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Questions the MMWD Refuses to Answer - Why?
We have shown MMWD Board Members many times the solid legal basis for MMWD to eliminate fluoride chemicals from of our public water. Yet the Board, Legal Counsel and General Manager's response is to refuse to read the evidence presented and instead, continue to push 2 spurious excuses for continuing this criminal practice.
1) Are MMWD Board Members, Legal Counsel Mary Casey and GeneralManager Krishna Kumar saying that the 1995 CA State water fluoridation mandate forces them to add a CA Code of Regulations listed toxic, corrosive hazardous waste to our drinking water?
At least 24 other CA communities have rejected water fluoridation with no consequences because the mandate leaves the decision to add fluoride chemicals to the water up to the local authorities. In Marin, that is MMWD Board Members.
2) Is MMWD telling us that even though the FDA states that fluoride chemicals used for the purpose of cavity prevention are drugs; and the FDA lists Hydrofluorosilicic Acid (HFA), the fluoride chemicals MMWD adds to our water, as an unapproved drug, that the National Sanitation Foundation (NSF) has the authority to override the FDA and approve HFA for ingestion for the purpose of cavity prevention?
NSF 60 is for the approval of "Drinking Water Treatment Chemicals." HFA is added to our water not to treat the water, but to treat people. Please show us in writing the proof that the NSF has the authority to override the FDA and approve medical drugs. The onus is on MMWD to prove this.
Furthermore, when the 1972 and 1977 water fluoridation initiatives were passed, the NSF was not in the picture, so not only were the fluoride chemicals not approved for the purpose they are put into our water, they were not approved at all. MMWD is in violation of the Marin water fluoridation ordinance that resulted from these votes.
Also, MMWD did not have the right to put up for a vote the forced medication of the population via our water supply, and these votes were based on false information.
3) Mary Casey's fabricated story about MMWD Real Estate revenue qualifying as the needed "separate income" is codswallop and the story was fabricated by Ms. Casey in Feb of 2013 after she was informed of this clause. All MMWD revenue is comingled. The mandate does not force MMWD to do their accounting this way.
The decision to "use" the real estate revenue to pay for water fluoridation is a decision that must be voted on by the board. Mary Casey does not have the authority to do this. This is another reason why MMWD is NOT bound by the mandate. Is MMWD telling us that the mandate forces them to use the real estate revenue to pay for water fluoridation, and that Mary Casey has the authority to make this decision?
4) Why is MMWD continuing water fluoridation without having done an environmental study? The California Environmental Quality Act is another reason MMWD is not bound by the mandate. MMWD must halt water fluoridation until an environmental study on its impact is done.
5) Where in the mandate does it state that MMWD is being forced to use the fluoride chemical hydrofluorosilicic acid? Why is MMWD using industrial grade, toxic, corrosive chemicals and not a pharmaceutical grade, FDA approved form?
6) HFA combined with chloramines and the anti-corrosive chemicals added because HFA is highly corrosive, creates and extremely toxic cocktail of chemicals and their toxic effects are greatly exacerbated when combined.
Why is MMWD pushing back against all the scientific and legal evidence on why water fluoridation is unethical, unsafe and illegal? MMWD is going against MMWD's own precautionary principle. MMWD Board Members are authorizing the addition of HFA to our water, and the Board Members have the authority to end this unethical practice.
7) Why do MMWD Board Members refuse to take a vote to end water fluoridation?
8) Do MMWD Board members understand that what they are doing is medicating us without our individual consent, without dosage control and without medical oversight? None of the Board Members has a medical license, so they should not be practicing medicine via our water supply. The Board Members do not have the medical knowledge to understand what these chemicals are doing to our bodies.
9) There is already a law in the State of California under the Health and Safety Code that provides for free, TOPICAL fluoride treatments to children in their schools. This law provides for a much safer, economical, more effective and accurate way of providing fluoride treatments, that does not force the entire population to participate in a medical process that is only intended for children. The Health and Safety Code leaves this medical treatment to licensed, dental practitioners.
CALIFORNIA HEALTH AND SAFETY CODE SECTION 104830-104865 104830.
Pupils of public and private elementary and secondary schools, except pupils of community colleges, shall be provided the opportunity to receive within the school year the topical application of fluoride or other decay-inhibiting agent to the teeth in the manner approved by the department. The program of topical application shall be under the general direction of a dentist licensed in the state and may include self-application…
Why is MMWD adding toxic fluoride chemicals to our water when this law exists?
The following are chapter summaries
of The Case Against Fluoride, written by Dr. Paul Connett and are reprinted
here with his permission. The link for the entire book online is provided
below.
Chapter Summaries from The Case Against Fluoride by Paul Connett, PhD, James Beck, MD,PhD, H. S. Micklem, DPhil
Chapter 1. Poor Medical Practice
Fluoridation — the deliberate addition of fluoride to the public water supply — is a poor medical practice because it violates the principle of informed consent to medication. It is indiscriminate and offers no control over the dose received by an individual. It makes inadequate allowance for differing sensitivity to toxic effects, or for the size and body mass of recipients; this last point is particularly important for young children who may receive proportionately much higher dosages than adults at a time when their bodies are far more vulnerable to toxic agents.
Fluoride used in the fluoridation of drinking water is considered to be a drug, not a nutrient. It is chronically toxic at moderate doses. As a drug, it has not been rigorously tested and has not been approved by the U.S. FDA. Fluoridation increases the chances that a child will develop fluorosis of the permanent teeth, which can be disfiguring and require expensive cosmetic treatment in a minority of cases. The notion that fluoridation is equitable is misplaced for two reasons: Children from low-income families are more likely to have poor nutrition, making them more vulnerable to fluoride’s toxic effects; and low-income families are least able to afford avoidance measures.
Chapter 2. An Inappropriate and Inefficient Practice
For many years, fluoride was believed to act systemically to prevent caries — tooth decay — by being incorporated into the enamel of the developing teeth. However, it is now known to act topically — that is, at the surface of the tooth. Thus, the main reason for ingesting fluoride has disappeared, but the increased risk of dental fluorosis and other possible health risks associated with the accumulation of fluoride remain. Even if fluoride worked via ingestion, using the water supply to deliver the drug would be highly inefficient since over 99.5 percent of the public water supply is not ingested, and most of the fluoride ends up in the environment.
Education, not fluoridation, is what is needed to fight not only tooth decay but also the related and much larger problem of childhood obesity.
Chapter 3. The Chemicals Used
Promoters of fluoridation claim that they are simply topping off the existing natural concentration of fluoride in the water supply to a supposed optimal level of around 1 ppm. However, it is not quite so simple as that. The chemicals used in most fluoridation programs — silicon fluorides obtained from the phosphate fertilizer industry — are not naturally occurring fluoride compounds or the pharmaceutical-grade substances used in dental products. They are derived from wet-scrubbing systems, contain other contaminants, and are officially characterized as hazardous waste by the U.S. EPA.
Over 90 percent of the chemicals used in the U.S. fluoridation programs are silicon fluorides. A bit less than 10 percent are industrial-grade sodium fluoride, the only fluoride compound that has received extensive toxicological testing. Several potential problems with the silicon fluorides exist, including (1) re-association of silicon and fluoride in the acidic environment of the stomach to form silicofluorides with unknown biological properties; (2) leaching of lead from brass fittings; and (3) increased uptake of lead into children’s blood.
Moreover, the addition of industrial-grade fluorides to the public water supply inevitably leads to exceeding the EPA’s MCLG for arsenic, a known human carcinogen, which is set at zero.
Chapter 4. Who Is In Charge?
Fluoride is a drug, unapproved and untested by the FDA. It has never been subjected to randomized clinical trials for effectiveness or safety, as required for other drugs. It is added to the drinking water of over 180 million Americans each day (in some cases against intense individual opposition). The virtues of this practice are extolled by the CDC, the ADA, and many other professional bodies that vigorously promote or endorse it. However, no federal agency accepts responsibility for any damages that may accrue. All pass the buck to a self-regulating, private consortium called the NSF, which in turn accepts no liability for the “safe levels” or the “safety of the chemicals” it recommends. Thus to answer the question posed by the title of this chapter (Who is in Charge?) for the American fluoridation program, the answer is no one. We can only assume therefore that whatever liabilities are involved in this practice are taken on by local communities or by state authorities where the practice becomes mandatory via state legislation.
Chapter 5. An Experimental Program
When the fluoridation of drinking water began, there was little evidence for its long-term safety, and since then little attempt has been made to monitor its health effects systematically. Because there are so many unanswered health questions, fluoridation of water must be considered an ongoing experimental procedure, and as such it is a violation of the Nuremberg Code, which forbids experimentation on humans without their informed consent. Only a minority of countries practice fluoridation. In Europe, nearly all countries either have never fluoridated their water or have ceased doing so. Yet the incidence of caries has declined just as much in those countries as in countries that practice fluoridation.
Chapter 6. Fluoridation and Tooth Decay
The benefits of water fluoridation have been greatly exaggerated. The early studies that served as the basis for initiating fluoridation were methodologically flawed (for further discussion, see chapter 7). Since those early studies, many studies have failed to control for confounding variables, particularly that of income level. For several decades caries rates have been declining at a comparable rate in both fluoridated and non-fluoridated countries. Together with supporting data of several kinds, this shows that factors other
than fluoride ingestion have been at work. Conversely, the experience of many poor city areas has shown that fluoridation cannot compensate for the shortcomings of diet and dental care.
Chapter 7. The Early Evidence Re-examined
There are several reasons to doubt the validity of the Dean et al. study on the relationship between caries incidence and the fluoride content of water. Subsequently, Ziegelbacker found no relationship, such as claimed by Dean, although there was a strong relationship between fluoride concentration and the incidence of fluorosis. Many serious flaws have been identified in the early trials of fluoridation, on which the modern dogma of fluoridation’s safety and effectiveness is built. Subsequent developments in tooth decay in the towns of Newburgh and Kingston, New York, in the years since 1955 (the year when the study there concluded) put into question the benefits claimed in 1955.
Chapter 8. Key Modern Studies
Several studies and reviews published since the 1980s have confirmed that any protective effect of fluoridation is extremely small, amounting on average to only a fraction of a tooth surface for the permanent teeth and not much more for the baby teeth. Several modern studies have shown that if fluoridation is stopped, decay rates do not increase. The dental crises reported in cities across the United States and elsewhere that have long been fluoridated show that fluoridation is insufficient to combat dental caries, especially in children from low-income families.
Chapter 9. The Great Fluoridation Gamble, 1930-50
As a result of studies on dental mottling, now called dental fluorosis, in the early part of the twentieth century, researchers in 1931 found that the cause of the condition was naturally occurring fluoride in the drinking water. From the outset it was established that this was a systemic effect. We define the Great Fluoridation Gamble as the notion that fluoride could cause that condition without having any other systemic effect on the body. Whatever the reasons led the U.S. PHS to endorse fluoridation in 1950, researchers did not have solid evidence to demonstrate either the short-term or the long-term safety of this practice.
Not only was safety not demonstrated in anything approaching a comprehensive and scientific study, but also a large number of studies implicating fluoride’s impact on both the bones and the thyroid gland were ignored or downplayed. It remains an open question whether this was simply a case of zealous dentists winning out over more cautious public health officials, as McNeil suggests, or there were sugar or other industrial or nuclear interests at play, as other commentators have suggested. Either way, the PHS decision was a serious blow to the notion that public health policies should be based on the very best science available and contradicted the Hippocratic admonition “First do no harm.”
We return to this matter in the next chapter, where we discuss the next phase of the Great Fluoridation Gamble, exploring the investigations of fluoride’s impact on health that took place or were published after the all-important PHS endorsement.
Chapter 10. The Great Fluoridation Gamble, 1950- present
The early caution about the possible side effects of fluoridation, shown by dental researchers such as Dean and Ast (see chapter 9), rapidly disappeared once the PHS had endorsed the practice in 1950. After 1950, the emphasis switched from somewhat halfhearted attempts to examine health issues to out-and-out promotion of fluoridation, which has involved downplaying and ignoring health effects. The main players set aside any doubts they may have had and embarked on what they saw as a mission, though in reality it remained a gamble. Doubts and caution were replaced with absolute certainty. The science of investigation was replaced by the politics of promotion. This situation has continued to the present day. As a result, fluoride has become a protected pollutant and fluoridation a protected practice. We examine further examples of the poor science that has protected fluoridation in chapter 22.
Chapter 11. Dental Fluorosis
The “optimal” fluoride concentration was originally defined as 1 ppm on the basis that that reduced caries but caused fluorosis in only about 10 percent of children and then only of the very mild type. Dean considered that even mild fluorosis was unacceptable aesthetically and indicative of systemic toxicity. More recent studies show that, by that criterion, many children in industrialized countries are receiving too much fluoride, even where the water is not artificially fluoridated. In fluoridated areas a substantial minority of children may have fluorosis of aesthetic concern (mild, moderate, or severe). Proponents of fluoridation admit only that this is a cosmetic problem that may call for expensive treatment. They are less ready to concede that it is in fact a manifestation of systemic fluoride poisoning.
Chapter 12. Fluorides Chemistry, Biochemistry and Physiology
The chemistry and biochemistry of fluoride, and its kinetics in the body, are such that fluoride can function as a cumulative poison when small amounts are ingested over a long period by drinking fluoridated water. Fluoride circulates in the blood and accumulates in calcifying tissues, which include the bone, the teeth, and the pineal gland. It can inhibit the function of a variety of enzymes in vitro (“in vitro” literally means “in glass” and is used to indicate an experiment performed outside the whole body). Also in vitro, in combination with traces of aluminum, fluoride can interfere with G proteins, used by many water-soluble messengers, such as hormones and growth factors, to deliver their messages to the inside of the cells of tissues they help regulate. Although more difficult to prove, it is reasonable to assume that many of the effects seen in vitro can occur in the whole body.
Chapter 13. Fluoride Poisoning of Humans: Early reversible Effects
A small minority of people, perhaps 1 percent, appear to be acutely sensitive to exposure to fluoride at the concentrations present in fluoridated water. The wide range of signs and symptoms resemble those seen in poisoning with larger amounts of fluoride. These findings date from the 1950s. However, far from leading to more extensive studies, they were ridiculed when introduced and have since been largely ignored. Also, an “authoritative” statement by the board of the American Academy of Allergy has been used repeatedly for almost forty years to dismiss the issue. It is long past time that governments that promote fluoridation investigated this matter in a rigorous scientific manner, as recommended by a number of independent observers.
Chapter 14. The 2006 National Research Council Report
The 2006 National Research Council report was the first U.S. report to look at low-level fluoride toxicity in a balanced way. The reporting panel’s task was to determine whether the maximum contaminant level goal for drinking water, currently 4 ppm, was appropriate for protecting health. The report concluded that the MCLG was too high and should be reduced. The report is clearly relevant to fluoridation since, if 4 ppm is too high (by an unspecified amount) to be acceptable as a contaminant, it cannot be sensible to deliberately add 1 ppm. That implies a safety margin of less than four times, possibly much less — absurdly small by normal toxicological standards. Despite this, the major promoters of fluoridation hastened to state that the report was irrelevant to fluoridation and could be completely disregarded, on the spurious grounds that it dealt only with exposure to fluoride at more than 2 ppm. Acceptance of such a tiny margin of safety indicates a cavalier disregard for public health. The report identified three main concerns — stage II skeletal fluorosis, bone fractures, and severe dental fluorosis —but also drew attention to other potential health hazards especially to the endocrine system and the developing brain.
Chapter 15. Fluoride and the Brain
In this chapter we have summarized the animal and human studies that show associations of fluoride with damages to the brain. Animal studies have indicated that fluoride can enter the brain and that the accumulation is dose-dependent. Animal studies have also shown biochemical changes and damage that can be viewed microscopically. Many of these studies have been carried out at relatively high doses, but one remarkable study by Varner et al. showed effects at a low level of exposure — 1 ppm in rats’ drinking water over one year of exposure. At this level a greater uptake of aluminum into the brain was observed, as well as beta-amyloid deposits such as have been associated with Alzheimer’s disease.
There have also been twenty-three studies indicating a lowered IQ in children associated with levels as low as 1.9 ppm of fluoride in drinking water. We do not claim that these IQ studies add up to conclusive evidence that water fluoridation impairs cognitive development. However, when you have twenty or more reports consistently suggesting a problem, and these have been backed up by studies indicating possible brain damage in aborted fetuses in areas endemic for fluorosis in China, as well as animal data indicating brain damage and abnormal behavior, and very little to set in the balance against them, it is wise to sit up and pay attention. The health authorities and governments of fluoridating countries show little sign of doing that.
We return to this failure to pursue important health studies in chapter 22. Meanwhile, we have to ask whether the saving of any amount of tooth decay, which we believe is slight at best (see chapters 6–8), could possibly justify taking the risk of interfering with the development of a child’s brain.
Chapter 16. Fluoride and the Endocrine System
The influence of fluoride on the human thyroid gland has a long history, going back to before the days of artificial fluoridation. Until recently, however, fluoridating countries have put virtually no effort into finding out whether drinking fluoridated water might adversely affect the functioning of that gland or other components of the endocrine system. The matter has been ignored or glossed over in officially sponsored reviews. This may well appear negligent, considering the prevalence of thyroid disorders in those countries.
There is evidence that consumption of naturally occurring fluoride, even in amounts comparable to the amounts in artificially fluoridated water, can affect human thyroid function, particularly when iodine intake is inadequate. Meanwhile, in vitro experiments confirm that there is cause for concern. Such experiments suggest that fluoride may inhibit the deiodinase enzymes that fine-tune thyroid function; and, in combination with traces of aluminum, fluoride can inappropriately activate intracellular signals on which much hormone function depends, including production and action of thyroid-stimulating hormone. Does fluoridation threaten the thyroid and through it many aspect sof human health? We don’t know, but it certainly looks more than possible, and the question should be pursued urgently, not ignored.
The pineal, another endocrine gland, is located between the two hemispheres of the brain and is responsible for the synthesis and secretion of melatonin. Research published in 2001 showed that fluoride accumulates in the human pineal and can reach very high concentrations in old age. Whether this affects pineal function is unknown. However, preliminary animal experiments indicated that fluoride reduced melatonin production and shortened the time to menarche (Luke, 1997). Thirteen years have passed, apparently without any attempt to replicate those potentially important findings.
Fluoride at doses achievable by drinking fluoridated water may impair glucose tolerance in some individuals. In view of the increasing prevalence of diabetes, this is of concern, particularly since diabetics often drink more water than non-diabetics. This requires further research and, meanwhile, underlines the inadequacy of regulatory levels for fluoride that are set merely to protect the majority of people, not the most vulnerable.
Chapter 17. Fluoride and Bone
In the sixty-year history of water fluoridation, the studies carried out on teeth in fluoridated communities vastly outnumber the studies done on bone. This reflects not the relative importance of these two systems but rather the fact that the fluoridation program has been largely driven by dental interests. It is surprising, given that 50 percent of the fluoride ingested each day accumulates in the bone, that the medical profession has not taken more interest in the matter. It does the profession little credit that bone levels of fluoride in fluoridated communities are not being monitored, an issue that we discuss further in chapter 22.
Despite the paucity of study on fluoride and bone, those studies that have been carried out indicate that there is an inadequate margin of safety to protect everyone’s bones from damage over a lifetime of exposure to fluoride, especially those who have impaired kidney function. Bone damage can result in symptoms almost identical to the first symptoms of arthritis: aching bones and joints. Bearing in mind that more than 46 million American adults are currently diagnosed with some form of arthritis — and the numbers are expected to rise — the failure to pursue a possible connection with lifelong consumption of fluoridated water is inexplicable.
A weight-of-evidence analysis of clinical trials, animal studies, and mixed epidemiological findings is highly suggestive that the accumulation of fluoride in bones from lifelong exposure to fluoride from fluoridated water and other sources will increase the risk of hip fractures in the elderly, especially those who have impaired kidney function. One important study from China (Li et al., 2001) indicates practically no margin of safety sufficient to protect a whole population with a lifelong consumption of water at 1 ppm from hip fracture. There is enough evidence on an increase in hip fractures to show that water fluoridation should be ended.
Chapter 18. Fluoride and Osteosarcoma
The possibility that fluoridation may be associated with an increase in osteosarcoma in boys and young men was raised as long ago as 1955. The matter was raised again, in 1977, by one of the authors of an NAS panel, which recommended that osteosarcoma rates be examined in young men less than thirty years of age in fluoridated areas. Nothing was done about this suggestion until an NTP study in 1990 reported a dose-related association between osteosarcoma in male rats that were fed fluoride. In 1991 the NCI reported that there was such an association in young males but not females in the U.S. population but discounted it on the grounds that it appeared unrelated to the duration of exposure. From 1991 to 2001 reports on this possible association have been mixed. In 1992, in a study of fluoridated communities in New Jersey, Cohn reported an association; other studies have not. In 2001, using a different approach, Elise Bassin found that young boys exposed to fluoridated water in their sixth, seventh, and eighth years had a five- to sevenfold greater risk of contracting osteosarcoma by the age of twenty.
Bassin’s thesis research sponsor, Chester Douglass, failed to warn the public, his peers, the NRC, or his funders about this issue for four years. Bassin’s thesis did not appear in public until 2005, and her data were not published until 2006. When they were published, the same journal published a letter from Douglass in the same issue claiming that his larger study would refute Bassin’s findings. That study was promised for the summer of 2006, but after four years it has not appeared. This same study had been mentioned even earlier in 2002 by Douglass at a meeting organized by the BFS in London. A possible reason that Douglass’s paper has not appeared is that his methodology is seriously flawed: It cannot test the central finding of Bassin’s thesis. Meanwhile, promoters of fluoridation are using that promise of a study as a way of dispelling concern over the possibility that drinking fluoridated water may contribute to boys and young men contracting a disease that is frequently fatal.
All parties agree that it is highly plausible from a biological perspective that fluoride could cause bone cancer. Fluoride reaches its highest concentration in bone and the pineal gland. Fluoride is known to increase bone turnover, and it is also established that fluoride can interfere with the genetic machinery of the cell in a variety of ways. Mutations (genetic mistakes) are most likely to occur during rapid bone turnover. Rapid bone turnover occurs during the mid-childhood growth spurt that corresponds to the window of vulnerability discussed by Cohn and identified by Bassin.
Chapter 19. Fluoride and the Kidneys and Other Health Issues
Most of the possible impacts of fluoride on tissues such as the kidneys and the reproductive, hepatic, and immune systems suffer from a lack of serious study in fluoridated countries. Since the kidneys concentrate fluoride to a greater extent than any other soft tissue except the pineal gland, they may be particularly at risk. Also, if the kidneys are not functioning well to begin with, less fluoride is excreted, and more lodges in the skeleton. Moreover, because kidneys become less efficient with age, the elderly are at greater risk. The issue of a possible relationship between fluoride and kidney stones (and stones in other tissues) is potentially important but has not been explored.
Studies on the other systems mentioned do not leave much room for complacency. Some people ridicule opponents of fluoridation for the long list of health effects sometimes claimed for the simple fluoride ion. It is easy to score cheap points here, but the fact is that, as we indicated in chapter 12, fluoride has a high biological activity that is very general in nature — for example, it inhibits many enzymes, it interacts with calcium ions (either directly or indirectly), and in the presence of a trace amount of aluminum, it interferes with hormonal messaging systems. Since enzymes and hormones are essential to all physiological processes, such activities are likely to produce a wide variety of effects.
Chapter 20. Margin of Safety
Proponents tend to use phrases like “high doses” and “not relevant to water fluoridation at 1 ppm” to dismiss concerns about harm caused by fluoride in areas endemic for fluorosis, arguing that the relatively high doses in these studies make the results irrelevant for exposures at 1 ppm concentration. They seldom discuss the concept of margin of safety, which is absolutely essential to determine a safe dose sufficient to protect everyone in society from a substance known to cause harm.
When government agencies have been forced to address the margin-of-safety issue for fluoride’s adverse health effects, they have invariably used safety factors that cannot be defended scientifically. In addition, they have often violated the very procedures they used in permitting or regulating other chemicals or pollutants. The worst example of an unacceptable manipulation of science in this respect has come from the EPA’s Office of Pesticides in the help it has given Dow AgroScience in its efforts to use sulfuryl fluoride as a fumigant on food in warehouses and processing plants. Just as fluoride has been dubbed the “protected pollutant,” we can now add that water fluoridation is the “protected practice” and sulfuryl fluoride is the “protected fumigant.” All of this represents very poor science. We return in chapter 22 to other examples of the dubious calculations that have characterized the promotion of fluoridation for over sixty years.
Chapter 21. The Precautionary Principle
In advance of any application of the precautionary principle, it is important to lay out and make transparent the important criteria that first need to be satisfied. We, as well as specialists in the field, have done this, and it is clear that the practice of water fluoridation is a violation of the precautionary principle on all the criteria presented.
Chapter 22. Weak and Inadequate Science
We have summarized a long list of examples of the poor science involved in promoting and protecting the fluoridation program. These include the use of endorsements in place of scientific evidence; the failure to involve a proper regulator such as the FDA; the poor monitoring of the accumulation of fluoride in the bones of individuals exposed to fluoride; the paucity of basic health studies in fluoridated communities; the failure to use dental fluorosis as a biomarker in epidemiological studies, especially on health effects in children; the frequent discounting of animal and biochemical studies; the excessive attention to studies on teeth while other tissues are largely ignored; the efforts to discredit any study that finds harm; the lack of concern for those who appear to be particularly sensitive to fluoride; the granting of highly sensitive studies such as those of osteosarcoma and hip fractures to dental schools rather than independent researchers; and the assumption that an absence of study means absence of harm.
The many activities of the ADA and other promoters appear to flow backward from the notion that fluoridation has been ordained safe and effective and that any evidence to the contrary must be flawed in some way. These examples of poor science are best explained by the need to protect the program at all costs. We discuss some of the possible motivations behind this unscientific stance in chapter 26. In the next chapter, we review the tactics used by fluoridation promoters, tactics that merely underline their inability to prove their case scientifically. If the science were in their favor, many of their tactics would be unnecessary.
Chapter 23. Promoters Strategies and Tactics
The two chains of command of the pro-fluoridation lobby, headed by the CDC and the ADA, respectively, and similar bodies in other fluoridating countries, have used a number of different tactics to achieve their overall strategy of keeping the public, the media, and dental and medical professionals away from the primary scientific literature that indicates that fluoridation is neither effective nor safe. Instead of encouraging impartial review of the literature and open debate, fluoridation proponents have tried to win the argument with a combination of extolling their own authority (particularly via endorsements) and dismissing the credibility of their opponents.
While there is no doubt that the various tactics discussed in this chapter have been very effective at protecting the fluoridation program, that protection may have come at a heavy price. These tactics constitute a series of betrayals. The refusal to publish articles that present negative information on fluoridation, the refusal to debate the issue in public, and the refusal to present both sides of the argument to dental and medical students all represent a betrayal of what we have the right to expect of science: a free flow of information. The expectation that dentists should promote fluoridation whether they have studied the issue or not and the disparagement and harassment of those who speak out against the practice constitute a serious betrayal of the standards we have the right to expect from any profession. Using the authority of governmental office or the prestige of one’s profession to confidently assure the public that fluoridation is safe and effective, when such assurance is not based on one’s own review of the literature, is the worst betrayal of all: it is the betrayal of the public’s trust.
Chapter 24. Self-serving Governmental Reviews
An examination of several reviews of fluoridation conducted by panels selected by profluoridation governments (e.g., Fluoridation Forum in Ireland, 2002; NHMRC in Australia, 2007; and Health Canada, 2008 and 2009) indicate a clear bias toward supporting government policy. In any review of this type the outcome is largely dependent on the nature of the panel selected, and in many cases it is fairly obvious from the panel’s makeup what the outcome of its review will be. These reviews amount to little more than self-fulfilling prophecies, once again illustrating the hold that politics has over genuine science in this matter.
Chapter 25. A Response to Pro-Fluoridation Claims
Proponents of fluoridation possess a wide repertoire of incorrect statements about the science and unfounded generalizations about those who disagree with them. We have reproduced and refuted some of the commoner ones in this chapter.
Chapter 26. The Promoters Motivations
In short, fluoridation makes a lot of money and provides a lot of prestige and power for a relatively small number of people. Whether that makes them “true believers” in this matter despite the weak evidence of the practice’s effectiveness and the growing evidence about health concerns is open to question. We like to think that for the vast majority of fluoridation promoters, it is more a matter of firm belief than a cause tainted with economic interest. However, it might take only a few people to be persuaded by larger economic considerations to influence the whole fluoridation-promoting apparatus. That is the danger and the power of the two chains of command, administered by the CDC and the ADA concurrently, discussed in chapter 23.
For those like ourselves who have studied water fluoridation it remains puzzling that rational people support this practice so vehemently. We will give the final word to Columbia University historian Jacques Barzun, who wrote this on the matter in 1964: In England, the Minister of Health has called the opponents of fluoridation cranks and fanatics; in this country, physicians who write on the subject to the newspapers fulminate against the unbelievers as if the Inquisition were back in our midst. To object to the plan is to be against science, that is to say a heretic. Scientific fact is of course irrelevant to the issue, which is purely civic, and which should be settled with the aid of simple questions, such as: Is it common sense to treat by universal dosing a small anonymous part of the population, without knowing how much or little of the treatment the intended beneficiaries will take? Is it economically wise to put medicine in the water supply, most of which will be used to wash streets, flush toilets, and make beer? And finally, is it right to subject everybody to a dosage of any kind without his consent? For there is no reason to stop at fluorides. The drinking water can carry tranquilizers, laxatives and aphrodisiacs, for the sake of giving chosen groups of the Children of Techne a happier life. One hopes behind the fluoride scheme there are politics and selfish business interests; the presence of solid ulterior motives would restore one’s faith in common intelligence.