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The Globe and Mail Fails Again

March 21, 2011 Leave a comment

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.

Calgary Falls to Fluoride Fear

February 11, 2011 28 comments

In a huge skeptic fail, the city of Calgary has announced that it will remove fluoride from its water supply.

The move comes after the city council voted 10-3 in favour of stopping the addition of fluoride to the city’s water.

And now, Fluoride Action Network, based in the U.S. but which has spearheaded the anti-fluoride movement in Canada and has succeeded in Waterloo and now Calgary, is moving its fight against reason to London, Ontario.

I live in Calgary now, and I used to go to school in London. Is this a personal attack against me!?

The Fluoride Action Network has a lot of similarities with the anti-vaccine movement. They are claiming that they are “are just pushing for a review that’s badly needed after decades of conventional wisdom.”

Yet the first thing you see on their homepage, in large font: “TAKE ACTION! A Reduction in Fluoride Levels is Not Enough: Tell HHS to End Fluoridation Completely”

As the CBC reports today, the city council acted without any input from Calgary’s citizens:

Earlier in the day, city council considered and rejected by a vote of 8-5 putting the fluoride issue to a plebiscite in the 2013 municipal election.

And this was my favourite quote:

Council also rejected referring the matter to an expert panel.

*FACEPALM*

So the City Council basically said “No, no. We won’t ask an expert. We know what direction the wind is blowing and we will go along with it.”

People are motivated by fear. A couple of months ago there was  this piece in Maclean’s magazine about Canadians reacting to these fear tactics, including fluoride:

the Waterloo regional council voted to stop the 43-year practice of adding fluoride to the municipal drinking water, after two local residents complained that it was making them sick. Forget the fact that the only known side effect from water fluoridation—from too-high fluoride levels, specifically—is something called dental fluorosis, a.k.a. stained teeth, and that the ban was implemented despite strong opposition from the very people who stand to benefit most from the ban, namely, local dentists. Waterloo residents are now revealed as the Birthers of dental hygiene, sticking to their thesis precisely because it is so implausible.

But anti-fluoriders stick to their convictions, saying that it is not the Government’s job to maintain the health of its people, which is a crock. The government is in place to do whats best for its people. They police the streets, they manage public transportation and they plow the roads. If adding a bit of fluoride to the water is in our best interest, why shouldn’t they do it?

Not convinced? You want some science? Well as stated above, the only side effect of excess fluoride is stained teeth.  Fear-mongerers attempt to convince us that fluoride consumption is correlated with bone cancer. But that study was not peer reviewed, and only looked at a small subset of the data. When compared with the entire population, that correlation disappeared. The authors of that study themselves noted that it had serious limitations.

But there are several reviews of actual peer-reviewed research stating that fluoride is perfectly safe at the levels maintained in public water supplies:

  • Water fluoridation. Parnell C, Whelton H, O’Mullane D. Eur Arch Paediatr Dent. 2009 Sep;10(3):141-8. (Conclusion: Water fluoridation, where technically feasible and culturally acceptable, remains a relevant and valid choice as a population measure for the prevention of dental caries.)
  • Systematic review of water fluoridation. McDonagh MS, Whiting PF, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, Misso K, Bradley M, Treasure E, Kleijnen J.BMJ. 2000 Oct 7;321(7265):855-9. (Conclusion: The evidence of a beneficial reduction in caries should be considered together with the increased prevalence of dental fluorosis. There was no clear evidence of other potential adverse effects.)
  • Water fluoridation in Australia. Spencer AJ, Slade GD, Davies M.Community Dent Health. 1996 Sep;13 Suppl 2:27-37. (Conclusion: Community water fluoridation continues to be the most effective and socially equitable measure for caries prevention among all ages by achieving community-wide exposure to the caries preventive effects of fluoride.)
  • Risk-benefit balance in the use of fluoride among young children. Do LG, Spencer AJ. J Dent Res. 2007 Aug;86(8):723-8. (Conclusion: Exposure to fluoridated water was positively associated with fluorosis, but was negatively associated with caries. Using 1000-ppm-F toothpaste (compared with 400- to 550-ppm-F toothpaste) and eating/licking toothpaste were associated with higher risk of fluorosis without additional benefit in caries protection.)
  • An update on fluorides and fluorosis. Levy SM.J Can Dent Assoc. 2003 May;69(5):286-91. (Conclusion: Water fluoridation and use of fluoride dentifrice are the most efficient and cost-effective ways to prevent dental caries; other modalities should be targeted toward high-risk individuals.)

Thankfully, residents of London Ontario seem to be approaching the issue with the right amount of skepticism.

“They refer to fluoride as being the equivalent of a poison or a toxin,” said Pollett, London’s top public health official. “These fears are not substantiated but nonetheless they raise concerns in people’s minds.”

Fluoride levels in London water “pose no risk to health,” he added.

London has had fluoride in its water since 1967. It costs about 40 cents per year per Londoner to put it in the system.

In another article written today by Ian Gillespie, his similar feeling about the absurdity of fluoride fears is quite apparent:

When asked about the benefits of adding fluoride to our drinking water, London Coun. Denise Brown said, “If you do any research on the Internet, you’ll find scientists believe there are health risks.”

Yes, that’s right.

And if you do more Internet “research,” you’ll also discover “experts” who argue that aliens hijacked the Voyager 2 spacecraft, Paul McCartney died in a 1966 car crash, Elvis Presley is alive and the Apollo moon landing was a hoax.

C’mon folks. Give your head a shake.

Yes, City Councilors are listening to whatever fringe group is loudest to make their decisions now it seems. They also believe that by doing “research on the internet” (what skeptics like to call ‘attending the University of Google’) they can get accurate and unbiased information.

So if you are a resident of London, please check out the real information about fluoride. Decades of credible research show that it is perfectly safe, over 90 Health organizations all over the world, who routinely review the scientific evidence, all endorse the use of fluoride in water.

The United States Center for Disease Control sees fluoride in public water supply as one of the 10 greatest public health achievements of all time.

Since water fluoridation has been around for so long, people forget what happens when you remove it.

“(Officials in) Dorval, Que., took the fluoride out in 2003,” [Dr. Lynn Tomkins, president of the Ontario Dental Association] says. “And the rates of dental decay in pre-schoolers there have doubled. That’s pretty alarming.”

So if you live in Calgary, you might want to start getting better dental coverage. Because fluoridation of water is of course “the most monstrously conceived Communist plot we have ever had to face.”