GENRE: Email letter
TO: Rick Paulas
AUTHOR: Daniel Z
DATE SENT: Wed, May 29, 2013 at 6:50 AM
TITLE: Attn: Rick Paulas, Re: Your latest article (in Food Rant)
STATUS: Awaiting response.
UPDATES: Please post all updates and comments in the LEAVE A REPLY section below.
References attached as PDF – at bottom of letter
I have just read your article (1). Whilst I appreciate that you took the time to cover the issue, there are a few points I would like to make in response.
a) You mention Dr. H. Trendley Dean’s work, but you neglect to include any critical analyses, which are freely available (2).
b) You state, “the positive benefits of water fluoridation are well known and scientifically proven.” But the truth is not so simple. When the University of York, for instance, examined the evidence on water fluoridation, the research team were surprised by its general weakness. In their own words, “Given the level of interest surrounding the issue of public water fluoridation, it is surprising to find that little high quality research has been undertaken” (3). Three years later they reiterated, “We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide” (4). In 2007, an article appeared in the British Medical Journal, noting that “the [York] reviewers were surprised by the poor quality of the evidence and the uncertainty surrounding the beneficial and adverse effects of fluoridation” (5). Building on this acknowledgement, in 2012, a leading public health researcher from the University of Western Australia wrote in the journal Public Health Ethics, “It would appear that the effectiveness of artiﬁcial water ﬂuoridation in the 21st century is at best questionable” (6). Even the leading opponents of fluoridation have expressed surprise at the poor quality of the supposed “evidence” for the “benefits” of water fluoridation, and have accordingly offered public critiques to draw attention to this fact (7-8).
c) You write, “The CDC called it one of their top ten Great Public Health Achievements by the U.S. in the last century.” That’s correct, but did you examine the quality of the paper upon which this statement is based? I share the following for your consideration: “Not a day goes by without someone in the world citing the CDC’s statement that fluoridation is “One of the top ten public health achievements of the 20th Century.” Those that cite this probably have no idea how incredibly poor the analysis was that supported this statement. The report was not externally peer reviewed, was six years out of date on health studies and the graphical evidence it offered to support the effectiveness of fluoridation was laughable and easily refuted” (9).
d) You mention that “a small cosmetic defect is possible” (i.e. dental fluorosis). However, dental fluorosis is caused by systemic overexposure to fluoride. In simple terms, fluoride has damaged the tooth-forming cells by an internal mechanism, hence it is a biomarker of exposure (10). According to a leading New Zealand dental researcher, “Common sense should tell us that if a poison circulating in a child’s body can damage the tooth-forming cells, then other harm also is likely” (11). When you look at this “cosmetic” result, you are seeing just that – the end result of damage – and when this is dismissed without full investigation, systemic health effects may be overlooked. I suggest you shift your perception of dental fluorosis from focusing on the mere result of the damage, towards a greater respect for the mechanism of damage.
e) You make the point that, “there’s an argument that it may hurt salmon populations”, although you should not have stopped there. According to the Canadian Water Quality Guidelines for Inorganic Fluorides, “Inorganic fluorides are a major bi-product of the phosphate fertilizer industry… Inorganic fluorides act as enzyme inhibitors and have wide-ranging effects” (12). 0.12mg/L is the protective limit set for aquatic life, which is much lower than levels used in artificial fluoridation (0.7mg/L–1.2mg/L). You could have gone much further than just discussing Salmon, in isolation.
f) You claim, “So while there’s a possibility that fluoride has a few negative side effects — and you just have look at those initial kids in early 1900s Colorado with the gross brown teeth to realize too much fluoride is a bad thing — these are all probably secondary to the big reason people hate fluoridation: They don’t like being told what to do.” Actually, if you had read the NRC Report’s full range of research recommendations (13), understood the full implications of these health concerns and knowledge gaps in relation to margin of safety (14), and also been aware of the misrepresentations of this report, as highlighted by its authors (15), then perhaps you would not dismiss peoples’ concerns so lightly.
g) “Most are already getting enough fluoride from toothpaste and other items to protect their teeth.” You could have also mentioned that fluoride works topically, not systemically (16), which adds to the argument that drinking it is unnecessary (17). As noted by Cheng et al. (2007), in regard to water fluoridation, “an uncontrollable dose of fluoride would be given for up to a lifetime, regardless of the risk of caries, and many people would not benefit” (5). It is important to make make a distinction between concentration and dose, the latter of which cannot be controlled (18). Range of intake varies widely, as acknowledged by the National Research Council (19).
My suggestion – the next time you cover this issue, delve much deeper. Extensive groundwork has been done, you just need to read it (20). If you do so, you will find merit in all the points I have made above, and much more.
If you need anything further by way of clarifications, additional information, or author contact details, just ask.
Daniel Z, BA, MA