Would a Vote On Fluoridation Accomplish Anything?

fluoride-waterBy Matt Williams

In the coming weeks as a member of the Water Advisory Committee (WAC), I am going to be formally and officially asked what my recommendation to City Council is regarding fluoridation of Davis’ water.

The following are some comments selected from the recent fluoridation discussion:

“If our water supply is fluoridated out of the tap, then all water especially used in food and drink preparation whether cooked or not, and for all personal uses, not just tooth brushing and daily tooth care, will have fluoride in it. Is that what I wish for…I don’t know, but I sure would like to vote on it.

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

  • “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.”

  • “I say it is time to let all the people of Davis and Woodland to exercise their right to vote.”

  • “Let’s see what the Davis voters eventually say on this.”

All of the sentiments expressed above argue that this is important enough of an issue that it warrants a vote of the citizens.  When I look at the voting option in the light of the opinions expressed below, I can’t help but wonder whether a citizen vote on fluoridation will accomplish anything.

  • “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.”

  • “Mike Harrington. If you are reading this, I will contact you later to discuss the opportunity to bring another lawsuit against the city for polluting the new expensive surface water with unneeded and harmful chemicals.”

The abundance of passion that the above comments demonstrate isn’t the only concern that having a vote raises.  History (and the comment below) tell us that 6 out of every 10 registered voters simply don’t care enough to vote.

  • “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.”

So I have two questions for all you readers out there, 1) Would a vote on fluoridation actually accomplish anything? and 2) If a vote actually does take place, will the people on the losing side accept the vote results and move on?

When I read the comments quoted above, together with those quoted below, I honestly don’t know what the answers to those two questions are. How would you answer them?

  • “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.”

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

  • “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.”

  • “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,”

  • “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.”

  • “If I had known that we would be adding fluoride to the water, I would have voted no on the surface water project.”

  • “I don’t think you could design a less effective way of delivering medication to the community if you tried. Fortunately, I am not the only one who feels this way as you will certainly hear from the community as we get into this debate.”

Author

  • Matt Williams

    Matt Williams has been a resident of Davis/El Macero since 1998. Matt is a past member of the City's Utilities Commission, as well as a former Chair of the Finance and Budget Commission (FBC), former member of the Downtown Plan Advisory Committee (DPAC), former member of the Broadband Advisory Task Force (BATF), as well as Treasurer of Davis Community Network (DCN). He is a past Treasurer of the Senior Citizens of Davis, and past member of the Finance Committee of the Davis Art Center, the Editorial Board of the Davis Vanguard, Yolo County's South Davis General Plan Citizens Advisory Committee, the Davis School District's 7-11 Committee for Nugget Fields, the Yolo County Health Council and the City of Davis Water Advisory Committee and Natural Resources Commission. His undergraduate degree is from Cornell University and his MBA is from the Wharton School of the University of Pennsylvania. He spent over 30 years planning, developing, delivering and leading bottom-line focused strategies in the management of healthcare practice, healthcare finance, and healthcare technology, as well municipal finance.

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99 comments

  1. 1) Would a vote on fluoridation actually accomplish anything? and 2) If a vote actually does take place, will the people on the losing side accept the vote results and move on?

    1) I think that you are accurate in your comment that the majority of Davis voters simply do not care enough
    one way or the other to bother to educate themselves, or vote on this issue. Therefore I think it is highly
    likely that a vote would do exactly what the opponents want it to do, namely put the decision into their hands
    This is not about public well being, it is about a vocal minority pushing to stop a public health measure
    largely because they do not like public health decisions and feel their individual political preferences should
    hold sway. You can see this in the comments about people not caring whether it is safe, or medically
    effective. They have their moral or ethical or political standard that they feel should take precedence. They
    conveniently forget that this is also “forcing” their will upon others by denying others something that would
    be beneficial.

    2) Will the people on the losing side accept the vote results and move on ?
    If the proponents lose, I guarantee that those of us in the medical profession, those in public health, will of course move on. We will continue to do our best to provide care to all of the citizens of the county. And we will watch those on the opposing side move away from the issue. I sincerely doubt that any one will step up as they have suggested to promote alternative strategies to help those in need of help with their medical and dental care. I suspect that having gained their goal, they will be content to drop back, celebrating their victory over the
    “lazy and stupid” and their “thick skulled” advocates. If I am wrong, and one the opponents would step up and actually work on a viable alternative, I will be the first to apologize, but I do not have high expectations.

  2. The default position is to not fluoridate, since the water is not presently fluoridated. So it would not make dental conditions in Davis[i] worse[/i] if the council decided to retain the status quo. Other means could be found to improve the dental health of lower-income citizens. So it would not be unreasonable for the city council to decide to maintain the status quo and choose not to fluoridate. If the proposal was to cease a current fluoridation program, the choice might be different.

  3. [quote]Other means could be found to improve the dental health of lower-income citizens.[/quote]

    I think that “could” is the operative word here. I would have no problem with the city adopting an equivalent alternative plan to improve the dental health of those who are at highest risk. For example, I would have no problem if the City Council were to say, ok, we will not add fluoride to your water, but we will tax you enough to provide equivalent benefit in terms of fluoride products and free dental care to those who need it.

    How many of those of you who oppose fluoridating the water supply would actively petition the City Council for such an alternative ? I eagerly await your posts. Maybe you could be the leaders in a petition for a positive alternative, not just naysayers. Maybe you could be the voices behind placing such an initiative on the ballot.

  4. “Other means could be found to improve the dental health of lower-income citizens.”

    but people like frankly don’t want to spend the money, so we let the perfect be the enemy of the good… again.

  5. Don Shor said . . .

    [i]”The default position is to not fluoridate, since the water is not presently fluoridated.”[/i]

    That isn’t actually a correct answer Don. Davis’ well water is currently naturally fluoridated to a level between 0.1 and 0.36 depending on the testing location.

    Sacramento River water has virtually no fluoride in it, so going to Surface Water as our primary supply will be effectively reducing the amount of naturally occurring fluoride in Davis water. The default position should therefore be fluoridation of the water coming from the WDCWA treatment plant to the same level as currently exists in Davis’ well water.

  6. Davis Progressive said . . .

    [i]”but people like frankly don’t want to spend the money, so we [b]let the perfect be the enemy of the good[/b]… again.”[/i]

    I think it is safe to say that for Frankly, the issue of [i]spending the money[/i] is absolutely minor when compared to the issue of [i]forced medication / informed consent[/i]. But with that said, I think your bolded comment above is one that applies to a lot of the anti-fluoridation arguments. I had a lively conversation with Barbara King, Pam Nieberg and Alan Pryor at the anti-fluoridation booth at the Farmers Market today. Their individual arguments varied somewhat, but each contained a healthy amount of “do no harm” which can be paraphrased into your words relatively easily.

  7. Matt Williams said…

    “Their individual arguments varied somewhat, but each contained a healthy amount of “do no harm” which can be paraphrased into your words relatively easily.”

    I don’t think that the anti-fluoridation arguments can be paraphrased into the words “let the perfect be the enemy of the good.” You are making an assumption here that there is good to be gained from fluoridating our drinking water. I and my fellow anti-fluoridation proponents would heartily disagree with that assumption.

  8. I will consider the City of Davis to be a “No Choice” City if we are not allowed to vote on this issue. All of us deserve a vote since we will be involuntary consumers of fluoride through our bathing, gardening, and produce consumption activities. Drinking fluoridated water isn’t the only issue here!

  9. The U.S. Food and Drug Administration (FDA) classifies fluoride as a drug when used to prevent or mitigate disease. Adding fluoride to water for the sole purpose of preventing tooth decay (a non-waterborne disease) is a form of medical treatment. Fluoride is the only chemical added to water for the purpose of medical treatment. All other water treatment chemicals are added to improve the water’s quality or safety, which fluoride does not do. Water fluoridation forces citizens to ingest a medication irrespective of their consent, which is unethical. Adding fluoride to our city’s water supply purposely exposes me and my children to a drug that we adamantly and emphatically do not want to ingest. There is no excuse for exposing everyone in our community to a drug in our water supply for the purported purpose of preventing dental caries. It is a basic human right to not be forced to ingest a medication against one’s will.

    It is not the right of a city council to add medication to my water supply. I want the city council to decide against water fluoridation. At the same time, I do not support a public vote on this issue. It is not my neighbor’s right to vote to add a medication to my water supply.

  10. As Jim Lehrer has said, “If we don’t have an informed electorate we don’t have a democracy. So I don’t care how people get the information, as long as they get it.”

    So here it is…

    http://www.scienceinmedicine.org/policy/statements/fluoridation.pdf

    When it comes to matters of science, the American public is easily swayed by unfounded fears. Community water fluoridation may be another example where the electorate does not vote for their best interest. This will not be the first time, nor the last.

  11. To answer medwoman, of course I would support taxing us enough to take care of the dental health of the most vulnerable. I would pay for toothpaste, toothbrushes, floss, dental education, and dental visits for those who can’t afford them.
    As a compromise position I would go further and say a person has a right to ingest fluoride, with informed consent, although I am not convinced I am doing them a service. Again, I’d be willing to offer free salt to all low income residents and let them choose unfluoridated or fluoridated salt, the latter imported from the European countries you say fluoridate their salt instead of their water.
    Matt, I’d prefer you vote no fluoridation than you vote have an election, which will likely be a contest of funding and energy to present the 2 sides. I fear the pro-fluoride group will be heavily funded – it is easier to sell donate waste fluoride to city water supplies than it is to dispose of it as a toxic byproduct of phosphate fertilizer production. I am not volunteering to spend my limited time and energy on an election of whether the majority can enforce fluoride ingestion on the rest. Election means choice – please vote for individual choice.

  12. That was very well articulated Adrienne. Thank you for taking the time to think that through and share it.

    I have one follow-up question for you (and anyone else who wants to answer). If the City added only enough fluoride to the surface water to bring it up to the current ambient fluoride level of Davis’ well water, would you consider that a workable compromise as well?

  13. @Ernesto: We’ve already established that you are fibbed to this group about being a UCD researcher, when you are not a UCD researcher. Obviously, then, “Ernesto” is just another pseudonym being used be a single person to create the illusion of a groundswell of support for the anti-fluoridation cause. This is highly unethical and I ask you to stop, please.

    Here’s more info about the unethical practices of those who oppose fluoridation:

    [u][u]http://www.quackwatch.org/03HealthPromotion/fluoride.html[/u][/u]

  14. Here’s more information on anti-fluoridation quackery:

    [url]http://scienceblogs.com/insolence/2010/12/02/anti-fluoridation-crankery-how-1960s/[/url]

  15. Matt, you write “I have one follow-up question for you (and anyone else who wants to answer). If the City added only enough fluoride to the surface water to bring it up to the current ambient fluoride level of Davis’ well water, would you consider that a workable compromise as well?

    Thank you for asking this question. Fluoride proponents like to use the argument, “Fluoride is ‘natural.’ We just want to top up what is there anyway.” Arsenic, like fluoride, leeches naturally from rocks into groundwater, but no one suggests topping that up. Besides, there is nothing “natural” about the fluoridating chemicals, as they are obtained largely from the wet scrubbers of the phosphate fertilizer industry. The chemicals used in most fluoridation programs are either hexafluorosilicic acid or its sodium salt, and those silicon fluorides do not occur in nature. Under international law, they cannot be dumped into the sea, yet we are being asked to believe that a dilution of about 180,000 to 1 is supposed to be safe when the same chemicals are added to the domestic water supply.

    I would like to bring something else up here. I heard pro-fluoridation speakers at the WAC meeting and at the board of supervisors state the amount of fluoride that we would be adding to the Davis water is miniscule, merely a drop among many many gallons of water. They ask, “How could anyone be concerned about such insignificant quantities of fluoride?” Such statements are nonsensical without reference to the toxicity of the chemical in question. For example, 1 ppm is about a million times higher than the safe concentration to swallow of dioxin, and 100 times higher than the safe drinking water standard for arsenic; it is also up to 250 times higher than the level of fluoride in mother’s milk.

  16. If anyone is clicking on the links that Brian has provided, I would suggest that they also go here [url]http://www.fluoridealert.org/fan-tv/10-facts/[/url]

  17. Dr. Leonard, your posts address a lot of questions, so let me share my thoughts on each starting from the last.

    The mothers milk argument is ridiculous for a myriad of reasons. First, humans who subsist on mother’s milk are not bombarded by the processed sugars that humans who have been weaned are exposed to. So why use an irrelevant standard as a point of comparison. Second, every single tooth that is exposed to mother’s milk is destined to fall out of the mouth of the human who drank the mother’s milk. Why would you cite a standard that has a 100% correlation with tooth loss?

    Arsenic has been scientifically proven to be toxic at virtually all levels of concentration. Dioxin has been scientifically proven to be toxic at virtually all levels of concentration. Tylenol has been proven to be toxic at high levels of concentration but very beneficial at low levels of concentration. Aspirin is toxic to me personally at any level of concentration, but is certainly not toxic to the vast majority of Americans. Your sweeping condemnation of fluoride does not appear to take into consideration concentration levels.

    You appear to be really concerned about the source of the fluoride ions that are the active agent in any fluoridation process. Is there something demonic about the phosphate fertilizer industry that we should know about? Children are a biproduct of sexual attraction. Does that mean that the natural children of rapists are to be castigated in principle?

    When you say, [i]”It is a basic human right to not be forced to ingest a medication against one’s will”[/i] what is the provenance of that right? Does it appear in the 10 Commandments? It it part of the Constitution?

    When you say, [i]”Adding fluoride to our city’s water supply purposely exposes me and my children to a drug that we adamantly and emphatically do not want to ingest.”[/i] do you actually have to ingest it? Do you have alternatives?

    Finally, lets look at your “rights” argument in a bit more depth. Let’s start by acknowledging that there isn’t a single universally accepted approach to ethical/moral decision-making The academics who study ethical/moral decision-making have generally agreed that there are five different approaches to.

    Let’s stat the five with the [i]Rights approach[/i], which focuses directly with an individual’s right to choose for him or herself.

    The second 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.

    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…”

    So my question to you is, [b][i]”By putting all your eggs into the Rights approach basket, are you not simply replacing a tyranny of the majority with a tyranny of the minority?”[/i][/b]

  18. Once again, the readers of this blog should be cautioned that “tleonard” is most likely just another pseudonym for the same *one* person who is attempting to create the illusion of a groundswell of support for anti-fluoridation quackery.

  19. Brian, once again you are seeing demons where there are no demons. Terri Leonard, MD has sent direct e-mails to every member of the WAC outlining her own personal perspective on this issue. Her first e-mail began,

    [i]”Dear Mayor Krovoza, Mayor Pro Tempore Wolk, Councilmember Swanson, Councilmember Frerichs, Councilmember Lee, and Members of the Water Advisory Committee,

    I am an M.D. and a mother of four children (ages 4 to 8) and I adamantly oppose water fluoridation. Water is for everyone, but fluoride is not. I support the right of an individual to ingest fluoride if he or she so chooses (although that is not a choice that I would make for my family, and I will discuss my reasons below). At the same time, I expect to be supported in my right to NOT ingest fluoride if I so choose. “[/i]

    Her e-mail ended as follows,

    [i]”Thank you for carefully considering these concerns.

    Sincerely,
    Terri Leonard, M.D.”[/i]

    I do not agree with all of the points Dr. Leonard makes, but I respect her right to make those points. You should respect her right as well.

  20. tleonard: [i]Besides, there is nothing “natural” about the fluoridating chemicals, as they are obtained largely from the wet scrubbers of the phosphate fertilizer industry.[/i]

    I’m not sure what should qualify as natural or not in your eyes. Human dental enamel ([url]http://en.wikipedia.org/wiki/Tooth_enamel[/url]) is made of hydroxyapatite, which is a calcium phosphate ([url]http://en.wikipedia.org/wiki/Hydroxyapatite[/url]). Much phosphate derives from decomposed animal material.

  21. Brian: Likewise, every person that I have seen post against fluoridation, I can account for a separate individual. I too was contacted by Dr. Leonard who had difficulty logging onto their account.

  22. tleonard

    [quote]”How could anyone be concerned about such insignificant quantities of fluoride?” Such statements are nonsensical without reference to the toxicity of the chemical in question.[/quote]

    I agree that such a statement would be “nonsensical” without reference to the toxicity of the chemical in question. That is not the case here. I have made numerous references to the only demonstrated toxicity of this
    substance in the amounts proposed. The only proven toxicity is fluorosis which has been well demonstrated to be a cosmetic issue at the proposed level. All of the other supposed toxicities have not been demonstrated at the proposed level and are merely conditions that opponents claim have been “associated”. As a doctor, I am sure you are aware that anyone can postulate an association between a substance and a disease to raise concern. This has played out in many situations in medicine over the past thirty years in some cases unjustly casting doubt on legitimate practices and in other cases proving highly lucrative to a group with a vested interest in the outcome. Many of these claims have nothing at all to do with the risk benefit of the devise, procedure or substance, but a false claim once made is very hard for the public to differentiate from a true claim.

    Regardless of our position on fluoride, I feel it is our obligation as medical professionals to argue from a place of evidence, not from false equivalency such as discussing the amount in breast milk or the amounts of known poisons.

    [quote]I support the right of an individual to ingest fluoride if he or she so chooses [/quote]

    I also support this right. I have yet to hear from any of the opponents of fluoridation how they believe that they are being forced to ingest tap water. Please help me understand, how, when many Davis families do not consume the tap water now because of taste preferences, that this is forcing anyone to consume tap water.

  23. “I have yet to hear from any of the opponents of fluoridation how they believe that they are being forced to ingest tap water.”

    Ah, let them eat cake!

  24. Matt…..

    I will start with your statement that the mother’s milk argument is ridiculous. A bottle fed baby in a fluoridated community is getting up to 250 times more fluoride than a breast-fed baby. It was after the 2006 U.S. National Research Council report made it clear that bottle fed babies were exceeding the EPA’s IRIS (Integrated Risk Information System) reference dose that the ADA finally recommended to its membership, in November 2006, that they advise their patients not to use fluoridated water to make baby formula.

    According to the CDC, 32 percent of children in the U.S. have dental fluorosis, which is a mottling or discoloration of the tooth enamel caused by excessive exposure to fluoride before the secondary teeth have erupted. In other words, the excessive fluoride that infants are exposed to by ingesting fluoridated water affects their permanent teeth. Now, proponents of fluoridation insist that dental fluorosis is merely a cosmetic problem, not a health problem. To claim that dental fluorosis is merely a cosmetic problem is to ignore an indication of a systemic effect that has caused some alteration of the biochemistry of the growing tooth. Opponents of fluoridation are concerned that dental fluorosis in a child may signal that damage to other tissues has also occurred. That damage may be less visible and less obvious, but possibly far more serious. There is no reason to believe that interference in biochemistry will not occur in other tissues as it does in teeth. For fluoridation promoters, it has always been an article of faith that the presence of dental fluorosis does not signal any other damage to the human body

  25. Matt…

    You wrote” Your sweeping condemnation of fluoride does not appear to take into consideration concentration levels.” Proponents of fluoridation stress how well engineers can control and monitor the concentration of the fluoridating agent added to the water supply. However, controlling concentration, measured in the case of fluoride in milligrams per liter, is not the same as controlling dose, which is measured in milligrams consumed per day. The dose gets larger the more water is drunk; and the larger the dose, the more likely it will cause harm. This is particularly serious for a substance like fluoride, which is known to be highly toxic at moderate to high doses, which accumulates in the bone, and for which there is little, if any, margin of safety to protect the most vulnerable against known health risks. We also receive fluoride from sources other than the water supply, and this amount varies from individual to individual. Thus, it is the total dose from all sources that we should be concerned about.

  26. Matt…

    You stated, “You appear to be really concerned about the source of the fluoride ions that are the active agent in any fluoridation process. Is there something demonic about the phosphate fertilizer industry that we should know about?”

    Yes, I am indeed really concerned about the source of the fluoride ions that are added to the water supply in fluoridation programs. Fluoridealert.org [url]http://www.fluoridealert.org/articles/50-reasons/[/url] does a really good job of summing up this concern in numbers 41-44 from their article “50 Reasons to Oppose Fluoridation”:

    41) The chemicals used to fluoridate water are not pharmaceutical grade. Instead, they largely come from the wet scrubbing systems of the phosphate fertilizer industry. These chemicals (90% of which are sodium fluorosilicate and fluorosilicic acid), are classified hazardous wastes contaminated with various impurities. Recent testing by the National Sanitation Foundation suggest that the levels of arsenic in these silicon fluorides are relatively high (up to 1.6 ppb after dilution into public water) and of potential concern (NSF 2000 and Wang 2000). Arsenic is a known human carcinogen for which there is no safe level. This one contaminant alone could be increasing cancer rates – and unnecessarily so.

    42) The silicon fluorides have not been tested comprehensively. The chemical usually tested in animal studies is pharmaceutical grade sodium fluoride, not industrial grade fluorosilicic acid. Proponents claim that once the silicon fluorides have been diluted at the public water works they are completely dissociated to free fluoride ions and hydrated silica and thus there is no need to examine the toxicology of these compounds. However, while a study from the University of Michigan (Finney et al., 2006) showed complete dissociation at neutral pH, in acidic conditions (pH 3) there was a stable complex containing five fluoride ions. Thus the possibility arises that such a complex may be regenerated in the stomach where the pH lies between 1 and 2.

    43) The silicon fluorides may increase lead uptake into children’s blood. Studies by Masters and Coplan (1999, 2000, 2007), and to a lesser extent Macek (2006), show an association between the use of fluorosilicic acid (and its sodium salt) to fluoridate water and an increased uptake of lead into children’s blood. Because of lead’s acknowledged ability to damage the developing brain, this is a very serious finding. Nevertheless, it is being largely ignored by fluoridating countries. This association received some strong biochemical support from an animal study by Sawan et al. (2010) who found that exposure of rats to a combination of fluorosilicic acid and lead in their drinking water increased the uptake of lead into blood some threefold over exposure to lead alone.

    44) Fluoride may leach lead from pipes, brass fittings and soldered joints. In tightly controlled laboratory experiments, Maas et al (2007) have shown that fluoridating agents in combination with chlorinating agents such as chloroamine increase the leaching of lead from brass fittings used in plumbing. While proponents may argue about the neurotoxic effects of low levels of fluoride there is no argument that lead at very low levels lowers IQ in children.

  27. Matt…

    You asked if there are alternatives to ingesting fluoridated water from the municipal water supply. Proponents of fluoridation counter the argument that fluoridation in the public water system violates the individual’s right to informed consent to medication by arguing that fluoridated water is only delivered to the tap and no one is actually forced to drink it. This argument certainly does not apply to low-income families. Their economic circumstances force them to drink the water coming out of the tap. Thus, a program that is billed as equitable is actually inequitable, since low-income families are trapped by a practice that may cause them harm.

  28. Matt…

    You asked, “When you say, “It is a basic human right to not be forced to ingest a medication against one’s will” what is the provenance of that right? Does it appear in the 10 Commandments? It it part of the Constitution?

    Every doctor knows that he or she cannot force an individual to take medicine without that patient’s informed consent. Doctor’s must tell their patients the benefits of any medicine prescribed and warn of any possible side effects. After they have done this, it is the patient who makes the final decision as to whether to take the medication. Informed consent is both an ethical obligation and a legal requirement spelled out in statutes and case law in all fifty states. By violating the individual patient’s right to informed consent, fluoridation allows decision makers, without medical qualifications, to do to the whole community what an individual doctor is not allowed to do to his or her individual patients.

  29. tleonard said . . .

    [i]”I will start with your statement that the mother’s milk argument is ridiculous. A bottle fed baby in a fluoridated community is getting up to 250 times more fluoride than a breast-fed baby. It was after the 2006 U.S. National Research Council report made it clear that bottle fed babies were exceeding the EPA’s IRIS (Integrated Risk Information System) reference dose that the ADA finally recommended to its membership, in November 2006, that they advise their patients not to use fluoridated water to make baby formula.”[/i]

    Terri, I fully understand the points you make, and acknowledge that the reduction in the “optimal levels” in recent years is the direct result of the incidence of fluorosis. However, since all the teeth that are exposed to breast milk and or infant formula drop out of a person’s mouth. The replacement of deciduous teeth begins around age six, when the permanent teeth start to appear in the mouth. As a result any fluorosis that is the result of infant formula literally disappears through natural processes. Further, your comparison of breast milk levels of fluoride is meaningless. How many elementary school children consume breast milk?

    tleonard said . . .

    [i]”According to the CDC, 32 percent of children in the U.S. have dental fluorosis, which is a mottling or discoloration of the tooth enamel caused by excessive exposure to fluoride before the secondary teeth have erupted. In other words, the excessive fluoride that infants are exposed to by ingesting fluoridated water affects their permanent teeth. Now, proponents of fluoridation insist that dental fluorosis is merely a cosmetic problem, not a health problem. To claim that dental fluorosis is merely a cosmetic problem is to ignore an indication of a systemic effect that has caused some alteration of the biochemistry of the growing tooth. Opponents of fluoridation are [b]concerned[/b] that dental fluorosis in a child may signal that damage to other tissues has also occurred. That damage may be less visible and less obvious, but possibly far more serious. There is no reason to believe that interference in biochemistry will not occur in other tissues as it does in teeth. For fluoridation promoters, it has always been an article of faith that the presence of dental fluorosis does not signal any other damage to the human body.”[/i]

    I have bolded the key word “concerned” in your passage above. Jehovah’s Witnesses are concerned about blood transfusions. Does their concern affect whether you will or will not accept a blood transfusion if and when you or your family need one? I respect your concern and look forward to any research that you can point to that has been done since the NRC Report was published voicing similar concerns. It seems logical that the anti-fluoridation proponents would have pounced all over those concerns and would be working hard to transform those concerns into scientifically confirmed problems, especially since the concerns were almost all associated with administration levels that are considerably higher than the 1.0 to 0.7 levels that are now considered to be “optimal.”

    Here’s a question for you. Mother Nature has seen fit to set the fluoride levels of Davis water in the 0.1 to 0.36 range. What has been the impact (both pro and con) of Mother Nature’s levels here in Davis?

  30. Terri, when I read points 41-44 I find myself with more questions. Can you help me put those broad statements into Davis context?

    For 41) how do the arsenic levels from the NSF report compare to the naturally occurring arsenic we currently experience in Davis water?

    For 42) what is the current pH of Davis water? Given all the naturally occurring mineral salts, I fully expect that the pH of Davis water is above 7.0, probably significantly above 7.0. It would appear that the Michigan study results do not apply to Davis water. Do you agree?

    For both 43) and 44), what sources of lead do you believe that Davis residents are exposed to that would experience the kind of increased lead uptake you describe?

  31. tleonard said . . .

    [i]”Matt… You wrote” Your sweeping condemnation of fluoride does not appear to take into consideration concentration levels.” Proponents of fluoridation stress how well engineers can control and monitor the concentration of the fluoridating agent added to the water supply. However, controlling concentration, measured in the case of fluoride in milligrams per liter, is not the same as controlling dose, which is measured in milligrams consumed per day. The dose gets larger the more water is drunk; and the larger the dose, the more likely it will cause harm. This is particularly serious for a substance like fluoride, which is known to be highly toxic at moderate to high doses, which accumulates in the bone, and for which there is little, if any, margin of safety to protect the most vulnerable against known health risks. We also receive fluoride from sources other than the water supply, and this amount varies from individual to individual. Thus, it is the total dose from all sources that we should be concerned about.”[/i]

    Here too I would argue that Mother Nature (with her 0.1 to 0.36 inclusion of fluoride ions in our well water) has provided us with a superb laboratory that has produced decades worth of experience and data on the very issues that you describe above. What does that evidence tell us about the long-running exposure of Davis residents to naturally occurring fluoride? Are we seeing actual incidents of the kinds of health problems listed in the health risks you cite?

  32. tleonard said . . .

    [i]”You asked if there are alternatives to ingesting fluoridated water from the municipal water supply. Proponents of fluoridation counter the argument that fluoridation in the public water system violates the individual’s right to informed consent to medication by arguing that fluoridated water is only delivered to the tap and no one is actually forced to drink it. This argument certainly does not apply to low-income families. Their economic circumstances force them to drink the water coming out of the tap. Thus, a program that is billed as equitable is actually inequitable, since low-income families are trapped by a practice that may cause them harm.”[/i]

    The social justice argument put forward by fluoride’s supporters says that low-income families can’t afford either toothpaste or dental care . . . in effect “trapping” them with dental disease. Someone is only “trapped” in your scenario if their ethical decision-making model places the same high value on Rights as you do. I suspect your weighting of that particular issue is much higher that the typical low-income family.

  33. tleonard

    [quote]Thus, a program that is billed as equitable is actually inequitable, since low-income families are trapped by a practice that [b]may[/b]cause them harm. [/quote]

    I see the issue of being “trapped by a practice that may cause them harm” quite differently from you.
    What we [b]know[/b] causes great harm and expense is dental caries, tooth decay and tooth loss. The opponents and proponents agree on this point. Our society has not chosen a route taken by many other countries, namely to provide adequate medical and dental care for all our citizens. What the proponents are attempting to do is to provide an inexpensive route to the prevention of cavity formation that is available ( note, available, not mandatory) for all. In medicine, to choose not to provide treatment is as powerful a choice as to provide it. As a doctor, I advise my patients to chose an option that provides a known benefit even if “associated” with an unproven, undemonstrated, and incoherent theory of potential risk.

    Choosing not to fluoridate the water is, from my point of view the choice to with hold a beneficial preventive measure from many of our community. This is where the real “force” is being exerted. To withhold a substance from those who will benefit from it because of their inability to pay is the true coercion.

    Water fluoridation provides an option, not a mandate, even to the individual since no individual is forced to drink the water. Refusal to fluoridate represents for many, a mandate to continue at a higher level of risk when a relatively inexpensive risk reduction option is available.

  34. I have few questions for the opponents of fluoridation.

    1) Do you drink Davis tap water?
    2) If you do, does the up to .36 ppm of fluoride in the water cause you concern ?
    3) Has anyone stopped drinking Davis water once they became aware of the amount of fluoride in it ?

  35. I would like to add one more question to medwoman’s

    4) The symptoms of fluoride hypersensitivity show up in the dermatologic, gastrointestinal and neurological systems. Those symptoms are eczema, atopic dermatitis, urticaria, epigastric distress, emesis, and headache issues. Do you currently consistently suffer from any of those symptoms?

  36. medwoman….

    By not putting fluoride in the water, you are not depriving anyone of access to fluoride. It is available in tablet form and in fluoridated toothpaste. From an economic perspective, avoiding fluoride in water is expensive, whether it involves purchasing bottled water for cooking and drinking, or the use of distillation equipment or reverse osmosis systems. Thus, lower income families are disproportionately burdened by fluoridation since by and large they cannot afford avoidance measures. The motivation for targeting poor children for extra help is laudable, but adding fluoride to the drinking water to do so is misguided. It makes an inequitable situation even worse. The children most likely to suffer from poor nutrition come from low income families, and people with inadequate diets are most vulnerable to fluoride’s toxic effects.

  37. The suggestion that “water fluoridation is safe for all” is an irresponsible position that clearly deserves rebuttal. It is clearly not for babies, dialysis patients, thyroid disease patients, or anyone that consumes a larger than average amount of soda/tea/juice/water etc. But is it for anyone at all if as the CDC tells us “you will get brittle aching bones” if you get too much over the years? [url]http://www.cdc.gov/fluoridation/fact_sheets/cwf_qa.htm#20[/url]

    Just how are we supposed to monitor our dosage of the drug? Not only do doctors have no way of monitoring your intake of fluoride, they do not routinely test your blood levels, which do not reflect bone, brain, & thyroid fluoride levels.

    WHAT AGENCY IS IN CHARGE OF FLUORIDATION?
    The CDC promotes fluoridation but;

    – Is [b]not[/b] overseeing the safety of the program
    – Does [b]not[/b] vouch for the safety of the chemicals used
    – Accepts [b]no[/b]other liability in the matter

    Also [b]no ownership of fluoridation[/b] at the American Dental Association (ADA), Environmental Protection Agency (EPA), the Food and Drug Administration (FDA), or the National Sanitation Foundation International (NSF). In fact, no federal agency accepts liability for the “safe levels” or the “safety of the chemicals” it recommends for fluoridation.

    Will that fall on the local water agency?

  38. Matt…

    You wrote,”[i]The replacement of deciduous teeth begins around age six, when the permanent teeth start to appear in the mouth. As a result any fluorosis that is the result of infant formula literally disappears through natural processes[/i].”

    Permanent teeth begin to form in the twentieth week of fetal development, and continue to form throughout infancy and early childhood, which is why fluoride exposure early in a child’s life so readily leads to dental fluorosis.

  39. Does anyone know how mank kids in Davis/Woidland don’t have access tlupridevtoothpaste?

    If there are 2000 and it cost $10//yr to give each one of then fluoride toothpaste thats $20k/ year. It has to cost much more than that to run the facility and purchase 12 million pounds of fluoride additive.

    How many kids is this intended to treat anyway?

  40. medwoman…

    You wrote,” [i]As a doctor, I advise my patients to chose an option that provides a known benefit even if “associated” with an unproven, undemonstrated, and incoherent theory of potential risk.[/i] “

    It is important to remember that we are talking about mass medication, not a drug that is prescribed after due consultation with an individual patient. A risk of harm estimated at, say, 1 in 10,000 may be entirely acceptable in the case of an individual patient. In fact, we accept far higher risks of undesirable side effects if we are seriously ill. But if we are giving a drug to nearly 400 million people worldwide, that risk translates into 40,000 cases of harm from one cause. The risks for some harms due to fluoridation are probably much higher.

    Proponents and opponents of fluoridation carry different burdens of proof. Proponents need to have conclusive proof of substantial benefit and very strong evidence for an extraordinarily low risk of harm. They have neither. For opponents, it should suffice to show that there is an identifiable risk of serious harm. Even small risks are indefensible when deliberately imposed on a large population. This is common sense, but it eludes the proponents of fluoridation, who continue to talk about small risks as if they are acceptable.

    The onus is on proponents to demonstrate that there is an adequate margin of safety between the doses that cause harm and the huge range of doses that may be experienced by those drinking uncontrolled amounts of fluoridated water and at the same time receiving unknown amounts of fluoride from other sources. And, such a margin of safety should be large enough to protect [i]everyone[/i] in society, not just the average person. The very young, the very old, those with poor nutrition, and those with impaired kidney function are more susceptible to fluoride’s harmful effects.

  41. Re: Matt

    [b]1) Would a vote on fluoridation actually accomplish anything?[/b]

    The default option is to not fluoridate because the plan violates ethics and accountability. A vote is an action that has a cost. The potential benefit of a vote is to stop the city from committing to an incorrect plan (water fluoridation). Since the default is no fluoridation, a vote is a “waste”, The entity that promotes fluoridation is accountable for the cost of the vote [b]AND[/b] any damage that may occur due to fluoridation. (Without the vote, the entity that promotes fluoridation is only accountable for the damage.) In additional, the entity that should be held accountable is not the “City”, but the individual proponents who are promoting the plan because ethically the city does not have its own money.

    [b]2) If a vote actually does take place, will the people on the losing side accept the vote results and move on?[/b]

    This question shows a fundamental misunderstanding of the function of voting. A vote is a decision mechanism. It itself does not determine what is correct or just. A decision decided by a majority says nothing about whether the decision is just. When a group of people uses voting as a mechanism to oppress a minority, the fault is [b]systemic injustice.[/b] People who exercise voting without understanding the ethical uses of voting can commit systemic injustice without realizing that they are doing anything wrong. On a matter whether there correctness can be defined, voting should not be used as a mechanism for decision making. It is irrational to vote on such situations.

  42. (Cont. on answer 2)

    The definition of integrity is to do the right thing regardless or the reward or effect to the self.

    When anyone is subjected to injustice, integrity dictates that anyone should protect the victim. The concept that the minority of a vote should always stop protesting would violate the definition of integrity. The concept of “majority rules” in this context is ethically incorrect. Belief in such concepts makes a community vulnerable to exploitation (by the majority) and systemic injustice.

  43. Edgar Wai said . . .

    [i]”The default option is to not fluoridate because the plan violates ethics and accountability.”[/i]

    As noted earlier in this thread your statement above is only correct if the only ethical decision-making approach you use is the Rights approach. Doing that clearly ignores the other four broadly accepted approaches to ethical decision-making. Those five approaches are:

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

    The second 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.

    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…”

  44. The situation here is that people are committing ethical crimes and do not understand that they are doing it.

    An ethical crime is a crime where, in principles, just laws try to codify. In reality, our current set of laws lags behind codifying ethics, and our legislation is vulnerable to codifying laws that violates ethical principles.

    One policy-makers base their decisions only on what is permitted by law, they are setting a standard lower than what ethics is. A policy-maker who does not understand this fundamental concept is vulnerable to implementing unethical or unjust policies while thinking that they doing the community a service.

    A policy-maker who subscribes to just laws is better than one who does not.

    A policy-maker who subscribes to ethics in addition to just laws is better than one who only subscribes to just laws.

    These concepts should be understood by the end of high school education, because people need to understand when they are victims of injustice so that they can initiate actions to implement accountability.

  45. Edgar Wai said . . .

    [i]”The definition of integrity is to do the right thing regardless or the reward or effect to the self.

    When anyone is subjected to injustice, integrity dictates that anyone should protect the victim. The concept that the minority of a vote should always stop protesting would violate the definition of integrity. The concept of “majority rules” in this context is ethically incorrect. Belief in such concepts makes a community vulnerable to exploitation (by the majority) and systemic injustice.”[/i]

    Edgar, the key ethical argument being put forward by the pro-fluoridation proponents is one of Social Justice. They argue that the victims that need to be protected are the low-income citizens who are burdened with significantly higher incidents of dental disease. You appear to be ignoring those victims. Is there a reason you are doing so?

    I am not commenting on the quality of the Social Justice argument, just noting that you are specifically ignoring/overlooking this clear ethical decision-making issue. You have done so for a reason. Can you elaborate on that reason?

  46. Edgar Wai said . . .

    [i]”The situation here is that people are committing ethical crimes and do not understand that they are doing it. “[/i]

    I believe the pro-fluoride proponents would agree with you that Social Justice ethical wrongs are indeed being “done” by allowing low-income citizens to have higher rates of dental care. Do you agree with that ethical belief of theirs?

  47. [quote]Proponents and opponents of fluoridation carry different burdens of proof. Proponents need to have conclusive proof of substantial benefit and very strong evidence for an extraordinarily low risk of harm. They have neither. [/quote]

    Well, this is where we disagree. I believe that there is demonstrated benefit and I believe that there is an extraordinarily low risk of harm. I have written many responses regarding why I do not believe that there is any substantial evidence of any harm at the proposed levels with the single exception of mild fluorosis, which I truly believe is a much smaller issue than the harm done by dental caries.

  48. Adrienne

    [quote]To answer medwoman, of course I would support taxing us enough to take care of the dental health of the most vulnerable. I would pay for toothpaste, toothbrushes, floss, dental education, and dental visits for those who can’t afford them.
    As a compromise position I would go further and say a person has a right to ingest fluoride, with informed consent, although I am not convinced I am doing them a service. Again, I’d be willing to offer free salt to all low income residents and let them choose unfluoridated or fluoridated salt, the latter imported from the European countries you say fluoridate their salt instead of their water. [/quote]

    I am sorry that it to me so long to respond to you. I really appreciate your willingness to consider another approach. Forgive me if I am cynical, but I doubt that enough people who are opposed to fluoridation would be willing to join you in in your support to enact such a program. However, I feel that people of good will can certainly work together to achieve positive goals even if their preferred option is not the one chosen. In this spirit, if the choice is made against fluoridation, I would like to invite you to join with me to explore other sustainable options. This is an open invitation to anyone who opposes fluoridation as well as, of course, to the proponents.

    Tia Will
    tia.will52@gmail.com

  49. The option of fluoridated salt, available as an option in grocery stores in some European countries, seems to me to be a reasonable solution for people who wish to ingest fluoride. I don’t know how it would work in this country though since oral fluoride is a prescription medication. If it could be made available here though, it would avoid the problem of mass involuntary medication.

  50. Re: Matt
    5 definitions of ethics ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7277:would-a-vote-on-fluoridation-accomplish-anything&catid=60:water&Itemid=92&cpage=30#comment-182128[/url])

    In your reply, you have admitted that my statement did not violate the definition of ethics by the “rights approach”, which is one of the five definitions that you stated.

    In your reply, you have also admitted that if the city decides to fluoridate despite opposition, the city [b]will violate ethics under the definition of the Rights Approach[/b].

    In the following, I explain to you that my statement [b]also did not violate the other four definitions.[/b]

    [b]Utilitarian approach[/b]

    [quote]The second 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.[/quote]

    People who will be affected by fluoridation includes those who want it and those who do not want it. The [b]perfect[/b] solution is to let those who want it get it, and those who don’t want it not be forced to get it. By definition, such a solution delivers benefit to [b]everyone who needs it[/b] and [b]imposes zero harm[/b].

    Note that since, by definition, the perfect solution will [b]do no harm[/b], we already know that water fluoridation is at least no optimal. To show that water fluoridation does not violate the utilitarian definition of ethics, one [b]must[/b] show how it is better than the alternatives such as dispensary of free fluoridated water without fluoridating the whole water supply. (This is not to say that that is a good idea. One must first confirm that there is such a need in Davis.)

    [b]Fairness or Justice approach[/b]
    [quote]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.[/quote]

    Discretionary access to fluoride treats equals equally (equal access to all who wants), and unequals unequally (does not impose fluoridation to those who don’t want). [b]Imposed fluoridation violates this definition of ethics.[/b]

    [b]Common-Good approach[/b]
    [quote]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.[/quote]

    By this definition, the alternative to deliver fluoride treatment only to those who want and need them meets this definition of ethics. [b]On the other hand, imposing fluoridation violates this definition of ethics because it harms those who do not want or do not need fluoridated water.[/b]

    [b]Virtue approach[/b]
    [quote]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…”[/quote]
    Public policies should strive to address all concerns. Imposing fluoridation violates this ideals by ignoring the concerns and/or fail to compensate or implement accountability to compensate the victims of the decision.

    * * *
    In conclusion, discretionary access to fluoride is ethical on all five definitions, while imposing fluoridation violates [b]all[/b] of the definitions:

    If the city decides to fluoridate the water supply:

    Ethics by Rights Approach – [b]VIOLATED[/b]
    Ethics by Utilitarian Approach – [b]VIOLATED[/b]
    Ethics by Fairness or Justice Approach – [b]VIOLATED[/b]
    Ethics by Common-Good Approach – [b]VIOLATED[/b]
    Ethics by Virtue Approach – [b]VIOLATED[/b]

  51. Re: Matt
    [Low income] ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7277:would-a-vote-on-fluoridation-accomplish-anything&catid=60:water&Itemid=92&cpage=30#comment-182130[/url])

    Discretionary access.

    Do you have a list of low-income people who wants to get fluoridate water?
    Do you have a “density map” of where they are in Davis?

  52. Re: Matt
    [Low income] ([url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7277:would-a-vote-on-fluoridation-accomplish-anything&catid=60:water&Itemid=92&cpage=30#comment-182131[/url])

    [quote]I believe the pro-fluoride proponents would agree with you that Social Justice ethical wrongs are indeed being “done” by allowing low-income citizens to have higher rates of dental care. Do you agree with that ethical belief of theirs?[/quote]

    The main factors of getting cavities are these:

    1) Eating sugary stuff
    2) Insufficient dental care for the dietary behavior

    [b]Social Injustice[/b] occurs when a person is forced to eat sugary stuff, or force to have insufficient dental care. We don’t call a situation social injustice when the cause is discretionary. Therefore, to analyze the situation in terms of social injustice, one must first articulate what causes are [b]forced[/b] by society.

    What [b]social force[/b] do you want to discuss that is causing social injustice in our context?

  53. In case the meaning of [b]Social Force[/b] is unclear, the following are some examples:

    a) Employment discrimination
    b) Law-enforcement discrimination
    c) Quality of service discrimination (Unequal treatment)
    d) Choice of product discrimination
    e) [i]etc…[/i]

  54. Edgar, I will leave it to the pro-fluoride proponents to present their counter arguments to your positions above.

    However, on a much broader view, I see a huge fallacy in all the approaches you have taken toward ethical decision-making. Specifically, you are assuming the 100% efficacy of discretionary actions. That is patently clear when you say [i]”Discretionary access to fluoride treats equals equally (equal access to all who wants), and unequals unequally (does not impose fluoridation to those who don’t want).”[/i] Access only achieves the desired outcome if the access is acted upon. What assurances do you have that access to fluoride will solve the high incidence of caries in the low-income population cohort?

    Further, you look at each ethical approach through the lens of the Rights approach. For example instead of analyzing all the benefits and harms under the Utilitarian approach you simply stop after making the sweeping (and unsubstantiated) statement that “The perfect solution is to let those who want it get it, and those who don’t want it not be forced to get it.” Where is your listing of all the other benefits and harms of fluoridation? Where is your utilitarian weighing of those aggregate benefits and harms?

    You fall into the same trap in your assessment of the Common Good approach when you say, “imposing fluoridation violates this definition of ethics because it harms those who do not want or do not need fluoridated water.” Other than your perception of an individual’s Rights, what harm do you believe fluoridation causes?

    Thus your “Violated” table only exists in the form you have provided it because you filter each approach through the lens of Rights. For you, Rights are supreme, and you are not bashful about imposing your sense of those Rights on everyone else with benevolent authority.

  55. If water fluoridation benefits some one and harms no one then no sane person could be opposed to its use.

    The governments of Germany, Austria, Japan, France, Norway, and many other developed nations have all explored and even implemented water fluoridation, but all of them have now renounced the policy and have stopped fluoridation.

    Why? Are they insane? Have they fallen for the hard right propaganda?

    This is a heuristic based approach to the issue. When an issue has too many variables to clearly analyze one approach is to consider what decision peers have made.

    The majority of the evidence from the other advanced nations who have explored water fluoridation is that it does not work in practice as predicted in theory.

  56. medwoman…

    You wrote

    [quote]I believe that there is an extraordinarily low risk of harm. I have written many responses regarding why I do not believe that there is any substantial evidence of any harm at the proposed levels with the single exception of mild fluorosis, which I truly believe is a much smaller issue than the harm done by dental caries.[/quote]

    The 2006 National Research Council report was the first U.S. report to look at low-level fluoride toxicity in a balanced way. The report concluded that the maximum contaminant level goal (MCLG) of 4 ppm in drinking water was too high and should be reduced. Since 4 ppm is too high (by an unspecified amount) to be acceptable as a contaminant, it is not sensible to deliberately add fluoride to our drinking water to bring the level of fluoride in our water up to .7 ppm. That implies a margin of safety of less than 5.7 times, and possibly much less, which is absurdly low by toxicological standards. Acceptance of such a small margin of safety indicates a disregard for public health.

    It is irresponsible to continue promoting fluoridation when studies indicate thyroid function may be lowered at 2.3 ppm, IQ in children may be lowered at levels as low as 1.9 ppm (or at 0.9 ppm if there is borderline iodine deficiency), and hip fractures in the elderly may be increased at levels as low as 1.5 ppm. Unless all of the relevant studies have been shown to be fatally flawed, there is clearly no adequate margin of safety to protect the whole population from these effects.

  57. Indeed, Germany rejected water fluoridation in 1977 because the beneficial level of water fluoride was too close to the harmful level. There is no margin of error.

  58. [quote]It is irresponsible to continue promoting fluoridation when studies indicate thyroid function may be lowered at 2.3 ppm, IQ in children may be lowered at levels as low as 1.9 ppm (or at 0.9 ppm if there is borderline iodine deficiency), and hip fractures in the elderly may be increased at levels as low as 1.5 ppm. Unless all of the relevant studies have been shown to be fatally flawed, there is clearly no adequate margin of safety to protect the whole population from these effects.
    [/quote]

    As I have stated previously, I do believe that the studies that were claimed to show a decrease in IQ were indeed fatally flawed. A summary of those flaws was actually provided by the Harvard group that conducted the meta analysis and included, lack of control for genetic factors, socioeconomic factors, educational factors. These flaws in and of themselves were sufficient to discredit these studies even before the declaration of the authors
    that these findings should not be extrapolated to the situation of industrialized countries which the opponents, including yourself seem to ignore.

    With regard to the hip fracture studies, I happened to be at the right point in time in my education to have read the original studies and do not agree with the claim you are making with regard to the margin of error. I consider the demonstrated harm to have involved much higher levels of exposure.

    In the interest of fairness, I do not know what reference you are using with regard to the thyroid issue and would appreciate you forwarding your primary source to me so I could consider it.

  59. Ernesto

    [quote]Indeed, Germany rejected water fluoridation in 1977 because the beneficial level of water fluoride was too close to the harmful level. There is no margin of error.[/quote]

    What is the source of your information that this is the reason that Germany rejected fluoridation for this reason.
    I have alternatively read that they chose not to fluoridate because of the “forced medication” issue.
    I would genuinely like to know the real reason that they opted not to fluoridate.

  60. [quote]”In 1978, the West German Association of Gas & Water Experts rejected fluoridation for legal reasons and because ‘the so-called optimal fluoride concentration of 1 mg per L is close to the dose at which long-term damage [to the human body] is to be expected.’ “

    Quotes from: Hilleman B, “FLUORIDATION: Contention won’t go away,” Chemical and Engineering News, 1988 Aug, 66:31 (The [ ] brackets were in the original article)
    [/quote]

  61. [quote]As I have stated previously, I do believe that the studies that were claimed to show a decrease in IQ were indeed fatally flawed. A summary of those flaws was actually provided by the Harvard group that conducted the meta analysis and included, lack of control for genetic factors, socioeconomic factors, educational factors. These flaws in and of themselves were sufficient to discredit these studies even before the declaration of the authors
    that these findings should not be extrapolated to the situation of industrialized countries which the opponents, including yourself seem to ignore. [/quote]

    The Following are excerpts from the last two paragraphs in the review article you mentioned by Harvard researchers titled “Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis”:

    “In its review of fluoride, the NRC (2006) noted that the safety and the risks of fluoride at concentrations of 2–4 mg/L were incompletely documented. Our comprehensive review substantially extends the scope of research available for evaluation and analysis. Although the studies were generally of insufficient quality, the consistency of their findings adds support to existing evidence of fluoride-associated cognitive deficits, and suggests that potential developmental neurotoxicity of fluoride should be a high research priority.”

    “In conclusion, our results support the possibility of adverse effects of fluoride exposures on children’s neurodevelopment.”

    Yes, the researchers admit that there are flaws, but it is very clear from their concluding statements that they would in no way agree with your statement that the studies they examined were, as you say, “fatally flawed.” Furthermore, if relevant fluoride studies have faults but still raise plausible doubts about safety, water fluoridation should be stopped until research yields reliable conclusions, in accordance with the precautionary principle.

  62. [quote]These flaws in and of themselves were sufficient to discredit these studies even before the declaration of the authors
    that these findings should not be extrapolated to the situation of industrialized countries which the opponents, including yourself seem to ignore.
    [/quote]

    Medwoman, you wrote that there was a “declaration of the authors that these findings should not be extrapolated to the situation of industrialized countries which the opponents, including yourself seem to ignore.” In fact, [b]the authors never made any such declaration[/b]. Such a declaration was falsely attributed to the authors of the Harvard study by the journalist Dion Lefler in the local newspaper the [i]Wichita Eagle[/i]. The newspaper article has been reprinted here [url]http://www.fluoridealert.org/news/harvard-scientists-data-on-fluoride-iq-not-applicable-in-u-s/[/url] A lead scientist in the Harvard meta-analysis, Dr. Philippe Grandjean, responded by repudiating the pro-fluoride slant of the newspaper article, criticizing the [i]Eagle[/i] for deceiving readers into thinking that the Harvard team had explicitly asked that their research findings be ignored. A response that Dr. Grandjean wrote to the [i]Wichita Eagle[/i] article is here [url]http://braindrain.dk/2013/02/fluoridated-water-and-brains/[/url]

    Fluoridealert.org published a press release about this, titled “Harvard Scientist Criticizes Wichita Paper’s Whitewash of Fluoride/IQ Study” [url]http://www.fluoridealert.org/articles/wichita_eagle/[/url] which states:

    “A poorly fact-checked article from a Kansas newspaper is being cited by well-funded advocacy organizations across the country to convince decision-makers, physicians and the public to disregard a peer-reviewed Harvard research paper linking fluoride to lower IQ in children, reports the Fluoride Action Network (FAN). Harvard scientist, Philippe Grandjean, MD, states the newspaper never “checked their information with the authors, even though statements were attributed to them.”

    The Kansas newspaper (the Wichita Eagle) heavily promoted fluoridation on its editorial pages in the buildup to a city referendum in which voters rejected an effort to fluoridate water. “We believe the newspaper’s bias showed up in news articles that were supposed to be objective and truthful but were not,” says Paul Connett, PhD, FAN Executive Director.

    Fluoridation is the addition of fluoride chemicals into public water supplies ostensibly to reduce tooth decay.

    The Wichita paper’s opening paragraph on the Harvard IQ study declared: “Harvard university scientists say Wichita voters shouldn’t depend on a research study they compiled to decide whether to put fluoride in the city’s drinking water to fight tooth decay.”

    This, however, was false. Dr. Philippe Grandjean, the senior scientist on the Harvard team, has criticized the Wichita paper for deceptively attributing its own conclusions on fluoridation to the Harvard scientists. Fluoridation’s potential to produce “chemical brain drain,” Grandjean writes, is an issue that “definitely deserves concern.”

    Grandjean also takes objection to the Wichita paper’s claim that the Harvard review only looked at studies that used “very high levels of fluoride.” The Wichita paper conveyed this impression by focusing on a single, cherry-picked study (Hu 1989) that was never published, nor even included in the Harvard review.

    The truth, Grandjean writes, is that “only 4 of 27 studies” in the Harvard review used the high levels that the Wichita paper described, and “clear differences” in IQ “were found at much lower exposures.”

    The journalist, Dion Lefler, who wrote the Wichita article had a record of getting basic facts about fluoride wrong. “This is the same journalist,” Connett notes, “who reported that the poison warning now found on all fluoridated toothpaste is not there because of fluoride—a blatant error that the paper has yet to correct.”

    “Instead of relying on a Kansas newspaper to discredit the findings of a peer-reviewed, published study by Harvard scientists, health authorities should be taking a long hard look at the wisdom and safety of forcing communities to consume fluoride chemicals in their water and food — a practice most developed nations rejected decades ago,” says Connett.

    Thirty-six human studies now link fluoride to children’s lowered IQ, some at levels considered safe in the US.”

  63. [quote]With regard to the hip fracture studies, I happened to be at the right point in time in my education to have read the original studies and do not agree with the claim you are making with regard to the margin of error. I consider the demonstrated harm to have involved much higher levels of exposure. [/quote]

    Fifty percent of the daily intake of fluoride is absorbed by and accumulates in bone. An important study from China (Li et al.,2001) indicates practically no margin of safety sufficient to protect a whole population with a lifelong consumption of water at 1 ppm from hip fracture.

  64. tleonard

    [i]”Furthermore, if relevant fluoride studies have faults but still raise plausible doubts about safety, water fluoridation should be stopped until research yields reliable conclusions, in accordance with the precautionary principle.”[/i]

    Terri, if the anti-fluoride forces share the sentiments you have expressed above, then why has there been no such follow-up research by the anti-fluoride community of scientists in the seven years since the NRC report was published in 2006? If you want to put a wooden stake in the heart of Dracula, then scientifically confirming the situation would seem to be of the highest priority. Is the anti-fluoride community asleep at the switch?

  65. [quote]Terri, if the anti-fluoride forces share the sentiments you have expressed above, then why has there been no such follow-up research by the anti-fluoride community of scientists in the seven years since the NRC report was published in 2006? If you want to put a wooden stake in the heart of Dracula, then scientifically confirming the situation would seem to be of the highest priority. Is the anti-fluoride community asleep at the switch? [/quote]

    Several important health studies have been published since the NRC report was published, and they add further weight to the NRC findings. For example, 12 studies finding an association between fluoride and reduced IQ have been published since 2006. Go here [url]http://www.fluoridealert.org/studies/brain01/[/url] and scroll down a little to see all the studies.

    Fluoridealert.org has compiled a comprehensive catalog of fluoride research, including detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity. Here is the link [url]http://www.fluoridealert.org/researchers/health_database/[/url]. According to Fluoride Action Network (FAN), “The Health Database sets forth the scientific basis for FAN’s concerns regarding the safety and effectiveness of ingested fluorides. The database is the product of over 10 years of research by FAN’s research team, led by attorney-at-law Michael Connett. In 2012, Connett conducted an exhaustive review of recent scientific findings, including research that, up to now, has only been available in Chinese and Russian. The current database reflects the findings of this new review.”

  66. [quote]As I have stated previously, I do believe that the studies that were claimed to show a decrease in IQ were indeed fatally flawed. A summary of those flaws was actually provided by the Harvard group that conducted the meta analysis and included, lack of control for genetic factors, socioeconomic factors, educational factors. These flaws in and of themselves were sufficient to discredit these studies….[/quote]

    I would like to respond by quoting fluoridealert.org [url]http://www.fluoridealert.org/studies/brain01/[/url]:

    “As both the NRC and Harvard reviews have correctly pointed out, many of the fluoride/IQ studies have used relatively simple designs and have failed to adequately control for all of the factors that can impact a child’s intelligence (e.g., parental education, socioeconomic status, lead and arsenic exposure). For several reasons, however, it is extremely unlikely that these limitations can explain the association between fluoride and IQ.

    First, some of the fluoride/IQ studies have controlled for the key relevant factors, and significant associations between fluoride and reduced IQ were still observed. This fact was confirmed in the Harvard review, which reported that the association between fluoride and IQ remains significant when considering only those studies that controlled for certain key factors (e.g., arsenic, iodine, etc). Indeed, the two studies that controlled for the largest number of factors (Rocha Amador 2007; Xiang 2003a,b) reported some of the largest associations between fluoride and IQ to date.

    Second, the association between fluoride and reduced IQ in children is predicted by, and entirely consistent with, a large body of other evidence. Other human studies, for example, have found associations between fluoride and neurobehavior in ways consistent with fluoride being a neurotoxin. In addition, animal studies have repeatedly found that fluoride impairs the learning and memory capacity of rats under carefully controlled laboratory conditions. An even larger body of animal research has found that fluoride can directly damage the brain, a finding that has been confirmed in studies of aborted human fetuses from high-fluoride areas.

    Finally, it is worth considering that before any of the studies finding reduced IQ in humans were known in the western world, a team of U.S. scientists at a Harvard-affiliated research center predicted (based on behavioral effects they observed in fluoride-treated animals) that fluoride might be capable of reducing IQ in humans. (Mullenix 1995)

    When considering their consistency with numerous animal studies, it is very unlikely that the 36 human studies finding associations between fluoride and reduced IQ can all be a random fluke. The question today, therefore, is less whether fluoride reduces IQ, but at what dose, at what time, and how this dose and time varies based on an individual’s nutritional status, health status, and exposure to other contaminants (e.g., aluminum, arsenic, lead, etc). Of particular concern is fluoride’s effect on children born to women with suboptimal iodine intake during the time of pregnancy, and/or fluoride’s effects on infants and toddlers with suboptimal iodine intake themselves. According to the U.S. Centers for Disease Control, approximately 12% of the U.S. population has deficient exposure to iodine.”

  67. tleonard said . . .

    [i]”Several important health studies have been published since the NRC report was published, and they add further weight to the NRC findings. For example, 12 studies finding an association between fluoride and reduced IQ have been published since 2006. Go here http://www.fluoridealert.org/studies/brain01/ and scroll down a little to see all the studies.”[/i]

    Terri, medwoman has addressed the issues with the significant (fatal?) flaws of the Chinese IQ Tests. I will defer to her prior comments on that issue. But with that said, lets take a quick look at the first of the listed studies, where the Low-Fluoride group that Wang, et.al. consider to be the baseline, is 0.18 to 0.76 mg/L. What does the Wang research make the proposed 0.7 mg/L level for the Davis? Baseline.

    tleonard said . . .

    [i]”Fluoridealert.org has compiled a comprehensive catalog of fluoride research, including detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity.”[/i]

    Terri, FAN’s own words tell the whole story. “The Health Database sets forth the scientific basis for FAN’s concerns regarding the safety and effectiveness of ingested fluorides.” The sum total of all the information in the database is, by FAN’s own admission, “[i]concerns[/i].” Wendy’s restaurants used to have an ad that asked “Where’s the beef?” My question to you is, why is it so hard for the anti-fluoridation forces to translate those concerns into conclusive evidence?

  68. [quote] My question to you is, why is it so hard for the anti-fluoridation forces to translate those concerns into conclusive evidence?
    [/quote]

    Pretty well impossible when one will never accept any conclusion other than the one started out with.

    In light of the fact that almost every developed nation in the world has decided that water fluoridation is not good public health policy, the burden of the proof is on those pushing for water fluoridation. They need to prove that it’s safe.

  69. [url]Terri, FAN’s own words tell the whole story. “The Health Database sets forth the scientific basis for FAN’s concerns regarding the safety and effectiveness of ingested fluorides.” The sum total of all the information in the database is, by FAN’s own admission, “concerns.” Wendy’s restaurants used to have an ad that asked “Where’s the beef?” My question to you is, why is it so hard for the anti-fluoridation forces to translate those concerns into conclusive evidence? [/url]

    The Health Database provides detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity.

  70. Ernesto, not impossible at all. All that is required is some focused, rigorous human trials like the ones that barbara King has provided to me about fluoride hypersensitivity. Those were double-blind, and clearly showed isolated evidence of the hypersensitivity to fluoride in a very small, but meaningful, portion of the population at high fluoride levels . . . levels considerably higher than what is being proposed here in Davis. [u]The conclusion is inescapable[/u] at the high levels tested. In that case the next step is to replicate the same study at the proposed levels rather than artificially high levels. In fact, here in Davis we have a de-facto laboratory for testing sensitivity at lower levels. We have ambient fluoride in our well water that has a weighted average level of 0.2. My question to Alan and Barbara and Pam and now to you and Terri is, “What is the incidence rate of fluoride hypersensitivity in Davis over the past 10 years (or so)? That is a very practical, down-to-earth test of one of the impact of one of the FAN concerns in our own community.

    Your statement that almost every developed nation in the world has decided against water isn’t based on scientific decision-making, but rather political decision-making. Just out of curiosity, when was the last politically driven decision that you felt was wrong-headed?

    Let’s look at your final sentence, [i]”They need to prove that it’s safe.”[/i] Are automobiles safe? Are airplanes safe? Is Tylenol safe? Is Viagra safe? In the 50 plus years of the use of fluoridation by millions and millions of Americans, how many unsafe outcomes have there been?

    I ask all the above questions not to be a PITA, but rather because they are the questions that I feel compelled to ask in my own personal due diligence in my role as a member of the WAC. Rest assured that the pro-fluoridation proponents have gotten equally difficult questions from me.

  71. tleonard

    [i]”The Health Database provides detailed summaries and exhaustive references for over 80 aspects of fluoride toxicity.”[/i]

    Terri, do any of them put a stake through Dracula’s Heart? If they have that ability, then they need to be repackaged to show their lethal power.

  72. Matt, so you’re assuming that almost every advanced nation in the world was independently bullied into choosing alternative fluoridation models by a shadowy “anti-science” conspiracy?

    Seems a little far fetched.

    Don’t open your mind so far your brain falls out.

  73. Ernesto

    [quote]Experts rejected fluoridation for legal reasons and because ‘the so-called optimal fluoride concentration of 1 mg per L is close to the dose at which long-term damage [to the human body] is to be expected.'[/quote]

    Thank you for stating your source. I have two comments about this. The first is with regard to the “legal” reasons. I suspect this was actually a political issue centering around the issue of “forced medication” which I simply do not believe is the case for reasons I have already stated. With regard to the issue of levels “too close to the dose at which long – term damage to the human body is to be expected”, again, just because a political body chooses to act with this as their justification does not make it scientifically true.

    I do not speak as someone who had a preconceived position on this issue. When I joined the Health Council a couple of months ago, I had no position what so ever on this issue since I felt I simply did not know enough about it. I did not take anyone’s word for anything that they were saying, but read the literature itself. I have simply come to a conclusion that is not popular with the opponents. I believe that the evidence for benefit far outweighs the potential risk for any condition with the exception of fluorosis. That is what the literature shows.
    With regard to public health, I am evidence, not politically based in my beliefs. I believe firmly that this should be a public health, not a political decision. Most of the opponents have chosen to entangle the two hoping to throw as many objections as possible out there hoping that if enough supposed negatives are piled up, they will sway opinion. This is not how I choose to operate and I hope it not the way the City Council will operate either.

  74. tleonard

    [quote]a finding that has been confirmed in studies of aborted human fetuses from high-fluoride areas.
    [/quote]

    Please site the original source. This would be of a great deal of interest to me.

  75. Ernesto

    [quote]In light of the fact that almost every developed nation in the world has decided that water fluoridation is not good public health policy, the burden of the proof is on those pushing for water fluoridation. They need to prove that it’s safe.[/quote]

    In light of your repeated comment that “almost every developed nation….” I thought I would provide a brief list of “developed” nations that have chosen water fluoridation for a significant amount of their population :
    Hong Kong, 65% of Israel, Ireland, Canada ( about 45%), Australia, New Zealand, Brazil, Chile, about 65 % of the United States. In the cases of countries who initially accepted fluoridation and then discontinued, at least according to Wikipedia, political considerations where a large factor in deciding to discontinue. This is not evidence based, it is largely politically based. Now certainly, if someone wishes to blog fluoridation on the basis of their political preferences, they have every right to do so. I simply disagree and do not feel that there personal or political preferences should be masked as unsubstantiated scientific or medical threats to health.

  76. Medwoman, in my field, when a new infrastructure project is proposed for a public implementation, a rigorous analysis includes a review of existing implementations of the technology from around the world. Much can be learned from the decision processes and experiences of others. A proposal or paper which ignored existing practice and experience would be resoundingly rejected.

    Even if the entirety of the international community whom have rejected water fluoridation did it solely on legal or ethical principles, entirely ignoring the science, the fact that this is a widely held principle suggests that it should not be casually ignored.

    And, no, your suggestion of not using tap water, is not an answer, for reasons that have been covered here many times already.

    Bringing water fluoridation to Davis and Woodland would trample over the strongly held beliefs of many residents. Consider that in the cost calculation.

  77. tleonard

    [quote]In fact, the authors never made any such declaration. Such a declaration was falsely attributed to the authors of the Harvard study by the journalist Dion Lefler in the local newspaper the Wichita Eagle. The newspaper article has been reprinted here http://www.fluoridealert.org/n…le-in-u-s/ A lead scientist in the Harvard meta-analysis, Dr. Philippe Grandjean, responded by repudiating the pro-fluoride slant of the newspaper article, criticizing the Eagle for deceiving readers into thinking that the Harvard team had explicitly asked that their research findings be ignored[/quote]

    In the interests of accuracy, I have read the entirety of the Harvard meta analysis and am going to quote directly from that paper the parts that I think are relevant to the authors qualifications of their view of the relevancy of the studies although as you correctly state, they did not use my exact words:

    1) “opportunities for epidemiological studies depend on the existence of comparable population groups expose
    to different levels of fluoride from drinking wate. Such circumstances are hard to find in many industrialized
    countries, because fluoride concentrations in community water are usually no higher than 1 mg/L….”
    2) Six of the studies identified ( but frequently cited by fluoridation opponents) were excluded because of
    missing information on the number of subjects or the mean and variance of the outcome.
    3) Two cohorts in the meta analysis were exposed to fluoride from coal burning and thus are irrelevant to our
    situation
    4) Author cited sources of heterogeneity:
    Information on the child’s sex and parental education were not reported in over 80% of the studies, and only
    7% of the studies reported household income. These variables were therefore not included in the models.
    Significant flaws in my opinion when assessing IQ.
    5) Table 1 demonstrates that 13 of the 22 studies which quantified the amount or range of fluoride in the
    water, the “reference range” or children having the higher IQs were receiving at least 0.7 ppm of fluoride
    in their drinking water ( indicating that the higher IQ children were being exposed to at least as much
    as is being proposed for our water).
    6) “Although most reports were fairly brief and complete information on covariates was not
    available, the results [u]tended to support the potential for fluoride-mediated developmental neurotoxicity
    at relatively high levels of exposure in some studies.” [/u]
    7) “The estimated decrease in average IQ associated with fluoride exposure based on our analysis may seem
    small and [u]may be within the measurement error of IQ testing[/u]
    8) “Our review cannot be used to derive an exposure limit, because the actual exposures of the individual
    children are not known. Misclassification of children in both high and low-exposure groups may have
    occurred if the children were drinking water from other sources “( which obviously is yet another factor
    that the primary researchers failed to control for).
    9) “Although the studies were generally of insufficient quality ….”

    I think this last statement nicely sums up the problems with these uncontrolled, inadequately monitored,
    inconsistent studies involving overlapping fluoride quantities and not demonstrably significant differences in IQ.
    When studies are of poor quality, it really does not matter how many you pile up, you have not demonstrated anything of scientific validity. The most accurate statement that the authors make is that “future studies should
    formally evaluate dose-response relations based on individual-level measures over time”. With this I agree.
    However, this meta analysis using poor quality studies does nothing what so ever to suggest any harm, and even supports the lack of demonstrable harm in the groups of children supposedly consuming 0.7 ppm or less daily. Please note that there are no controls or measurements at all of other potential sources of fluoride in any of the children’s environments.

  78. [quote]Sierra Club Opposes Portland Water Fluoridation Measure 26-151

    NEWS RELEASE
    FOR IMMEDIATE RELEASE
    March 27, 2013

    SIERRA CLUB OPPOSES PORTLAND WATER FLUORIDATION MEASURE 26-151

    PORTLAND, Ore. – The Sierra Club today announced its opposition to Ballot Measure 26-151, the water fluoridation measure that voters will decide on this May. The Club made its decision based on long-term evidence of adverse health risks from fluoridation chemicals and the concern that fluoridation would introduce dangerous quantities of toxic and carcinogenic chemicals into local rivers through sewage effluent.

    “Human health is intertwined with the health of our rivers, aquatic life, and entire ecosystem,” said Antonia Giedwoyn, spokesperson for Oregon Sierra Club’s Columbia Group, which made the decision to oppose the measure. “We strongly support comprehensive dental care for our children, but this is the wrong path to that goal.”

    “Sierra Club opposes fluoridation, because it would degrade some of the purest drinking water in the world. Kids are already bombarded with multiple toxins from plastics, pesticides, and air pollution. Adding fluorosilicic acid, a byproduct of the phosphate fertilizer industry, to Portland’s water would be a profound disservice to our children,” Giedwoyn said.

    Fluorosilicic acid added to all Portland water would drain into rivers and streams. Fisheries scientist and Columbia Group Chair Jeff Fryer explained the club’s concerns about adding over 1 million pounds of fluoridation chemicals a year into Portland’s water system.

    “We are disappointed that City Council rushed the fluoridation vote before evaluating impacts to salmon and other aquatic life, because there is no question that fluoridation chemicals would add a large quantity of a known toxin into rivers that are already overloaded with toxins,” Fryer said.

    Claims that fluoridating the water would add a “natural mineral” are false. Fluorosilicic acid — which is neither natural, nor a mineral — is the chemical mixture the City would use to fluoridate. This man-made chemical is highly corrosive and is classified as “hazardous” by the National Institutes of Health’s Hazardous Substances Data Bank. Unlike fluoride in toothpaste, fluorosilicic acid is not pharmaceutical grade.

    Numerous scientific studies have linked fluorosilicic acid exposure in drinking water to serious health risks such as increased risk of bone cancer, neurological impairment, thyroid dysfunction, and more.

    If the measure passes, the City will charge water ratepayers for a fluoridation facility estimated to cost between $3.5 and $7.6 million, along with $575,000 per year indefinitely on fluoridation chemicals and plant operations.

    “Spending millions of dollars to pollute our water with fluorosilicic acid, an industrial waste, would be dangerous and misguided. We can better serve Portland kids by increasing their access to dental care and prevention,” said Sierra Club member Sheila Golden, chair of Columbia Group’s Bull Run Task Force.

    “For the sake of our children and our rivers, Sierra Club urges you to vote NO on acid fluoridation chemicals this May,” said Giedwoyn. “Sierra Club has been committed to healthy children for more than a century, and we want fewer chemicals in our water, not more.”[/quote]

    [url]http://orsierraclub.wordpress.com/2013/03/27/sierra-club-opposes-portland-water-fluoridation-measure-26-151/[/url]

  79. This video is a TV news report on a hydrofluorosilicic acid spill at a water treatment plant in Illinois. It burned holes in the concrete.

    Hydrofluorosilicic acid is used to fluoridate water at the plant. The newscaster says so at about 50 seconds.

    [url]
    http://www.youtube.com/watch?v=szL2Ofzvpcs%5B/url%5D

    Hydrofluorosilicic acid is a toxic waste. If cities weren’t paying for it the manufacturers would have to spend money disposing of it as such.

  80. Ernesto said . . .

    [i]”Matt, so you’re assuming that almost every advanced nation in the world was independently bullied into choosing alternative fluoridation models by a shadowy “anti-science” conspiracy?

    Seems a little far fetched.

    Don’t open your mind so far your brain falls out.”[/i]

    Ernesto, one way to look at the difference between you and me is that you see fluoridation as the problem and I see a deficiency in dental health as the problem.

    Another way to look at the difference between you and me is that you are happy pointing out what you see as a problem and simply walking away with a smug look on your face, whereas I see the identification of a problem as an obligation to come up with one or more possible solutions to the problem identified.

    So if you don’t like the dialogue that I am sparking in my quest for a workable solution for the dental health deficiency problem we face, then all I can say is, [i]”That is your problem Bunky.”[/i]

  81. medwoman said . . .

    [i]”Please cite the original source. This would be of a great deal of interest to me.”[/i]

    medwoman, I put the term “aborted human fetuses from high-fluoride areas” into Google and came up with the following information from [url]http://www.fluoridealert.org/studies/brain01/[/url]

    [i]IQ Study #9: Li (1994)

    Citation:Li Y, et al. (1994). Effects of high fluoride intake on child mental work capacity: Preliminary investigation into the mechanisms involved. Journal of West China University of Medical Sciences 25(2):188-91 (republished in Fluoride 2008; 41:331-35).

    Location of study:Sichuan Province, China

    Size of study:158 children from two neighboring townships (107 children with various degrees of dental fluorosis; 51 children with no dental fluorosis)

    Age of Subjects:12-13 years old

    Source of Fluoride Exposure:Food contaminated by coal smoke

    Fluoride Content of Grain: – Children with no dental fluorosis = 0.5 mg/kg- Children with dental fluorosis (HiF1) = 4.7 mg/kg- Children with dental fluorosis (HiF2) = 5.2 mg/kg- Children with dental fluorosis (HiF3) = 31.6 mg/kg

    Controls for Confounding Factors:sad:1) The areas have similar levels of fluoride in water (0.3 mg/L) and air (0.02-0.51 mg/m3) and similar levels of zinc in soil. (2) The areas townships have similar economic and cultural status, lifestyle, dietary habits, basic constituents of food. (3) Age, gender, and grade level of the children are kept “as constant as possible.” (4) Children with acute or chronic diseases not related to fluoride were excluded from study.

    Type of IQ Test: Mental Work Capacity determined by number of letters found (NLF), rate of error (RE), index of mental capacity (IMC), short-term memory capacity (SMC), visual reaction time (RT).

    Results:sad:A) Children with dental fluorosis in mid-exposure group (HiF2) have reduced short-term mental capacity (p

  82. medwoman….

    you wrote [quote]However, this meta analysis using poor quality studies [b]does nothing what so ever to suggest any harm[/b]…[/quote]

    Really? “…[b]nothing what so ever to suggest any harm[/b]…”? Not even a teeny weeny bit of harm?

    First, I would encourage anyone reading this to please read the Harvard study which can be found here [url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491930/[/url].

    Second, it is surprising that you feel qualified to make such an extreme, sweeping, and dismissive statement about a peer-reviewed, published study by Harvard scientists. You base your position in part upon cherry-picked sentences and fragments of sentences that you pull out of context from the study’s text. You yourself wrote in another post [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=30[/url]
    [quote]To be completely honest, I do not review the statistical analysis myself when reviewing articles since
    my mathematical and statistical skills are lacking. I do however review the materials and methods portions of
    the original papers with a friend who does possess these skills prior to commenting. [/quote]

    The results section of this Harvard systematic review and meta-analysis discusses in great detail the statistical analysis applied to the studies. Here is a small portion of that extensive results section:

    Pooled SMD estimates. Among the 27 studies, all but one study showed random-effect SMD estimates that indicated an inverse association, ranging from –0.95 (95% CI: –1.16, –0.75) to –0.10 (95% CI: –0.25, 0.04) (Figure 2). The study with a positive association reported an SMD estimate of 0.07 (95% CI: –0.8, 0.22). Similar results were found with the fixed-effects SMD estimates. The fixed-effects pooled SMD estimate was –0.40 (95% CI: –0.44, –0.35), with a p-value < 0.001 for the test for homogeneity. The random-effects SMD estimate was –0.45 (95% CI: –0.56, –0.34) with an I2 of 80% and homogeneity test p-value < 0.001 (Figure 2). Because of heterogeneity (excess variability) between study results, we used primarily the random-effects model for subsequent sensitivity analyses, which is generally considered to be the more conservative method (Egger et al. 2001). Among the restricted sets of intelligence tests, the SMD for the model with only CRT-RC tests and drinking-water exposure (and to a lesser extent the model with only CRT-RC tests) was lower than that for all studies combined, although the difference did not appear to be significant. Heterogeneity, however, remained at a similar magnitude when the analyses were restricted (Table 2). By your own admission, you are unable to evaluate the quality of this analysis, yet you say that this meta-analysis “does nothing what so ever to suggest any harm.” You are on the Yolo County Health Council, which is the group appointed to advise the Yolo County Board of Supervisors on all aspects of health in the County. Your colleague, Dr. Michael Wilkes, wrote [url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7274:health-councils-support-for-fluoridated-water&catid=60:water&Itemid=92[/url] “Over the past several years we have carefully considered aspects related to the fluoridation of drinking water in our county. We have looked at current scientific evidence, read scholarly reports by learned bodies, and considered potential opposition to fluoridation from community members.” He also wrote,”Despite cries from alarmists and suggestions of conspiracy theories, when used at the recommended levels of 0.7 parts per million there are no harms, dangers or side effects.” Your eager dismissal of the Harvard meta-analysis, despite your inablility to evaluate its statistical methods, should raise skepticism among the public about the opinions of the Yolo County Health Council regarding the harms, dangers, or side effects of water fluoridation. You go so far as to say that the Harvard meta-analysis [quote]supports the lack of demonstrable harm in the groups of children supposedly consuming 0.7 ppm or less daily.[/quote] You ignore the fact that one of the studies showed decreased IQ at a water fluoride level of .88 ppm, 6 of the studies showed decreased IQ at levels of 1-2 ppm, and 10 of the studies showed decreased IQ at fluoride levels of 2-4 ppm. In conventional risk assessment, the U.S. EPA uses a default margin of safety of ten. This means the EPA seeks to limit exposure to chemicals to levels that are ten times less than the levels that cause adverse effects. Margin of safety is a deeply rooted cornerstone in all modern risk assessments, yet you act as if you don’t even know the concept exists.

  83. I was just reading this article about the dental disease crisis in Kentucky, a state that is 99.8% fluoridated. The Kentucky experience underscores the fact that dental disease is not caused by a fluoride deficiency, but rather by the same thing that causes obesity, diabetes and heart disease – the poor Standard American Diet.

    http://tinyurl.com/bg8w3wp

  84. tleonard

    How about a little honesty in at least putting in my entire quote:

    [quote]However, this meta analysis using poor quality studies does nothing what so ever to suggest any harm, and even supports the lack of demonstrable harm in the groups of children supposedly consuming 0.7 ppm or less daily. Please note that there are no controls or measurements at all of other potential sources of fluoride in any of the children’s environments. [/quote]

    Yes, I will stand by my quote including the dosage as accurate. There was nothing in even those poorly done studies that implies that there is harm at 0.7ppm which was in their reference range for the higher IQ children.
    I am well aware of the concept of the concept of margin of safety, I am also aware that the authors themselves point out that their findings may be within the measurement error of IQ testing. This statement alone is enough to conclude that even the authors do not feel that these findings are sufficient proof of harm, only that it may exist and that more testing is needed.

    As for your comment about my inability to assess the statistical analysis. Guilty as charged, but you would not have known that had I not stated it myself in the interest of fairness. I believe that you also left out the part of my statement where I clearly said that I did not just blow off the statistics, but rather consulted with a colleague who is very proficient with statistical analysis and was of the opinion that the evidence was not of enough strength, as the authors themselves imply, to make any definitive statement.

    So again, in the interest of a full discussion on the facts, not on sound bites from FAN literature, could you please provide original articles to support your contention that fluoride is associated with breast cancer,
    and fetal brain toxicity as you have claimed. Neither Matt’s nor my literature searches seem to have turned up anything supportive of these claims in peer reviewed journals. If I am wrong, I will be quick to advise.

  85. ebowler

    [quote]I was just reading this article about the dental disease crisis in Kentucky, a state that is 99.8% fluoridated. The Kentucky experience underscores the fact that dental disease is not caused by a fluoride deficiency, but rather by the same thing that causes obesity, diabetes and heart disease – the poor Standard American Diet. [/quote]

    I do not believe that anyone is claiming that “dental disease is caused by a fluoride deficiency”. Dental disease,
    like almost all disease is multifactorial. Fluoride is a mitigating factor that can reduce the risk by strengthening enamel and affecting the ability of microbes to adhere to the teeth. My belief is that it should be used as part of a comprehensive strategy which would include as I posted earlier:
    adequate nutrition
    minimization of junk foods
    optimization of dental hygiene
    free access to dental and medical care
    There are many approaches to the improvement of public health. It just happens that we are at a point in time when we have the ability to decide as a community to implement one step in the process. I personally would
    push to enact all of them, but with this much push back just in terms of fluoridation, can you image how likely I am to make much headway in getting everyone in to the dentist regardless of their ability to pay ?

  86. @medwoman

    But the Kentucky experience suggests that water fluoridation does not mitigate the development of dental caries and other dental disease. I wish that more people would embrace your interest in dietary change. Many traditional cultures with no access to dental care had superb dental health prior to the introduction of processed western foods. A nutrient-dense diet is the most important factor in this whole equation yet the one that receives the least attention.

  87. ebowler said . . .

    [i]”A nutrient-dense diet is the most important factor in this whole equation yet the one that receives the least attention.”[/i]

    ebowler, I heartily agree. The question I have is, is this an either/or situation or a both/and situation?

  88. What Kentucky (the most fluoridated state in the nation at 99.8%) has clearly demonstrated, is that if people continue to consume the Standard American Diet (SAD), all the fluoride in the world will not prevent dental disease, in which case, the people will need access to dental care to deal with the resulting problems. Of course they will also need access to medical care to deal with the resulting obesity, diabetes, hypertension, heart disease and many cancers. Until we change the root cause of all these conditions, the SAD, we will just be whistling in the wind (and spending extraordinary amounts of money on healthcare) in an attempt to deal with the fallout.

  89. I’ve been watching what’s going on in Portland with the fluoridation issue.

    The city council tried to sneak it through, after Portland rejected it at the ballot 3 times. But the people got out a petition that forced it onto the ballot.

    The voting ends tomorrow. It’s an ugly debate. Very vicious. The pro-fluoridation side is losing in the polls I’ve seen, but it’s close.

    Discussing this issue locally with friends and neighbors, I’ve seen a lot of anger on this issue from anti-fluoridation people who don’t usually seem to get fired up about stuff. Not much excitement on the pro-fluoridation side, it’s more a sort of ambivalence.

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