Commentary: Fluoridated Water in Davis a Longshot At Best

fluoride-water

Despite the powerful advocacy by both the Yolo County Board of Supervisors and the Yolo County Health Counsel led by Dr. Michael Wilke, the idea of a Davis City Council decision to support fluoridated water in Davis appears to be a longshot, at best.

One of the problems the city faces is that a number of people have expressed the sentiment publicly and privately to the Vanguard that they supported the water project, but had they known it would have led to fluoridated water, things would have been different.

This was a sentiment expressed on both the left and the right.

For instance, the poster Frankly, an ardent conservative, wrote, “If I had known that we would be adding fluoride to the water, I would have voted no on the surface water project.”

Another poster wrote, “I supported Measure I but I am opposed to fluoridating our water supply. The money it would cost to do this would be better spent giving fluoride drops to those who would benefit from/need it.”

Adrienne Kandel added, “I too voted for the water project not expecting fluoridation. I’d have given it more thought but happily can afford and have a RO filter.”

Nancy Price, on the other hand, said she didn’t know whether she would support fluoridation, “but I sure would like to vote on it.”

While initially I opposed the idea of voting on fluoridation – after all, at some point we elected representatives to make even tough decisions for us and, if we do not agree with them, we can always find someone else to run and vote them out.

However, in this case, there is a fairness issue at play.  We brought the matter to the voters in the first place and we did so without the fluoridation issue.  Several people above and in private expressed to the Vanguard that had they known there would have been fluoridation, it would have changed their vote on Measure I.

This represents a dilemma for the Davis City Council.  One official told the Vanguard that this was precisely why the council initially sought to separate the question on fluoridation: they did not want the two issues to become entangled.

At the same time, they insisted this was not an effort to hide the ball, but rather the need to decide the core issue first and then other side issues.

The explanation rings true, and certainly there is no overwhelming sentiment on the part of the council – at least the members we spoke with, none of whom chose to go on the record.  In fact, not one councilmember or individual in city government told the Vanguard, yes, I support fluoridation.

One councilmember was legitimately concerned with the choice issue, while another simply said this was by no means a done deal.

Another official conceded that likely this would come to a vote of the people, and their belief is that it would be defeated.

But simply putting the matter to a vote raises additional questions.  For one thing, the question is whether the Davis City Council should vote to put the matter on the ballot or allow a group of citizens or perhaps First 5, one of the chief advocates for public fluoridation, to finance a ballot drive themselves.

The city has scant resources at this time, and if advocates are that impassioned about the matter, they would be better positioned to put it on the ballot and advocate its passage.

Dr. Michael Wilkes, who chairs the Yolo County Health Council and is a professor of Medicine and Public Health at the UC Davis School of Medicine, told the board, “The issue of fluoride is really sort of a silly debate.”

“This issue of fluoride is really a no-brainer, it is something for which in my scholarly opinion, the data is so clear and so convincing,” he said, “the two elements in terms of its effectiveness at preventing tooth decay and its safety – that it really is the reason that all of the organizations… support it.  They don’t just mildly support it, they majorly support it as a major health innovation.”

He noted that the Center For Disease Control calls it one of the major health innovations of the last 100 years – fluoride made number seven on the list.

But at least some of the research is in dispute and critics point to overexposure of fluoride by children and adolescents and incidents of fluorosis as evidence that the idea of fluoridation should be greeted with skepticism.

In the end, we see it likely that the city of Davis will ultimately punt on this issue and either allow the advocates to put it on the ballot or move on with the water project without fluoridation.

However, given the interesting nexus between those on the far left and those on the far right, it is by no means assured that even if placed on the ballot, the matter would pass.

While local health advocates and researchers appear to support fluoridation, it is not difficult to find convincing literature to the contrary.  All of which would create the kind of lack of consensus among the experts that will lead the person in the middle to vote no as the safer option.

In short, we believe it highly unlikely that the city will go to fluoridation and it will be interesting to see if Woodland would choose to fluoridate their water supply alone.

—David M. Greenwald reporting

Author

  • David Greenwald

    Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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90 comments

  1. Does anyone know a good dentist in town who supports a water supply free of adding the byproducts of the fertilizer industry? I saw at dentist I was considering at the pro-fluoridation meeting with one of those green drop stickers on his shirt, and decided to drop him from consideration.

  2. When is the WAC’s decision expected?
    Wouldn’t it be ironic if the majority (or all) of the dentists in Davis supported fluoridation and Davis decided no? Not sure I like that logic.

  3. If they want to put drugs in our water supply, they had better put it on the ballot.

    By hiding it, the City conveniently left this issue out of the Measure I debate.

  4. SODA

    [quote]When is the WAC’s decision expected?
    Wouldn’t it be ironic if the majority (or all) of the dentists in Davis supported fluoridation and Davis decided no? Not sure I like that logic.[/quote]

    On 5/23 the WAC will hear a presentation from the opponents of fluoridation.
    In June a third presentation before the WAC including proponents and opponents will be heard following which the WAC will make its recommendation.

    And yes, this is very ironic. And the comment made by Alan Miller illustrates what a lot of local dentists are encountering. They would like to speak out in favor of fluoridation and do not feel that they can because of the risk to their practice.

  5. [quote]I don’t know, but I think it’s will end up being a political decision by the council, not a policy one.[/quote]

    And how sad is that. A public health decision is likely to be made on the basis of very questionable and unsubstantiated fears, using laundry lists of what might happen, although no one has ever been able to demonstrate that it does happen for 60+ years over what has been demonstrated to be a major benefit to the health of those who have absolutely no voice in this but are most affected.

    People seem to have very short memories, medically speaking. Vaccination against measles, mumps and rubella
    has saved countless lives and yet was nearly derailed by the false accusation based on totally unsubstantiated claims, that this vaccine caused autism. After virtual eradication of these diseases, there have been deaths attributable to refusal to vaccinate. Now its true, no one is going to die from lack of an additional 0.4ppm of fluoride in their drinking water. But the thought process is the same and as a doctor ( and not ashamed of it despite Frankly’s opinion) it is appalling to me to allow fear and speculation to override evidence and reason.

  6. I would vote “NO.” Back in the early 1950s when I was 12 years-old or so, one of my first political arguments with my father was against fluoridation of my city’s water, when my father – the doctor – was supported it. He argued that he and government knew best. I argued then and do now, that the people should vote and government should not coerce us to ingest a chemical additive that we do not want. Fluordation is the easy fix; it is harder for government to systematically address through sound public policy the real issues of poverty, public health, nutrition, diet and access to wholesome food, and affordable dental and medical care. Most surveys indicate these are the reasons for poor dental health.

    A serious problem is that cash-strapped public schools cut deals with the snack food and soft rink industry to put vending machines in schools. Time to get them out!

  7. [quote]However, in this case, there is a fairness issue at play. We brought the matter to the voters in the first place and we did so without the fluoridation issue. Several people above and in private expressed to the Vanguard that had they known there would have been fluoridation, it would have changed their vote on Measure I
    [/quote]

    If this had been done in stealth, I would agree. However, that is definitely not the case as is demonstrated in the past threads on the Vanguard. On June 13, 2011, Alan Pryor submitted an article called ” Time to Talk about the F Word in the Woodland Davis Water Project. This was well before the Measure I vote. The concerns had already been put forth. This was hardly hidden from view, as was pointed out by Helen Thompson at the WAC meeting
    in April. I see no issue of fairness since this had been opened for public discussion before the surface water debate had even fully engaged.

  8. While I don’t think the issue was “hidden” or “stealth,” I don’t think it was on people’s minds when they cast their votes as evidenced by three people who post here – and I’ve talked to about five others in the same camp.

  9. Now’s the time for Davisites to step up to the plate to support rationality rather than bowing to the objections of a tiny few people whose arguments really don’t stand up.

  10. [i]By hiding it, the City conveniently left this issue out of the Measure I debate. [/i]

    Regardless if it was purposely hidden or overlooked, I think it would have put Measure I at much greater risk of losing.

    It is a dated practice… one that made sense in a time before we had 200 toothpaste and mouthwash choices containing fluoride and before we were spending billions of dollars on public assistance for low income residents who should be able to afford toothpaste.

    With all due respect to the medical professionals out there that make their living telling the rest of us how better we will be if we ingest this compound or that chemical, ya’ll are stuck on stupid. First, read the previous paragraph. Second, we are talking about the past Orwellian practice of force-medicating through the water system. I don’t care if you think it is 100% harmless to all people to force them to ingest fluoride in their tap water, it is a violation of your Hippocratic Oath. Doctors are not in the business of dispensing social justice, they are in the business of dispensing healthcare services to each individual base on that individual’s needs. I DO NOT NEED EXTRA FLUORIDE. NEITHER DOES MY FAMILY! So, by supporting this prehistoric practice of force-medicating me and my family with fluoride in the water system, you are OVER-MEDICATING ME AND MY FAMILY. You are in fact doing so because of your concern about some other person or family that does not get enough fluoride. Think deeply about that. Your intentions are good, and I’m sure you are going to struggle to admit that the practice is wrong, but it is wrong. You should stop supporting it and start working on other methods to get more fluoride dispensed to ONLY those that require it.

  11. ” I think it would have put Measure I at much greater risk of losing.”

    I agree.

    “With all due respect to the medical professionals out there that make their living telling the rest of us how better we will be if we ingest this compound or that chemical, ya’ll are stuck on stupid. “

    I don’t understand this point. Does a dentist make more money if more people have tooth decay? Yes. So why would they support something that decreases tooth decay, if it is as you suggest? Dr. Wilke is an educator, a researcher, and a volunteer, what’s his motivation?

  12. @Frankly: No once is being “force medicated” if the people agree to it. That’s what democracy is all about. Let’s see what the Davis voters eventually say on this. On top of that, you are simply giving false information. It’s certainly not a “dated practice.”

  13. [i]Dr. Wilke is an educator, a researcher, and a volunteer, what’s his motivation?[/i]

    People in the medical profession are motivated to improve health. They are used to telling all the rest of us how to live our lives.

    The problem here is a crossing of a line. If I am a banker, is it right for me to advocate that my government force every single person out there to open a savings account, get a credit card and take out a loan because it is good for their fiscal health and well-being to develop credit history? It is certainly NOT right. It is their choice.

    No two people are the same and have the same circumstances. No two families are the same and have the same circumstances. No doctor should support the dumping of medicine into the water system to treat 100% of all people and all families the same. That crosses a clear line and breaks their oath to do no harm… even if you want to make the argument that the risk of harm is minuscule.

    Brian, you are wrong. This is not a democratic political process issues. It is a moral and ethical issue. The majority has no right to force a minority to ingest medicine against their will. They have no right to decide to pollute our ONLY water supply with UNNECESSARY chemicals that a minority does not want to ingest. Your European brethren get this. I think progressives in the town are just not as progressive as those folks across the pond that they admire so.

    Just because the water supply is a convenient dispensary mechanism, does not make it right. I have no problem spending some of our hard-earned tax dollars to dispense free fluoride to people that want it and need it. Many of you that want to force-medicate the population through the water system also support having the government give out free stuff… so just start handing out free toothpaste and toothbrushes to all those poor and lazy people that don’t get enough fluoride.

  14. @Frankly: Sorry, I just don’t follow what you’re saying. THAT is why we have politics and political processes, so that people can act on their moral beliefs. If you think something is immoral, then the burden is on you to convince others to vote as you do.

  15. Bottom line, water fluoridation is a scam for allowing toxic waste producers to dump it in our water supply, and tell us it’s good for us.

    The fluoride they put in the water is not the same compound that is applied to teeth in toothpaste and fluoride applications.

    Dental fluorosis is dismissed as a minor aesthetic problem, but it is no fun for people who have it. It’s an embarrassment that many seek treatment for, if they can afford it.

    See this article [url]http://www.mysanjosecosmeticdentist.com/blog/2011/12/will-teeth-whitening-help-my-fluorosis-stains/[/url] , for an example.

  16. quote]People seem to have very short memories, medically speaking. Vaccination against measles, mumps and rubella has saved countless lives [/quote]

    Firstly, measles, mumps, and rubella are communicable diseases that can be spread through society. It defies plausibility to equate these serious life-threatening diseases with cavity rates. Secondly, there is plenty of solid peer-reviewed scientific information using double-blind studies supporting the efficacy of vaccination and the lack of side-effects.

    In contrast, there has never been a single controlled dose, double-blind study performed with drinking water fluoridation that statistically takes into account confounding factors such as income level, nutrition, access to dental health care, etc. This is the Gold Standards of medical research. The complete lack of these studies and paucity of good evidence supporting the efficacy of fluoridation and lack of side effects raises the skepticism of the lay community and many in the medical community itself.

    In fact, proponents of fluoridation in Davis have not presented ANY written or oral scientific evidence or references to peer-reviewed literature that fluoridation of drinking water prevents cavities. They have just kept rolling out local medical professionals, such as Dr. Wilkes, who repeatedly asserts that in his “scholarly opinion” the issue is a “no-brainer”.

    Such a condensending opinion is insulting to the intelligence of our community. If the pro-fluoridation camp has facts and studies they can reference that conclusively shows that fluoridation of drinking water works, then share them with the community. They had an excellent opportunity to do that at the last WAC meeting but speaker after speaker stood up and functionally stated, “Just trust me, I am a doctor (or dentist), I know what is best”.

    In fact, when one speaker was asked to refer to the specific source of his assertions as to the efficacy of fluoridation, he rudely told the questioner,”Just go to the NIH website, you can easily find it” and refused to be more specific.

    This is an often repeated strategy employed by fluoridationalists…keep to the high road with local big-guns, don’t get bogged down in facts, and never ever get into a two-way debate in a public forum.

    In contrast, those of us opposed to fluoridation who do not enjoy the bully pulpit have only referenced, peer reviewed publications and/or hard facts and figures to substantiate our assertions about lack of efficacy and the possibility of serious side-effects of excess fluoride ingestion.

    Fortunately, in a town as well-educated as Davis, facts and science generally prevail.

  17. @Ernesto: Sorry, I’m not impressed. There are always compromises when people live together in densely populated areas as part of a complex society. It’s a matter of balancing things and looking at the entire picture. If you’re using the word “scam” when it so obviously is not a scam, then that means you’ve lost the argument.

  18. Kind of interesting how Frankly, Ernesto and alanpryor’s posts all have very similar grammatical errors in them. It’s also very interesting how the local anti-fluoridationists’ FB group has virtually no subscribers. Only *one* person on my friend’s list clicked “Like” on it. Makes me wonder.

  19. [i]Kind of interesting how Frankly, Ernesto and alanpryor’s posts all have very similar grammatical errors in them.[/i]

    Brain damage from over-fluoridation.

  20. I don’t know Ernesto, but I know Frankly and Alan Pryor, they are about as different as anyone can be except on this issue.

  21. Brian, fact is, you’ve got nothing. The word is getting out, and people are getting pissed. Davis is one of the most educated cities in the nation. My neighbors include engineers,scientists, and researchers, many in environmental fields. We know how to read literature, we know the shape of scientific policy debates. Our brains don’t drop out of are heads when a MD says something, even if it’s “for our own good.”

    Instead of fighting this pointless battle, why can’t we get together and figure out how to get fluoride drops and toothpaste to families who can’t afford it? It’s got to cost less than fluoridating the entire water supply. West Sacramento is finding out that it’s a lot more expensive than they thought.

  22. @Ernesto: Sorry, you’re just flat-out wrong man. You haven’t even been reading the articles that the detractors have posted here. Rhetorical pseudo-bravado like this isn’t going to get you very far, my friend.

  23. ” It’s got to cost less than fluoridating the entire water supply. “

    Not according to the information cited at the Board of Supervisor’s meeting. The Pedetrician from First 5, said it costs a lot more to cover the insurance for fluoride prescriptions along with the problem of actually making sure the children in need get it on a regular basis.

    “For every dollar we spent on fluoridation, we save $38 on dental treatment,” he argued.

  24. [i]they are about as different as anyone can be except on this issue[/i]

    Which reminds me that I need to apologize and correct my tendency to attribute this to a liberal progressive pursuit. Just like Measure I, people cross political/ideological lines to take a position. I respect all people with an opinion on this even as I claim they are stuck on stupid.

    Brian, why not add vitamins to the water since there are malnourished poor people in our county?

  25. David, first of all consider the source. First 5 is advocating for the program. Anyone can trot out a cost/benefit analysis that comes up with an answer they like. Why? Because cost/benefit analysis is a subjective analysis method — they are filled with assumptions, many of them that are debatable amongst credible sources.

    Can F5 respond to the NTEU 280 – (the scientist union of the EPA!!) — with anything beyond soothing platitudes?

    [url]http://www.nteu280.org/Issues/Fluoride/NTEU280-Fluoride.htm[/url]

  26. While there clearly is a great deal of passion in this discussion, judging by the sheer number of comments on the topic over the past week, I really think you are all missing the big picture.

    I recall an upper division Medical Microbiology class I took at Berkeley in the early 80’s where the Professor described the near absence of evidence of tooth decay in the fossil record prior to the importation and wide use of processed sugar into European society. In other words, if you are truly interested in reducing tooth decay in society, focus on the major contributor, the amount of sugar in our food, not some ‘feel good’ measure like fluoridation. As a side benefit, we would also reduce the incidence of obesity, Metabolic Syndrome, Diabetes and any number of other health issues.

    The problem of course is that removing processed sugar from our diet takes more effort than simply dumping fluoride into our water system and calling it a day. Fluoride in the water may be beneficial, or then again, maybe not, but in either case it is insignificant compared with the real cause of tooth decay (and many other more important health issues).

  27. @Brian Riley; a lot of the information that pro-fluoride proponents use is 40 years old or more, so Ernesto’s use of 10 year old info is more current I would say.

    @ Alan Miller: an excellent dentist to go to is Dr. Visse Storm. She is located on the corner of F St. and 6th, I believe. She is very up-to-date on both fluoride and mercury issues in dental care.

    Here is why, no matter how much cheaper it is to fluoridate water instead of providing topical drops, etc., it is just money–and health–thrown away:

    42) The chemicals used to fluoridate water in the US are not pharmaceutical grade. Instead, they come from the wet scrubbing systems of the superphosphate fertilizer industry. These chemicals (90% of which are sodium fluorosilicate and fluorosilicic acid), are classified hazardous wastes contaminated with toxic metals and trace amounts of radioactive isotopes. Recent testing by the National Sanitation Foundation suggest that the levels of arsenic in these chemicals are high and of significant concern.

    43) These hazardous wastes have not been tested comprehensively. The chemical usually tested in animal studies is pharmaceutical grade sodium fluoride, not industrial grade fluorosilicic acid. The assumption being made is that by the time this waste product has been diluted down, all the fluorosilicic acid will have been converted into free fluoride ion, and the other toxics and radioactive isotopes will be so dilute that they will not cause any harm, even with lifetime exposure. These assumptions have not been examined carefully by scientists, independent of the fluoridation program.

  28. Here’s an excerpt about that 1999 statement:

    Quote:

    “…In 1999, the union published a white paper entitled [i][i]Why EPA’s Headquarters Union of Scientists Opposes Fluoridation[/i][/i].” It panders to all of the usual health fears that surface in every anti-fluoridation document: cancer, osteosarcoma, kidney damage, hip fractures, and reduction in childhood IQ. Like most other anti-fluoridation tracts, it references only the few articles that support these fears and provides no mention of the wealth of countervailing evidence. It is a natural descendant of the early style of presentation by John Yiamouyiannis in his 1982 treatise [i]The Lifesaver’s Guide to Fluoridation[/i]. Both were prepared by scientists, but they do not follow the rules or traditions of science. There is almost no difference between the Union’s white paper and similar documents prepared by lay anti-fluoridation groups with no scientific background.”

    Unquote

    Freeze, R. Allan and Jay H Lehr. 2009. The fluoride wars : how a modest public health measure became America’s longest-running political melodrama, p. 272.

  29. “First 5 is advocating for the program”

    Ernesto, it’s not like they stand to profit from the program, so I don’t see how it negates their position here.

  30. Mark:

    “The problem of course is that removing processed sugar from our diet takes more effort than simply dumping fluoride into our water system and calling it a day. Fluoride in the water may be beneficial, or then again, maybe not, but in either case it is insignificant compared with the real cause of tooth decay (and many other more important health issues).”

    I think you’re understating the problem by several orders of magnitude. And so while you’re point is well-taken, people can be forgiven for seeking a shorter-term solution here.

  31. DG: “[i]I think you’re understating the problem by several orders of magnitude. And so while you’re point is well-taken, people can be forgiven for seeking a shorter-term solution here.[/i]”

    The benefit of fluoridation (if there in fact is one) is totally insignificant compared to the root cause of the problem. It is not a solution, short-term or no, it just makes some people ‘feel’ better.

    Both the money spent on the program, and the passions displayed on both sides of the issue, are completely misplaced and totally wasted. It is in short, bad public policy.

  32. Ok… has anyone modeled how the fluoridated water would circulate thru the City, particularly during summer/peak times? Where would the dosages be injected…if at the headworks, and if the optimal dose was provided, many users would receive less than the optimal dosage. If the dosing was done to make sure every one got the optimal dose, then many would receive much more of the fluoride than optimum.

    It should be modeled, particularly for the peak demand times, when the fluoridated water is mixed with well water.

  33. David, I’m guessing that First 5 gets grant/funding for getting the program implemented. Otherwise they don’t devote employee hours to it.

    Brian,

    [quote]There is almost no difference between the Union’s white paper and similar documents prepared by lay anti-fluoridation groups with no scientific background.” [/quote]

    This is a weak argument. Are the lay anti-fluoridation groups doing good science possibly? Are the authors working backwards from a pre-formed conclusion to discredit those who hold an anti-water-fluoridation opinion?
    Honestly, that is really the substance of most of what I hear the pro-fluoridation people say — they just assume they’re right and work backwards to conclude that people who disagree are wrong.

  34. @Ernesto: Please read the quote again. It states that neither papers: “follow the rules or traditions of science.” That’s pretty clearly stated.

    I think it’s pretty clear that you are not a UCD researcher, as you claim to be.

  35. Mark West, I completely agree with you about the need to address the root cause of the problem. I have raised 5 children in Davis and not one of them ever had a cavity. We don’t consume processed foods or sugar and we don’t get cavities. My 1 child who developed a cavity after leaving home did so while going to law school in a fluoridated town in Connecticut. My family does not need or want fluoride, and had I known that the water project came with fluoride attached, I would have voted against it.

  36. What makes less sense, using fluoridation in the water system to fight tooth decay, or using an unreasonable fear of fluoridation to justify blocking access to clean water for generations to come. There is an adage concerning noses and faces but I can’t quite remember what it is.

  37. From what I understand, fluoride is beneficial for growing children to strengthen their teeth. But why should adults ingest it? I remember visiting a school in Arizona (and keep in mind that just because Arizona does something does not make it wrong – or stupid); the teacher directed her students in a fluoride coating (unless the parents objected). I do not think that the number of cavities is out of the norm because of not fluoridating their water. Perhaps someone could find statistics concerning whether this practice is just as effective (or not… or more so).Inquiring (and open) minds want to know.

  38. Mark West, I disagree that the fear of fluoridation is unreasonable.

    “In 2006, the National Academy of Sciences recommended that the EPA lower the maximum allowable level of fluoride in drinking water. The academy’s report warned severe fluorosis, a disorder resulting from the absorption of too much flourine, could occur at 2 parts per million. And a majority of the report’s authors said a lifetime of drinking water with fluoride at 4 parts per million or higher could raise the risk of broken bones.

    In 2005, the heads of 11 EPA unions, including those representing the agency’s scientists, demanded that EPA reduce the permissible level of added fluoride in water to zero, citing research suggesting it can cause cancer. Other studies have pointed to neurotoxicity and hormone disruption from excessive fluoride.” LA Times Jan. 8, 2011

    With almost half of America’s adolescents showing signs of fluorosis, it seems to me that it is fluoridation of the municipal water that is unreasonable.

  39. Market research in 2008 identified 412 distinct types and sizes of toothpaste. 96% of these contained fluoride.

    [quote]The Fluoride Years

    The introduction of fluoride wasn’t just a hit with everyday brushers in the pre-Mad Men era of the 1950’s [b](about the same time that we started adding fluoride to drinking water)[/b]. Crest’s first fluoridated toothpaste was considered a major scientific milestone, earning the ADA seal for cavity prevention—the first toothpaste to do so.

    The presence of fluoride slows down the breakdown of tooth enamel. When enamel stays strong, cavities stay away. The iconic “Look Ma, No Cavities” TV spot wouldn’t have been possible without this technological breakthrough.

    After 25 years, the original formulation was tweaked slightly to lengthen its shelf life. Fluoristan was changed Fluoristat, offering even greater cavity protection.

    In the early 2000s, researchers found a miracle ingredient: sodium hexametephosphate. It whitens by loosening and breaking the bonds of external stains. But it doesn’t just clean, it also protects. Its long-lasting protective barrier helps safeguard against future stain buildup.

    After toothpaste addressed cavities by introducing fluoride, it focused its attention on new achievements. In 1995, “a stabilized version of stannous fluoride” was developed, and Crest Gum Care toothpaste was rolled out.

    When Crest Pro-Health debuted a few years later in August 2006, it continued a history of innovation. The technology behind Crest Pro-Health came from 10 years of testing and development. It’s supported by 15 patent applications and more than 70 published pieces of literature on the ingredients. Most importantly, it combines all the benefits of the past in one tube: anti-cavity, anti-gingivitis, sensitivity protection and whitening.

    The technology and possibilities of toothpaste continue to evolve. Now, toothpaste can whiten, protect against gum disease, and treat sensitive teeth.[/quote]

    Bottom line… we don’t need fluoride in the water, but everybody should be brushing their teeth with toothpaste.

  40. ebowler: It is a simple issue of magnitude of importance. Adding fluoride to the water may in some cases be beneficial in terms of tooth decay, but any benefit is swamped by the damage caused by processed sugar in our diet. It is silly to fight over the minuscule potential benefit while ignoring the big picture.

    Similarly, any potential harm caused by fluoride in the water system is completely swamped by the huge damage resulting from a shortage of clean water. It is silly to discuss blocking the surface water project out of fear of a hypothetical prospect of fluoridation.

    Both arguments are silly.

  41. Mark West

    [quote]The problem of course is that removing processed sugar from our diet takes more effort than simply dumping fluoride into our water system and calling it a day. Fluoride in the water may be beneficial, or then again, maybe not, but in either case it is insignificant compared with the real cause of tooth decay (and many other more important health issues).[/quote]

    While I agree with you that our dietary habits including sugary drinks and foods are overall more important than the exact amount of fluoride and that removing these from the diets of both children and adults is more challenging than fluoridating, I feel that you are creating a false dichotomy. I do not know any health professionals who do not advise their patients to limit their consumption of these substances and especially to limit the amounts they give to their children. No one I know is promoting water fluoridation as a panacea.
    I think that all of us in favor see it as part of a comprehensive strategy that includes a nutritionally sound diet,
    adequate oral hygiene, access to regular dental care, and optimization of the amount of fluoride. Since our society has not seen fit to make access to all of these measures available to all of our population, it seems to me that when given the opportunity, we could at least provide the most cost effective for the entire population as an option…..not as some are trying to claim ….a “forced medication”. And not one of you who is making this claim has yet explained how, or by whom you will be “forced to consume” the tap water.

  42. Alan Pryor

    [quote]This is an often repeated strategy employed by fluoridationalists…keep to the high road with local big-guns, don’t get bogged down in facts, and never ever get into a two-way debate in a public forum.

    In contrast, those of us opposed to fluoridation who do not enjoy the bully pulpit have only referenced, peer reviewed publications and/or hard facts and figures to substantiate our assertions about lack of efficacy and the possibility of serious side-effects of excess fluoride ingestion.
    [/quote]

    I find these comments quite ironic in view of the behavior of the opponents at the presentation of the proponents at the WAC. When there was an obvious error in the listing of speakers, with one list having my name on it and the other omitting my name due to a timing issue, the opponents, on a technicality,
    refused to allow WAC members to ask me questions. While I agree this was procedurally correct, it was hardly done in the spirit of openly allowing an exchange of information. And this was done after I had apologized and explained the situation. So, in this setting, who was actually stifling the exchange of information ?

    And the proponents have no monopoly on rudeness ( implying that I was too lazy to “do the research” and unwillingness to be forthcoming with sources. One opponent posting on another thread made the assertion that there was an association between fluoride and breast cancer, and when asked repeatedly for her source since breast cancer is a major career interest of mine, has not forwarded any information on this issue.

    What I would like to see, what you claim to want, is exactly what I said at the WAC. A full airing of all the concerns and a decision made on the basis of the best evidence available. I do not feel this will be achieved by
    attributing nefarious and hidden goals, name calling, rudeness or suppression of anyone’s views by any method. But that is just one doctors opinion.

  43. Medwoman: “[i]I do not know any health professionals who do not advise their patients to limit their consumption of these substances and especially to limit the amounts they give to their children. No one I know is promoting water fluoridation as a panacea[/i].”

    I am certain that using fluoridation to treat tooth decay is every bit as effective as giving ‘Frankly’ an “Elmo Band Aid” to treat [b]my[/b] sucking chest wound…

    You should be ashamed of yourself. If you are interested in reducing your own tooth decay, reduce your intake of sugar. If you are interested in reducing tooth decay in the population, get the AMA to advocate for the removal of the sugar subsidy, the corn subsidy, and maybe even the regulation of high fructose corn syrup as an addictive food additive, not a type of food. Those steps will make a difference, and as an added benefit, you might start dealing with real issues like obesity, diabetes, heart disease and metabolic syndrome.

    Advocating for fluoridation is a feel good cop out by a medical community too lazy to make a real difference. So, shall I send you another package of Elmo Band Aids or do you feel like being a Physician today?

  44. I’m guessing medwoman has done far more in her lifetime to promote the health of individuals and communities than you have, Mark. So calling her lazy and telling her she should be ashamed of herself is bizarre.

    This conversation and topic have gone completely off the rails. I seriously don’t care what happens with fluoridation in this community. But it’s become one of those topics I don’t even want to discuss with people for fear they’ll turn out to be strangely fanatical about it. I can’t even imagine caring enough about it to get so caustic and worked up on it.

  45. [b]Relevant vs Irrelevant[/b]

    When a person opposes fluoridation on the grounds of ethics, arguments about benefits and costs are irrelevant. Unless the people supporting fluoridation can establish the ethical grounds, it is meaningless for them to present benefit and cost data. Until a person supporting fluoridation has an ethical ground, it is unnecessary for a person opposing fluoridation to argue about the benefit, harm, and cost. Such arguments are only meaningful to people who can’t tell the difference between relevant and irrelevant information.

  46. [b]Ethics vs Politics[/b]

    An ethical decision is a decision that does not contradicts the principles to protect the others. A political decision is a decision made in order to affect an outcome.

    To argue that a decision is political, one must identify how (or declare their belief that) the current decision will help the decision-maker gain advantages in changing things in some way.

    If the city had planned to fluoridate the water but decided to down-play it during the vote for Measure I, the decision to down-play it can be argued to be political (i.e. it is down-played in order to gather more support). In this case, it would also be unethical because it fails to protect the alignment between what the voters are voting for and what the voters would actually get.

  47. [b]Fear vs Respect and Accountability[/b]

    Some had argued that opposition of fluoridation is based on personal fear. Such argument ignores the grounds of ethics, which has nothing to do with personal fear but respect and accountability.

    Respect is the permission for others to be responsible for their actions. Accountability is the commitment to compensate others for one’s own fault.

    When a person ignores the decision of others and make decisions for them, the person is not respecting them. When a person makes a change without a commitment to compensate those who are negatively affected, the person is not acting accountably.

    In our context, fluoridation is a change that requires defining accountability because the change is not a personal choice. The change directly affects more than the person making the decision (or supporting the decision). In the ethical mindset, the first consideration is the protection of the welfare of others, which includes ensuring that if the change negatively affects someone, the person making the decision has enough resource to fix the issue by reversing the effect or by compensation.

    If the entity cannot afford to “undo” or “compensate”, the entity cannot afford to make such decision on behalf of others. (They can still make such decision for themselves because that would be a closed-system: aka reap what you sow.) A solution that does not violate ethics in such situation is to let each individual make a decision that only affects themselves.

  48. The above are fundamental concepts required for ethical policy-making. They are required knowledge to answer the following questions ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7258:commentary-unimpressed-why-im-not-moved-by-the-fluoridation-outrage&catid=60:water&Itemid=92&cpage=60#comment-181714[/url]):

    [quote]1) If opponents of fluoridation of the water supply truly believed in the toxicity of fluoride, why would several of those who are the most adamant have suggested providing drops, washes, or even tablets to the economically disadvantaged if desired ?[/quote]

    Answer: Respect and accountability

    A person who opposes fluoridation on the grounds of toxicity may not oppose providing fluoride drops because providing fluoride drops would not have a behavior effect on those who wants no fluoride added to their tap water, thus respecting their existing way of life. Even if the drops are toxic for everyone, whoever chooses to get them do so at their own risk.

    [quote]2) If they truly believe it is a toxin, why is no one calling for its removal from the current water supply ?[/quote]

    Answer: Accountablity

    The accountability to add or remove fluoride from the water is the same. At this very moment, no one needs to be accountable for the fluoride content that naturally exists in the water because there is no change being made to it. If a change is proposed, whoever proposing the change must consider a multitude of effects because the proposer is accountable for all known and unknown effects. A diligent person would not casually decide to change nature in either way.

    [quote]3) Why has not a single opponent made any mention of the choice of a number of European countries to add fluoride to their salt ( also ingested) as an acknowledgement of the potential benefit of fluoride even though those countries have chosen not to add it to the water supply ?[/quote]

    Answer: Logical fallacy

    The prevalence of a measure is not a logical indicator of the benefit of the measure. For a person to acknowledge benefit from that statement, the person must first distinguish causal effect from superstition.

  49. Edgar

    “The prevalence of a measure is not a logical indicator of the benefit of the measure. For a person to acknowledge benefit from that statement, the person must first distinguish causal effect from superstition.”

    This is the only statement that you have made that I agree with in it’s entirety. The opponents have repeatedly stated that we should follow the example of the European countries that have chosen not to fluoridate their water. Their argument is that since many are not doing it, we should not either. This is not a valid argument since as you have stated prevalence is not synonymous or even necessarily an indicator of benefit.

  50. Edgar

    A few thought about ethics and accountability. I do not limit myself to the narrow view you seem to be espousing.
    As a doctor I have a number of different levels of accountability. As a clinical practitioner, I have accountability to the individual patient that I am seeing at a given time. It is my duty to provide the best advice and service that I can to her as an individual while respecting her autonomy of choice based on her values. But that is not where my responsibility ends. I have a responsibility to her family as well. If the patients physical and emotional state are not conducive to caring for herself or her children there is a broader perspective that must be taken into account.

    Similarly there are situations in which the broader community well being must be taken into consideration as part of my accountability.
    A dramatic example of this would be either quarantine or forced medication of an individual who has multiple drug resistant tuberculosis, but does not believe in antibiotics or who refuses to wear a mask in public.. I am not in any way suggesting that this is the same as fluoridation, but am rather using it as an example of a medical situation in which a doctor must choose between accountability to the individual ( with respect to their autonomy) or accountability to the community. This example is quite black and white, but there are many situations in medicine where the issue has shades of grey.

    If I am interpreting your position correctly, you seem to be seeing this exclusively from the point of view of an individual who does not want to feel compelled to drink the water. Please note that no one is actually compelled to drink tap water. My view as a doctor involved in both individual patient care and public health is that the issue of what is “accountable” “ethical”behavior is not nearly as cut and dried as you portray it.

  51. Since I have come out in favor of fluoridation, I want to again make a point that I have made previously.

    I believe firmly that this decision is a public health, not a political issue since there is no coercion involved. No governmental body forces any one to drink tap water. Many folks in Davis do not drink it currently since they do not like the taste. No one arrives to force it down their throats.
    Granted, one can rally a certain segment of the population by claiming this. But that does not make it true.

    I also firmly believe that the decision should be made on the best medical and scientific evidence available. My search of the literature has led me to the conclusion that the benefits out weigh the risks. I understand that others interpret the literature differently. I bear them no animosity for their different perspective. What is most important to me here is that public health policy be decided on the basis of the medical/scientific merits,
    Not on the basis of speculation, dubious association, unsubstantiated observation or someone’s strongly held political beliefs. This we should all be able to do without shouting each other down, belittling each others beliefs, questioning people’s competency, accusing others of some moral or ethical lapse, or calling others idiots. That we establish a precedent for rational, civilized debate in our community is much more important to me than whether or not we fluoridate our water at this particular point in time.

  52. [i]But it’s become one of those topics I don’t even want to discuss with people for fear they’ll turn out to be strangely fanatical about it. I can’t even imagine caring enough about it to get so caustic and worked up on it.[/i]

    We have one water system.

    It is a public water system.

    We all pay for it.

    It is supposed to deliver water… just water.

    Note to all you blanking do-gooders out there. Get it in your thick skulls that the water system is not yours to use to save all the stupid and lazy people out there (removing poor people from the list because they already get enough subsidy to afford fluoridated toothpaste). Because doing so makes you stupid and lazy too. Just because something is convenient does not make it right. If you want to stop tooth decay, then do it the right way. Do not put any chemicals in OUR water using OUR water system other than what is ONLY REQUIRED to keep OUR water clean and safe.

  53. Frankly provides a very apt example of what I would like to see us abandoned in our public discourse.
    Do you really believe that the use of “thick skulls” ” stupid and lazy” really adds to the credibility of your points ?
    What would be wrong with attempting to discuss the issues logically and without disparagment of others ?

  54. Medwoman, I hear your sincere feelings on this matter. You are giving your honest opinion, and a medical background is a solid foundation on which to stand. But there are others with equally credible backgrounds, who also have sincere feelings on that matter.

    I can start with my friends and neighbors: a water engineer, a UCD biochemistry professor, a MS Environmental Engineer who worked for the Air Resources Board, and a wetland ecologist. These people are not religious fundies or John Birchers. All of them have substantial training in relevant science and engineering. All of them are opposed to water fluoridation.

    At the national level we have groups like The Sierra Club, The Environmental Working Group, and EPA Professional Union NTEU 280, who also have science based opinions that lead them to oppose water fluoridation.

    To close, here’s an excerpt from NTEU 280’s work on fluoridation.

    [quote]Fluoridation: Recent History

    A Partial, Annotated List of Recent Events, Articles, Hearings, Reports, and Research.

    May 6, 2003 – EPA Science Forum session on fluoridation. For the first time since 1978, a government agency, the EPA, invited a discussion on the merits of fluoridation. However, no one from government agencies or non-governmental organizations that endorse and promote fluoridation, such as the CDC, U.S. PHS, or the ADA, would agree to the EPA’ s invitation to speak for fluoridation. Second Look’s Statement of Concern, with names gathered so far from organizations and individual professionals, was released in support of the EPA union of professionals’ call for a Congressional investigation.

    March, 2003 – Article in International Journal of Occupational & Environmental Health, Vol.9, No.1, Jan/Mar2003, by D.W. Cross and R. J. Carton, Ph.D., titled, “Fluoridation: A Violation of Medical Ethics and Human Rights”

    April 25, 2002 – EPA’s National Risk Management Research Laboratory states that the release of fluoride in drinking water from silicofluorides is “not well understood”, expresses concern over fluoride’s interactions with other chemicals, and asks for research.

    September, 2001 – Sierra Club issues a position statement on fluoridation, citing “…valid concerns regarding the potential adverse impact of fluoridation on the environment, wildlife, and human health.”

    May, 2001 – Rachel’s Environment & Health News. Comprehensive article on fluoridation by Dr. Paul Connett, Michael Connett, and Ellen Connett (http://www.rachel.org )[/quote]

    [url]http://www.nteu280.org/Issues/Fluoride/flouridelist.htm[/url]

    Thanks for reading!

  55. Ernesto: You’re citing 10 to 13 year old studies. A decade ago we were all still using dial up and flip-cell phones. The world has changed a lot since then.

  56. @David, the pro-fluoridation literature is much older – rotary phones.

    What difference do phone styles make in regards to the costs/benefits of water fluoridation?

  57. Medwoman – I think they are apt labels for those ignoring the clear an frequently repeated arguments against fluoridation. Nobody on that anti-fluoridation side is arguing that fluoride in the water is not beneficial. But, you and others are ignoring or dismissing the harm. You and others are also dismissing the clear ethics problem with force-medicating the population. That makes you either stupid or thick-skulled.

    Does name calling help? Probably not. But neither has debate. Everyone is lined up on one side or the other.

    There is a clear ideological connection here. Those leaning politically left seem to see the world as being filled with a bunch of incapable, lazy and stupid people that they have been anointed to constantly save. This is the savers syndrome. Those leaning politically-right see a world filled with a bunch of incapable and lazy people mostly because those on the political left perpetuate it with demands of ever-increasing social justice (read: “saving”).

    Medical professionals are in the business of saving people, so it is not too hard to understand why they would support dumping medicine into the drinking water to help save the stupid and lazy people.

    But, if these same medical professionals cannot admit the problems with this practice, then they too are exhibiting stupidity and laziness.

    What medical professional on this blog has come forward to discuss the alternatives for the same goal of saving all the stupid and lazy people from tooth decay? Provide me a true cost benefit analysis, and you get my attention. Just demand we maintain the old practice while labeling me a fanatic and irrationally fearful, and I will call you stupid and lazy.

  58. Even if one opts to refrain from drinking fluoridated water, we know that there is also considerable transdermal absorption of fluoride from showering and bathing. The only way to avoid fluoride exposure in the home would be to install a reverse osmosis filtration system to remove it. RO systems are not without their own problems as they also remove all natural minerals in addition to being very expensive. There is also the problem of food and beverages prepared outside the home filtration system such as in restaurants. Those who wished to avoid fluoride exposure would also have to refrain from eating or drinking in local restaurants.

  59. Ernesto – I have seen a number of 2011 studies.

    Frankly:

    “What medical professional on this blog has come forward to discuss the alternatives for the same goal of saving all the stupid and lazy people from tooth decay? “

    So underprivileged kids are stupid and lazy people? I take great offense to that. When we got our nephew, his mouth was so full of decay, we had to give him fluoride pills and try to save his teeth. We’re talking about a 7 year old at the time. Please think before you make these kinds of comments.

  60. Sorry David. I think if you go back and read, I have repeated myself over and over that I have no problem with an outreach program for low-income people to get the kids fluoride.

    I never consider any of the kids stupid or lazy, it is the adults. I think I have been consistent in making that point in every blog post that addressed issues with children. And, from what I understand, you have taken over from relatives that could not care for him. Did they allow his teeth to become full of decay for any reason other than they were stupid and/or lazy?

    So, is this impulse to support adding fluoride to the water primarily due to the percentage of parents that are stupid, lazy or otherwise unable to insure that their kids brush regularly with fluoride toothpaste, and/or have a diet that doesn’t include mounds of sugar? I think so. And it backs my point.

    I think to a very large degree people respond to what is expected of them. If you add fluoride to the water to save them from being too stupid or too lazy to ensure that their kids eat well enough and brush well enough, then their kids too will grow up expecting nanny government to take care of their diet and teeth.

    I would prefer we spend our resources developing self-sufficiency along with helping to save the person from immediate harm.

    If the Democrat Party put as much effort into canvassing the poor neighborhoods handing out free toothpaste and brushes and nutritional information as it does to canvass those same neighborhoods for Obama votes, maybe those on the left would have greater credibility with me for demanding we force-medicate the population.

  61. If conservatives put this much passion into the fact that they are consuming neonicotinoids, glyphosate, and BT on a nearly daily basis, we might actually get faster reform of the pesticide/GMO registration process and might even be able to change farm policy.
    Your extreme sensitivity on this fluoride issue is way out of proportion to the toxicity, I would say. And trying to tie it to “world views…Democrats…Obama…nanny state….” blah blah blah is just fatuous.

  62. good point don, i’m glad you brought that up because i’ve been thinking that for awhile. i’m sure frankly will plead to the pro-choice issue, but it’s a false argument imo. it’s not like you have a choice about exposure to pesticides or any number of toxins in the air. argument of convenience.

  63. [i]Your extreme sensitivity on this fluoride issue is way out of proportion to the toxicity[/i]

    My extreme sensitivity is in proportion to the absurdity of the people that support the practice of forced-medicating 100% of the people, when much less than 100% of the people need the medication, and some will be harmed by it.

    My extreme sensitivity is in proportion to the previously undisclosed decreased value of the product that I voted to receive and pay extra for.

    My extreme sensitivity is in proportion to the increase in nanny state policies that tend to keep more people stupid and lazy.

    My extreme sensitivity is in proportion to my disappointment of the medical professionals that continue to prop up this ancient Orwellian practice while also bristling at the inference that they have a problem with over-prescribing and over-medicating in general.

  64. [i]it’s not like you have a choice about exposure to pesticides or any number of toxins in the air[/i]

    You are comparing policies to remove toxic substances to one where we are adding toxic substances? You may not understand the irony of this, but it stands out quite strongly.

  65. no. actually in both cases they are added. pollutants and pesticides are added to the environment just as fluoride would be added to the water. there’s no difference. you’re simply trying to justify your inconsistent positions by inventing differences that don’t exist.

  66. Holly cow Davis progressive, are you sure you cannot tell the difference between public policy to limit or remove toxic substances from our environment, and public policy to add toxic substances to our water?

    I think we might not every be able to communicate if you are unable to understand this simple point.

  67. currently the public policy adds toxins to our environment right? you seem unconcerned about those toxins which are far more toxic and harmful than the one you are railing against.

  68. Neonicotinoid pesticides are registered in California for use on many specialty crops, including:
    Broccoli
    Brussels Sprouts
    Cabbage
    Cauliflower
    Pak Choy
    Collard
    Cucurbits
    Eggplant
    Kale
    Kohlrabi
    Lettuce
    Melon
    Peppers
    Tomatillo
    Tomato
    Neonicotinoids are systemic, meaning they are taken up into the plant and are distributed throughout the plant. You can’t rinse them off. You are ingesting them every time you eat these crops. How often do you eat salad, greens, tomato sauce, salsa?

    88% of corn is GMO, 93% of soy, 94% of cottonseed, 90% of canola. Most of these are glyphosate resistant. Glyphosate is a systemic herbicide, so you are ingesting it every time you eat these products. If you’re like most Americans, you eat them several times a day. Bt is the other GMO in corn; it is for caterpillar control. So you are ingesting Bacillus thuringiensis every time you eat that type of GMO corn.

    Does that bother you, that you are being force-treated with pesticides every day? Do you believe it is safe to consume small amounts of pesticides and bacteria every day? Whom do you trust about the safety of these products?

    Unless you buy entirely organic food products, you can’t avoid these. It is very difficult to avoid the byproducts of corn and soy. Do you have the same level of anger about the mass consumption of pesticides that is forced on the public by agribusiness corporations? Do you trust the government officials who oversee the registration and regulation of these products?

    I’m pretty sure Alan shops according to these issues, and grows most of his own produce. So he has consistency on his side in his concern about toxicity, regulatory processes, and his analysis of the expertise involved. My guess is he is equally concerned about these food issues. Are you?

  69. I am concerned about pesticides and GMOs. I try to avoid to the extent that it is possible by buying local and organic foods.

    But that is beside the point. I am not being asked how I feel about pesticides and GMOs. I cannot substantively effect change on that front right now. The question at hand is whether or not we should fluoridate our water, and I oppose that for reasons similar to why I support sustainable, non-GMO food pathways.

  70. Fruits and vegetables do not flow through a public delivery system that is plumbed into my house and requires me to pay an expensive monthly fee for. I have copious choice as to what food I purchase and from where. I can even grow my own in my garden.

    The cost of organic food has been dropping for years, and will continue to.

    I think you are struggling to make a point worth responding to.

    Ernesto is making the fabulous point that most Davisites should agree with… keeping our food and drink natural… no added chemicals… no GMO. More and more people are doing so. The market for organic, natural and raw foods is expanding profoundly. But, here we are back to talking about adding more junk to our water.

    Irony abounds!

  71. [i]currently the public policy adds toxins to our environment right?[/i]

    Well, no this is not accurate.

    Current public policy allows private producers to use certain chemicals in their production processes.

    Last I checked it wasn’t government mandating crop dusters drop pesticides on the fields to make sure poor kids don’t accidentally eat a bug.

  72. This is a silly conversation.

    I already buy RO water, but this isn’t always possible for everyone, and I certainly can’t shower in it, or water my garden with it. And I can’t make restaurants use it.

    That, again, is one of the problems with water fluoridation. You cannot easily control the fluoride exposure levels because people have different bodies and different water usage patterns.

  73. Frankly

    [quote]Nobody on that anti-fluoridation side is arguing that fluoride in the water is not beneficial.[/quote]

    This is simply not an accurate statement. Alan Pryor has stated repeatedly on these threads that he does not believe fluoride in the water is beneficial. You can go back and read this in his posts if you do not believe me.

  74. Frankly

    [quote]But, you and others are ignoring or dismissing the harm. You and others are also dismissing the clear ethics problem with force-medicating the population. [/quote]

    I really wish that you had been at the WAC. I was allowed three minutes during which time I clearly stated that I felt that all of the concerns should be fully considered. I have also stated that here. My partner will vouch for the fact that I have spent hours and hours searching the literature and claims made by the opponents. I am neither ignoring nor dismissing the possibility of harm. I am stating that there is clear evidence of the cause and effect relationship between high fluoride levels and fluorosis. There is strong evidence that elderly women given 20 to 50 mg / day of fluoride in tablet form were shown to have increased brittleness of their bones and thus were at higher risk of hip fracture. This is all that has been demonstrated. You will not find anyone much more antifluoride than Alan Pryor, and he has stated clearly that all the other considerations are association only and that in > 60 years of use, no other adverse effect has been found. So for me, when a toxicologist says this in addition to the entirety of the peer reviewed literature over 60 years, I think that is quite telling.

  75. Ernesto

    I truly appreciate your approach. I have stated previously that I have chosen to focus my readings on fluoride to the medical issues involved since that is my area of expertise. I agree that there are many other considerations and am leaving those largely to others. I have read all of the medically related sources that you have listed including several pieces by Dr. Connett. I have not, and probably will not, be reading the primary sources regarding the environmental effects, cost concerns and other issues, but will be following the pro and cons sides carefully. I hope that I had made it quite clear that my writings were going to be limited to the medical considerations as I know that there are many in Davis who know much more than I about these other issues.

    It does seem to me however, that there is a tendency amongst many who post here, to disdain the expertise of those who happen to disagree with their opinion and an unwillingness to even consider a different point of view.
    The consideration of another point of view is exactly what I chose to do when I found out after my recent appointment to the Health Council that fluoridation was a major issue. I was unwilling to accept either side at face value. I started with the literature handed out by the opponents at Farmer’s Market, read it thoroughly, and then started going painstakingly through the medical literature on each of the conditions that anyone has posted as being a concern. When I do not have the expertise to interpret the data, as in pediatrics, I consulted with my pediatric colleagues. What I found is exactly what Alan says. There is causal evidence for fluorosis at higher than proposed levels. There would be causal evidence for increased risk of bone fracture at 20- 50 mg / day. There is no causal evidence for any other medical condition.

  76. [b]Alternatives[/b] Re ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7270:commentary-fluoridated-water-in-davis-a-longshot-at-best&catid=60:water&Itemid=92&cpage=30#comment-181860[/url])

    [quote]The opponents have repeatedly stated that we should follow the example of the European countries that have chosen not to fluoridate their water. Their argument is that since many are not doing it, we should not either. This is not a valid argument since as you have stated prevalence is not synonymous or even necessarily an indicator of benefit.[/quote]

    When a person mentions that European countries do not fluoridate water but fluoridate salt, the underlying reasons may include the following:

    1) To state an alternative implementation that would not impose a change onto the people. In Germany, fluoridation of salt is not done by the government but by private firms. This follows my explanation earlier that if fluoridation saves money, whoever that is currently losing money will naturally be willing to make the investment to start a firm, thus not violating the ethics of [b]respect[/b] or [b]accountability[/b].

    2) To counter proponent’s argument (of prevalence) using an argument of the same type of logic. By definition, an objective person may change their decision once they get additional data that points to alternatives. When a proponent suggests an argument of prevalence, and an opponent counters it with an argument of greater prevalence, [b]regardless whether prevalence is relevant, the dogmatism of the proponent is exposed.[/b] A proponent who intends to be objective and has integrity is expected to either change their decision or to nullify their conclusion.

  77. [b]Damage[/b]
    [Re] ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7270:commentary-fluoridated-water-in-davis-a-longshot-at-best&catid=60:water&Itemid=92&cpage=30#comment-181863[/url])

    [quote]If I am interpreting your position correctly, you seem to be seeing this exclusively from the point of view of an individual who does not want to feel compelled to drink the water. Please note that no one is actually compelled to drink tap water. My view as a doctor involved in both individual patient care and public health is that the issue of what is “accountable” “ethical” behavior is not nearly as cut and dried as you portray it.[/quote]

    In your reply I see that you do not understand the difference between choice and damage. To confirm that your understanding of ethics is coherent (that you use ethics to make a decision, instead of changing the definition of ethics to suit a pre-made decision), please articulate your considerations in the following scenario:

    Scenario:

    John and Mary are standing face to face. John tells Mary that he wants to swing his arm across Mary’s face. Mary tells John not to do it because that will hit her. John ignores Mary and swings his arm and hits Mary on her face, which resulted in a bruise that caused Mary pain and medical bill of $10.

    John says, “I declared what I wanted and Mary understood what I wanted to do. She [b]chose not to dodge[/b]. I am not responsible for her pain or medical bill.”

    Please explain how you decide whether John’s perspective is ethical or unethical, and what the ethical outcome in this [b]simple[/b] scenario should be.

  78. How do you tell the difference between someone who uses ethics to make a decision, and someone who simply label whatever decision they make to be “ethical”?

    A way to tell the difference is to ask the person to define their principle of ethics, and let them explain how each decision they claim to be ethical is derived from those principle. By definition, someone who uses ethics to make a decision has a definition of what ethics means. Without knowing what it means, it is impossible to consciously use ethics to design or to test a policy. Without that definition, the person will not be able to tell whether the decision is ethical or unethical.

  79. Edgar Wai said . . .

    [i]”In your reply I see that you do not understand the difference between choice and damage. To confirm that your understanding of ethics is coherent (that you use ethics to make a decision, instead of changing the definition of ethics to suit a pre-made decision), please articulate your considerations in the following scenario:

    Scenario:

    John and Mary are standing face to face. John tells Mary that he wants to swing his arm across Mary’s face. Mary tells John not to do it because that will hit her. John ignores Mary and swings his arm and hits Mary on her face, which resulted in a bruise that caused Mary pain and medical bill of $10.

    John says, “I declared what I wanted and Mary understood what I wanted to do. She chose not to dodge. I am not responsible for her pain or medical bill.”

    [b]Please explain how you decide whether John’s perspective is ethical or unethical, and what the ethical outcome in this simple scenario should be.[/b]”[/i]

    Edgar, in the realm of ethical/moral decision making there isn’t a single answer, or single approach. The academics who study ethical/moral decision making haver generally agreed that there are five different approaches to ethical/moral decision making.

    The first approach is the [b]Utilitarian approach[/b], which starts by identifying the various available courses of action, and then determining who will be affected by each alternative and what benefits or harms will be derived from each alternative. When all is said and done the Utilitarian approach chooses the alternative that will produce the greatest benefits and the least harm is chosen because ethically it is the one that provides the greatest good for the greatest number.

    The [b]Rights approach[/b] focuses directly with an individual’s right to choose for him or herself.

    Aristotle developed the [b]Fairness or Justice approach[/b], which says “equals should be treated equally and unequals unequally” That approach boils down to meaning everyone should be treated equally with no favoritism or discrimination shown.

    The [b]Common-Good approach[/b] focuses on “ensuring that the social policies, social systems, institutions and environments on which we depend are beneficial to all.” So to make a decision based on the common-good of all involved in the decision would be to make sure that that outcome provides a benefit to all individuals.

    The [b]Virtue approach[/b] is the least complicated of the five in that it “assumes that there are certain ideals toward which we should strive…”

    John’s declaration clearly shows that he is following the Rights approach to ethical decision making when he asserts that, “I declared what I wanted and Mary understood what I wanted to do.” If John and Mary live in a society that has adopted the Rights approach as its ethical decision making standard then his decision is indeed ethical. Many people here in America get very agitated about the Rights that the this country adopted in the 2nd Amendment to the US Constitution. However, if John’s actions are judged using any one of the other four approaches, John’s actions get a much less charitable assessment.

  80. Fluoridated salt is available in some European countries for those people who wish to ingest fluoride, allowing them to choose either fluoridated or non-fluoridated salt. It is just another choice at the grocery store. That seems to me to be a reasonable solution for people seeking to ingest fluoride and does not force the rest of the population to be involuntarily medicated. Here we have the option of prescription fluoride drops or tablets, which also allow for individual choice (and medication consent) re oral fluoride. In Europe, it has been the involuntary medication argument that has been the most persuasive the against fluoridation of municipal water.

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