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Re: Fluoride - Demand AARP Take Action

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Message 1301 of 1,417

Steve, 

 

Please cut the derogatory comments.  Attacking the messanger rather than the message is a bully tactic used by Trump.  Or did you go to the University of Trump to learn how to be a bully?  If so, you must have a PhD in bully.

 

Speculation arsenic is an essential nutrient.  As long as you agree the quality of speculation evidence is just speculation, lets go more to the facts on fluoride and not speculate.  Don't get me wrong, speculation can lead to some great inovation, but speculation is not a strong scientific reason to eat arsenic.

 

I'll stick with EPA's "zero MCLG" until the evidence is stronger than speculation.     

 

And even if someday a physiologic function for arsenic is found, the beneficial and harmful dosage will need to be determined.   A great deal more research on arsenic needs to be done.

 

SPECULATION:  The need for fluoridation is stronger than the need for arsenic in the diet.  However, the same flawed logic that arsenic is essential is used to claim fluoride is essential.  

 

Speculation is low quality evidence, along with conspiracy theories.  I reject both and so should you.  

 

For efficacy, stick with RCT studies like the FDA does.

 

For risk, the precautionary principle and freedom of choice MUST be seriously considered.

 

Bill Osmunson DDS MPH

 

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1302 of 1,417

There are no flaws in my posts, as evidenced by your inability to to provide any valid evidence to demonstrate any such “flaws”.  Your unsubstantiated personal opinion obviously does not qualify as such.

 

The EPA, as a matter of policy, sets the MCLG at zero for substances  which can be carcinogenic, regardless the level at which carcinogenicity may occur.  Arsenic at high levels can be carcinogenic.  

 

In regard to the undesirability of a zero level of arsenic:

 

“Definition of specific biochemical functions in higher animals (including humans) for the ultratrace elements boron, silicon, vanadium, nickel, and arsenic still has not been achieved although all of these elements have been described as being essential nutrients. Recently, many new findings from studies using molecular biology techniques, sophisticated equipment, unusual organisms, and newly defined enzymes have revealed possible sites of essential action for these five elements.”

 

—Nutritional requirements for boron, silicon, vanadium, nickel, and arsenic: current knowledge and speculation.

 Nielsen FH.

FASEB J. 1991 Sep;5(12):2661-7

 

Steven D. Slott, DDS

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1303 of 1,417

Yes, Bill.  Good scientists are not “dogmatic and absolute”.  Good scientists rely on valid evidence from reliable sources.  They do not rely upon erroneous  personal opinions, unsubstantiated claims, and speculation.  When you have valid, peer-reviewed scientific evidence to support your claims, feel free to provide it at any time.   Attempting to cloak the absence of such evidence in personal philosophical  opinions is transparent and disingenuous.

 

As for your “sub-topics”

 

1.  Yes, concentration and dose are two different quantifiers.  Your acknowledgement of this elementary concept does not change the facts.

 

The intake, or dose, of fluoride from optimally fluoridated water is very strictly controlled.  For every one liter of such water consumed, 0.7 mg fluoride is ingested.  The average water consumption of adults is 2-4 liters per day.  Ten liters is roughly 2.5 gallons.  If you know of anyone ingesting 2.5 gallons of water on a daily basis you should caution him/her  about the dangers of water toxicity.  No public health initiative is expected to account for extreme behaviors such as this.

 

Prior to attaining the daily limit of  fluoride intake from optimally fluoridated water in conjunction with that from all other normal sources, water toxicity would be the concern, not fluoride.  When the amount of a substance which can be ingested falls below the level of adverse effects for that substance, then dose is not a concern in regard to adverse effects.  Presumedly  you understand this as you seem to have no problem with any “uncontrolled” dose of chlorine, ammonia, or any of the other substances routinely added to public water supplies.

 

Ironically, the non-fluoridated systems for which you advocate are far less controlled in regard to fluoride dose than are fluoridated systems.  While fluoridated systems maintain a constant fluoride concentration of 0.7 mg/liter, non-fluoridated systems are only governed by a maximum allowable level of 4.0 mg/liter, nearly 6 times that of fluoridated systems.

 

2.  Both the EPA maximum allowable level, and the US DHHS recommended optimal level, of fluoride in drinking water obviously take into account total fluoride intake from all sources.  Believe it or not, the scientists establishing such levels are not incompetent.  

 

Simply put, water is fluoridated at 0.7 mg/liter (ppm=mg/liter).  Thus, for every liter of fluoridated water consumed, the "dose" of fluoride intake is 0.7 mg.  The average daily water consumption by an adult is 2-4 liters per day. The US CDC estimates that of the total daily intake, or "dose", of fluoride from all sources including dental products, 75% is from the water. 

 

The National Academy of Medicine has established that the daily upper limit for fluoride intake from all sources, for adults, before adverse effects will occur, short or long term, is 10 mg. As can be noted from a simple math equation,  before the daily upper limit of fluoride intake could be attained in association with optimally fluoridated water, water toxicity would be the concern, not fluoride.  

 

The range of safety between the minuscule few parts per million fluoride that are added to existing fluoride levels in your water, is so wide that "dose" is not an issue. 

 

3.  FAN claims as to what NHANES data “clearly shows” does not constitute proper interpretation of this data by any qualified, reliable entity.

 

The severe level of dental fluorosis is the only level of this effect considered to be an adverse effect.  Severe dental fluorosis is  rare in the US and, as clearly noted by the 2006 NRC Committee on Fluoride in Drinking Water, does not occur in communities with a water fluoride content less than 2.0 ppm.  And yes, this takes into account fluoride intake from all sources.  These scientists were not incompetent either.  

 

4. An image of some graph you claim to be from the EPA, with no citation to the original is meaningless.

 

5.  Your unsubstantiated personal opinion as to what the EPA “ignored” or “proposed without support” is meaningless and irrelevant.

 

6.  It has been  determined, through countless peer-reviewed scientific studies,  that  a concentration of 0.7 mg/liter fluoride in drinking water fluoride is beneficial in preventing a significant amount of  very serious dental infection in populations served by that water.

 

Steven D. Slott, DDS

  

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Re: Fluoride - Demand AARP Take Action

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Message 1304 of 1,417

Steve,

 

Please provide just one prospective peer reviewed randomized controlled trial on the cost effectiveness of water fluoridation.  

 

Most studies are estimates of assumptions, not measured evidence.  I call that hopeful guessing.

 

Just one study please.

 

And if fluoridation is cost effective, then countries, states, or counties with water fluoridation should have lower costs and lower prevelance of caries, but they don't.

 

Certainly costs for dental treatment should be lower in fluoridated communities and that should result in lower dental insurance rates?  But that's not the case.

 

And there should be fewer dentists per 1,000 population in fluoridated communities, but that is not what I've found.

 

Yes, if we assume fluoridation is effective, then we can estimate the savings, but measured evidence such as Maupome do not show evidence of cost savings.

 

Bill Osmunson DDS MPH

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Re: Fluoride - Demand AARP Take Action

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Message 1305 of 1,417

Steve,

You asked for any peer reviewed evidence fluoride at 0.7 -1.4 ppm (Oh, that was lowered because HHS found it was not safe) now 0.7 ppm.

 

NHANES 2000 and 2011-12 showing 20% of adolescents have moderate/severe dental fluorosis.  Remember, all members of NRC 2006 report on fluoride for the EPA unanimously agreed severe dental fluorosis is an adverse health risk, in other words, harm.  

 

The question is not one of whether people are being harmed with the addition of fluoride in public water which is over exposing them to fluoride.   The question is "how many" are over exposed.

 

Bill Osmunson DDS MPH

 

 

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Re: Fluoride - Demand AARP Take Action

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Message 1306 of 1,417

Steve,

 

Your statements that the cost effectiveness and safety of fluoridation are without question is unprofessional and unscientific.  

 

For good scientists, everything is in question, even gravity and life itself.  When a person claims a theory and policy is "without question," that means the person is not looking at all the evidence.   

 

Science questions.  Religion is without question.

 

Bill Osmunson DDS MPH

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Re: Fluoride - Demand AARP Take Action

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Message 1307 of 1,417

Steve,

 

What physiologic function reqires arsenic (or fluoride or lead)?  

What scientific evidence can you provide that arsenic is, as you say, "desirable?"

 

Bill Osmunson DDS MPH

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Re: Fluoride - Demand AARP Take Action

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Message 1308 of 1,417

Steve,

 

There are so many flaws in your posts, it is hard to know where to start.

 

For example you state,  "A zero level of arsenic is neither attainable  nor likely to be desirable.  The EPA maximum allowable level of arsenic in drinking water is 10 parts per billion."

 

I agree zero level of arsenic is not likely.  However, the EPA has zero as the Maximum Contaminant Level Goal (MCLG).  What scientific evidence can you provide the EPA is in error and some arsenic is desirable?  

 

Bill Osmunson DDS MPH

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Re: Fluoride - Demand AARP Take Action

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Message 1309 of 1,417

Scientists. . . good scientists. . . are not dogmatic and absolute, non-negotiable.  Good scientists understand that not all evidence, research, facts are known.  We are always challenging the evidence and questioning the theories.   The terms "ignorant"  "always" "never" "established" are terms to be avoided.  Camping on assumptions is hazardous because 50% of what science has "established" is wrong and we don't know which 50%.  An open mind is essential.

 

I want to break the concept of fluoridation into small sub-topics for more clarity.

 

Lets talk about one aspect of dosage, which involves how much are we getting? and how much do we want?

 

1.   CONTROLLED DOSAGE FROM WATER:  The concentration of fluoride in water is a concentration, not a dosage.  Concentration of fluoride in water makes no "dosage" sense unless we know how much water the patient is ingesting.  Some ingest almost no water and others ingest over 10 liters a day.  Dosage of fluoride from water is uncontrolled because the amount of water consumed by each individual is not controlled.  Water is a poor medium for dispensing any substance used to treat humans or animals.

 

2.   TOTAL FLUORIDE EXPOSURE:  In all discussions on fluoride, total fluoride exposure is essential.  Individuals consume a great deal of fluoride from many sources.  Swallowing toothpaste, pesticides, post-harvest fumigants, medications, and much more.  A discussion of fluoridation MUST consider all sources of fluoride exposure, not just water.  A statement such as a Harvard Professor tried to use, "water fluoridation has never been shown to cause any harm," is deceptive.  In fact, I don't know any human study which has isolated out only water fluoridation as the only source of fluoride exposure.  

 

3.  MANY ARE INGESTING TOO MUCH FLUORIDE:  NHANES clearly shows a huge increase in dental fluorosis to 60% of adolescents in 2011-2012, a biomarker of excess fluoride exposure.  Note the EPA graph below:

00001.jpgEPA 2010  The US EPA Relative Source Contribution of fluoride in 2010 shows fluoride daily intake is excessive (percentage above the black line) for about a quarter to a third of children.  

The EPA ignored the 10% of children drinking more water.  

The EPA ignored infants below six months of age.  

The EPA proposed, without support, claiming fluoride is a third safer (RfD).

 

 

And we have not considered, yet, "HOW MUCH FLUORIDE IS BENEFICIAL?"

 

Bill Osmunson DDS MPH

 

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Re: Fluoride - Demand AARP Take Action

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Message 1310 of 1,417

“CaryAnne”

 

Karen, please stop fear-mongering about skeletal fluorosis.  Aside from the mound of misinformation you’ve posted, you’ve clearly demonstrated that you have no idea as to the difference between dose and concentration of fluoride, much less the effect of either.

 

Once again, skeletal fluorosis is not a concern in regard to optimally fluoridated water.  If it was, this disorder would be rampant in the nearly 75% fluoridated US by now.

 

From the US Department of Health and Human Services:

 

“Several of the more recent reviews on the safety of fluoride intake have discussed skeletal fluorosis, which is extremely rare in the United States. Epidemiological studies in the U.S. of communities with naturally occurring fluoride in the water 3.3 to 8 times the amount in optimally adjusted water supplies found no evidence of skeletal fluorosis. Pages 45-47 of the 1991 Department of Health and Human Services document Review of Fluoride: Benefits and Risks discusses the topic of skeletal fluorosis topic in more detail and provides references. Only 5 cases of skeletal fluorosis have ever been reported in the U.S. In these cases, the total fluoride intake was 15 to 20 mg./fluoride per day for 20 years.”

 

https://aspe.hhs.gov/cdc-—-fluoridation-hhs-response-rfr

 

 

In regard to your other claims:

 

1.  Your attempt to equate your own ignorance of the facts with the knowledge of all other seniors.....i.e. “we seniors understand”...... is an insult to the intelligence of seniors everywhere.  Unsubstantiated claims as to what you think you know, have no foundation in fact, much less any valid evidence to support them.

 

2.  Because a study has the word “fluoride” in it, does not make it relevant to the minuscule amount of fluoride in optimally fluoridated water.

 

a.  In the 1991 study you cite, the osteoporosis treatment consisted of administering 22 mg of fluoride per day.  Yeah.... no kidding.....with  that incredibly massive dose of fluoride, there would undoubtedly be problems.  

 

The amount of fluoride obtained from consuming one liter of optimally fluoridated is 0.7 mg.

 

b. Neither is the  2002 study you cite of any relevance.  It is in regard to guidelines in the management of osteoporosis.  Water fluoridation is not intended, or expected to prevent osteoporosis.  Fluoridation is simply the adjustment of the level of existing fluoride in water to that concentration at which has been determined to result in significantly reduced amount of dental decay in the populations served by that water.

 

c. In your third cite.....an opinion piece posted  on an antifluoridationist website.....long time fluoridation opponent, Hardy Limeback, expresses his “concern” about fluoridation effects on human bone.  Limeback’s own 2010 study demonstrates there to be no effect on human bone from fluoride at the optimal level at which water is fluoridated:

 

“Many decades of epidemiological studies have shown minImal evidence of any effects of fluoride administration on bone, and it is therefore very unlikely that municipally fluoridated water affects adults with healthy bone. In this study, no
effects of fluoride on mineralization (by BSE) and no substantive negative effects of fluoride administration on bone mechanical properties were observed”
 


—The Long-term Effects of Water Fluoridation on the Human Skeleton

Chacra, Limeback, et al.

Journal of dental research 89(11):1219-23 · November 2010

 

3.   Unsubstantiated claims of some phantom “science” you believe to  exist somewhere or another, are obviously meaningless.

 

4.  Studies on arthritis are irrelevant to water fluoridation.  There is no valid, peer-reviewed scientific evidence of any association of optimally fluoridated water with arthritus.

 

5.  Anecdotal claims and self-diagnoses  of your own perceived ailments are of no relevance.  If you have valid, documented diagnoses of the cause of any medical condition you may have, from qualified, properly licensed and credentialed healthcare providers, feel free to present it at any time. In the meantime, you are probably exacerbating any such medical conditions by failing to obtain proper diagnoses and treatment.  

 

 

Steven D. Slott, DDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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