Please provide a specific example of what you mean by “assess the evidence” and provide details of an anti-fluoridation organization that assessed the evidence and did not rely on reviews and reports which allegedly assess the evidence.

 

Q7) Do you accept the 28 references (2000 – 2018) I just posted in response to the comment by rs as endorsements or as legitimate scientific studies and reviews?  All of them concluded that community water fluoridation was effective at reducing dental decay, and none concluded there were any health risks – the only risk listed for drinking water containing 0.7 ppm was the recognized increased risk of minimal dental fluorosis.

 

Q8) You state, “In my opinion, the Cochrane and NRC 2006 review need to be taken together, because Cochrane looks at 'benefit' and NRC looks at 'exposure' and 'isk'."  Really?  Explain the following:
~> The 2006 NRC Fluoride Review committee (which included at least three dedicated FOs) “was asked to evaluate independently the scientific basis of EPA’s MCLG of 4 mg/L and SMCL of 2 mg/L in drinking water and the adequacy of those guidelines to protect children and others from adverse health effects”.  The review listed absolutely no harmful health-related finding or recommendation for water containing fluoride ions at the SMCL of 2.0 mg/l – three times the optimal level for CWF.  Provide the exact citation in the 2006 NRC review that concluded CWF guidelines (or water containing three times the guidelines) caused any adverse health effects.
~> You, like rs, have apparently not read the Cochrane review – or you were wearing your anti-science activist blinders, because you completely missed the first “Key result” which states in part, “Our review found that water fluoridation is effective at reducing levels of tooth decay among children. The introduction of water fluoridation resulted in children having 35% fewer decayed, missing and filled baby teeth and 26% fewer decayed, missing and filled permanent teeth. We also found that fluoridation led to a 15% increase in children with no decay in their baby teeth and a 14% increase in children with no decay in their permanent teeth.” These conclusions were based on studies that met Cochrane’s very stringent review criteria and were mostly published before 1975.  The reviewers listed study limitations, yet they published the conclusion that evidence demonstrated the effectiveness of CWF largely before the use of fluoridated toothpaste, rinses, etc. became widespread.  How would that conclusion be possible if there was no evidence that CWF was effective?  Did fluoridation magically become ineffective post-1975?  The fact is that the complexity of the Cochrane review makes it an easy target for conclusion manipulations by FOs.

 

Q9) How do you explain fact that fluoridation opponents have no support for their paranoid opinions besides INFOWARS: Alex Jones, "I grew up in Dallas, Texas, drinking sodium fluoridated water. All the scientific studies show my IQ has been reduced by at least 20 points.", Natural News: Mike Adams, and a handful of alternative health, environmental, spiritual and cultural organizations you listed as opposing CWF?

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Scientific Consensus Continues to Support CWF

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rs – While it is true, your "opinion is not particularly important", that fact has not prevented you from continually presenting your speculations and opinions. 

 

Q1) Stop with the distractions and explain why you believe (and provide conclusive proof) that all scientists who do not recognize the opinions of anti-science activists are “not trained scientists who actually do controlled experiments using the scientific method”? 

 

Q2) What relevance does your rant about “drug companies that promote the sale of a drug to the general public…” have to do with community water fluoridation (CWF)?  Are you actually accusing all the organizations and institutions represented in the references below and all the organizations (mentioned repeatedly) that publically recognize the benefits CWF of presenting “advertisements based on opinions”?

 

Q3) You seem to have an opinion that “There is no mechanism by which swallowed fluoride can improve the structure of normal hard crystalline enamel…”  Your opinions must be better than the conclusions of all authors in the references presented below.  You claimed the 2015 Cochrane review, Water fluoridation to prevent tooth decay, “recognize no studies that are sufficiently controlled to conclude any benefit exists scientifically yet”.  Have you actually read the Cochrane review?  If you had, you were wearing your anti-science activist blinders, because you completely missed the first “Key result” which states in part, “Our review found that water fluoridation is effective at reducing levels of tooth decay among children. The introduction of water fluoridation resulted in children having 35% fewer decayed, missing and filled baby teeth and 26% fewer decayed, missing and filled permanent teeth. We also found that fluoridation led to a 15% increase in children with no decay in their baby teeth and a 14% increase in children with no decay in their permanent teeth.” These conclusions were based on studies that met Cochrane’s very stringent review criteria and were mostly published before 1975.  The reviewers listed study limitations, yet they concluded the evidence demonstrated the effectiveness of CWF largely before the use of fluoridated toothpaste, rinses, etc. became widespread.  How would that conclusion be possible if “There is no mechanism by which swallowed fluoride can improve the structure of normal hard crystalline enamel…”  Do you believe the Cochrane review is just another “advertisements based on opinions”?

https://fluorideexposed.org/norman-rockwell-fluoride-toothpaste

 

Q4) Also, as requested previously, explain the fact that if the anti-F opinions about the allegedly obvious and dangerous health effects of CWF were even remotely legitimate, the overwhelming majority of scientists and health professionals continue to accept the scientific consensus that fluoridation is safe and effective – as evidenced by the fact that all major, recognized science and health organizations in the world (not just the CDC and ADA as you seem to believe) accept that consensus. 

 

Q5) Explain why, if the anti-F opinions about the allegedly obvious and dangerous health effects of CWF were even remotely legitimate, only Natural News, INFOWARS, and a few other alternative health organizations listed in previous anti-F comments reject the scientific consensus.  If you don’t accept the concept of a legitimate scientific consensus agreed upon by the majority of relevant experts, provide your “not particularly important” opinion of how the conclusions regarding the safety and effectiveness of community water fluoridation should be determined – and by what group (or groups) of experts.

 

Q6) What is your evaluation of the reviews and studies published since 2000 that have unanimously concluded that community water fluoridation reduces dental decay?  None of these reviews reported any health risks from drinking optimally fluoridated water, only an increased risk of very mild to mild dental fluorosis.  The reviews/studies include:

rs – While it is true, your "opinion is not particularly important", that fact has not prevented you from continually presenting your speculations and opinions. 

 

the 2018 National Toxicity Program fluoride study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815826/
the 2018 study, Water Fluoridation and Dental Caries in U.S. Children and Adolescents;
http://journals.sagepub.com/doi/abs/10.1177/0022034518774331
the 2018 Water Fluoridation Health Monitoring Report for England;
https://www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for-england-2...
the 2018 study, Contemporary evidence on the effectiveness of water fluoridation in the prevention of childhood caries – Australia;
https://onlinelibrary.wiley.com/doi/abs/10.1111/cdoe.12384
the 2018 Food Safety Authority of Ireland Fluoride Report;
https://www.fsai.ie/news_centre/tds_fluoride_30042018.html
the 2018 CDC Statement on the Evidence Supporting the Safety and Effectiveness of Community Water Fluoridation

https://www.cdc.gov/fluoridation/guidelines/cdc-statement-on-community-water-fluoridation.html

the 2017 Swedish report, Effects of Fluoride in the Drinking Water;
https://www.ifau.se/globalassets/pdf/se/2017/wp2017-20-the-effects-of-fluoride-in-the-drinking-water...
the 2017 National Health and Medical Research Council 2017 Public Statement – Water Fluoridation and Human Health in Australia;
https://www.nhmrc.gov.au/guidelines-publications/e44-0
the 2017 EPA Response:  Fluoride Chemicals in Drinking Water; TSCA Section 21 Petition
https://www.federalregister.gov/documents/2017/02/27/2017-03829/fluoride-chemicals-in-drinking-water...

the 2017 history of public health use of fluorides in caries prevention

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329778/

the 2016 World Health Organization report: Fluoride and Oral Health;
http://www.who.int/oral_health/publications/fluroide-oral-health/en/
the 2016 (update) Best Practice Approach - Community Water Fluoridation -  Association of State and Territorial Dental Directors

https://www.astdd.org/bestpractices/BPAFluoridation.pdf

the 2016 systematic review of published studies:  Does cessation of community water fluoridation lead to an increase in tooth decay?

https://jech.bmj.com/content/70/9/934

the 2015 Manual of Dental Practices, Council of European Dentists;
https://cedentists.eu/library/eu-manual.html
the 2015 U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries;  Demonstrates how the scientific consensus changes based on legitimate evidence – not fearmongering.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547570/
the 2015 Cochrane Water Fluoridation Review;
https://www.cochrane.org/CD010856/ORAL_water-fluoridation-prevent-tooth-decay
the 2015  Health Effects of water Fluoridation - An Evidence Review.  Ireland Health Research Board

http://www.hrb.ie/fileadmin/publications_files/Health_Effects_of_Water_Fluoridation.pdf

the 2014 AAP Clinical Report: Fluoride Use in Caries Prevention in the Primary Care Setting
http://pediatrics.aappublications.org/content/134/3/626

the 2014 Royal Society of New Zealand, Health effects of water fluoridation;
http://www.pmcsa.org.nz/wp-content/uploads/Health-effects-of-water-fluoridation-Aug2014.pdf
the 2013 Congressional Research Service, Fluoride in Drinking Water: A Review of Fluoridation and Regulation Issues;
https://fas.org/sgp/crs/misc/RL33280.pdf
the 2013 Community Guide Systematic Review, Dental Caries (Cavities): Community Water Fluoridation

https://www.thecommunityguide.org/findings/dental-caries-cavities-community-water-fluoridation

the 2011 SCHER Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water:
https://ec.europa.eu/health/scientific_committees/environmental_risks/docs/scher_o_139.pdf
the 2011 Guidelines for Canadian Drinking Water Quality: Guideline Technical Document – Fluoride

https://www.canada.ca/en/health-canada/services/publications/healthy-living/guidelines-canadian-drin...

the 2007 Dutch Ministry of Health and Welfare and Sports:  Economic evaluation of prevention: further evidence, GA de Wit;
https://www.rivm.nl/bibliotheek/rapporten/270091004.pdf
the 2006 Australian NHMRC systematic review of the efficacy and safety of fluoridation

https://www.ncbi.nlm.nih.gov/pubmed/18584000
the 2003 US Department of Health and Human Services, Toxicological Profile for Fluorides, Hydrogen Fluoride and Fluorine.

https://www.atsdr.cdc.gov/toxprofiles/tp11.pdf

the 2000 York, Systematic review of water fluoridation;
https://www.bmj.com/content/321/7265/855.full.print
the 2000 Community Preventive Services Task Force, Preventing Dental Caries: Community Water Fluoridation
https://www.thecommunityguide.org/sites/default/files/Oral-Health-Fluoridation-Archive.pdf

 

Q7) If your evaluation of the literature cited above is, "The problem is people think it works because of vast published literature which is nor controlled because humans cannot be placed  in cages where groups have identical  brushing habits, have all agreed to stop eating candy and sweets, etc.", can you cite any scientific studies that meet your criteria for inclusion that support the anti-F opinions?

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Re: More Irrelevant Distractions

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Message 865 of 1,448

Randy,

 

I stand by my statements because you do not provide evidence to the contrary.   If you would spend more time checking the endorsements rather than simply regurgitating the mantra, you would be shocked.

 

Circular referencing is a huge problem.  

 

Chuck provided some of his favorite endorsements.  Lets look at the first one, the Hispanic Dental Association policy statement located at:  http://www.ada.org/~/media/ADA/Public%20Programs/Files/FLResources_Hispanic_Dental_Association_Endor...

 

HDA references other endorsements as their evidence for their position.  For example, they reference the CDC, Surgeon General, and USPH.  However, no primary research is provided.

 

The CDC is slightly better with a longer list of cherry picked endorsements from other like minded organizations.  https://www.cdc.gov/fluoridation/organizations/index.htm

 

CDC goes further with a list of links, 

 

Community Water Fluoridation

collapse

Randy, maybe you could help me out here.  CDC lists basics, guidelines and recommendations, data and statistics, promotional resources, FAQ, and operators and Engineers.  What do you see missing???  Science.  Well that is hidden under Guidelines and Recommendations, as Scientific Reviews and Reports: Assessing the Evidence.    CDC did not assess the evidence, they rely on reviews and report which allegedly assess the evidence.    Lets, very briefly in summary look at their references.  

 

The Community Preventive Services Task Force,  (Cherry picked members who support fluoridation and avoided much science not supporting their position.)

 

NRC 2006  (CDC cherry picks the 2006 report.  And severe DF is now over 2%, or about 4-7 million people being harmed, known and undisputed harm, and CWF is a contributing factor, not the only factor.  NRC has too many reservations and concerns with recommendations for further study than space permits here.  Read the report and remember it is 12 years old, so read the last 12 years of research on each topic.)

 

US PHS.  ( USPHS references the CDC, circular logic and again cherry picks research.)

 

CDC. (CDC references itself, circular logic.)

 

IOM  (IOM's dietary guidelines for 1997.  What is the current IOM dietary guideline for fluoride?  Look it up.)

 

Cochrane review of 2015.  (See below)

 

Australian NHMRC (Again, cherry picked evidence)

 

WHO 2005  (WHO recommendations are not followed.  WHO advises to determine how much fluoride people are getting before starting fluoridation.  To my knowledge, no community, city, state, or country has determined with empirical measured evidence the current fluoride exposure prior to starting fluoridation.  They blindly start to fluoridate based on endorsements, not science.)

 

In my opinion, the Cochrane and NRC 2006 review need to be taken together, because Cochrane looks at "benefit" and NRC looks at "exposure" and "risk."  

 

Cochrane with my emphasis in bold. 

 
Authors' conclusions: 

"There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.

 

Randy, "very little contemporary evidence" does not give me confidence.  When we see huge increases in fluoride exposure from other sources, certainly we need contemporary evidence.  And the mother of all confounding factors which decreased dental caries by 4 to 5 teeth prior to fluoridation is not considered.  What was it?  Maybe that confounding factor is what caused caries to decline and not fluoridation.  With very little contemporary evidence, my confidence in mass medication evaporates.  We need good contemporary evidence to support fluoridation before fluoridation is continued.

 

Continuing with Cochrane Authors' conclusions;

 

"The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.

There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.

There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation."

 

Randy, is that what you call a robust endorsement of fluoridation?  I would say you need to read and weep.  But the CDC references Cochrane as evidence every single person, infants, adults, elderly, all ages, all health conditions, even those without teeth must ingest more fluoride. . . even without consent.

 

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Re: Fluoride - Demand AARP Take Action

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Message 866 of 1,448

Thank you Carry Anne. Yes nothing more needs to be said for normal rational people. 

As far as my opinion on the motives and reasons why one would support fluoridation, they are all different, and my opinion is not particularly important, nor anyone's business anyway. 

Endorsements that do not provide the experimental data and methods behind it are not science. Drug companies that promote the sale of a drug  to the general public without presenting the side effects data, the experiments, methods, snd results with error, and the structure and its mechanism of action, are nor science. They are advertisements based on opinions. Simply because such advertisements are rampant does not make it a scientific consensus. Far more is needed  for that. 

And when the CDC and ADA claim fluoridation is effective and harmless for consumption for generations  to come in perpetuity, when vast data demonstrate otherwise, this is advertisement, not science and certainly not a scientific consensus. 

There is no mechanism by which swallowed fluoride can improve the structure of normal hard crystalline  enamel that forms only when fluoride is not significant in the bloodstream during  tooth formation. Fluoride in saliva bathing teeth us 93000 times less concentrated than in toothpaste and even paste manyfacturers want to raise it to 5000 ppm because it is ineffective at existing levels of 1500.

Fluoridating people is hopeless at preventing caries. The problem is people think it works because of vast published literature which is nor controlled because humans cannot be placed  in cages where groups have identical  brushing habits, have all agreed to stop eating candy and sweets, etc. . The cochrane review by actual scientists recognize no studies that are sufficiently controlled to conclude any benefit exists scientifically  The science with caged animals prove no effect at all on caries while fluorosis increases. . 

Stick to the science and oppose fluoridation of man. 

 

 

Richard Sauerheber, Ph.D.
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Re: Fluoride - Demand AARP Take Action

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Message 867 of 1,448

... however if you really want to get into the scientific part of what exactly happens when you add fluoridation chemicals to the water, I suggest this item has some very useful information. 

ChemistryHWpage.jpgChemistry HW

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Re: Fluoride - Demand AARP Take Action

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Message 868 of 1,448

MuddledMottled.jpg

 

Fluoridation does not prevent cavities but does cause dental fluorosis, but even if that wasn't the case... it is still immoral mass medication that doses municipal water with a contaminated product that causes or worsens disease and disability in many consumers. 

 

Moreover, fluoridation chemicals are harmful to the environment. There is nothing more to say about it. 

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More Irrelevant Distractions

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rs – No one is questioning the scientific fact that fluoride ions, dissociated from whatever the source (natural minerals, fluoridation chemicals or foods) are absorbed in the GI tract.  What on earth is your point? That nonsense has absolutely nothing to do with the questions I asked BillO. 

 

You have also continued to dodge my questions about your understanding of CarryAnne’s libelous descriptions of fluoridation supporters as, “[affected by] financial benefit, ignorant, willful blindness, morally corrupt, cowards &/or sociopaths" and BillO’s derogatory descriptions as, “the credibility of those so called "scientific" organizations has been seriously tarnished.  They do not protect the public…  They are lemmings, followers, part of a herd, not scientists

 

Do you agree with these claims about several of the organizations that publically recognize the benefits and safety of community water fluoridation (CWF), and do you apply those descriptions to all organizations that support CWF and their members?

 

It is noted that you and other anti-science activists (ASAs) like Mike Adams (Natural News) and Alex Jones (INFOWARS) make claims like “The problem with advertisements from the ADA and dental officials at the CDC and others is that these are not trained scientists

 

The problem with that claim – as has been pointed out repeatedly – is that there are only a relatively few outlier trained “scientists” and “health professionals” who have dogged personal beliefs and severe fluorine paranoia which require them to dismiss the scientific consensus that fluoridation is safe and effective.

 

There are many ASAs who believe vaccinations are dangerous and should be banned – or who believe they have seen or been abducted by aliens – or that the world is ruled by a reptilian elite – and the list goes on….  Should they all be believed because they have strong personal biases and beliefs?

https://www.theatlantic.com/national/archive/2013/10/how-spot-reptilians-runing-us-government/354496...

 

Stop with the distractions and explain why you believe (and provide conclusive proof) that all scientists who do not recognize the opinions of ASAs are “not trained scientists who actually do controlled experiments using the scientific method”?  Also, as requested in the past, explain the fact that if the anti-F opinions about the allegedly obvious and dangerous health effects of CWF were even remotely legitimate, the overwhelming majority of scientists and health professionals continue to accept the scientific consensus that fluoridation is safe and effective – as evidenced by the fact that all major, recognized science and health organizations in the world accept that consensus.  Then explain why only Natural News, INFOWARS, and a few other alternative health organizations reject the scientific consensus. 

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Re: Fluoride - Demand AARP Take Action

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No. Even fluoride at 0.7 ppm is fully converted to HF at pH 2. This is the means by which fluoride gains entry into the blood from the acidic stomach. If it were the charged ion, very little  would be able to penetrate the stomach lining. 

After HF (which is hydrophobic and able to penetrate any lipid membrane) enters  the blood at pH 7.3, it of course  is reionized to the fee fluoride ion. This is indeed how ingested   fluoride accumulates in bone. 

This is scientific fact  (and consensus)  

The problem with advertisements from the ADA and dental officials at the CDC  and others is that these ar not trained scientists who actually do controlled experiments  using the scientific method. These groups merely interpret data from published materials that are usually not sufficiently controlled because humans cannot be placed in cages to control diets, hygiene, etc to make proper judgments on whether eating fluoride affects caries. Controlled animal studies prove caries are not  affected by fluoridated water use, all while dental fluorosis incidence is elevated. This confirms human studies that were more objectively done by Ziegelbecker, and by Teotia, and by Yiamouyianns. 

 

 

Richard Sauerheber, Ph.D.
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