Fluoride - Demand AARP Take Action

[CarryAnne]

“The evidence that fluoride is more harmful than beneficial is now overwhelming… fluoride may be destroying our bones, our teeth, and our overall health.” - Dr. Hardy Limeback,  former President of Canadian ADA, Head of Preventive Dentistry at Univ of Toronto, 2006 National Research Council Scientist (2007)

The 2006 National Research Council on Fluoride in Drinking Water commented to the EPA that fluoridation at 1 ppm can be anticipated to be harmful for those with reduced renal function and the elderly. The NRC confirmed that fluoride not excreted by kidneys builds up in bones, resulting in arthritic pain and increased brittleness. However, there were no EPA studies on the whole health impacts of fluoridated water on susceptible population such as kidney patients, children, those with prolonged disease or the elderly. There still aren’t. 

However, there is mounting science from other sources that “optimally fluoridated” water, which is known to cause varying degrees of dental fluorosis in 58% of Black American adolescents and 36% of White American adolescents, is causing subtle deficits in ability to remember or focus. That same “optimal level” has also been proved in a 2014 study as being nephrotoxic in rats with chronic kidney disease. Chronic kidney disease (CKD) affects approximately 15% of Americans, although CKD is quadruple the rate in Black Americans, and predictably worse in older Americans. 

Perhaps the most horrifying part of the story of fluoridation is that not only is at least 50% of every drop of fluoride that has passed the lips of a Baby Boomer permanently stored in bones, fluoride isn't the only poison in packages of fluoride that originate as the waste product of aluminum an phosphate industry. 100% of the fluoride sampled in a 2014 study was contaminated with aluminum; arsenic and lead were other common contaminants. In other words, fluoridated water serves as a delivery system for aluminum and lead into our bones and our brains. As we all know, aluminum is associated with Alzheimers in adults, and lead is associated with learning disabilities in children. Approximately 15% of the population who is sensitive to chemicals cite inability to think clearly and overwhelming fatigue as symptoms of exposure to fluoridated water. 

Our generation was part of a great human experiment. It may have had noble intentions based on the faulty hypothesis that  drinking fluoridated water prevented cavities. It is now known that any perceived benefits of fluoride are from tooth brushing.  Our grandchildren are the third generation in this travesty. I suggest we all DEMAND the AARP stand up for us and our grandchildren by issuing a strong position paper calling for the cessation of water fluoridation. 

SCIENCE REFERENCES

1. 2014 in Toxicology. Effect of water fluoridation on the development of medial vascular calcification in uremic rats. (“Optimal levels” worsen kidney function😞 http://www.ncbi.nlm.nih.gov/pubmed/24561004
    
2. 2015  in Neurotoxicology and Teratology. Association of lifetime exposure to fluoride and cognitive functions in Chinese children: A pilot study.  (Children with visible dental fluorosis perform less well on memory tasks, correlating with the degree of severity of their fluorosis. One of a series of human and animal studies with the same consistent findings.😞 
1. http://www.ncbi.nlm.nih.gov/pubmed/25446012  
2. http://braindrain.dk/2014/12/mottled-fluoride-debate/ 
   
   
3. 2014 in Physiology and Behavior. Fluoride exposure during development affects both cognition and emotion in mice. (Measurable behavioral changes😞 http://www.ncbi.nlm.nih.gov/pubmed/24184405
   
   
4. 2014 in International Journal of Occupational and Environmental Health. A new perspective on metals and other contaminants in fluoridation chemicals. (All samples of fluoride are contaminated with aluminum, plus other contaminants like arsenic, lead and barium); 
1. http://www.ncbi.nlm.nih.gov/pubmed/24999851
2. http://momsagainstfluoridation.org/sites/default/files/Mullenix%202014-2-2.pdf
   
   
5. 2014 in Scientific World Journal. Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention. (Health risks and cost don't justify minimal and questionable dental benefit.):  http://www.hindawi.com/journals/tswj/2014/293019/

RACIAL INEQUITY (FOIA)

Here are three Oct 2014 news articles on the content of the Freedom of Information Act documents. Rev. Andrew Young, former UN ambassador has pursued them with the CDC, but to little effect. Civil Rights leaders have been calling for an end to community water fluoridation (CWF) since 2011. 

• 1. Black Americans disproportionately harmed: http://www.thenewamerican.com/usnews/health-care/item/19317-feds-blacks-suffer-most-from-fluoride-fl...
• 2. CDC, ADA and Pew inappropriate relationships: http://benswann.com/do-newly-released-emails-reveal-conflict-of-interest-between-the-cdc-and-the-ada...
• 3. Kidneys, Civil Rights & Ralph Nader: http://portland.indymedia.org/en/2014/10/428383.shtml

2015 LEGAL ARGUMENT (GROSS DISPROPORTIONALITY) 

There is a legal initiative in Peel, Ontario (pop 1.3m) to remove fluoride from the water supply based on the principle of gross disproportionality, i.e. marginal benefit does not justify great risk of harm. There is also a political effort afoot in Canadian govt to mandate fluoridation and thereby make the legal argument moot. I suggest this document is well-worth printing.  http://fluoridealert.org/wp-content/uploads/peel.june2014.pdf

• a. The first 19 pages of this document is about the legal strategy. It includes summary of US legal cases that found water fluoridation harmful to the public, but legal under US "police power" mandate.
• b. Starting on page 20 is a devastating affidavit by Dr. Kathleen Thiessen, NAS/NRC scientist and international expert in risk assessment. Very readable summary of science indicating harm to populations in “optimally” fluoridated communities. 

POPULATION WITH LOW CHEMICAL THRESHOLD

1. In excess of 25% of previously healthy Gulf War Veterans have Multiple Chemical Sensitivities, which includes sensitivity to fluoride. See: http://www.va.gov/rac-gwvi/docs/committee_documents/gwiandhealthofgwveterans_rac-gwvireport_2008.pdf 
1. EXCERPT: “It is well established that some people are more vulnerable to adverse effects of certain  chemicals than others, due to variability in biological processes that neutralize those chemicals, and clear them from the body.” - Research Advisory Committee on Gulf War Veterans’ Illnesses 2008 
2. Affidavit of Dr. Hans Moolenburgh: https://fluorideinformationaustralia.files.wordpress.com/2013/01/affidavit-moolenburgh.pdf
1. Except: “As a summary of our research, we are now convinced that fluoridation of the water supplies causes a low grade intoxication of the whole population, with only the approximately 5% most sensitive persons showing acute symptoms.The whole population being subjected to low grade poisoning means that their immune systems are constantly overtaxed. With all the other poisonous influences in our environment, this can hasten health calamities.” 
3. PubMed Listed Studies on immune system response: 
1. a. Fluoride makes allergies worse, rats (1990): http://www.ncbi.nlm.nih.gov/pubmed/1707853 
2. b. Fluoride makes allergies worse, in vitro (1999): http://www.ncbi.nlm.nih.gov/pubmed/9892783
3. c. Immune system of the gut (2010): http://www.hindawi.com/journals/iji/2010/823710/ 
4. d. ASIA Syndrome, adjuvant impact (2011): http://www.ncbi.nlm.nih.gov/pubmed/20708902
5. e. Gene predicts fluoride sensitivity (2015): http://www.ncbi.nlm.nih.gov/pubmed/25556215
6. f.  Brain has an immune system (2015): http://www.ncbi.nlm.nih.gov/pubmed/26030524

AARP - STAND UP on our behalf! 

[CarryAnne · Accepted solution]

 Dr. Joel Bohemier’s presentation to the Commissioners of Collier County, FL  includes quotes for EPA, CDC and others under oath from TSCA trial depositions. This presentation was part of the Commissioners deliberation that resulted in its unanimous vote to end fluoridation last week: https://unite.live/widgets/4142/recording/player#  

It is in the hands of Judge Chen, now, but I've got to say that the closing on Feb. 20th was odd.

Not only did Judge Chen pepper both attorneys with questions, the EPA attorneys seemed to admit that fluoride exposure at doses consistent with water concentration of 1.5 ppm, 2 ppm and 4 ppm had been proven to result in lower IQ per studies of mom-child pairs performed in Canadian and other communities across the world. They admitted this despite the official policy of the U.S. EPA stating there is no harm up to 4 ppm (the actionable threshold for remediation) other than mild cosmetic dental fluorosis (tooth staining) at or above 2 ppm. The Canadian government has an actionable threshold of 1.5 ppm which is consistent with the WHO guidelines. 

When Judge Chen challenged the EPA that per both plaintiff and defense witnesses, shouldn't there be a protective uncertainty or safety factor of at least ten to protect consumers applied to 2 or 4 which would protect teeth from moderate dental fluorosis which a recent Health Canada is concern at 1.56 ppm and from severe dental fluorosis which the 2006 National Research Council (NRC) said was an adverse health risk at 4 ppm which would also protect brains, EPA Defense attorney said that would be an interesting thought experiment, but Plaintiff attorney didn't argue about dental fluorosis (which by the way is positively associated with lower IQ and learning disabilities) so the judge could not legally do so. Frankly, it almost seemed like the EPA attorneys were threatening the Judge. 

Judge Chen pushed back about EPA "Health Protective Assumption" guidelines, but EPA insisted that the Judge must not act based on science or consumer protection, but on strict interpretation of statutory law and the skill of the Plaintiff attorney in proving his case. 

On the other hand, Plaintiff attorney was clear that the Toxic Substances Control Act (TSCA) only requires that any specific use of a chemical (fluoridation programs) not pose an "unreasonable risk" to consumers which include susceptible sub-populations like pregnant women and their offspring and bottle-fed babies. All five plaintiff witnesses were quite clear that optimally fluoridated water per CDC guidelines is subtly and permanently damaging the brains of millions of children. Even EPA witnesses and attorneys admitted that there is "something there" in the scientific evidence showing neurotoxic effects at 0.7 ppm, but argued it is not clearly defined enough to identify a "Point of Departure" for the EPA to perform a risk assessment. 

Really? 

Three Benchmark Dose Analyses which are the gold standard for beginning risk assessments and established uncertainty factors have identified that 0.2 mg/L, which is one tenth of 2 ppm, as harmful. This suggests that no fluoride exposure is safe for baby brains and is a scientifically justifiable Point of Departure in anyone's book.  

BMCL

But let's make it even easier for thick-headed fluoridationists to understand: 

• No amount of fluoride in water or food is safe for pregnant women and their fetuses; bottle-fed infants and young children; the elderly and any in fragile health, such as diabetics or those with thyroid or kidney disease. 

[CarryAnne · Accepted solution]

 “Today’s ruling represents an important acknowledgement of a large and growing body of science indicating serious human health risks associated with fluoridated drinking water. This court looked at the science and acted accordingly. Now the EPA must respond by implementing new regulations that adequately protect all Americans – especially our most vulnerable infants and children – from this known health threat.” - Wenonah Hauter, Director of Food & Water Watch in “Historic Court Decision in Fluoridation Toxicity Case Orders EPA to Act” (Sept. 25, 2024)

Well, it as been a busy few weeks! 

Not only was the final NTP Systematic Review, "Fluoride Exposure: Neurodevelopment and Cognition" published in August (despite political efforts by HHS/PHS and ADA to scuttle it) after five (or was it six) peer reviews, the Final Findings and Conclusion of Law from a lengthy de novo trial was rendered in September with excellent detail, and the 2024 Cochrane Systematic Review, "Water fluoridation for the prevention of dental caries," published in October repeated that dental fluorosis is an adverse effect of fluoridation, a practice which provides no benefit to adults or lower socio-economic groups. The Cochrane authors also wrote that the very small benefit they were able to document to children from "poor quality" studies at high risk of bias "may not be real." 

In other words, community water fluoridation is all risk and no benefit. Fluoridation is dental mythology, a magic potion tooth-fairy tale. The most important thing is that Judge Chen ordered the EPA to take action to eliminate the risk to consumers. 

• UNSAFE: p. 2:  the Court finds that fluoridation of water at 0.7 milligrams per liter (“mg/L”) – the level presently considered “optimal” in the United States – poses an unreasonable risk of reduced IQ in children.

• HAZARD: p 5:   The pooled benchmark dose analysis concluded that a 1-point drop in IQ of a child is to be expected for each 0.28 mg/L of fluoride in a pregnant mother’s urine. This is highly concerning, because maternal urinary fluoride levels for pregnant mothers in the United States range from 0.8 mg/L at the median and 1.89 mg/L depending upon the degree of exposure. Not only is there an insufficient margin between the hazard level and these exposure levels, for many, the exposure levels exceed the hazard level of 0.28 mg/L.
  
  

• CERTAINTY: p. 77: The scientific literature in the record provides a high level of certainty that a hazard is present; fluoride is associated with reduced IQ. There are uncertainties presented by the underlying data regarding the appropriate point of departure and exposure level to utilize in this risk evaluation. But those uncertainties do not undermine the finding of an unreasonable risk; in every scenario utilizing any of the various possible points of departures, exposure levels and metrics, a risk is present in view of the applicable uncertainty factors that apply.
  
  

• VULNERABILITY: p. 76: The size of the affected population is vast. Approximately 200 million Americans have fluoride intentionally added to their drinking water at a concentration of 0.7 mg/L. See Dkt. No. 421 at 206-07 (undisputed). Other Americans are indirectly exposed to fluoridated water through consumption of commercial beverages and food manufactured with fluoridated water
  
  

• SUSCEPTIBILITY: p. 76: Approximately two million pregnant women, and over 300,000 exclusively formula-fed babies are exposed to fluoridated water. The number of pregnant women and formula-fed babies alone who are exposed to water fluoridation each year exceeds entire populations exposed to conditions of use for which EPA has found unreasonable risk; the EPA has found risks unreasonable where the population impacted was less than 500 people. 

[StevenS353310]

Osmunson, continued.......

15.  I have no “paradigm shift”.  I’m doing exactly as I said.  I’m correcting the misinformation you continually post, and have no desire to “discuss dentistry, fluoride, or other issues” with you, as you proposed in your previous comment.

16.  The FAN claim of what “NHANES shows”  is FAN’s interpretation, not that of NHANES.  You clearly admit here that moderate/severe dental fluorosis is not attributable to fluoridated water.  What you are therefore seeking to do is end fluoridation due to an effect that is not attributable to this public health initiative.  

17.  Yes, your arguments against the NTP study are not compelling in the least.  This is particularly true in view of the fact that your group promoted and blustered about this study from the very beginning, yet by some strange twist now finds it to be fraught with limitations and  having utilized questionable methodologies.  The no uncertain terms in which the results of the study debunked FAN’s claims, has nothing to do with this sudden shift in confidence in the NTP, I presume........

I fully agree.  No one study is proof of anything.  This is precisely the point  fluoridation advocates have been hammering home against the cherry-picking of antifluoridationists for years.  You should tell this to your FAN colleagues.  They are the ones who blustered about the NTP study as one “that could end fluoridation”,  who misrepresent Bashash as “proof” of neurotoxicity, and who constantly cite Bassin for their ridiculous cancer claims, while ignoring the volume of science which has clearly demonstrated just the opposite.  

Your claim of 6 to 1 is typical of the unsubstantiated nonsense constantly put forth  by antifluoridationists.  Providing titles of studies which contain the word “fluoride” in them somewhere does not denote relevance, validity, or proper representation of the results of such studies......as the EPA made clear in its 40 page rejection of the most recent meritless FAN petition.

18.  Anecdotes about what you claim the NTP told you are meaningless and irrelevance.  

The ones who “pops open the champaign” were FAN and its followers who blustered about this NTP study at the beginning, only to have their champaign go completely flat when the study results didn’t go as planned......to the surprise of no one except antifluoridationists.

19. As both York 2000 and Cochrane 2015 clearly noted, RCTs on large, population-based initiatives such as water fluoridation are infeasible, and will thus never be done.  Not only are the observational studies on fluoridation entirely acceptable, such studies have been clearly demonstrated to provide equally reliable results as RCTs.

“We found little evidence that estimates of treatment effects in observational studies reported after 1984 are either consistently larger than or qualitatively different from those obtained in randomized, controlled trials.”

—-A Comparison of Observational Studies and Randomized, Controlled Trials

Kjell Benson, B.A., and Arthur J. Hartz, M.D., Ph.D.

N Engl J Med 2000; 342:1878-1886

DOI: 10.1056/NEJM200006223422506

“However, empirical proof that observational studies of treatment are widely off the mark has been surprisingly elusive.2 Four meta-analyses contrasting RCTs and observational studies of treatment found no large systematic differences (Benson 2000, Concato 2000, MacLehose 2000, Ioannidis 2001).”

—-Why do the results of randomised and observational studies differ?

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7020 (Published 07 November 2011)

20.  Perhaps it is you who “should  read the NZ court case again”.....or actually read  for the first time, which your comments indicate you have not yet done.  If you did, then maybe you would cease misrepresenting it.  That aside, it’s interesting that you attempt to base your “choice” argument on one court case in New Zealand given that you previously professed the inadvisability of relying upon “one single study”.  I rest my case about the cherry-picking of antifluoridationists.

You have the option of purchasing fluoride-free bottled water, utilizing an RO filter, utilizing rain water, obtaining water from rivers and streams.....

Options are choices.  Inconvenience does not equate to force.  You are free to consume fluoridated water, or to obtain fluoride-free water from other sources.  Entirely your choice.

21.  Your “bottom line”:

a.  Your personal opinion as to whom is ingesting what is unsubstantiated, unquantified, and does not demonstrate  harm from optimally fluoridated water.  It is certainly not a reason to deprive entire populations of the very valuable disease preventive benefits of this public health initiative.

b.  The dose of fluoride from optimally fluoridated water is very strictly controlled.  For every one liter of such water consumed, 0.7 mg of fluoride is ingested.  When the amount of a substance which can be ingested falls below the level of adverse effects for that substance, then dose is not of concern in regard to adverse effects.  Before this level could be attained from ingesting optimally fluoridated water in conjunction with fluoride intake from all other normal sources of fluoride, water toxicity would be concern, not fluoride.

This is true not only for fluoride but for chlorine, ammonia, and the myriad other substances routinely added to public water supplies. 

c.  There are  no “freedom of choice” issues involved with water fluoridation.  You are  free to consume it or not.  Entirely your choice.

d.  The effects of fluoride are both topical and systemic.  The systemic effects are demonstrated in the mild to very mild dental fluorosis which which may be associated with optimally fluoridated water.  Mild to very mild dental fluorosis is a barely detectable effect which causes no adverse effect on cosmetics, form, function, or health of teeth.  As peer-reviewed science has demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse.  Dental fluorosis can only occur systemically. 

—-The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH

http://jada.ada.org/content/140/7/855.long

Additionally, topical effects of fluoride are made possible through its ingestion. Saliva with fluoride incorporated into it provides a constant bathing of the teeth in a low concentration of fluoride all throughout the day, a very effective means of dental decay prevention. Incorporation of fluoride into saliva occurs systemically.

Further evidence of systemic benefit is provided by:

------Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States

United States Centers for Disease Control

Recommendations and Reports

August 17, 2001/50(RR14);1-42

 Additionally, in a 2014 study Cho, et al. found:

-----Systemic effect of water fluoridation on dental caries prevalence

Cho HJ, Jin BH, Park DY, Jung SH, Lee HS, Paik DI, Bae KH.

Community Dent Oral Epidemiol 2014; 42: 341–348. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

---Buzalaf MAR (ed): Fluoride and the Oral Environment. Monogr Oral Sci. Basel, Karger, 2011, vol 22, pp 97–114

(DOI:10.1159/000325151)

e.  Unsubstantiated claims about some phantom studies existing somewhere or another....are meaningless and irrelevant.

f.  There is no valid, peer-reviewed scientific evidence of any sensitivity to fluoride at the optimal level.

G.  Your “greatest blunder” in regard to this issue is a failure to properly educate yourself on it from reliable, respected sources of accurate information.

Steven D. Slott, DDS

[BillO538145]

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:

EPA 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

[StevenS353310]

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

[StevenS353310]

Bill, I’ll go round and round in your little circles as long as you would like. However, no matter how many times you keep repeating the same invalid arguments, the facts will not change.

Yes, science should not be treated like religion or politics. It is a mystery why you continue to do so. The only ones I see injecting religion into the issue of fluoridation, for whatever reason, are opponents. You and Connett do so repeatedly.

Again, posting misrepresentations, false claims, and misinformation does not you make you a “messenger” of anything but nonsense. I am personally aware of no attempts to “shoot” you, for whatever bizarre reason you keep making that reference.

Yet once again.......

1. The opinions of the New Zealand justices were just that....opinions. They are not rulings, and carry no force of law. Countless people have opinions on fluoridation. Interestingly enough, the opponents putting out their nonsensical misrepresentation of this ruling, conveniently omit the opinion of the justice which differed with those of the others. The ruling of the NZ Supreme Court in this case was that the arguments presented by the antifluoridationists were inadequate to warrant overturn of the lower court ruling against the antifluoridationists. Their appeal was therefore rejected and the lower court ruling was upheld.  

2. The US FDA has no jurisdiction over the contents of public water supplies. It therefore makes no more difference to water fluoridation what the FDA approves, than it does what the Girl Scouts of America approve.

3. The US FDA has jurisdiction over consumable retail products. It is certainly free to testify to Congress or anywhere else how it classifies these products. Such testimony has no relevance to contents of public water supplies.

4. The NZ justices did not agree that “fluoride is a drug”. Just the opposite. They unanimously agreed that under the regulations set forth under the NZ Medicine Act, fluoridating agents are not drugs. The antifluoridationist challenge to the validity of those regulations had already been rejected.

“The Supreme Court has unanimously dismissed New Health’s appeal against both aspects of the Court of Appeal decision. The Court found that the regulations were valid because they were not made for an improper purpose, nor were they made on the basis of an error of law. The Court agreed with the Court of Appeal that the question as to whether the fluoridating agents were medicines prior to the making of the regulations was moot.”

Fluoridation: New Health NZ v South Taranaki DC Wednesday, 27 June 2018, 12:30 pm Press Release: NZ Supreme Court Supreme Court of New Zealand Te Kōti Mana Nui 27 JUNE 2018 http://www.scoop.co.nz/stories/PO1806/S00307/fluoridation-new-health-nz-v-south-taranaki-dc.htm

5. You forgot to include the Girl Scouts in your little list of whom you claim thinks fluoride is a drug. Where does GSA stand, Bill? I mean, their opinion on the contents of drinking water supplies is every bit as relevant as that of the other groups you list.

6. What you deem you have gleaned from a perusal of the laws of some unknown state or another, could not be any more meaningless or irrelevant. How you personally define fluoride could not be any more meaningless or irrelevant. Produce a ruling from any court of last resort that water fluoridation is illegal.

7. My comment does not “suggest” there are no drugs involved with fluoridation. It states this as a fact. Whatever “poison laws” to which you refer, are a mystery.

What you personally deem to be “options” for fluoride classification is meaningless and irrelevant. Fluoride has always existed in water. It is regulated by the US EPA, as are all other contents of such water.

8. The concentration of the existing fluoride content in public water supplies is adjusted through fluoridation to that level at which has been established that maximum dental decay resistance occurs in the population served by that water, with no adverse effects upon anyone. The fluoride ions added to adjust to this level are identical to those which already exist in water. An attempt to suddenly proclaim these fluoride ions to be a “drug” is obviously ludicrous.

9. Arsenic is ubiquitous in nature. It is added to water constantly. To prevent this occurrence would be nearly impossible. The amount of arsenic which can legally exist in drinking water at the tap, is 10 parts per billion The amount of fluoride which can legally exist in drinking water at the tap is 4.0 parts per million. As long as these amounts are not exceeded there are no legal violations. Optimally fluoridated water contains 0.7 parts per million fluoride.

10. Under the US Safe Drinking Water Act of 1974, the EPA has complete jurisdiction over the contents of drinking water. There is no “EPA legal council ” that somehow cedes this jurisdiction to the FDA. It is a congressional mandate.

“SDWA authorizes the United States Environmental Protection Agency (US EPA) to set national health-based standards for drinking water to protect against both naturally-occurring and man-made contaminants that may be found in drinking water. US EPA, states, and water systems then work together to make sure that these standards are met.”

https://www.epa.gov/sites/production/files/2015-04/documents/epa816f04030.pdf

11. The FDA never “withdrew approval of fluoride supplements”. Unlike fluoride in water, fluoride supplements are retail consumables, regulated under the FDA. They are therefore subject to the “drug” label of that agency. Drugs which were already on the market prior to 1938 when the 1906 Food and Drugs Act was revised were grandfathered in under the then new regulations. The 1906 law was revised to require testing of new drugs introduced into the market after 1938. Drugs already on the market at that time with no evidence of safety concerns were considered to be safe and not required to undergo the testing for new products which had no such existing record. Fluoride supplements were already on the market then, with no reason to question their safety. To this day, here has been no credible evidence that these supplements are in any manner unsafe. Had there been, the FDA would have reevaluated its decision to grandfather the substance......as it is currently doing with caffeine, a substance which had also been grandfathered but is now being questioned due to to effects of large doses in energy drinks.

The list of grandfathered drugs is extensive and includes, along with fluoride supplements and caffeine, such commonly ingested substances as acetaminophen, aspirin and codeine.

Antifluoridationist attempts to portray the grandfathering of fluoride supplements as an indication that such substances are unsafe, are misrepresentative and dishonest.

12. Penicillin does not already exist in water as does fluoride. Introducing this drug into water supplies as you suggest would be introducing a new substance not already being ingested from the water. Penicillin also has clearly documented adverse side effects, including potentially fatal allergic reactions, which fluoride does not at the optimal level utilized in fluoridation.

13. I have not stated you to have received any payment from FAN or AEHSP. I stated that you were extensively involved with this antifluoridationist faction. Given your lack of denial that you are a former Director of FAN and your admission that you are the Chair of the AEHSP Board, which is the same Board for FAN, the extensiveness of your involvement with FAN is self-evident.

14. Seeking to undermine the most cost-effective means of dental decay prevention in entire populations based on nothing but false assertions, unsubstantiated claims, and misinformation is neither ethical nor moral.

to be continued......

Steven D. Slott, DDS

[BillO538145]

Steve,

We agree on many aspects and accuse each other of not following the facts and the science. 

We agree, science should not be religion and we need to look at factual evidence, not opinion.  

We agree the FDA does NOT have jurisdiction over public water.

We agree opinions of organizations are not facts, just opinions.

We disagree on cost effectiveness of fluoridation.

We disagree on safety.

We disagree on judgment.  Appears you feel the Girl Scouts opinion is just as reasoned as Supreme Court Justices.

We disagree that Washington State is an "unknown" state.

We disagree that fluoride is a drug.  Toothpaste says it is.  As a dentist I have prescribed fluoride.  FDA says it is a drug.  Those are facts.  

We disagree on the FD&C Act's definition of drug.  Natural occuring fluoride is not a drug, it becomes a drug when marketed with the intent to mitigate, prevent, cure or treat a disease.  Steve, the definition of a drug is not the chemical, but the use of the chemical, the marketing of the chemical.  The FDA regulates the manufacturer and the manufacturer must gain FDA NDA for any substance used with the intent.  Read the FD&C Act.  Read the FDA web page on drugs and the development of drugs.  Read for yourself.  Read the facts.  The FDA does not exempt a manufacturer from NDA simply because they "adjust" the concentration of the chemical.  The chemical can be fake, non-existant, ineffective, or placebo, the definition is based on the "INTENT" of use.  

I agree with the fact that arsenic is added to water as a contaminant of such things as hydrofluorosilicic acid and water treatment chemicals.  The MCLG is zero, but that is not usually possible.  

If the intent of adding arsenic to water was to treat or prevent a disease, the substance then becomes a drug.

Steve, think this through.  If I took a drug which exists in water in very small amounts, such as penacillin or lithium, and simply adjusted the concentration, would that substance be legal to market and sell as a substance to treat disease and without a prescription or FDA NDA?   No.   Dilution of the substance does not exempt the substance from FDA NDA.  Concentration makes no difference.  Efficacy makes no difference.  The intent of use determines whether a substance is a drug.  

Your quote of the SDWA is correct but incomplete.  The SDWA also prohibits the EPA from adding anything for the treatment of humans or animals.  The EPA regulates contaminants, which fluoride is a contaminant.  

So lets look at the evidence.

Later.  I'm off to protest and march against children being taken away from their parents and treated like criminals.   

[CharlesH595927]

Clearly fluoride can be .

A natural mineral in drinking water
A mineral nutrient
A water additive
An over the counter medication
A prescription medication
An industrial chemical
An industrial pollutant
A fumigant
A rat poison

Each of these statements is true. There are important, critical distinctions between each use, each concentration, and the purity standards which define the various incarnations of "fluoride." Different governmental bureaucracies have regulatory responsibility depending on the specific use.

The willful refusal to acknowledge these clear and easily understood distinctions is an important element in fluoridation opponents misleading the general public.

[CharlesH595927]

Here is the truth regarding your worry about arsenic added to water with fluoridation:

[BillO538145]

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

[StevenS353310]

Bill, 

1.  The cost-effectiveness of fluoridation is without question.  I will gladly cite the numerous peer-reviewed studies clearly demonstrating this fact. If you want to trot out Thiessen’s study as cherry-picked  “evidence” against these studies I’ll be glad to explain to you the fallacy of her study.

2.  The safety fluoride at the optimal level at which water is fluoridated is without question.  In the 73 year history of this initiative, hundreds of millions having ingested optimally fluoridated water during this time, there have been no proven adverse effects.  Zero.  There is no valid, peer-reviewed scientific evidence that fluoride at this level is, in any manner, unsafe.

3.  The effectiveness of fluoridation is without question.  It has been clearly demonstrated in countless peer-reviewed studies right up to the present.  I will be glad to cite as many as you would reasonably care to read.

4.  Opinions are opinions.  Justices are not health-care professionals or experts.  They issue rulings on legal points of law, not on science.  While they are as welcome to their personal  opinions as is anyone else, these opinions are  no more binding than those of the GSA or anyone else.  Your implication to the contrary is erroneous and dishonest.  

Rulings by the court are legally binding.  The reasoning they used to get to that point is not. 

5. I didn’t state that “Washington state is an ‘unknown state’ “.  You simply stated that “in all state laws I have reviewed”  without specifying which states, or which laws.  Therefore, whatever laws to which you refer were from some states unknown to readers.  Given that you now only mention Washington, it seems a safe assumption that your “in all state laws which I have reviewed” means you have read through a few of the laws of the state of Washington. 

6.  Consumable, retail fluoride under the jurisdiction of the Food and Drug Administration is labeled  by that agency under its drug classification,  as opposed to labeling  it under its food classification.  Fluoride in water supplies is under the jurisdiction of the EPA.  The EPA does not label such  fluoride as a drug.  Those are the facts.

7.  Sure the FDA classifies retail consumables under its jurisdiction as either food or drug, depending on what the FDA deems is their intended use.  

The EPA does not categorize substances under its jurisdiction in such manner.  Among many other responsibilities, the EPA determines safety levels of substances within drinking water supplies, and mandates adherence to those levels.  Fluoride in water is under the jurisdiction of the EPA, not the FDA.  It is therefore not subject to  FDA classification or labeling, any more than it would be subject to  the classification and labeling system of any other agency.    The laws and regulations of the FDA are irrelevant to fluoride under the jurisdiction of the EPA. 

The EPA  maximum allowable level of fluoride in drinking water is 4.0 pom.  

Water is fluoridated at 0.7 ppm, well under that level.

8.  Arsenic is everywhere in nature.  Arsenic dissolved out of  rock formations  is added to water as  that water flows over rocks or when the ground water level sinks to a certain level.    It is added to water from industrial pollution, fertilizer and pesticides in runoff, and from rain and snow which removes it from the air.  Any arsenic added to water from hydrofluorosilic acid is in barely detectable amounts far below EPA mandated maximum levels of safety.  

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.  Given strong evidence that arsenic is an essential nutrient, a zero level would likely do more harm than good.  

9.  How you so desperately want the US Environmental Protection Agency to classify substances under its jurisdiction is meaningless and irrelevant.  

10.  The EPA does not add anything to water for the treatment of humans or animals.  Decisions to add additional fluoride to water  are not made at the federal level.  They are  made at the state and local level, with implementation at the local level.  

11.  Anything in drinking water supplies other than H20 is a contaminant.  The EPA regulates the levels at which contaminants may exist in drinking water for purposes of safety.  The maximum allowable level of fluoride in water is 4.0 ppm.  Water is fluoridated at 0.7 ppm, far below this maximum. 

12.  Yes, let’s do look at the evidence....the valid, peer-reviewed scientific evidence.  Your personal opinions, desires,  and speculation do not qualify as such.

Steven D. Slott, DDS

[BillO538145]

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

[StevenS353310]

Bill, I can’t even hazard a guess as to what you deem to be  the relevance of European dental amalgam to the public health initiative of water fluoridation.  Perhaps you can find a forum on dental amalgam somewhere else, let’s  but stay on topic here, okay?

Steven D. Slott, DDS

[BillO538145]

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

[StevenS353310]

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

[BillO538145]

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 1986Bill Osmunson DDS MPH

[ri1666]

WOW This is very interesting...I wish the pro-fluoridation people in this conversation...would just Stop and lay down their bias and look at the information in your posts. Thank you Dr Osmundson for taking the time to post these and other findings that shine light on the fact that drinking fluoride is a 20th century idea that needs to end!

[StevenS353310]

Yes, “Conversationalist”, antifluoridationists constantly do wish fluoridation advocates would cease correcting the  misinformation supporting  the confirmation bias against fluoridation, of these antifluoridationists.  Exposing the misinformation posted by  those such as Osmunson and Spencer, holding them  accountable to provide valid evidence to support their claims, does indeed make it far more difficult for them to impose their personal ideology unto entire populations.  It would be decidedly simpler if they didn’t have to deal with such annoyances as facts and evidence.

However, as long as antifluoridationists keep posting their unsubstantiated claims and misinformation here, I, for one, will continue to correct it.  The readers of this forum deserve no less than truth and accuracy.

Steven D. Slott, DDS

[BillO538145]

Thank you for your comments.  Please spread the word,

TOO MANY ARE INGESTING TOO MUCH FLUORIDE

Over a hundred million Americans are ingesting too much fluoride and promoters of fluoridation mistakenly want governments to continue giving us more fluoride without our consent, without an honest review of science, and knowing too much fluoride causes harm.  

The graph below based on Iida's data, peer reviewed by the Journal of American Dental Association, 2009, is powerful.  The data is not from the more recent NHANES 2011-2012 survey which reports 60% of adolescents have dental fluorosis.  This older survey reported 40% had dental fluorosis.

Iida's data shows an increase in dental fluorosis with increased fluoride concentration in the water.  Remember, when water fluoridation first started, the public was assured maybe 10-15% of the public would get dental fluorosis because such a small amount of fluoride was being added to the water.  In order to get dental fluorosis down to about 15%, the fluoride concentration in the water would need to be less than 0.3 ppm, the natural fluoride concentration for many in the USA.   Without question, increased fluoride exposure causes increased dental fluorosis in the population at large.

Now to the second major point in this data.  Note how the caries rate changes with increased fluoride exposure.  The amount of caries decrease is hardly detectable.   Governments are mass medicating (supplementing, administering without consent) the diet of everyone, young, unborn, old, those with kidney problems, those with cancer, those without teeth, everyone, with little or no evidence from this data of benefit.    Those most harmed are the very children promoters are trying to help, the poor.

Reasonable people looking at both sides of the fluoridation controversy would stop fluoridation simply because too many are ingesting too much fluoride.  Add the lack of benefit, the cost, the loss of freedom of choice and the known risks and we realize fluoridation is one of public health's greatest blunders.

[BillO538145]

Steve,

Before you start calling me dishonest, please read what I have written.  I carefully said the "data" is from Iida.  We all make mistakes, but you are not reading things carefully and then disparage me publicly.  Slander is not professional.  Stick with the message, not the messanger.

  K Thiessen compiled the graph of data from Iida and my memory is Iida got the data from the 2000 NHANES.

You say the study is misrepresented, but again you misread my post.  I am not representing the study, I am representing the data from the study.  Just because Iida et al and reviewers and editor chose to spin the data to promote fluoridation, and omit the problems the data presents, is not the point of the discussion.

The point of the data is that most of us agree that with an increase in fluoride water concentration, indeed we see an increase in dental fluorosis.  If you dispute that fact, please provide your evidence.

The second point is that dental caries does not appreciably change regardless of fluoride concentration in water within those ranges unless a gee whiz graph is made.  If you dispute the NHANES data or Iida data, please explain.

Bill Osmunson DDS MPH

[StevenS353310]

No, Bill.  You’re the one not reading.  I stated that the claim was made  that the graph was based on IIda and Kumar, but that that you cited it in a manner misrepresenting it as having been taken directly from Iida and Kumar....i.e. the large citation directly over the graph.  You did the same with that graph “based on NHANES data”.  You are taking graphic analyses of data, put together by some unnamed sources,  and misrepresenting those graphs to be from sources you cite.  I stand by my original statement.  Your dishonesty is staggering.  

If you want to present information you believe supports your position, then cite it correctly and don’t misrepresent its origin.  Dishonesty is that which is not professional.  

You should also learn the difference between slander and libel.  I’ve been maliciously libeled by antifluoridationists so often that I am well aware of what constitutes both. 

Steven D. Slott, DDS

[BillO538145]

Steven,

I am not misrepresenting the data and you have not shown that I am.

I have clearly presented where the data has come from and graphs have been made from the data to better illustrate the point.

Again, if you have a problem with the points I am making, please attack the points, the message, rather than me.

My point so far are:

Many are ingesting too much fluoride.  So far, you have refused to comment.  You don't like how I referece the data, but you don't explain how you disagree with the fact that too many are ingesting too much fluoride.

Instead, you and Johnny Johnson (and others) misrepresent water fluoridation as though it is the only source of fluoride.  May I repeat, no one has ever lived with water fluoridation as the only source of fluoride.  Your statements are unrealistic and anyone seriously listening to what you are saying will discredit your statement.  You must use TOTAL fluoride exposure, not just water fluoridation.

Once you agree that many have excess fluoride exposure, then lets move on to "how much total fluoride is optimal?"   And then we can move on to "is that optimal total fluoride safe?"

We have not agreed on the first step because you keep attacking the messanger rather than the message.

Bill Osmunson DDS MPH 

[StevenS353310]

Bill, the dishonesty of your comments and posts are  self-evident, as I have amply demonstrated.  In accordance with your  bizarre Trump analogies, you seem to be playing by his playbook.....make outrageous claims enough times and people will begin to believe them, regardless of their lack of validity.  I’m fine with the ability of intelligent readers of these comments to easily ascertain your dishonesty.  

I have not felt any need to comment on many of your personal opinions as they are completely unsubstantiated.  Your graphic analyses of data prepared by some unnamed sources are valid evidence of absolutely nothing.  It is neither my, nor anyone else’s, responsibility to disprove your unsubstantiated claims.

The bottom line is that there is no valid, peer-reviewed  scientific evidence of any adverse effects on anyone from total fluoride intake from optimally fluoridated water in conjunction with that from all other normal sources of fluoride.  You have provided nothing to contradict  that fact.

Steven D. Slott, DDS

[BillO538145]

Seven,

You attack the messanger but have no comment on the message.

Many, millions, are exposed to too much fluoride.  Your lack of response to that most critical point is evidence of the lack of science behind the continued addition of fluoride to public water.  Why give more fluoride when half of our youth have too much?

HHS lowered their recommendation.  Another government agency or the courts will lower it some more.  Where are the good scientists with responsible ethics calling for a reduction in total fluoride exposure?

I am not interested in going into the risks of excess fluoride exposure because you simply will not acknowledge the fact that too many are ingesting too much.  When you acknowledge that 60% of adolescents with dental fluorosis is too many, 20% with moderate/severe is too many, then we need to discuss the source of fluoride which needs to be reduced.

Topical has some benefit.

Systemic has mixed evidence of benefit.

The first step is for you and Johnny Johnson and the American Fluoridation Society to recommend a source of fluoride which needs to be reduced or stopped to reduce the rapid rise in dental fluorosis.  

What is your recommendation and the American Fluoridation Societies official position on excess exposure?   Stop Medications with fluoride?  Foods with fluoride?  Air with fluoride?  or fluoridation of public water?

The answer is obviously public water fluoridation.  All the other sources of fluoride have significant benefits (and risks), only water fluoridation is without a benefit.  

Too many are ingesting too much fluoride.

Bill Osmunson DDS MPH

[StevenS353310]

Bill, I notice that as antifluoridationists become more and more frustrated with the facts and evidence presented debunking their claims, they begin making inane personal comments and project their own personality traits unto the commenters who are  frustrating them.  If you need anger management courses, that’s your business, but try not to project your problems unto me.....okay?

Your unsubstantiated personal opinions on the peer-reviewed scientific evidence you have requested, and which I have provided, is unqualified and obviously of no relevance.  What value you seem to believe there to be to some uncited graphs of something or other will remain a mystery known only to you, I suppose.

The bottom line is that I can and do provide valid scientific evidence to support my claims.  You cannot, and do not, for your own.

Steven D. Slott, DDS

[BillO538145]

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

[StevenS353310]

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

[BillO538145]

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

[StevenS353310]

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

[BillO538145]

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

[StevenS353310]

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

[BillO538145]

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