Fluoride In The Water

[camembert]

Are you mental?

No, deadly serious...

As I undestand it, brushing reduces gum disease and has never been proved to reduce decay, unless used with a paste containing - FLUORIDE!!

[Tarroo Ushtey]

I am troubled that morally people should insist that they are not exposed to something that will be advantagous to someone else and which will have no measurable ill effect on them simply due to their personal qualms about it which are not evidence based.

 

That is nothing new really is it Chinahand. We can all list many issues where our opinions differ with "generally accepted public opinion" but, if we want to be a part of society we have to accept this fact and move on. You can't please all the people, all the time......

[saveourwater]

Personally I am certain our politicians don't have the balls to do it. I think I regret that, but well that is how the system works - scare people, make it seem like a huge issue and then let the politicians bottle it. Well done saveourwater - the Island will remain towards the end of dental care league tables and the costs will remain high to treat it.

 

Interesting you should mention league tables. When the surveys of 5 year old’s began back in 1993/94 the IOM topped the league tables. We had the best teeth when compared with the North West and England.

 

2 years later there is a jump of 17.9% in the decay rate and all of a sudden we have the worst teeth compared to the UK. Then we go up and down a few percentage points every 2 years after that (but nowhere near 17% either way) and hover around a 50% decay rate - meaning we have the worst teeth compared to the UK right up until the present day.

 

Now call us suspicious if you will, but we thought it was a little odd that we could go from having the best teeth to the worst within a space of 2 years so we asked to see the raw data. Despite numerous requests from Quintin Gill MHK we have still not been given access to the raw data.

 

What we do know however is that all primary schools and middle schools on the Island used to have bi-annual inspections, check ups – not surveys. Now they are not inspected at all only ‘surveyed’ once every 2 years.

 

We also know that in that first survey nearly all of the Island’s 5 year old children were included in the survey (98.5%) – when we had the best teeth – including the private school. In recent years however that figure has dropped substantially to around a third. Does that mean that only the schools in more deprived parts of the Island are being surveyed and that data is being deliberately distorted? Well only the raw data can show that but the government won’t let us see it.

 

Interesting though isn’t it, when we surveyed nearly all the children on the Island and had 2 inspections a year we had the best teeth. Now that we have stopped doing inspections and only survey a ‘mystery’ third of the kids we have the worst teeth.

[VinnieK]

Are you mental?

No, deadly serious...

As I undestand it, brushing reduces gum disease and has never been proved to reduce decay, unless used with a paste containing - FLUORIDE!!

 

Yeah, I know. I accept that fluoride is safe and the possible side effects minimal. It's the policy side of intervention I disagree with, so you can keep your skanky teeth fetish pictures to yourself.

[camembert]

Are you mental?

No, deadly serious...

As I undestand it, brushing reduces gum disease and has never been proved to reduce decay, unless used with a paste containing - FLUORIDE!!

 

Yeah, I know. I accept that fluoride is safe and the possible side effects minimal. It's the policy side of intervention I disagree with, so you can keep your skanky teeth fetish pictures to yourself.

 

Actually agree with you there.

I think the government should give us a decent dental service first before thinking about adding Fluoride to the water. Instead they decide to copy what England do.

[camembert]

Personally I am certain our politicians don't have the balls to do it. I think I regret that, but well that is how the system works - scare people, make it seem like a huge issue and then let the politicians bottle it. Well done saveourwater - the Island will remain towards the end of dental care league tables and the costs will remain high to treat it.

 

Interesting you should mention league tables. When the surveys of 5 year old’s began back in 1993/94 the IOM topped the league tables. We had the best teeth when compared with the North West and England.

 

That is nothing to be proud of, the North West have the worst levels of decay in England!

[saveourwater]

That is nothing to be proud of, the North West have the worst levels of decay in England!

 

Well you are correct in stating that the decay levels for the North West are amongst the highest in England but I was actually including England as well i.e. IOM / North West / England.

 

The figures for 1993/94 were as follows: -

 

Decay rate Amongst 5 year old children (%)

 

IOM 37%

 

England 43%

 

North West 55%

 

Personally I think that is something to be proud of, we had the best teeth by a long shot and we did regular school inspections.

 

Now we have the worst teeth with a decay level of aorund 52% and we no longer even bother looking at our childrens teeth whilst they are at school - apart from when we want to selectively survey a mystery third of them to arrive at the decay rate.

 

Something is rotten here on the IOM and it's more than just some of the kids teeth.

[ballaughbiker]

I think the established protocol is examining about a third. Of course it depends which third as I think some schools are much worse than others.

 

I've just asked the bloke who did the 93/94 survey why he did a higher percentage. He just looked blank and gave a gallic shrug. He's not well you know....

Its hard to argue that the 93/94 survey could be less accurate with a higher sample though.

[incandescent]

To Chinahand

 

You enquire as to my interest in the fluoride debate and how engendered, and I respond as follows.

Following my arrival to take up a post on the Island, unaccompanied by my family, this afforded me an unusual amount of free time on evenings and weekends. During such times I familiarised myself with the historic background, culture, social facilities, and local media which lead to this debate. Having read ‘The Fluoride Deception’ book by Chris Bryson I considered my family experience derived from a fluoridated area to be a worthwhile contribution to assist others, and was made of my own volition. It is noteworthy that at the end of the Fluoride Deception Book, reference is made to Dr Paul Connett who invited an open scientific debate on fluoride and no one turned up.

 

However, I was not expecting the level of disingenuous vitriolic diatribe which often appears on this site, and you should know it is not my intention to become ensnared into a game of verbal ‘parry and thrust’. My duties and responsibilities are many and I will endeavour to find time to respond to apposite matters. You should appreciate that unlike yourself I do not have the unlimited time to sit in front of a Computer screen.

 

Science and integrity

 

Your “passion for the integrity of science” is acknowledged. Science is the possession of knowledge as distinguished from ignorance or misunderstanding and is dependent upon incisive observations from which conclusions can be drawn. On the premise that observation is the starting point of science you have chosen not to observe facts that I have presented to you and others which does not receive your scientific consideration but political dismissal. You express dislike for ‘cherry picking’ data and ignoring other factors which is precisely the observation that can be directed at you. So let’s look at an important specific example concerning Nobel Prize winners opposed to fluoride. You tell us what you could not find in this regard, but did not say what I suspect you might have found which was the comment made by Dr Arvid Carlsson Nobel Laureate in Medicine and Physiology 2000. Dr Carlson has stated on the subject of fluoride - “It is against all principles of modern Pharmacology, it is really obsolete, there is no doubt about that. Nations using it should be ashamed of themselves it’s against science actually” Is he not in your opinion suitably and ably qualified to make this statement? Whether your ‘scientifically literate’ proclamation would or should have assisted you to discover this statatement is open to conjecture. For further reference of a scientific persuasion you can go to www.Fluoridealert.org.

 

What also of more than 1600 medical, scientific and other professionals referred to as opponents of fluoride? Are they all crazy and you know better?

Baroness Hayman states “We accept that dental fluorosis is a manifestation of systemic toxicity” This was ignored, and so were many other honestly presented and diligently researched points, not as an attempt to make me right and others wrong, but hopefully to inform in the spirit of factual debate and contribution.

 

Whilst I carry no brief for S.O.W they appear to answer questions and criticisms put to them in a courteous, thorough and sincere way as a result of which they are subjected to an unacceptable level of abuse.

 

I would like to understand your position in respect of the poor children with shocking and distressing dental difficulties more recently displayed on the Forum. Are you saying that the children on the Isle of Man are not getting enough fluoride?

 

 

There is much to say that has not yet been said, and I have more to contribute. My first two contributions to this site should provide you with sufficient opportunity to prove this data incorrect, failing which you make my case thus far. I am sure you will agree that there is little point in me answering more of your questions if you do not respond to mine.

 

 

“The most dangerous untruths are truths moderately distorted”

George Christopher Lichtenberg – German Physics Professor and Scientist

 

 

The FDA – for general reference

 

Finally, your recent comment in respect of the Food and Drug Administration FDA being portrayed as a reliable authority is questionable. For an organisation which I understand receives more than half its funding from those it is supposed to police is suspect. The US Government Accounting Office stated that “The FDA lacks a clear and effective process” and “There is a lack of criteria (in the FDA) for determining what safety actions to take and when to take them”

Dr. David Graham, Associate Director of Science and Medicine in the Office of Drug Safety on the 23 November 2004 made the following statement “I would agree that the FDA as currently configured is incapable of protecting America against another Vioxx. Simply put, the FDA and the centre for Drug Evaluation Research (CDER) are broken”. Recent published research data on anti depressants and other damaging treatments does not reflect well on the FDA.

[manshimajin]

You should know it is not my intention to become ensnared into a game of verbal ‘parry and thrust’. My duties and responsibilities are many and I will endeavour to find time to respond to apposite matters. You should appreciate that unlike yourself I do not have the unlimited time to sit in front of a Computer screen.

 

The fluoridisation issue is worthy of intelligent discussion. Your messages are helpful in contributing to this.

 

May I respectfully suggest however that instead of further stoking 'verbal parry and thrust' and ranking your time as more important than that of others you simply stick to the point?

 

Otherwise it can sound pompous which detracts from your valuable input.

[ballaughbiker]

Otherwise it can sound pompous

Agreed

[Chinahand]

It is noteworthy that at the end of the Fluoride Deception Book, reference is made to Dr Paul Connett who invited an open scientific debate on fluoride and no one turned up.

Incandescent, I cannot reconcile this statement to the large amount of work done in preparing the York Review, which itself has generated considerable follow up work by the Medical Research Council, and in addition to this there are the large studies undertaken by the Irish Health Authorities which have been highlighted by SOW - which have been very useful in helping me understand the issues, and especially fluorosis. The Harvard studies on cancer etc etc. Looking at the primary research I see a vibrant field full of on going work. Nearly all the studies I’ve used to back up my positions were published this century – current, up to date research conclusions.

However, I was not expecting the level of disingenuous vitriolic diatribe which often appears on this site, and you should know it is not my intention to become ensnared into a game of verbal ‘parry and thrust’.

This is an internet forum – it is boisterous, doesn’t suffer fools, and involves name calling – are you really surprised by that? I can only assume you don’t have a lot of experience in the internet.

I have called Saveourwater a fool, wondered if he is a knave, and said he is a tinhat conspiracist.

I am happy to stand by those statements – he consistently distorts and goes to the extremes. He believes that the Health Authorities and the scientific establishment are deliberately suppressing evidence and that fluoridation is a conspiracy to dispose of chemical waste. I think any objective look at these claims would put the holder of these views on the fringe, if not the lunatic fringe.

You express dislike for ‘cherry picking’ data and ignoring other factors which is precisely the observation that can be directed at you. So let’s look at an important specific example concerning Nobel Prize winners opposed to fluoride.

…

What also of more than 1600 medical, scientific and other professionals referred to as opponents of fluoride? Are they all crazy and you know better?

I’ve got two points to make about this – firstly science. Science is a hard nosed, cynical business which has hard rivalries and groups who maintain one theoretical position in opposition to another – punctuated equilibrium, the utility of string theory, the role of information in black holes, etc etc. The followers of rival theories can be frankly rude about each other and their response to the others claims usually amounts to “where’s your evidence and you’ve not thought about X which shows your association of this evidence with your theory is exaggerated.”

But for all this academic rivalry there is usually a consensus opinion – one theory has broad support, the other is the contender. Libraries are full of Phd theses looking at how one consensus becomes established and then mutates, and changes either into a new rival consensus, or into a more nuanced version of itself.

It is fascinating when the issue leaves the academy and becomes political and social – there is a definite phenomenon where this starts to generate lists of supporters – 1000 scientists who do not support global warming, 100 people (usually without relevant qualifications) who do not support evolution – countered light-heartedly by the 884, and counting, people with a given name derived from Stephen who have Phds in a relevant science and who do support evolution.

Science is not numbers it is evidence and when people start publishing lists of supporters it really only shows to me they have lost the scientific argument and are resorting to politics.

Now the consensus scientific view is that fluoride (no matter what its source) is a vital element in improving oral health and the benefits of using it appropriately vastly outweigh the risks. There is then the specific issue of fluoridation – again the scientific consensus is that this also overall will result in an improvement in oral health, with the gains off set by a far smaller number of problems – mainly fluorosis.

But with fluoridation there is then an additional problem which is my second point – this treatment needs the entire population to be treated with all the political issues of mass medication.

Your quoted (dare I say cherry picked ) Nobel Prize winner is concentrating on the issue of mass medication and the issues surrounding it.

Mass medication is a trade off – you are going to get side effects – it is difficult to control dosage. I acknowledge these things, but I also then look at the benefits vrs the risks.

There is a valid argument to be had about fluoridation; science is a vital part of it as it will allow you to narrow down and quantify the trade offs. But the decision on whether those trade offs are worth it is not a scientific but a political decision.

Earlier I did a rough and ready calculation and showed that about for every hundred 15-year-olds you will save 110 cavities which need to be, or have been, filled or removed, but have 10 extra cases of fluorosis (at ANY level) if you fluorinate.

Now that I’ve thought about it that is an underestimate as this estimate is based on the DMFT score which only records decay in permanent teeth. In order to be accurate you should also be adding to this the decay, and fluorosis, in their baby teeth (dmft). The data on this is more difficult. They do record dmft at 5-years-old – which is a pretty good, if underestimating, proxy for total decay in baby teeth. But they give no give fluorosis figures for baby teeth.

So what I’ve done is assume the fluorosis levels are the same in 5-year-olds baby teeth as they are in 15 year olds permanent teeth – I believe this is an exaggeration, but I will be happy to be proved wrong if someone can supply more accurate data. How does this change the figures?

Well by 15 years old, fluorination will have saved 100 children 180 cavities, but resulted in 20 cases of fluorosis at any level above questionable. The majority of the fluorosis cases will be very mild, or mild and it is doubtful that they will need any intervention whatsoever, but a small proportion should be treated with caps etc – That is basically the trade off. Being vastly favourable to the fluorosis side of the argument – 20 treatments to cap mottled teeth vrs 180 treatments to drill and either fill or remove decayed teeth.

I have tried to quantify the issue as accurately as I can as a lay person looking at the issue – I am certain people will be able to nuance it more, but at the back of the envelope level it is acceptable.

If you want to add in cancer you’d have to look at tens of millions of 15-year-olds with tens of millions of fillings (and a small numbers of deaths under General anaesthetic) to offset a tiny number of cases of cancer, if any – the consensus science cannot see any correlation.

I would like to understand your position in respect of the poor children with shocking and distressing dental difficulties more recently displayed on the Forum. Are you saying that the children on the Isle of Man are not getting enough fluoride?

So the debate on this forum has unfortunately reached the levels of going to extremes – yes pictures of the worst fluorosis and the worst cavities are vying for attention.

In the one hundred 15-year-olds I am using as my data set it is not unreasonable to expect some of the 180 cavities will be respresentative of the worst decay pictures shown (99th percentile etc), but the numbers are such that you will need a significantly larger number than 20 cases of fluorosis at any level to be guaranteed of seeing such bad fluorosis.

 

You ask me do I want the children of the Isle of Man to get more fluoride. Quite definitely I do – ideally from using a tooth brush and fluoride tooth paste. But I am not indifferent enough, or idealistic enough to expect that those kids brought up in families uncaring of oral hygene to suddenly become three times-a-day brushers.

The Island’s oral health would be significantly improved by fluoridation – even once you have offset the much smaller number of cases of children needing treatment for fluorosis.

The 180 cavities saved for 20 cases at any level of fluorosis is accurate enough for me to have made up my mind.

[pontiuspilot]

once again Chinahand you and i are in agreement. especially with regards to SOW.

He does indeed have more than a whiff of a fanatic about him.

as his views are so extreme it would be wrong of any government trying to decide on a matter designed to improve public health to pay too much attention to him.

as you and I have said SOW distorts the science for his own aims. it is the good name of science that i wish to defend the most. if people such as him, who step into the scientific arena with no real right to be there, that often bring science itself into disrepute.

he has entered the bear pit, if he does not like the heat he finds while in it he should turn about and remove himself from the debate.

fools are not suffered within science, but those who admit when they are wrong are often applauded for doing so.

[saveourwater]

Chinahand

 

Thanks for the explanation of your blatant rudeness, now we understand a little more of your moral character.

 

You say that fluoridation is cost effective and base this assertion on your interpretation of the latest Irish data i.e. 180 fewer filling or extractions would save more money than treating 20 cases of fluorosis so let’s look at that:-

 

180 x £42.50 = £7,650 (I got the £42.50 from a random phone call to an Onchan dental surgery and asked for the NHS price of a filling or extraction – which includes a check up).

 

Now let’s look at dental fluorosis and bear in mind that dental fluorosis usually affects more than just one tooth and can affect the entire mouth (well in nearly all the examples I have ever seen of the condition take a look here Fluorosis LINK), anyway let’s be conservative and say that just the front 2 teeth have to be treated instead of say 4 or 6.

 

2 x £320 = £640 x 20 = £12,800 the £320 is the price for ‘private’ treatment of dental fluorosis via veneering from the same Onchan surgery and we already know that you have to go private because you cannot have dental fluorosis treated on the NHS.

 

However this £320 per tooth not only has to come out of your own pocket (or the parents pockets) but I believe it is advisable that veneers are not carried out until you are at least 18 years old. So if you get this fluorosis under 18 (which you will) you have to go around for years with manky looking teeth, compared to a toothache which can be treated within days. How is this going to affect the child emotionally and psychologically?

 

So what you have just done Chinahand by fluoridating the Manx water is to have ‘potentially’ saved the tax payer £7,650 per cohort of 100 children but you have added a burden to an unknown sector of the tax paying population of £12,800.

 

Not only that but it is highly likely that some of those affected by fluorosis will not be able to afford the private treatment, so you have effectively introduced a new disease of the poor. Added to this you have the expense of the upkeep of treatment for the dental fluorosis, yes fillings also require upkeep but to keep veneering teeth every 10 years or so you need to remove 0.5 mm of enamel eventually resulting in crowning or capping of the teeth so potentially a huge cost over a lifetime one which many will simply never be able to afford.

 

Even if your figures are correct and I doubt this from my previous request for you to factor in the interventions in Ireland such as fissure sealants and percentages of untreated decay (which you have not yet done) what fluoridation does is ‘potentially’ save the government money without addressing the cause of the problem and burdening another sector of the population with a new disease. This is why governments are so interested in fluoridation and if this is what you find to be acceptable then it is you that should take up your deserved place at the centre of the lunatic fringe.

 

You also totally ignore the fact that humans have a right to ingest what they wish to and have rested your case on that of economic statistics. We are people, we have rights, we are not just numbers in some government fiscal yearbook but perhaps this is all a new concept to you and beyond your understanding.

[ans]

if you think that logical argument will work with SOW forget it, as you have alluded he is a one trick pony with his needle stuck. when i have pointed out his scientific short comings to him he gets very nasty indeed. i have the messages to prove it.

 

I think in the interests of establishing moral character for both sides, it's only fair these messages are revealed by one side or the other.