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Tuesday, 07 May 2013

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Garth Dever

Thanks Aquadoc for the exposure given to this well balanced book. I recommend it to health science students as well as pro and anti fluoride people alike. It is American centric as the title indicates. However much recent fluoride research, especially from Europe, supports the view that the main benefit accrues from a topical effect. Your comment "The topical v. systemic issue: experts still debate which is better, but I just reread the relevant chapter in F & L and they indicate that the systemic approach is the dominant belief." descibes the situation beatifully - the dominant belief. Fluoridated water and fluoride tooth paste both supply fluoride ions to the teeth and dental biofilm ( plaque).

nyscof

The authors of The Fluoride Wars seem stuck in the 1950's when children played in the spray of DDT trucks, smoking was encouraged by physicians and adding unnecessary fluoride chemicals into public water supplies, as an unproven children's tooth decay medicine, seemed like a good idea. The book is neither objective nor middle ground and borders on plagiarism in parts. It definitely reflects the authors pro-fluoridation beliefs.

It appears the authors did little original research and borrowed many quotes from other published sources. The authors seem to have little interest in, or a poor understanding of, actual fluoride science.

They use inflammatory quotes and stories from articles available on the Internet and then write how worried they are that the Internet is used as a tool for propaganda.

Actually, the internet is almost the only place you can read, unfiltered, what those of us opposed to fluoridation have to say. We believe you are smart enough to sort out the truth.

As pointed out by Dr. Paul Connett in his review of this book, the authors are aware of the National Research Council's (2006) 500+ page report on the health effects and toxicology of fluoride but the authors of The Fluoride Wars don't report on what's in it. Any book on fluoride or fluoridation that doesn't include the findings and recommendations of this major review of current fluoride science shouldn't be taken seriously.

The authors describe the fluoridation battle in Connersville, Indiana, where a fluoride supporter and magician foolishly eats a whole tube of fluoridated toothpaste to prove it is non-toxic. However, it is toxic. Such a stupid stunt by a small child could be fatal. Instead of explaining the health risks associated with this performance, the author denigrates fluoridation opposers for suggesting this magician used sleight of hand to switch to a tube of non-fluoridated paste. The story and quotes are lifted from a newspaper article available on the Internet.

These shenanigans enabled fluoridation to begin in Connersville in 2000 despite a 1999 research article published in Community Dentistry and Oral Epidemiology (1999 Aug;27(4):288-97) which showed that Connersville children already consumed too much fluoride from food and dental products putting them at greater risk of dental fluorosis (discolored teeth). Instead of reducing intake as this research paper advised, local dentists misinformed legislators and residents that children needed more via water fluoridation. The authors of The Fluoride Wars fail to tell readers this vital information even though Wiley publishes both this journal and this book. They should all be very embarrassed.

It's also revealing that the authors acknowledge Warren Wood as providing supportive reviews of the final manuscript. We wonder if this is the same Warren Wood who was on the Louisiana Fluoridation Advisory Board which is charged with promoting water fluoridation. I don't see any evidence that the authors consulted any scientist or activist opposed to fluoridation

Those interested the history and politics behind the unscientific and risky practice of fluoridation can read The Fluoride Deception by award-winning journalist Christopher Bryson. It's original, clearly referenced and a good read.

Those interested in fluoride science and how, even low doses added to public water supplies, can be harmful to some people - especially babies, high water drinkers, thyroid and kidney patients - read the NRC report (Fluoride in Drinking Water: A Scientific Review of EPA's Standards)

And, if you are truly objective, you will reach "The Case Against Fluoride," at least twice so you can know both sides of the issue. You are free to believe in fluoridation. I am free to oppose it. Unfortunately, water fluoridation takes away my freedom of choice.

The water supply should never be used as a vehicle for drugs. Fluoride is not a nutrient or essential for healthy teeth. Like all drugs, it has adverse side effects that affect different people in different ways.

Michael

Hi, Matt, BT, Mark R, Paul, and Mike.

Thanks for all your comments!

I will address your question and comments. Keep in mind I am not an expert - I just read a book (twice!) and some of the references contained therein.

Interesting about San Jose, CA. San Jose is over 50% larger than Portland (985,000 v. 600,000) but the Portland system serves 300,000 outside the city limits. But even so, San Jose would be the larger unfluoridated city. Thanks, BT.

I am sorry I may have 'spoiled' things by making my review more of a report or too comprehensive. I was actually worried that it wasn't enough. But I would encourage you to read the book. It is fascinating and comprehensive - is it ever!

Regarding the effectiveness of fluoride at different ages: my understanding is that fluoride is effective for all age levels; see CDC and ADA:

http://www.cdc.gov/fluoridation/fact_sheets/cwf_qa.htm#20

http://www.ada.org/fluoride.aspx

I am sure there are reasons why people who have been getting fluoride still get cavities. I suspect it has to do with sugar consumption. The book notes that dental caries were virtually unknown in the Middle Ages and before. Only when humans started ingesting lots of refined sugar did the affliction become 'a plague' (one person's words). Queen Elizabeth I had a horrible problem with tooth decay - too many sweets!

As to why the ADA supports fluoridation when it could cut into their business: I guess it would be too self-serving not to support something that reduces cavities. But I think it has to do with the fact that they viewed it has a public health issue about which they could not remain silent.

As to the 'halo effect' and why we still need fluoridated water: it's hard to know how much the 'halo effect' is influencing an individual because you would have to keep tabs on everything the person ate and drink. Maybe Freeze and Lehr cited a work on this; I am sure someone has done this. But I believe that the recommended concentration of fluoride in DW has declined over the years just for that reason - fluoride toothpaste, etc.

My dentist also told me to chew xylitol gum.

The topical v. systemic issue: experts still debate which is better, but I just reread the relevant chapter in F & L and they indicate that the systemic approach is the dominant belief. Apparently teeth do better when they are 'bathed' (?) in fluoride-containing liquid that can penetrate all the nooks and crannies in one's mouth with more exposure time than a topical application.

Paul - as always I appreciate all your comments. I don't agree with you but that doesn't make me right....Bless you.

I don't worry about someone screwing up and overfeeding fluoride into supplies. I have served on water utilities' community boards. I know a number of people who work in municipal water utilities (poor sample size: n= 10) and they all take their jobs and responsibilities very seriously. I also have seen the 'redundant' systems that will minimize accidents. But accidents do happen - recall Milwaukee in 1993. Not fluoride-related, but a drinking-water disaster.

Do read the book....I just barely scratched the surface.

And thanks again.

Mark R

I have the same question as Mike Christie - what is the best way to use fluoride? One dentist told me it is only useful when kids are growing teeth so anything after that is pointless. Another said bathing teeth in fluoride helps kill the bacteria that forms the acid that makes holes in teeth. That argument speaks for regular topical use of fluoride. That same dentist told me xylitol also helps by neutralizing the acids directly.

By the way, my experience is no fluoride and one cavity in 49 years. My wife had fluoride and has lots of cavities. I think genetics play a role as well.

MikeChristieTO

Hi Michael, Thanks for the article.

One big point in your summary jumped out at me - for non-fluoridated communities that also show a decline in dental caries (and are likely getting their fluoride from toothpaste, food/beverage, etc.), doesn't that beg the question as to why it's being added to drinking water if one is already getting it from all of these other sources in the first place?

I also have to assume that these old studies (some even pre-dating home refrigeration!) wouldn't account for how our modern diets could be getting enough fluoride without adding it to water supplies. See USDA list of foods/beverages containing fluoride here: http://www.ars.usda.gov/Services/docs.htm?docid=6312

Finally, have to wonder about TOPICAL application of fluoride to one's teeth vs. SYSTEMIC ingestion of fluoridated water to the body. Wouldn't a direct application of fluoride be better than the body having to deal with excess fluoride?

BT

FWIW, I think San Jose is still the largest unfluoridated city. The (county) water district voted funds in December, but I don't think everything is operational yet.

http://www.mercurynews.com/news/ci_22222403/santa-jose-getting-fluoride-citys-tap-water

PAUL F MILLER

For me the fluoride story exposes the tawdry story of how professions though admirable are duped and in turn dupe their clients, ie, dental patients. The degree of deception on the part of all the players .. “big-chemical” … government regulators .. water purveyors public and private … is amazing and what is even more amazing is that it continues today…

We are as easily misled today as when fluoride “snake-oil” was first $old to us … we remain even today obediently … sheep and ostriches …

Matt Heberger

Great book review, Aquadoc. The only problem is that it's so comprehensive that I don't feel compelled to read the book. I'm inclined to seek out "The Environmental Pendulum" though. I think that concepts of dose, exposure, and risk are profoundly misunderstood in our culture. Drinking too much water can kill you (hyponatremia). But try living without it!

To make n=3, I grew up with fluoridated water, and at 38, I'm yet to have a cavity.

Here's the thing I never understood: Why do nearly all dentists support fluoridation? Wouldn't they have more business without it?

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