CDC misleads legislators about fluoride's kidney effects. Is it a Cover-up?

Emails released through freedom-of-information  requests reveal that at least two members of the US Center for Disease Control's Oral Health Division have private worries about fluoride's risks to kidney patients but publicly deny any concern.

Artificial fluoridation began in 1945, aimed at teeth, without considering how unnatural fluoride chemicals could affect other body functions or population subsets, such as kidney patients.

CDC says, “The safety and effectiveness of fluoride at levels used in community water fluoridation has been thoroughly documented…”

But,  William Maas, (former CDC Oral Health Division Director) admits “There is a lot of uncertainty,” regarding fluoride’s effects to kidney patients in a May 2011 email to ADA Director of Congressional Affairs, Judith Sherman, (a registered ADA lobbyist).

Cc’d is William Bailey, then acting Director of CDC’s Oral Health Division, who responds: “End stage renal disease may be another issue. Since the body excretes fluoride through the kidneys, it is reasonable to assume that people with end stage [renal] disease may experience a buildup of fluoride.”

Bailey also mislead  the Fairbanks, Alaska,city council in 2008 claiming studies he listed proved fluoridation’s safety and effectiveness when they didn't.

Now working with the PEW-funded Campaign for Dental Health, formed to protect and promote fluoridation, Bailey told the Loveland (Colorado) Utility Commission on November 19, 2014: “I believe that fluoridation is a healthy practice...It is not associated with any negative health effects,” according a Loveland newspaper.

In 2012, the National Kidney Foundation withdrew its support of water fluoridation citing the 2006 National Research Council (NRC) report indicating that kidney patients are more susceptible to fluoride’s bone and teeth-damaging effects.

The NRC reports that the kidney-impaired retain more fluoride and risk skeletal fluorosis (an arthritic-type bone disease), fractures and severe enamel fluorosis, which may increase the risk of dental decay. More specifically:

“Human kidneys… concentrate fluoride as much as 50-fold from plasma to urine. Portions of the renal system may therefore be at higher risk of fluoride toxicity than most soft tissues.” p.280

“Early water fluoridation studies did not carefully assess changes in renal function.” p.280

“future studies should be directed toward determining whether kidney stone formation is the most sensitive end point on which to base the MCLG [EPA’s maximum contaminant level goal allowed in water].” p.281

“The effect of low doses of fluoride on kidney and liver enzyme functions in humans needs to be carefully documented in communities exposed to different concentrations of fluoride in drinking water.” p.303

“Thus, more studies are needed on fluoride concentrations in soft tissues (e.g., brain, thyroid, kidney) following chronic exposure.” p.102

In 1980, a toxicologist, Brian Dementi, with the Virginia Department of Health wrote in his ignored report, “where the kidney is concerned persons with impaired kidney function may suffer from acute fluoride toxicity when consuming water containing as little as 2 ppm fluoride.”

Dementi writes, "In discussing the effects of fluoride upon the kidney, it seems appropriate at this point to indicate that whereas the kidney fulfills the important task of removing toxic substances, such as fluoride, from the system.  There is the consequent danger of fluoride intoxication in those individuals with impaired renal function who ingest fluoride...It is evident that fluoridated water poses an enhanced threat to those among the populace who have impaired kidney function."

In 1990, the New York State Department of Health published a study, “Fluoride: Benefits and Risks of Exposure,” alerting officials that fluoride can be harmful to kidney patients, diabetics and those with fluoride hypersensitivity even at “optimal” levels. More study was advised; but ignored. Without this vital information, government bureaucrats continue to claim fluoridation is safe.

The National Kidney Foundation’s (NKF) former fluoridation position statement also carried surprising cautions. The NKF advised
monitoring children’s fluoride intake along with patients with chronic kidney impairment, those with excessive fluoride intake, and those
with prolonged disease. But NKF now admits, “exposure from food and beverages is difficult to monitor, since FDA food labels do not
quantify fluoride content.” The USDA lists fluoride content of common foods here.

The NKF’s April 15, 2008 statement goes further: “Individuals with CKD [Chronic Kidney Disease] should be notified of the potential risk  of fluoride exposure.”

“More than 20 million Americans have CKD, and most don’t even know it. More than 20 million others are at increased risk for developing CKD,” NKF reports.

The American Dental Association, in its Fluoridation Facts Booklet,reports that “decreased fluoride removal may occur among persons with severely impaired kidney function who may not be on kidney dialysis.”

According to Schiffi in the Journal Nephrology Dialysis Transplantation, “a fairly substantial body of research indicates that patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity.”

Ibarra-Santana, et al. report “patients with renal disease presented more severe dental fluorosis [white spotted, yellow, brown and/or pitted teeth] than children without renal disease, in the Journal of Clinical Pediatric Dentistry

Bansal, et al. in Nephrology Dialysis Transplantation reports: “Individuals with kidney disease have decreased ability to excrete fluoride in urine and are at risk of developing fluorosis even at normal recommended limit of 0.7 to 1.2mg/l of fluoride in drinking water.”

Ng, et al, report in the journal, Bone, their research suggest that “in ROD [renal osteodystrophy], bone fluoride may diminish bone microhardness by interfering with mineralization.”

Researchers report “that drinking water fluoride levels over 2.0 mg/L can cause damage to liver and kidney functions in children and that the dental fluorosis was independent of damage to the liver but not the kidney, published in Environmental Research.

According to a 1975 editorial in Kidney International, “Trace doses of fluoride leave the blood within minutes, concentrating principally In

bone and kidney...”

More fluoride/kidney information here  and here

CDC Official Lied About Fluoridation Safety

A CDC fluoridation spokesperson, dentist William Bailey, told the Fairbanks, Alaska, City Council in 2008 that the CDC doesn't do original fluoride/fluoridation safety research. Instead the CDC relies on many reviews and reports from the US and other countries. Some of the studies Bailey cited actually do not support fluoridation's safety and/or efficacy as he professed: Transcript:  https://web.archive.org/web/20080531015347/http://fluoridealert.org/bailey1.html

Legislators rely on government officials and rarely fact-check their testimony. But we did.

Here’s the truth about  reports Bailey served up  (some still listed on the CDC's website under fluoridation safety):

National Research Council (2006)

This isn’t a fluoridation risk/benefit analysis. It found EPA’s current fluoride maximum-contaminant-level-goal (MCLG) for drinking water is not protective of health and must be lowered. EPA has yet to act upon this recommendation. Several members of the NRC panel believe fluoride's MCLG should be as close to zero as possible. (1)

Agency for Toxic Substances and Disease Registry (2003)

This report says "… subsets of the population may be unusually susceptible to the toxic effects of fluoride and its compounds…the elderly, people with osteoporosis, people with deficiencies of calcium, magnesium, vitamin C, and/or protein." (2)

University of York, UK (2000)

About this report, the Centre for Review and Dissemination writes “We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.”(3)

Lewis and Banting, Canada (1994)

“The effectiveness of water fluoridation alone cannot now be determined,” they write.(4)

New York State Department of Health (1990)

Researchers report that  fluoride can be harmful to kidney patients, diabetics and those with fluoride hypersensitivity even at “optimal” levels..

The authors concluded, “…it is currently impossible to draw firm conclusions regarding the independent effect of fluoride in drinking water on caries prevalence using an ecologic study design.”(5)

World Health Organization (2006)

This report, not about fluoridation, documents high levels of natural fluoride causing human bone and teeth malformation in many countries.(6)

Medical Research Council, UK (2002)

This report, not a fluoridation risk/benefit analysis, identifies fluoridation health uncertainties such as total exposure and bone effects.(7)

Institute of Medicine (1999)

Since fluoride is not a nutrient, this report set the adequate intake from all sources to avoid children’s moderate dental fluorosis (discolored teeth) and, also, the upper limit to avoid crippling bone damage -- which the IOM admits “is too high for persons with certain illnesses…”(8)

References:

1) Fluoride in Drinking Water: A Scientific Review of EPA's Standards," Committee on Fluoride in Drinking Water, National Research Council, Executive Summary, 2006http://www.nap.edu/nap-cgi/report.cgi?record_id=11571&type=pdfxsum

2) US Agency for Toxic Substances and Disease Registry, Toxicological Profile for Fluorides, Hydrogen Fluordie, and Fluorine, (2003) http://www.atsdr.cdc.gov/toxprofiles/tp11.pdf

3) "What the 'York Review' on the fluoridation of drinking water really found," October 28 2003,A statement from the Centre for Reviews and Dissemination http://www.york.ac.uk/inst/crd/fluoridnew.htm

4) Lewis DW, Banting DW. Water fluoridation: current effectiveness and dental fluorosis. Community Dent Oral Epidemiol. 1994;22:153–158 http://www.ncbi.nlm.nih.gov/pubmed/8070242?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

5) Kaminsky LS, Mahoney MC, Leach J, Melius J, Miller MJ. Fluoride: benefits and risks of exposure. Crit Rev Oral Biol Med. 1990;1:261–281 http://cro.sagepub.com/content/1/4/261.full.pdf+html

6) World Health Organization, "New WHO report tackles fluoride in drinking-water," November 2006   http://www.who.int/mediacentre/news/new/2006/nw04/en/

7). Medical Research Council. Medical Research Council Working Group Report: Water Fluoridation and Health. September 2002. http://www.mrc.ac.uk/news-events/publications/water-fluoridation-and-health/

8) Institute of Medicine, Food and Nutrition Board. Fluoride: Background Information. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Report of the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC http://www.nap.edu/openbook.php?isbn=0309063507

Deception at Gov't Pro-Fluoridation Rallies

This letter was written in 2005, after I attended an expensive PR event to promote fluoridation hosted by the Centers for Disease Control and the American Dental Association at the ADA's Chicago headquarters. I don’t remember if I received a reply from now-retired dentist William Bailey who was the CDC’s primary fluoridation promoter.

William Bailey, DDS, MPH
Department of Oral Health
Centers for Disease Control and Prevention
Atlanta, Georgia

Hi Bill

It was a pleasure speaking with you at the fluoridation symposium
even if you are on the wrong side of the issue. It's so rare that I
meet a fluoridation proponent who is as courteous as you were to me.
And I thank you for that. However, what I heard at that symposium is
disturbing.

A thread running through the delivered speeches is that you all seem
to believe that folks opposed to fluoridation disseminate
misinformation. No fluoridation opponents were speaking before this
assembled crowd. Yet lots of misinformation and improper behavior
was flowing, for example:

1) Dr. Lynn Mouden's presentation about the Arkansas fluoridation
battle maligned one of my new friends, and Mouden's fellow
Arkansasan, who was outside picketing. He also insulted Arkansas
legislators and falsely reported that State Senator Jack Critcher
voted down the fluoridation mandate bill. An Arkansas
newspaper, "The Lovely Citizen," reported Mouden's words and then
Critcher's correction of Mouden's un-truths (See:
http://www.fluoridealert.org/news/2352.html). I suggest this article
be disseminated to all Symposium attendees as a "what not to do" and
hope they don't repeat Mouden's misstatements and further malign or
embarrass Arkansas residents, legislators or themselves.

2) Several speakers dismissed Dr. Dean Burk and Dr. John
Yiamouyiannis' cancer study because it wasn't adjusted for important
variables, they said. This often-repeated criticism is false.
Burk/Yiamouyiannis did make adjustments. When fluoridation
proponents are put on the witness stand in courts of law, they are
unable to scientifically invalidate the Burk/Yiamouyiannis study.

For example, Pennsylvania Judge Flaherty presided over a case which
focused on the validity of the Burk-Yiamouyiannis study. Over the
course of five months, the court held periodic hearings which
consisted of extensive expert testimony from as far away as England.
Flaherty found "[p]oint by point, every criticism made of the Burk-
Yiamouyiannis study was met and explained by the plaintiffs. Often,
the point was turned around against defendants. In short, this court
was compellingly convinced of the evidence in favor of plaintiffs
[fluoridation opponents]."

Then fluoridationists further misinformed legislators, others and me
by reporting that Flaherty's case was "thrown out of court for lack
of evidence." So I wrote to Flaherty in 1996. This is what he
said: "My decision regarding the fluoridation of the public water
supply, made during my tenure as a trial judge almost twenty years
ago, was on appeal, purely a jurisdictional issue...That the
practice is deleterious is more and more accepted -- its utility
doubted."

3) Another speaker, Dr. George Stookey, reported that after 15 years
of water fluoridation which began in 1945, Grand Rapids had about a
50% less tooth decay rate than Muskegon, the non-fluoridated control
city. He stressed that no other fluoride was around back then.
However, Muskegon started fluoridation in 1951. So, in effect,
Stookey's comparison was made between two fluoridated cities, which
actually indicates something other than fluoridation was protecting
the teeth of Grand Rapids' children.

4) I was shocked when Missouri's Ashley Micklethwaite expressed fear
of anti-fluoridationists in her talk. She advised attendees to get
unlisted phone numbers to avoid us. It seems fluoridationists have
been so good at creating a negative image of Americans who fight for
pure water that they believe their own PR.

When my and my daughter's picture appeared in a Long Island
newspaper in the early 1980's as opposed to fluoridation, I got very
alarming phone calls directed to my then 5-year-old. I never assumed
these troubling calls were from dentists or fluoridationists.
However, Dentists don't have a monopoly on sanity. Google searches
reveal dentists who murder, rape, commit Medicaid fraud and more. We
don't judge a whole barrel by a few bad apples. So I'm surprised
your speaker expressed such a fear of us.

If only you had allowed chemistry professor Paul Connet, PhD,
Executive Director of the Fluoride Action Network to speak as he and
I requested, Ms Micklethwaite would have seen her fear was
misguided. Also, maybe Dr. Connett could have corrected your
speakers' blunders before they permeate throughout the country and
those 7 foreign countries which were represented at the symposium.

Not there to defend himself, one of your speakers took a cheap shot
at Dr. Connett. Florida dentist Robert Crawford said, "The fellow
that was out here in the book covers when you went to the
celebration of fluoridation out in the tent the other day [Paul
Connett] . They flew him in to debate us. Can you imagine what you
feel like standing up here and debating somebody standing between
two book covers." This brought laughter from the audience who,
apparently, are quite comfortable denigrating opponents of
fluoridation.

Crawford bragged about his successful Pinellas County fluoridation
strategy. He made this outrageous statement, "We identified county
officials who were anti-fluoride and we had no further contact with
them. And we cut them off, totally." In effect, Crawford cut off
anyone who doubted fluoridation; hardly a noble thing to do. Is he
protecting people or fluoridation? Would his malpractice insurance
cover him should he use the same tactics with a patient who
questions him? I found him quite disturbing.

5) A symposium attendee, during a question and answer period,
brought up misinformation disseminated on the National Institutes of
Dental Research's (NIDCR) website, where a "history of fluoridation"
said H. Trendley Dean did not find fluorosis at "optimal" levels of
fluoride in drinking water. This person called and spoke to the
writer at NIDCR who then researched his objection and agreed it
should be re-written. However, she said it was a low priority for
her and she would get around to it someday. Since the symposium and
his public revelation of this error, it has been corrected, however,
but not before the incorrect information from this "reliable
source," the NIDCR, was repeated in On Tap magazine and elsewhere.

I and others opposed to fluoridation are routinely personally
denigrated by dentists and/or fluoridation proponents in person, in
writing and on the internet, including from members of the public-
dental-health listserv (my taxes at work?). I was called a baby-
killer to my face by a dentist. Many exceedingly derogatory and ugly
comments have been and are directed towards me on the internet where
some dentists actually sign their real names and addresses, their
criticism so apparently accepted within the profession. Dentists
opposed to fluoridation are routinely tongue lashed by their
colleagues on internet mail lists and message boards.

I can only wonder what's been going on in private fluoridation
meetings and at taxpayer subsidized dental schools over the years to
provoke such hatred towards us.

This may be why California Dentist David Nelson felt so comfortable
laughing at us on Wednesday July 13, 2005, while I snapped his
picture. Nelson mockingly told me he was Kip Duchon, a federal
employee. This, by the way, is a federal crime which I reported to
his superiors, who probably will do nothing about it.

I was also offended when Dr. Nelson and two female colleagues
chuckled when the Missouri presenter made a reference to San Jose
woman writing and sending information to Missouri legislators. I
felt like I was back in Junior High School. It scares me that these
people are guardians of my health.

Fluoridation proponents have created an American myth that fluoride
is absolutely safe. The average person is afraid to overdose on the
water-soluble, relatively harmless vitamin C. But very few Americans
similarly fear fluoride. That's very odd. Since just a teaspoon of
fluoride could and has killed. That may not be your intention; but
that's certainly the reality.

As you know, very few grants are available to study ill health
effects of fluoride. And studies declaring fluoridation's benefits
are out-dated and scientifically flawed by today's standards,
according to the National Institutes of Health and the UK's York
Commission.

I hope in the future you will invite Dr. Paul Connett, Dr. William
Hirzy, Dr. David Kennedy or another equally qualified fluoridation
opponent to speak before any fluoridation meeting, symposium or
gathering. You are doing no one a service by disallowing our
participation in tax-payer funded fluoridation programs.

If your goal is to protect the health of Americans, you'll invite
one of our speakers. If your goal is just to win, you will not. If
our science is so misrepresented as fluoridationists tell
legislators in private, you'll be able to show us where we are wrong
in public.

The internet is often maligned as providing misinformation to
fluoridation truth seekers. But the truth was definitely not on
display at this government sponsored event. I fear New York State
Department of Health employees, present at this symposium, will come
back armed with misinformation, and use it to fluoridate more New
Yorkers against their will and without their full knowledge of harm,
further wasting my taxes.

However, I did enjoy our pleasant conversation about New York State.
Someday I'd like to have a pleasant conversation with you about
fluoridation.

I look forward to your response.

Yours truly,

Carol Kopf

Copy to:

Willliam Maas, DDS director of CDC's oral health program

U.S.Senator Charles Schumer
U.S. Senator Hillary Clinton
U.S. Representative Peter King
NYS Senator Kemp Hannon
NYS Senator Owen Johnson

Mayor Heartwell Grand Rapids, Michigan

Dr. George Stookey

Dr. Lynn Mouden, director of the Arkansas Health Department's Office
of Oral Health

Dr Julie Louise Gerberding, Director,Centers for Disease Control and
Prevention

Dr. Elmer Green, Director,Bureau of Dental Health, NYS Dep't of
Health

Dr. Jayanth Kumar, Director, Oral Health Surveillance and Research,
Bureau of Dental Health, NYS Department of Health

Gov't Strategizes with Private Groups to Protect Fluoridation

The following FOIA-obtained emails seems to show how the US Centers for Disease Control (CDC) works closely with the American Dental Association (ADA) and the PEW Foundation to protect fluoridation rather than the American public whose health they are entrusted to protect. The documents also reveal the disdain and lack of respect for people (me) who ask valid questions concerning fluoridation. I added the red parts to further identify the major players.

From: Duchon, Kip (CDC/ONDIEH/NCCDPHP) [CDC National Fluoridation Engineer, Oral Health Division]

Sent: Wednesday, May 05, 2010 11 :53 AM

To: 'McGinley, Jane' [RDH, MBA, Manager, Fluoridation and Preventive Health Activities, American Dental Association]

Cc: Bailey, William (CDC/ONDIEH/NCCDPHP) Dentist, Acting Director, CDC Oral Health Division

Subject: FW: Chinese Fluoride 

I regret to inform you that Carol Kopf seems to have gotten my email and she sent this directly to me, the first such instance, but no doubt, not the last. I am forwarding a copy of my response to you for you of all people probably need to know she is digging deeper into this issue. I think she was very displeased to hear about the Belgium supplier that we only recently identified a couple of months ago.

This was a combined investigative effort of Dave Hellmann and me to identify them and find out about their product They really have not been marketing in the US, but the AWWA committee is working to get the word out for they produce their product using the old Solvay method and looks like a very nice product. I'm not too sure, but wouldn't it be great if it was actually a byproduct of chocolate manufacturing, but it is unlikely. 

Kip Duchon, P.E.

National Water Fluoridation Engineer

---------------------------- 

From: Duchon, Kip (CDC/ONDIEH/NCCDPHP)

Sent: Wednesday, May 05, 2.010 11:06 AM

To: 'Carol S. Kopf

Subject: RE: Chinese Fluoride 

Dear Carol 

Normally requests for information should come in through our public information box so that the correct person can answer the question you might have. That can be found at http://www.cdc.gov/fluoridation/contact.htm

I am probably the correct person for this particular question, so I will be glad to answer your question.

Since the EPA terminated their additives program in 1988, they simply do not have the resources to track the over 50 additives used in water treatment facilities. NSF International is a standards organization and does not track this type of information but they do monitor the activities of the certifying entities and report to the Association of State Drinking Water Administrators and EPA. Both NSF (a different entity from NSF International) and UL, which combined represent over 85% of the water fluoridation additive certification activities, do not publically report on tonnage or marketing.

CDC does not have an additives monitoring program but we compile some limited information on the topic, and I will attempt to give you my best opinion on these answers, but please understand this is my opinion and not the opinion of

CDC since we don't actually have a formal additives program.

My understanding is that the Chinese sodium fluoride that is NSF Standard 60 certified is derived from a full neutralization of fluorosflicic acid using caustic soda, but I have not actually been to the production facilities to confirm that information.

Sodium fluoride products with Standard 60 certification are derived from either full neutralization of fluorosilicic acid, or neutralization of hydrogen fluoride. 

A majority of the sodium fluoride being used in the US is derived from fluorosilicic acid and an AWWA survey of water plant operators using sodium fluoride in saturators that is currently being compiled has preliminary results showing that a majority of operators are satisfied with the fluorosilicic acid derived product, but there seems to be a preference for the hydrogen fluoride derived product. These products are not by-products but are specifically made for uses including water fluoridation. 

At this time, product is available from China, Japan, and Belgium

and a US domestically produced product is certified from a facility in Illinois that is currently not producing product but has periodically been used intermittently in the past few years. 

The AWWA survey is part of our effort to periodically review our standards and if there is change or difference in the products and if an update is needed. That survey is in progress and results are not yet complete.

Sodium fluorosilicate with Standard 60 certification is derived from partial neutralization of fluorosilicic acid. It is not a byproduct but is specifically manufactured for use including water fluoridation. At this time the overwhelming source is domestically US produced, but NSF certified product is also available from China and Belgium

NSF Standard 60 certified Fluorosilicic is overwhelmingly produced in the US as a high-purity vacuum extraction from gypsum slurry derived from phosphate fertilizer production. There are no smokestacks belching this stuff although that is

a great science fiction tale. Less than 5% of the product is from gas partitioning of silica-tetrafluoride from hydrogen fluoride and less than 1% is from hydrogen fluoride etching of silica products. The product is available from US, Mexican,

and Canadian sources.

Kip Duchon, P.E.

National Water Fluoridation Engineer

----------------------------------

From:  Carol S. Kopf

Sent: Wednesday, May 05, 2010 9:32AM

To: Duchon, Kip (CDC/ONDIEH/NCCDPHP)

Subject: Chinese Fluoride

Kip

Both the EPA and NSF International haven’t been able to answer this question for me. Hope you will.

It is about the Chinese fluoride. Is it derived from phosphate fertilizer? If not, what is it derived from.

Also the CDC's website says that most of the fluoridation chemicals are collected from fertilizer companies; but not all. What are the other sources of fluoridation chemicals?

Are they made specifically for fluoridation or are they a by-product of some other manufacturing process?

A Louisiana State Legislator said on the floor of the State Senate yesterday that some fluoridation chemicals are purchased from Belgium? ls that true?

Please name all the countries that import fluoridation chemicals into the US

Thank you for your assistance

 ·

Carol Kopf

From: Bill Maas (Consultant) mailto:BMaas-consultant@pewtrusts.org] [former Director, CDC Oral Health Division and now consultant to the Pew Foundation to promote fluoridation]

Sent: Thursday, May O5, 2011 01:04PM

To: Judy Sherman (ShermanJ@ADA.ORG) ShermanJ@ADA.ORG [Judy Sherman is, a now retired, ADA lobbyist]

Cc: Bailey, William (CDC/ONDIEH/NCCDPHP); Lewis Lampiris (lampirisl@ada.org) [In 2006, Lampris began working with the American Dental Association as director of the Council on Access, Prevention and Interprofessional Relations; he held this appointment until 2012.]

Subject: Implications of CDC demotion, as seen through eyes of CWF opponent

I don't want to overreact to the rantlngs of a long time anti-fluoridationist,  but l.came across something that may get traction in contributing to perceptions about what HHS and CDC really believe about fluoridation now {since to save face, it is unlikely to retract its 1999 proclamations about fluoridation as a great public health achievement}.

Councilman Vallone, of NY City, has proposed discontinuation of CWF in NYC. Dr. Neal Herman, a former city dental director, wrote Vallone a letter, which Vallone's office has shared with many long-standing opponents of fluoridation, including Carol Kopf, who wrote the attached letter. [Apparently the NYC Dental Director shared my letter with Bill Maas. Why? You can read my whole letter here http://fluoridedangers.blogspot.com/p/blog-page.html ] 

As usual, it includes a difficult-to-separate mix of correctly quoted statements from credible scientific reports along with misleading assertions about health risks or lack of health benefits from fluoridation.

But, what caught my eye as new was the following:

"You mention that the Centers for Disease Control recognizes fluoridation as one of the ten greatest and effective public health innovations ever. Then why has tooth decay rates gone up since that statement was made and why was the CDC’s oral health Division demoted to a branch no longer working for children. It seems that statement just doesn't hold water. It's just words strung together that has no scientific basis."

About the only good thing l can say about the reorganization is that the Division of Population Health is to include what used to be the Division of Adolescent and School Health, but I don't know how visible that will be to counter the charge that this is a Division not "working for children".

This certainly is relevant to the recommendations of the IoM committee to HHS that perceptions matter. CDC’s reorganization sends a message about one of the gret public health achievements of the 20^th century that may be difficult to counter.

Bill Maas

----------------------

From: Bailey, William (CDC/ONDIEH/NCCDPHP)

Sent: Thursday, May 05, 2011 1:34 PM

To: 'BMaas~consultant@ pewtrusts.org'; 'shermanj@ ada.org'

Cc: 'lampirisl@ ada.org'

Re: Implications of CDC demotion, as seen through eyes of CWF opponent

So true.

---------------

From: Bill Maas (Consultant) [mailto:BMaas-consultant@pewtrusts.org]

Sent: Thursday, May 05, 2011 01:09 PM

To: 'Sherman, Judy C.'

Cc: Bailey, William (CDC/ONDIEH/NCCDPHP); Lampiris, Lewis N.

Subject: RE: Implications of CDC demotion, as seen through eyes of CWF opponent

Yes, it reveals how carefully fluoridation's opponents watch organizational actions like that of CDC, and how readily they will use that to undermine public health.

----------------------------------

From: Sherman, Judy C. [mailto:shermanj@ada.orgl [ADA Lobbyest]

Sent: Thursday, May O5, 2011 1:07 PM

To: Bill Maas (Consultant)

·Cc: 'wdb9@cdc.gov'; [William Bailey]; Lampiris, Lewis N.

Subject: Re: Implications of CDC demotion, as seen through eyes of CWF opponent

Thank you for this. May I share with people on the Hill?

---------------------------------------

These emails were part of 2600 pages of documents obtained by Dan Stockin, MPH, and revealed at the 5^th Annual Fluoride Action Network conference on September 6-8 in Washington DC.

FOIA Documents here

Stockin PowerPoint

Keep Fluoride Toothpaste Out of Children's Reach, Expert Cautioned in 1980

The following is quoted from Gary M. Whitford, PhD, DMD, August 1981

“Some fluoride-containing products, however, have enough of the ion to be hazardous and should be handled and stored with caution.  For example, a 1.23 percent fluoride gel contains 12,300 ppm or 12.3 milligrams per gram [such as dentists' fluoride treatments]. Thus, one ounce (28.3) grams) contains 348 milligrams, a life-threatening dose for a 11.5 kilogram or a 25 pound child.  Even the popular fluoride toothpastes may be hazardous to small children. These products typically contain 0.1 percent fluoride or 1000 ppm.  Thus, an eight ounce tube containing 226 milligrams of fluoride, could endanger a 16 or 17 pound child…Therefore such products should be kept out of the reach of those who are at risk."

“Dental fluorosis, a disorder of enamel mineralization which can be produced only during the development of the enamel prior to tooth eruption, is generally regarded as a toxic manifestation of chronic intake of excessive fluoride.  Exactly, how much fluoride is too much is uncertain.”

                                                 Gary M. Whitford, PhD, DMD, August 1981

                                “Fluorides: Mechanism of Action Efficacy and Safety,”

                                      Dental Caries Prevention in Public Health Programs

                                        Proceedings of a Conference October 27-28 1980

                                            Sponsored By the National Caries Program

                                                 National Institute of Dental Research

                                           US Department of Health and Human Services

                                         Edited by Alice M. Horowitz and Hilah B. Thomas

Excerpts above and below by Gary M. Whitford, PhD, DMD

Dr. Nichols asks Dr. Whitford the following question:  "If I gave you two items, one a 9 ounce size of Crest toothpaste another a 7 ounce bottle of 0.2 percent sodium fluoride solution, could you discuss the toxicity of each in relation to a 20 kilogram child?"

Dr. Whitford answers "There would be 225 mg of fluoride in the tube. The 7 ounce bottle is about 0.1 percent fluoride so it would contain about 200 mg of fluoride...I think that the potential for toxicity, if ingested all at once, would be about equal.  Assuming that 30 mg of fluoride per kilogram of body weight is fatal, these doses would be dangerous for seven and nine kilogram children, respectively  [15 to 20 pounds]. I'm unaware of any report indicating that death has occurred from the ingestion of toothpaste or a 0.2 percent sodium fluoride solution.  It is, however, conceivable that it could happen. For that reason, when our children were younger, we purchased the 4 to 6 ounce tube of toothpaste and kept them out of their reach."

Fluoride is readily absorbed from the gastrointestinal tract. That which appears in the feces is mainly if not entirely, unabsorbed fluoride and usually accounts for only about 5 to 10 percent of the amount ingested daily. Some factors, however, decrease the absorption of fluoride, particularly divalent and trivalent cations such as calcium, magnesium and aluminum. If high concentrations of these ions are present with the fluoride at the time of ingestion, systemic absorption is reduced.

From the plasma, fluoride diffuses to the extra cellular and intracellular fluids of the soft tissues where it rapidly reaches a steady-state distribution.

As the plasma curve rises, so do the concentrations of fluoride in the muscle, the liver, the heart, and all soft tissues

The excretion pattern of fluoride, however, is not exactly this way in all people.  The age of the individual influences how much fluoride is removed from the body...  The excreted percentage of a fluoride dose generally varies as a direct function of age. The younger the individual, the less excretion.  The older the individual, the more of a given dose is excreted.  This result is attributable principally to the growth rate and age of the skeleton and the surface area of bone mineral available for fluoride uptake. In the growing individual, these factors favor enhanced fluoride uptake so that relatively less is excreted in the urine.

According the some findings that we made a few years ago, fluoride excretion is a function of the pH of the urine. At a low pH, fluoride excretion is also low and as the urine pH rises, the rate of fluoride excretion rises as well.

The diet of most infants is either mother’s milk or a formula based on cow’s milk.  The urine pH of  infants who are solely formula fed is generally lower, sometimes markedly so, then that of solely breastfed infants and the would be expected to excrete less of the fluoride delivered to the kidneys in the blood.  Such differences in excretion rate might or might not be desirable depending on the quantities of fluoride involved.

Thus, difference in diet, among several other important factors, will tend to produce urine pH values that approach one end or the other of the physiologic range. These factors influence the uptake of fluoride by developing teeth and the fluoride levels of the oral fluids. Therefore, they can affect the cariostatic efficacy of fluoride in certain individuals or perhaps the development of fluorosis in others.

Dental fluorosis, a disorder of enamel mineralization which can be produced only during the development of the enamel prior to tooth eruption, is generally regarded as a toxic manifestation of chronic intake of excessive fluoride.  Exactly, how much fluoride is too much is uncertain.”…Probably no single dose, or narrow range of doses can be determined because of several variables. The age and body weight of the child or fetus, the frequency of the doses, the peak plasma levels, the magnitude of the more sustained fasting plasma level, are among the factors to be considered.  Nevertheless, the early data provided by Dean are pertinent. 

According to his findings and classification system, when the community index of fluorosis exceeds 0.6, the incidence and severity of fluorosis begins to constitute a public health problem warranting increasing consideration.  This index value was reached in communities with water fluoride levels of 1.6 to 1.8 ppm.  Thus the margin of safety for avoiding a degree of dental fluorosis which may be of public health concern is rather low at somewhat less than two and is another reason for carefully monitoring fluoride levels in water.