Brainwash Mouthwash?

[Skeddan]

Sorry to interrupt eye-poking with response to Lost Login. (BTW Chinahand - this might address a couple of points you raise)

 

I often struggle to follow the thread of your argument but it seems that you are arguing ...

Apologies. Point is given as counter-argument to Chinahand saying these problems would show up. Basically I've given a few of the reasons why the data is not 'clean' and reliable. Without such data one cannot identify such linkage or show no correlation. Chinahand's argument was that no problems have been noticed in tracking wF. For this point to be valid one must posit that there is good data - which there isn't. If you don't have good data, you don't have evidence one way or another and don't know.

 

Yes but is there any link?

I don't know. There simply isn't good enough data to say one way or another. But there is a real theoretical possibility there might be such links. (By 'theoretical' I mean in terms of know properties of F in terms of crossing blood brain barrier, enzyme inhibition, DNA damage, neurotoxicity, bio-accumulation, dosage-dependent effects etc.)

 

If there were no real theoretical possibility and all relevant theoretical hazards such as ADHD had clear etiology / causes then it would be tinfoilist to worry about wF. (For example putting chalk in the water supply would probably be entirely safe - if a little pointless).

 

Do States were there is Fluoridation show a markedly different pattern to those that have no Fluoridation.

Pattern of what? IQ deficiencies, ADHD, sterility? Again a problem with not having crystal clear data (be nice if had the kind of data Chinahand has on autism for all theoretical possible hazards). Yes there is data on geographic distribution of diagnosed ADHD. The problem is that there is no consistency in diagnosis. Whether or not it is picked up on varies from area to area. Similarly many people have dyslexia and aren't diagnosed for years. In some places identification of people with dyslexia is first rate. That varies with health boards so there is no 'true' picture. That variance easily swamps a minor increase in incidence (3% increase may be 'minor' in these statistical terms, yet be a major health and social issue) However with autism it is pretty obvious something is wrong and reported cases are very close to the 'true' picture.

 

Just because two things happen in a country does not nmean they are linked.

Yes. Like baldness and raining - doesn't mean there is a causal relationship even if statistically linked. Then again when there is a theoretical possibility of a linkage (face validity to the hypothesis) then you cannot discount there being such a link. With theoretical risks I don't know if they are linked. Equally I cannot say they aren't. (I would also add that many of these syndromes have various different underlying causes - i.e. a kind of bouquet of different conditons which present in similar way - like sneeze disorder analogy. It is highly improbable F would explain all - but it may explain some).

 

The onus should be to show that this is safe and have high quality research with appropriate methods to show no wF does not explain any of the theoretical hazards. So the question is not to show 'is there a link'? but 'is there no link?' - if someone says there is no link that is a distortion given the lack of good studies and data. To say 'no evidence of a link' at present means no more than 'we don't know - we haven't got the data or done the studies'.

 

America I believe is the most obese country in the World and it has increased overtime. Would you link this to Fluoridation. There has been an increase in car ownership in the US over the period that Fluoridation has been in place. Should we link this to fluoidation. I would say as it is clearly absurd but presumably you would not rule it out on the basis that it has not been proved there is no link?

In the case of car ownership there is no theoretical possibility. No point in making any study. Obesity is explained by overeating, genetic susceptibility, lack of exercise etc. Explosion of auto-immune disorders, ADHD, sterility, etc. is not yet explained. Eventually it will be. Maybe F might be a factor which might explain some 'subtypes' of these conditions. (Would that totally surprise you?). Maybe if (hypothetically) all health problems were fully explained, F in low dosages might turn out to have no ill effect. (No one really knows).

 

Note the MRC clearly state there needs to be further studies of health hazards. They don't propose studies if there is no theoretical possibility of a problem, nor if there were adequate studies to show there isn't. They made the point the studies so far were poor and wanting.

 

(BTW, many academic papers and reports such as this are written in a manner where the import is often lost to the layman - it is a bit like the language of diplomacy which has to be decoded to get the true meaning - rather than taken in the way it often is by those outside the field. Same is true for statistics - lies, and damned lies arise from interpretations by those inexpert in how to evaluate these).

 

What is worth noting and is that the bouquet of risks wF theoretically poses are serious ones which in the worst case scenario could be a devastating public health disaster. (just imagine the same level of unexplained health problems in IoM as in US - cost to health service, economy, families, individuals, etc.). Sorry if that sound like scaremongering. It is just risk assessment in my book. (a technical matter - which to a non-analyst may seem 'scary').

 

I have to admit I am probably in principal in favour of water fluoridation as I believe the evidence shows it is beneficial to a level and the known side effects are minor, basically some mottling of teeth which is generally not noticeable.

One should also factor in the unknown side effects that theoretically might arise from this. (and ideally evaluate risk of eventuating and calculate the cost - e.g. 1/100 chance that there will be a 5 point drop in IQ over 10 years, 1/40 chance of an additional 3% of children getting ADHD in next 30 years, 1/20 chance of 0.2% of females getting PCOS and 0.3% of males having fertility problems). Tot up the cost. Dull accounting. (then factor in human and societal impact....) However as yet one cannot do the ideal - it may be 40% risk - it could turn out to be causal and 100% for some and unrelated to others. We don't know. Is it worth the risk? What is the benefit and how does this compare to alternative options?

 

I question whether it is ethically right to add it to the water supply and that there other additional methods which could improve our dental hygiene. I have to admit that in general I would probably be anti fluoridation if these were the arguments that had been put forward against fluoridation as I am of the opinion that nothing should really be done or added to our drinking water except what is required to make it safe to drink.

I agree - in fact this is to me the be-all and end-all of the issue. The question of safety etc. is 'academic' - or should be. It is maybe a mistake to be debating the issue of safety risks of F. However I am not campaigning against wF. Rather it is an interesting topic in its own right.

 

However I dislike the way the anti fluoridation lobby have tried to in my eyes misrepresent science and scare monger. On that basis they have turned me from a potential supporter of the anti lobby to an opponent.

 

I dislike this too! What caught my attention was what struck me as possible linkage with various neurological and endocrinal conditions - and I looked into it from that. A lot of bad apples in the anti mob doesn't make wF safe. It may discredit many arguments and tar all with the same brush, but it is not scientific evidence giving one the requisite degree of confidence that wF is safe. (It just makes one uncomfortable that one might be associated with these tinfoilers).

 

Lost Login - your other points raises interesting questions - but this goes somewhat wider in scope to general discussion of political process. I'd be interested in discussing further, but for now will keep to wF topic.

 

Sorry I'm sometimes a bit oblique, pithy or lapse into tech jargon. Do let me know if there's anything which isn't clear and should be clarified.

[ballaughbiker]

Forgetting the possibility of risk of fluoridation for a minute I'd just like to suggest that the problem of dental decay appears to have been trivialised somewhat. Of course this has been exploited by some of the antis and is a well recognised anti-anything arguing technique. Just show the proposed (whatever) isn't really necessary and maybe your halfway into winning the argument. Add to this some real scaremongering into unprovable risks and most people with think twice. If you want to turn this into a think once situation suggest a link to cancer (hey, don't worry if it's unprovable) to frighten the shit out of everyone.

 

Despite being a firm anti on human rights grounds I cannot help but keep thinking that if there was any proveable link to ingesting fluoride ion at 0.75 ppm it would have been established by now. Fluoridation is hardly new. Its been happening from between 50 and x million years. How long a trial do you really need? Well, keep suggesting countless links to unprovable risks and you can keep this going for ever but it aint science!

 

Finally, its easy for someone not affected by a disease to trivialise it. Tooth rot is still extremely common in certain sections of western civilisation and its effects last a lifetime. Before anyone thinks "its just a filling" it can in worst case scenarios caused death. Its treatment can cause death. Thats not an unprovable myth, its a fact. Obviously I haven't suffered its worst result but my life has been significantly affected by one of the most easily preventable diseases. I don't therefore think its a trivial disease and neither would anyone else who has seen its effects on a daily basis.

 

 

 

Oh Declan, I might agree with you more if we had a real government......

[Skeddan]

I'm not sure about what you are saying about there being "no good reason has been suggested for putting chemicals in the water".

 

Areas with fluoride in their water have on average 2.25 fewer fillings per person than areas without it. The York report showed that this reduction is statistically valid and takes account of fluoride toothpaste use etc.

 

That's 180,000 fillings that will be saved on the Island (pop 80,000) over a generational change, and a saving that will continue in perpetuity.

(my highlighting)

 

Chinahand - I don't mean to shoot you down, but rather hope to disabuse you of some misconceptions from statistics etc.

 

Areas with wF might have this on average, but this doesn't mean this result will be obtained by wF. Consider 5% are from the hypothetical country of Cariestan where they have terrible teeth, rest have a few fillings without wF and no change after. Maybe the dental problems in Cariestan are well treated by F - perhaps they they have genetic susceptibility. On average there may be 2.25, 1 or 0.5 fewer (I think 0.5 is what York reported as indicative), but that statistics doesn't mean it's a proven treatment across the board. (I think York criticised the studies as poor and also noted that it was inconclusive - if I remember).

 

You say 180,000 fillings will be saved. What exactly is the dental problem in IoM? You won't save a single filling if everyone already has perfect teeth. You could save more if people are like those from Cariestan .

 

There may well be a problem in IoM, but what is it? Maybe there are 500 people with really appalling caries problems (perhaps genetic susceptibility) if so, wF might help them - but they could also take tablets, use topical treatments etc. etc. Maybe there is a capital cost of £5m to set up and ongoing cost of £1m pa. That could be £10K per person +£2k p.a in dental treatment by not using wF. Adjust the figures and maybe there are 2000 people with terrible teeth (£2.5k + £500 p.a) - which could subsides F tablets, regular check ups, or even a wF dispenser installed in their house (if they chose).

 

Also when you say 180,000 fillings will be saved by wF. But this is slanted in one sense. To evaluate properly one should compare to the projected effect if the same money were invested in other dental interventions. It could be it saves 20 fillings a year compared to other alternatives. It could be it saves -200 compared to targeted treatment.

 

You should also look beyond 'simple statistics' - for example there will be a confidence level and range of effect.

 

Be careful how you use statistics and beware of dangers that these can lead one to draw erroneous conclusions.

 

I know there is a dislike of consultancy studies by IOMG, but this is a case where there perhaps ought to be a good study made. What I have seen from BFS and the like wouldn't cut it from an analyst-consultant in a decent mgmt consultancy. Using this as a basis to determine policy is very iffy if that's the case.

 

However IMO the ethical issue should mean this is a non-starter anyway.

 

(Incidentally e-coli in public water supply will effect everyone. wF will not).

[nipper]

Looks with the last few posts that we have been going rather deep and wide into all this and off on a few tangents too.

 

How about bringing the tooth decay problem back on course and looking at the simple fucken cause of the problem. For example, informing young mothers of the potential hazards of allowing their children to suck on a can of Coca Cola a few times a day. I think that is a matter that each and every side of this argument can agree on.

 

It saves all that second guessing and psycho-analizing opposing sides.

 

Only problem is, what do the chemical companies do with all that flouride they have to spare?

[ballaughbiker]

Only problem is, what do the chemical companies do with all that flouride they have to spare?

 

Are you seriously suggesting that the reason for fluoridating water is to get rid of a byproduct? Have I understood you correctly or was it meant to be humourous?

 

I agree with your point on diet however but in real life its never going to happen, just in the same way as people will continue smoking

[%age]

They won't continue smoking. Not like they used to anyway.

 

They're being educated into the error of their ways now.

 

To draw a parallel, tell all mums that they can allow their kids as much fizzy drinks as they wish and if they don't want to brush their teeth at night - no problems. But they pay for the dental bills out of their tattoo/cigarette money.

[Chinahand]

On average there may be 2.25, 1 or 0.5 fewer (I think 0.5 is what York reported as indicative), but that statistics doesn't mean it's a proven treatment across the board. (I think York criticised the studies as poor and also noted that it was inconclusive - if I remember).

 

You are being over harsh saying the studies USED were of poor quality.

 

From the executive summary:

 

214 studies met full inclusion criteria for one or more of the objectives. No randomised

controlled trials of the effects of water fluoridation were found. The study designs used

included 45 ‘before and after’ studies, 102 cross-sectional studies, 47 ecological studies, 13

cohort (prospective or retrospective) studies and 7 case-control studies. Several studies were

reported in multiple papers over a number of years.

 

The York report used 26 studies to obtain its statistics on caries reduction - all the other studes were rejected as they did not reach the research quality required. Only studies of moderate quality and above could be included and they stated all the studies examined were of moderate quality level B. These studies were mainly before and after studies. They also examined some studies which looked at what happened when fluoride was removed from an area and found similar effects in reverse.

 

The results showed a reduction of cavities between 0.5 and 4.4 per person; median 2.25.

 

This I think is the only statistically significant result the York report found. Both fluorosis and zero cavities included 0 at 95% confidence levels when comparing low fluoride with 1.0ppm.

 

Skeddan if you are being honest in your acceptance of science this is a robust statistically valid result. Using the ranges we can say with 95% confidence that between 40,000 and 352,000 cavities will be saved in a generation by fluoridating the IOM's water and these saving will continue in perpetuity.

 

Currently the IOM has poor tooth quality - I would be willing to speculate that this will mean that the effect will more likely be above the average than below, but accept this is speculation.

 

26 studies of moderate quality, mainly examining the before and after affects are not junk science.

 

When you say its "not a proven treatment across the board" I feel you are grasping at the tails of the distribution. That is dangerously close to cherry picking.

 

The IOM is not some exceptional place - it is a standard British Islands population, with poor dental hygene, and probable dental inequality.

 

This makes it high on the list of places likely to significantly benefit from fluorination.

 

You will probably say at what cost, but you should not ignore the costs of the current situation.

 

I am all in favour of increased education in dental hygene, increased use of fluoride tooth paste etc.

 

But the savings apparant from fluoridation are maintained even with the historical increase in brushing using fluoride toothpaste etc:

 

From the excetutive summary:

 

In those studies completed after 1974, a beneficial effect of water fluoridation was still evident

in spite of the assumed exposure to non-water fluoride in the populations studied. The metaregression

conducted for Objective 1 confirmed this finding.

[Skeddan]

Fluoridation is such a clear variable to data mine on I find it inconceivable that it hasn't been included in similar studies to the above - it has been done with Bone Cancer why not in other areas

Oops - I noticed an error in what I posted earlier. I said wF was a good variable but other data was poor. Saying F is a clear variable to data mine is not actually true.

 

Point is that 1ppm or whatever in water supply does not give clear and accurate data on the amount of F ingested by a person. Some may get X mg p.a. others living in the same area may get 10 times this amount.

 

 

 

Besides ethical issues, Ballaughbikers comments and comments in 'Champix' thread made me realise I'd made an unwarranted assumption in considering the case against was solid. I am now thinking there could after all be a case for F - ethical issues aside.

 

The error I made was in mistakenly assuming potential outcomes / health hazards / risks, would have negative impact if they eventuated. Caries etc. is a problem which IoMG and populace considers to be an issue. If all the risks which might eventuate were of little consequence to govt, economy, etc., then there is a good case for wF.

 

So if there were a few dozen more sterility problems, a few dozen more with dyslexia and couple of hundred with psychological disabilities, would that actually matter? The error is to think it would. Depending on the problems themselves, possibly it wouldn't. This could simply be ignored - i.e. no special services or the like need to be provided - fertility treatment would have to be sought privately, the rest could be ignored. No public care or treatment need be provided for these kinds of problems. i.e. Let them rot.

 

Now the case for wF becomes quite good. It would only be a public health disaster if these normally very costly problems had to be dealt with. They don't. They can simply be ignored and swept under the carpet as it were. If you or your children happen to get struck by one of these conditions, well just tough - that's the luck of the draw that goes with addressing the issue of caries which it is a matter of policy to treat and not ignore.

 

Given such policy choices with high value put on treating caries, no value put on problems like sterility mental health issues etc. I'm persuaded that the case for wF might be very much stronger that I took it to be (ethical considerations aside).

 

In case anyone thinks I am being sarcastic or the like, I'm really not. It is a simple matter of accounting. If there is no reason to care about a given consequence it doesn't weigh against wF. Whether or not to care about such matters is a policy decision - i.e. up to govt and people. (Just as might decide not to provide expensive care to the elderly or let people starve on streets rather than provide welfare). I was imposing my own views on the matter rather than making an objective analysis. I stand corrected. The values of the IoM electorate may not be the 'caring' ones I had implicitly assumed - in which case wF comes out well.

[Chinahand]

Fluoridation is such a clear variable to data mine on I find it inconceivable that it hasn't been included in similar studies to the above - it has been done with Bone Cancer why not in other areas

Oops - I noticed an error in what I posted earlier. I said wF was a good variable but other data was poor. Saying F is a clear variable to data mine is not actually true.

 

Point is that 1ppm or whatever in water supply does not give clear and accurate data on the amount of F ingested by a person. Some may get X mg p.a. others living in the same area may get 10 times this amount.

 

 

But the point is we are discussing the narrow issue of wF (as you call it), not the general issue of F!

 

Adding wF will INCREASE the fluoride exposer of an area. The issue is does this addition have any measurable effects to the good and to the bad.

 

The rest of your post confirms to me you are one of the most unusual posters I have come across - you inhabit a very unusual world - Oscar Wilde springs to mind - the cost of everything and the value of nothing, but there you go!

[Lonan3]

Personally, I don't give a stuff about scientific explanations about why its good or bad for us! I am sick of the state trying to make those kind of decisions on our behalf. I do not want unnecessary chemicals added to my drinking water.

If we have a problem with our teeth and gums its because we have a shite dental service on the island that is only concerned with extracting money from our wallets and filling practitioners pockets with loads of money.

If the government want to spend some of our money on improving the dental health of the residents, let them start by improving the number and quality of NHS dental practitioners.

[VinnieK]

I genuinely don't understand why putting chlorine in your water to stop people getting E coli infections is any different than putting fluoride in to stop cavities. Both are medical conditions being treated by a water additive. An alternative would be not putting in the chlorine and asking everyone to boil their water before drinking it, filtering it or whatever.

 

Are people really saying we should do this based on the precautionary principle.

 

Because E Coli leads to quite serious illness, getting a filling is a comparitively piffling affair. I think your analogy is massively flawed. Asking people to filter/boil, or otherwise treat their drinking water themselves is a considerable inconvenience and quite rightly falls under the mandate the state has to perform large scale public works that the average individual cannot perform for themselves. Prevention of tooth decay is, however, a trivial affair for the individual and consists of little more than maintaining good oral hygiene and a sensible diet.

 

I'm certainly not anti-fluoride in the sense of many who campaign against its addition to our water supply, but, nevertheless, the argument that it's the individual's responsibility to care for the teeth in their head is a powerful one (given that it's well within the individual's ability to do), and a reasonable objection.

[ballaughbiker]

Skeddan - good post. I would not want to, and have no right to impose my views on others and this is why I have become an 'anti' and nothing will change that. However I am convinced that fluoridation of the water would significantly benefit the kids whose lives will be affected by this disease in the same way mine has.

 

In the early 90s I was involved with Nobles anaesthetists who were gassing very young children to enable rotten teeth to be removed. This is a significant procedure and not without its risks. I was amazed how many there were in the twice weekly sessions and how many teeth required extraction in children sometimes younger than 5. I think the majority were very traumatised by this procedure as well as suffering the other obvious disadvantages of early tooth loss. I have no knowledge of current numbers but I doubt if much has really changed in 15 years.

 

In my opinion, water fluoridation would start to significantly reduce this problem although it would take time (10 years plus) but the benefits would last for that person's lifetime. They would be spared some of the trauma, discomfort, cost and potential associated health effects related to tooth repair. I made sure my son (now 18) had fluoride drops from being a baby and he has no fillings at all. I will of course never know if that would have been the case had he not had them but following my experiences, I wanted to make sure.

 

I would agree that all rampant tooth decay is the fault of the sufferer or their parents. No matter how much education is provided there will always be a hardcore in any population who will suffer throughout their lifetime. Apparently the Island has more than its fair share of these and there is evidence to confirm this. Although both my parents left school at 16 and did very ordinary jobs they were certainly not 'thick' or uncaring and I still ended up with a mouthful of possibly very toxic metals and wouldn't have if I had drunk fluoridated water. It's very easy to say its their fault, tough! but I hope we are a bit more of a caring society than that.

 

Despite being on the same side as saveourwater and others(he doesn't think so however) I have been appalled at some of the cherry picked, unscientific, scare mongering spin that has been dished out by some antis. Yes it's their opinion, which they have every right to it just as I have but I think they've worried lots of people unecessarily who will now say no "just in case". Although the dosage at 0.75 ppm will mean very different individual dosages this has been the case since time was in naturally fluoridated areas. There are no provable ill effects at this level. Finally, I would never be in favour of adding anything further to our water in any case if it was not found naturally occuring in other areas of the British Isles. For this reason, I do not believe added fluoride ion at 0.75 ppm is a medication, forced or otherwise.

[Lost Login]

Personally, I don't give a stuff about scientific explanations about why its good or bad for us! I am sick of the state trying to make those kind of decisions on our behalf.

 

Fair enough so you would be in favour of the relaxation of legislation on all food stuffs and drinks and what can be included in them. Personally I am happy for the experts with the scientific facts at their finger tips to make the decisions on my behlaf as I know that the beer or water I drink, food that I eat etc will be of a certain standard.

[ballaughbiker]

we have a shite dental service on the island that is only concerned with extracting money from our wallets and filling practitioners pockets with loads of money

 

Hmmm, I haven't had that experience. It sounds like you ought to become a dentist if that's how it is.....

[Chinahand]

Question to Ballaughbiker - you personally are against fluoridation, but that is a different question than whether it should be government policy.

 

This is an unusual, but not that uncommon, situation politicians are faced with - their job is to make decisions for the "good" of the community they represent (whatever that means!!) and it is usually agreed that this should be irrespective of their own biases.

 

This can mean ignoring their own personal views and implementing a policy they disaprove of, but where they can see the benefits.

 

I fully admit going "If I ignored my own preferences I would do it" sounds barmy. I suppose a better attempt is - ignoring the diverse philosophical or moral concerns (which are so diverse in a given constituencey I should not take my own beliefs as necessarily representative) at a technical level does this policy have utility.

 

This is the type of advice an expert technical panel would be expected to provide or whatever.

 

I've spent too many hours repeatedly reguritating the science I have found on this topic from the BMA, CDC, the WHO, British Dental Foundation etc etc etc.

 

My own feelings is that doing this would have measurable benefits and unmeasurable adverse consequences. It is a given that as the adverse consequences are unmeasurable their social costs are also negligable - this is where I totally disagree with Skeddan who seems to be saying we should ignore genuine costs, simply because WE do not have to pay for them.

 

I am sure the polititians of Gateshead are much relieved that they do not have to make any decision on this - this substance is naturally in the water of their constituents, no one has to approve adding it.

 

The Islands polititians are very poor decision makers, they tend to provaracate and too easily allow a vocal minority dicatate policy to the majority. I am reasonably certain Fluoridation is a non starter because of this.

 

I've always said I'm neutral on the issue - I hope I have the wherewithal to ensure my family will have good dental hygene and exposure to the correct levels of fluoride.

 

On a societal/political level I suppose I wish the Island had naturally fluorinated water or had done it in the 1950s. If this had been done I cannot see their being multiple threads etc debating forced medication.

 

I personally think FAR too much is being made of this issue, mainly due to the despicable tactics of those distorting the evidence.

 

The fact that a significant proportion of our population has poor dentition, would benefit from fluoridation, with no significant measurable downsides for myself etc isn't such an issue for me to do more than write some posts on an internet forum! But I am troubled by the claims that the ethics and morality of this issue are all on the sides of the anti's.