The Globe and Mail Fails Again

The Globe continues its descent from decent reporting to tabloid-like fear mongering. The culprit this time is a completely unskeptical article containing a condensed interview with Paul Connet, “a U.S. academic and public-health advocate”. He has recently penned a book called ‘The Case Against Fluoride’.

The article is available here, but I was so disappointed with the article’s lack of counter evidence or even discussion, that I feel the need to provide such commentary here. Let’s look at a few of the questions that were asked:

Before you became involved in this issue, you were skeptical that fluoride was harmful and thought critics of the practice were misguided. What changed your mind?

There were two things. The first was that fluoride interfered with hydrogen bonds, which are common in proteins and other important molecules in our bodies. That sent alarm bells ringing through my head. The second was that the level in mothers’ milk was incredibly low. When you see what nature’s take on it is, which is don’t give the baby much fluoride, then I felt this doesn’t make any sense to add it to water.

Hydrogen bonding is a form of attraction between the positive hydrogen atom and an electronegative atom. Connet is referring to a paper written in 1981 in the Journal of the American Chemical Society. The paper found that hydrogen bonds are quite strong in a fluoride-amide solution and that this may affect proteins. Amides also appear in proteins, and he believes that this will have some kind of biological effect. I have not found, however, any papers finding that this effect can be extended to fluoride detrimentally affecting human proteins in vivo. In fact, it is fluoride’s effect on hydrogen bonding that may be part of the reason it is beneficial to tooth enamel.

His second reason for fearing fluoride just seems silly. It’s not in breast milk therefore we should not use it? This just flat-out doesn’t make sense. We have evolved to a point where we can use medicine and vaccines to improve our health beyond that which has naturally occurred through evolution. To deprive an infant of these advantages because they are not in mother’s milk is ridiculous.

In the case of fluoridation, the water supply is being used as a drug-delivery mechanism to treat a medical condition. Why is this wrong, in your view?

It violates people’s right to informed consent, which has always been the strongest argument against fluoridation. We’ve never done it with other drugs. Since fluoridation began in 1945, not one other substance has been added to the water to address a health concern. You shouldn’t use the water supply to deliver medication, for obvious reasons. You can’t control the dose. You can’t control who will get it. There is no individual supervision. The whole practice doesn’t make sense from a medical point of view.

True, we have never use water to deliver other drugs. But we have in salt. Iodised salt was introduced in the United States in 1924 to help prevent goiters and iodine deficiency. I don’t hear anyone complaining about the lack of goiters.

Dose control is a noble concern, but not relevant. So long as the fluoride concentration is controlled and tested regularly (about 0.5 to 1 mg/L), it would take an unfeasible amount of water ingestion to even have a chance of causing any detrimental health effects.

The right to informed consent is actually the one argument I think has merit. However, people are always informed if fluoride is added to their water supply and do have the option to get a water filter to remove the majority of it if they wish.

The first U.S. fluoridation trial began in the mid-1940s. Would fluoridation pass a modern, drug-style clinical trial or risk assessment?

There is no way on planet Earth that you could get fluoridation through today. It’s only because it’s been an inherited practice and so much credibility is at stake for the medical community that keeps it going.

This is just flat-out wrong. Studies on the effect of fluoride have never stopped and continue to be updated. The consensus remains the same: fluoride is an effective and safe means of preventing dental caries.

What are the health dangers from fluoridation?

I think we’re going to pay a huge price. I’m convinced, based on animal studies, clinical trials and epidemiological studies, that drinking fluoridated water for a whole lifetime will increase your risk of arthritis and also increase your risk of hip fractures, which is very serious in the elderly. The reason for these problems is that half the fluoride people ingest is stored in the bone. We may also have a problem with it lowering the IQ of children. There are 23 studies from four countries that have found a possible association between drinking naturally fluoridated water and lower IQ in children.

Regions which have artificially fluoridated water, that is, water in which the fluoride concentration is controlled, show no significant correlation between arthritis or hip fractures. The statement that “half the fluoride ingested is stored in the bone” is not necessarily true. 75-90% of ingested fluoride is absorbed and in adults about 60% of absorbed fluoride is retained. Connet’s concern about the IQ of children comes from studies of naturally fluoridated water, that is, water which does not have the fluoride added by the city, but comes from natural sources or fluoride pollution. These naturally fluoridated waters supplies usually have much, much higher concentrations of fluoride than artificially fluoridated sources.

A lot of these concerns are based on flimsy evidence and straw man arguments. There are however, a couple of things I do actually agree with:

1. Naturally fluoridated water supplies are a problem because the concentration are too high and may cause adverse health effects. However, this concern should not be unfairly extended to artificially fluoridated water supplies.

2. The argument about informed consent is a valid one. But if you don’t want fluoride in your water because of this reason, don’t argue it based on health effects; argue it based on an informed consent platform.

Oh and one more thing. I am actually worried about the fluoride in MY water supply. The reason is because Calgary has voted to remove it.

I will definitely be making sure there is fluoride in my toothpaste.