Thursday, June 25, 2015

Fakes, Frauds, Fabricators and Fluoridationists

Fluoridation protectionists have faith in fluoridation; but fluoridation research reviewers need science. And it's just not there.

The trusted UK-based Cochrane Group is yet another respected scientific research body to find that fluoridation’s benefits are built upon a house of cards (June 2015).  Cochrane reports that studies purporting to show fluoridation’s ability to reduce tooth decay are out-dated, have a high risk of bias and were conducted before the widespread use of fluoridated dental products, in other words - scientifically invalid. 

Unlike the US Centers for Disease Control and the American Dental Association which work very closely together with industry promoting fluoridation, Cochrane does not accept commercial or conflicted funding which Cochrane says “is vital for us to generate authoritative and reliable information, produced by people who can work freely, unconstrained by commercial and financial interests.”

Fluoridation is newly framed as a boon to poor kids. But, Cochrane reports, “There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries [cavities] levels across SES [socio-economic-status or income]."

Other untrue arguments fluoridationists present to too-trusting governing bodies aren’t supported by valid science either e.g. fluoridation benefits adults and tooth decay rates go up when fluoridation is stopped. Cochrane could find no proof that this is true.

As is often the case, new information doesn’t stop organized dentistry from spinning the results to protect and promote fluoridation.

The Cochrane’s fluoridation review was conducted using a precise scientific method over a necessary period of time. It took the British Dental Association (BDA) less than one day to spin Cochrane’s results via a news release, cherry-picking data to report favorably - that fluoridation reduces cavities by up to 35%. Cochrane answered its critics on its blog

The BDA's figure is based on the poor and biased science, revealed by Cochrane, which shows a child’s  fluoridation “benefit” is just less than two primary teeth or one permanent tooth over their lifetimes. Even if this “benefit” was based on sound-science, this small decay reduction doesn’t justify the hundreds of millions of dollars poured into fluoridation schemes, lobbyists, hand-outs, research reviews, strategy meetings, spokesperson training and fluoridation consultants and PR agents hired by the CDC and many states and organizations to protect and promote fluoridation. The costs to remedy fluoride's health-damaging effects add to the country's financial burden.

According to Dr. Stan Litras BDS BSc, Cochrane pooled old data from as long as 70 years ago when decay rates were 10 times greater than today. Thus the slim cavity reduction Cochrane reports reflect savings over the entire period from the 1930's to the present. "This is not an indication of any reductions to be expected in contemporary society," he writes

After the BDA's news release, an unnamed author wrote an article on an American Academy of Pediatrics (AAP) fluoridation-promoting website, also criticizing Cochrane in an all-too-familiar knee-jerk non-scientific fashion. 

The CDC funded the Cochrane Review to upgrade the 2013 U.S. Community Preventive Services Task Force’s Fluoridation Recommendation (which itself is based on the same low-quality evidence.

When Cochrane's review didn't come out the way CDC would have liked, the CDC diverted attention away from Cochrane in favor of the out-dated Task Force Review. 

It should be noted that the Task Review says the basis for its report is a previous 2000 fluoridation systematic review dubbed the "York Review" (McDonagh 2000). In 2003, the York (McDonagh 2000) reviewers were forced to explain: "We are concerned about the continuing misinterpretations of the evidence...We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide."

Fluoridation protectionists will always pick apart any study or review that’s critical of fluoride or fluoridation; but never look in their own backyard – even when objective researchers point out flaws.

It was admitted that fluoridation gives dentistry “political viability” in a 1981 Journal of the  American Dental Association article. (“Fluoridation Election Victory: A Case Study for Dentistry in Effective Political Action”)

In the 1940s and 1950s, dentists in their eagerness to have a magic bullet that would enhance their professional prestige, promoted fluoridation heavily and dismissed legitimate debate over the merits of fluoridation within the scientific, medical and dental communities, according to an American Journal of Public Health article by Catherine Carstairs, PhD (June 2015). 

Carstairs writes, “Moreover, some of the early fluoridation studies had methodological problems, which may have exaggerated their benefits.”

Carstairs concludes “After 70 years of investigation, there are still questions about how effective water fluoridation is at preventing dental decay and whether the possible risks are worth the benefits,” she writes. 

Also surprised by the lack of valid fluoridation science, John Doull, PhD, Chairman, US National Research Council fluoride panel that produced the groundbreaking 2006 fluoride toxicology report was quoted by Scientific American as saying:

“What the com­mittee found is that we’ve gone with the status quo regarding fluoride for many yearsfor too long, reallyand now we need to take a fresh look,” Doull says. “In the scientific community, people tend to think this is settled. I mean, when the U.S. surgeon general comes out and says this is one of the 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these ques­tions are unsettled and we have much less infor­mation than we should, considering how long this [fluoridation] has been going on. I think that’s why fluoridation is still being challenged so many years after it began. In the face of igno­rance, controversy is rampant.”

Maybe Doull was surprised  because voices of opposition have been suppressed since the early days of fluoridation, according to Chemical and Engineering News (1988). Journals rarely published articles critical of fluoride or fluoridation.

A Nassau/Suffolk (NY) Oral Health Coalition created a rule that members had to sign an affidavit claiming they would promote the goals of the NYS Oral Health Coalition so that the one fluoridation dissenter would be forced to leave or lie.  I left.

On another occasion (April 18, 2015), I was rudely asked to leave a free pro-fluoridation strategy session funded by my taxes, in my neighborhood and at a public university.  Only later did I discover through a freedom of information request that organizers were fearful of my attendance and that the decision to oust me came from the then Dental Bureau Chief, dentist J. V. Kumar. Ironically, they were teaching dental hygienists how to answer questions from those who oppose fluoridation!

Authors of a 1999 textbook (revised 2005), by Burt and Eklund,  admitted that the early fluoridation trials, which are the foundation for the entire fluoridation program, “were rather crude…statistical analysis by today’s standards, were primitive; data from the control communities were largely neglected after the initial reports, with conclusions based on the much weaker before-after analyses.”

Some examples of those mistakes were reported in  Fluoridation Errors and Omissions in Experimental Trials, by Sutton

In 2001, a National Institutes of Health (NIH)/CDC panel convened to evaluate tooth decay research, published between 1839 and 1965, and reported

 "... the panel was disappointed in the overall quality of the clinical data that it reviewed.  According to the panel, far too many studies were small, poorly described, or otherwise methodologically flawed" (over 560 studies evaluated fluoride use).

Even pro-fluoride dental researchers worried that the lack of evidence-based-dentistry practiced in the US will hurt their reputations. For example, Dentist Amid Ismail, when he was a Professor at the University of Michigan School of Dentistry, in a report to the NIH panel wrote,

"If the current weak trend of caries research in the United States continues, history will be harsh on all of us for our failure to use our knowledge and resources to reduce, if not eliminate, the burden of one of the world's most prevalent diseases."

In 2001, Cohen and Locker reported that fluoridation may be immoral with benefits exaggerated and risks minimized Journal of the Canadian Dental Association .   "Ethically, it cannot be argued that past benefits, by themselves, justify continuing the practice of fluoridation," they write.

A 1990 New York State  Department of Health report concluded

“The effectiveness of water fluoridation alone cannot now be determined…the effects of fluoride exposure cannot be accurately assessed based solely on the fluoride content of drinking water in an area”

In 1978, Pennsylvania JudgeJohn P. Flaherty who had a science background, presided over a court case (Aikenhead v. Borough of West View), where fluoridation proponents were sworn under oath to tell the truth and were subjected to cross-examination. He concluded,

“In my view, the evidence is quite convincing that the addition of sodium fluoride to the public water supply at one part per million is extremely deleterious to the human body, and, a review of the evidence will disclose that there was no convincing evidence to the contrary...”

In the 1950’s, Francis Bull, the state dental director in Wisconsin, argued that cavities could be decreased by practicing good oral hygiene, restricting sugar consumption, and improving diet, but he didn’t trust the public to do that.  Fluoride, in his view, offered the first real preventive from dental caries, according to Carstairs AJPH article.

Bull infamously lead dental directors in 1951 to “sell” fluoridation with slick PR and political strategy but to never ever debate. For example:

“Now, why should we do a pre-fluoridation survey?  Is it to find out if fluoridation works? No. We have told the public it works, so we can’t go back on that.”

“You know these research people – they can’t get over their feeling that you have to have test tube and animal research before you start applying it to human beings.”

The “say this; not that” approach to political fluoridation activism is still encouraged by a pro-fluoridation activism website claimed by the American Academy of Pediatrics's  that was created by a PR agency.

Fluoridation promoters generally use a CDC slogan as proof that fluoridation is safe and effective.  But few realize that the CDC does not do original research but relies on others’ reports and reviews, many of which do not prove that fluoridation is safe and effective, as former CDC Oral Health Division Director erroneously presented to a Fairbanks, Alaska, city council.

In 2009, the American Public Health Association used the same misinformation

Other believers presented the same misinformation more recently e.g. (slide 9)

Taxpayers should be shocked to learn that the CDC does spend time and money on political strategy to win fluoridation referenda, according to “The Public Votes on Fluoridation – Factors Linked to the Outcome ofFluoridation Campaigns,” (CDC April 2010)

Here’s some of the advice given:

“For the most part, the less visible the campaign, the more likely that fluoridation was approved by the voters.”

“Conduct social marketing research with voters…This could be valuable in developing the most effective campaign messages and finding the best ways of promoting these messages to the public.”

“In all four sites where fluoridation was approved, fluoridation advocates were able to write or influence the wording of the ballot. Ballot wording becomes an important piece of voter education, the way a ballot measure is phrased can influence how voters interpret and cast their votes.”

“The take-away message is that it cannot be assumed that people will trust only official and/or governmental sources of health and scientific information. The American public is becoming increasingly confident about making their judgment about what is good science. The term “junk science” may no longer be an effective communication strategy.”

But “junk science” is the exact phrase still used by many fluoridation promoters e.g. Shelly Gehshan, when she represented the Pew Foundation.

You would think some investigative reporter would write a book about this.  Oh yeah, someone did.

 “Fluoride science is corporate science. Fluoride science is DDT science. It’s asbestos science. It’s tobacco science It’s a racket,” said Christopher Bryson, the award-winning investigative reporter who wrote, The Fluoride Deception, after ten years of study.

We've had 70 years of fluoridation reaching record numbers of Americans, 60 years of fluoridated toothpaste, a glut of fluoridated dental products and a fluoride-saturated food and beverage supply.  Yet, the US is still facing a tooth decay epidemic along with a steep increase in fluoride overdose symptoms - dental fluorosis (discolored teeth).

The Surgeon General reported in 2000 that tooth decay is a silent epidemic in the US. Since then things have gotten worse. According to Wendell Potter on the Huffington Post:
--  Since 2000, the number of people living in areas where they can't easily see  a dentisthas climbed from 25 million to 47 million.
-- The number of people seeking treatment for dental problems in hospital  emergency rooms--one of the most expensive and least effective places to treat patients in pain because of bad teeth and diseased gums--nearly doubled from 1.1 million in 2000 to 2.1 million in 2010.
-- Dental decay is still the number one chronic illness among children.

-- More than a third of elementary school children have untreated tooth decay; the rate is twice as high for Hispanic and non-Hispanic black children and even worse for Native Americans.
-- Even though more children have dental benefits, half of all kids on Medicaid  did not get in to see a dentist in 2011, in large part because 80 percent of dentists nationally still do not accept Medicaid payment

Harvard describes a court case about a few corporations that sell fluoridated toothpaste and reported they "had long ago launched products with the maximum amount of fluoride allowed by health authorities. Yet caries [cavities] remained a significant threat to public health in many countries, both developing and developed." 

Every fluoride modality promises that steep cavity declines can occur.  Tooth decay should be obliterated by now if all that was true. But it's getting worse.

So, why is fluoridation still promoted?
Maybe the wheels of government turn slowly.  It took 50 years before the cancer/smoking link emerged from the scientific literature into popular acceptance.

Or, maybe, we might say Follow the Money!


1 comment:

willythered said...

Carol, thank you for this hard hitting summary/update on this issue, and your tag-line hits the nail on the head. Based on the 2011 USGS Minerals Yearbook: Fluorspar, where production and use data on the hydrofluorosilicic acid (HFSA) used for fluoridation, about 275,000 tons went into that market.

That much HFSA waste by-product cannot be discharged into waterways, nor can the gases from which it is formed be discharged into the atmosphere under current environmental laws and regulations. How fortunate for phosphate fertilizer producers that they can sell it to water authorities and have THEM discharge about 99% of it into waterways vis public sewer systems.

Sales prices range from $500/ton to over $2000/ton. Assuming an average price of $1000/ton, the purveyors of HFSA have a revenue stream of about $275 million/year, assuming 2011 is a typical year.

Follow the money indeed!