GUEST POST: Ken Perrott – Making sense of the fluoride debate

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John Minto’s blog article The science is not “settled” on the benefits of fluoridation of water supplies is timely. For better or worse, fluoridation is in the news again and we better discuss it. John is in essence, reporting a talk by US anti-fluoride activist Paul Connett. I didn’t attend the meeting John did but the article is a good summary of the arguments Paul advanced in our recent on-line exchange (see Fluoride Debate).

I disagree with Connett’s arguments but welcome John’s summary precisely because it enables us to discuss them here. I am not really partisan on the fluoridation issue – but am partisan when it comes to science. That is my main interest in this and similar controversies (such as climate change and evolutionary science). I don’t like to see science misrepresented and distorted and that is an issue here with Paul Connett’s arguments.

Let me stress first that I admire John personally but think he is mistaken about the fluoridation issue. I am sure John will take my comments here in good faith and I hope he will be happy to discuss this issue further.

Settling in with science

First, I take issue with John’s title – because it’s along the lines of the “when are you going to stop beating your wife” question. Who exactly is claiming the science is settled? Some readers may point to Sir Peter Gluckman, the Prime Minister’s Chief Science Advisor, but they would be wrong. You can check yourself by reading his article  What is in the water? where he wrote:

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“The science of fluoride in water is effectively settled. It has been one of the most thoroughly worked questions in public health science over some decades. There is a voluminous scientific and lay literature that needs to be considered.” [My emphasis]

That word “effectively” makes a world of difference. Yes, I know it is easy to miss (I did myself at first – see Poisoning the well with a caricature of science) but I think anti-fluoride activist promotion of this misinformation (the science is settled) is intentional, not accidental.

In practice scientists want to qualify every statement they make, one of the reasons they are often poor communicators. They are never totally certain. It is more about probabilities and degree of certainty – not absolute knowledge. Scientific knowledge is always provisional, subject to improvement (sometimes even change) with time and more data. That is just the way it is for a process building knowledge by relying on information from the real world.

You want absolute certainty – go see a preacher, not a scientist. But we all know that scientific knowledge, for all its incompleteness, works – and we wouldn’t be where we are today without it.

Science is never settled – but often the knowledge is good enough for governments and society to rely on for decisions and policies. Often, and on many subjects, the science is effectively settled.

We humans are used to working with that level of probability and degree of certainty. Yes, we sometimes get it wrong but we learn from our mistakes and move on. More often we get it right and make progress. In fact, if we always waited around until our knowledge was completely “settled,” until we were absolutely sure of things, we would have become extinct very early on because that is just a recipe for doing nothing. Cynical use of a precautionary principle to deny action in such cases is irresponsible. Especially when the action would reduce pain and suffering or improve our health.

There is plenty of empirical evidence for the beneficial role of fluoride in bones and teeth. Fluoridation of drinking water, salt and milk have been shown effective. The only confirmed downside so far is an increased risk of very mild dental fluorosis. The science behind fluoridation is effectively settled.

Yes, there is still plenty of scope for improving our knowledge. There are areas which are worth researching further. It is wise to also keep abreast of the changing dietary froms of fluoride intake. We know that excessive intake has negative health effects so it is important regulatory standards are maintained at appropriate levels. In New Zealand we have a body which monitors research and disseminates current findings thought the health community – the National Fluoridation Information Service. (Beware, though, of the New Zealand Fluoridation Information Service – it is an astroturf organisation set up by local anti-fluoride activists – see Anti-fluoridationist astro-turfing and media manipulation).

There is ongoing research here and elsewhere. Don’t believe anyone who suggests research on the role of fluoride has somehow stopped – it hasn’t.

Connett’s problem

John seems impressed by Paul’s presentation and arguments. I am not so impressed. My online exchange with Paul left me with the impression that he works hard in his retirement trawling the literature to find anything he can use to raise doubt about fluoridation and the effectiveness of fluoride for oral health. He starts with pre-conceived conclusions – he is acting as a political activist, not an objective scientist. (In fact, Paul has not done any original research on fluoride or fluoridation and has no credible scientific publication on the subject).

Confirmation bias is only human – we all do it. One has to work hard to overcome it but political activism doesn’t help. Paul doesn’t work in a scientific community, he is executive Director of the Fluoride Action Network (FAN). I can understand the effect on Paul of being surrounded by people whose group thinking encourages this bias – unlike a scientific community where peers routinely critically assess and comment on one’s ideas and work. It is much harder for a political activist, especially a leader, to change his or her ideas, or admit mistakes – to follow the evidence – than it is for a working scientist.

Connett’s ideological committment is wider than opposition to fluoridation. His FAN is allied with anti-vaccination and anti-GM activists through the Health Liberty Network. Similarly in New Zealand the New Health New Zealand/New Zealand Health Trust, the anti-fluoride organisation which took the High Court action to stop fluoridation in south Taranaki,  also campaigns against vaccinations, genetic engineering and chemtrails (see Who is funding anti-fluoridation High Court action? ). It is basically a corporate-funded political lobbying organisation working to promote the interests of the industry selling “natural health products” and “health care products, devices, practices and services within New Zealand.” Incredibly it has charity status so we are all subsiding its activity through our taxes.

Critical and intelligent analysis required

“Skeptical scrutiny is the means, in both science and religion, by which deep thoughts can be winnowed from deep nonsense.” – Carl Sagan

It is tempting to just accept arguments from our “own side” in these sorts of debates – and most protagonists do. Confirmation bias in action. But a proper understanding of the scientific debate in these issues requires us to approach questions intelligently. Recognise the complexity of the research and published literature. Recognise the inevitable confirmation bias and cherry picking going on. We should attempt to critically consider all the available information as far as practical.

With this in mind lets look at some the arguments that impressed John.

Is fluoridation effective?

It is not ethically possible to do the ideal double blind, controlled experiment to answer that question for humans as we might with mice.  So conclusions must be drawn from intelligent and critical examination of existing information. Unfortunately, cherry-pickers select data ignoring details like actual sources for fluoride intake, residential status, movement, education,  alternative and new dental treatments, etc. This can be why some poeple actually believe fluoride is ineffective.

In Cherry picking fluoridation data I used the NZ data from the Ministry of Health’s database to produce the graph below . This dataset relies on dental clinic location, not the child’s residential address, to decide on fluoridation status. So it is not the ideal “experiment.”

MEAN DECAYED, MISSING AND FILLED TEETH

Screen Shot 2014-02-11 at 5.30.48 pm

However, the plots clearly show fluoridation is effective but appears to decline in effectiveness in recent years – since about 2007. While some anti-fluoride activists argue that this shows fluoride is not effective the more rational explanation is that we are seeing the conversion of the school dental clinic to a “hub and spoke model“. This leads to more mixing of children from different fluoridated and unfluoridated areas.

Similarly, there is the problem of variability in the data due to low numbers and/or varaibility in dental practices. It is easy to cherry-pick the data from selected regions or years to produce figures showing fluoridation is ineffective or even that non-fluoridated children have less tooth decay! That misrepresentation by anti-fluoride activists is rife among anti-fluoridation activists in New zealand.

In todays modern world with extensive movement of individuals, multiple sources of dietary fluoride and availabilty of dental treatments it is important to analyse claims carefully. The comments by the author of a scientific paper I read recently are especially relevant:

“The preventive impact of water fluoridation is of necessity different in a place with comprehensive, widely accessible dental services, and which also enjoys the benefits of various sources of fluoride that contribute to substantial overall exposure for most children. .  .  . the role of water fluoridation in supporting good oral health must be weighed against other measures that may achieve similar success but at a higher cost, such as the widespread utilization of sealants. Moreover, it is unwise to resort to restorative interventions to meet the challenge of dental decay when a primary prevention measure such as water fluoridation preserves the integrity of dental tissues overall, is less expensive, and is more effective.”

Breast milk and bottle-fed infants

John has accepted Paul’s argument against fluoride based on the low concentrations in breast milk. But that is the naturalistic fallacy – “because it occurs in nature it must be right.” The fallacy becomes a bit more obvious when we consider that breast milk is also deficient in other trace elements like  zinc, selenium and iron. John is quite wrong to conclude “its clear that bottle-fed babies ar being unnecessarily exposed to potential negative effects from ingesting fluoride.”

Mind you, there is room for concern by over-cautious parents. Excessive fluoride intake by babies can lead to very mild dental fluorosis. It is less of an issue than the far worse problems of tooth decay but health authorities understand parental concerns. Because there is the possibility that infants fed formula made from fluoridated water can on occasion take in an excessive amount of fluoride, health authorities advise concerned parents to use formula made up with unfluoridated water some of the time to reduce intake.

Of course, anti-fluoride activists misquote this advise to imply that formula made with flouridated water is dangerous for infants. It isn’t.

Hastings project

John should have taken Paul Connett’s story on this with a large grain of salt. Connett is being unprofessional and biased in claiming this project was fraudulent. it is a serious charge and he should know better.

Connett takes an isolated out-of-context letter to argue his case and ignores completely the published reports from the project (Ludwig and Ludwig, et al. 1958, 1959, 1962, 1963, 1965, 1971). Reasons for abandonment of Napier as a control are clearly explained in published papers (Ludwig et al (1960), Ludwig & Healy (1962) and Healy et al (1962)). In direct contrast to the claim John  reports from Connett that benefits of fluoridation were not seen 8 years after the beginning of the project in 1954/1955 the 1958 paper concluded “fluoridation has produced a substantial reduction in the prevalence of dental caries in children aged six, seven and eight years.” The subsequent papers had similar conclusions.

I discussed this in more detail in my exchange with Connett and suggest John read my article for a list of these publications for him to check out for his own satisfaction. In that article I also plotted some of the data using different starting times to show any changes in dental practice at the beginning of the project did not have an over-riding influence on the conclusions.

A long-term trial involving large numbers of people, like the Hastings project, inevitably has all sorts of issues and problems. It is irresponsible to leap on an individual problem and shout “fraud.” Frankly, considering the seriousness of such a charge in the scientific community I think Connett’s behaviour is unethical.

Topical misrepresentations

Anti-fluoride activists often distort the scientific understanding of the role of fluoride in limiting tooth decay. They use current understanding of the surface mechanism involved in inhibiting the initiation of decay in existing teeth to claim ingested fluoride is useless – or even that fluoride must be applied topically to be effective! Fluoridated water and food helps support the necessary fluoride concentrations in saliva and surface biofilms supplementing the less frequent brushing with fluoridated toothpaste (see Topical confusion persists). Fluoride also helps strengthen developing teeth before eruption. Data shows that there is a beneficial effect of systemic fluoride which lasts to advanced age. The surface and systemic actions of fluoride are not exclusive but complimentary.

But let’s not forget about the beneficial role of optimum amounts of ingested fluoride to bones.

IQ studies

Paul Connett makes mountains out of the mole hills of a few poor quality studies reporting a decline in children’s IQ correlated with high concentrations of fluoride in well water. These studies ignored confounding factors like heavy metal contamination, family education, schooling and incidence of breast-feeding (known to influence IQ). Reviewers of these studies acknowledge they are not relevant to the fluoridation issue – and we all know the danger of trying to infer cause from correlation. (See figure below).

Screen Shot 2014-02-11 at 5.31.46 pm

I agree with John – the reporting of such studies (these got wide attention in 2012) should be  a “spur for higher quality studies to confirm/adjust/reject these findings.” He will no doubt be pleased that a very recent New Zealand study, using better data, has shown no effect of fluoridation on children’s IQ, but the expected positive effect of family education and breast-feeding.

One of Paul Connett’s “tricks” is to imply that todays researchers ignore such studies. I guess he is playing on the conspiracy theory mentality.

As for stopping fluoridation “in the meantime” to follow a “precautionary principle” – should we stop the sale of organic produce because of its observed correlation with autism – that data is far more convincing than the poor quality IQ data? Of course not. We need to approach such reports and data more intelligently and critically.

Scotland and Europe

Paul Connett is hardly original in advocating tooth brushing campaigns to fight tooth decay – we do that here to. But health authorities generally see these as complimentary to, not alternatives to, health policies like fluoridation of water, salt or milk, and dental applications involving fluoride. The Scottish ChildSmile programme that impressed John, for example, includes this target:

“At least 60% of 3 and 4 year old children in each SIMD quintile to receive at least two applications of fluoride varnish per year by March 2014.”

Connett is disingenuous to use this programme as “evidence” fluoride is not effective.

He is similarly disingenuous to quote cherry-picked studies showing no increase in tooth decay after cessation of water fluoridation as “proof” of ineffectiveness when the same studies reported substituted programmes of fluoride mouth rinses, salt and milk fluoridation and fluoride dental treatments. And, yes, most of Europe does not fluoridate it’s drinking water (for a range of reasons like high natural concentrations of fluoride, unsuitability of the water reticulation systems, etc.), but again alternative methods of fluoride delivery such as fluoridated salt and dental treatments are common.

Dispassionate look or worry-mongering?

John describes his approach, and presumably that of Connett’s as “dispassionate.” I disagree. Connett, especially, is purposely attempting to promote doubt about the science by cherry-picking and misrepresenting it. His activist organisation FAN and its New Zealand branch Fluoride Action Network of NZ (FANNZ) promotes this doubt. Many, if not most, of his supporters are ideologically driven and are often active on similar issues like anti-vaccination and anti-chemtrail campaigns. Some of them get right to what they see as the heart of the matter and rave on about Agenda 21 and the use of fluoride to keep us “sheeples” docile.

But things are never as simple as the picture presented by conspiracy theorists and ideologically motivated political activists. We should be wary about simply accepting their arguments, no matter how convincing they appear.

With subjects as complex as human health and the often contradictory appearance of the scientific literature we cannot afford to be naive. We should alway approach these claims critically and intelligently. And check them out for ourselves by considering all the available evidence.

 

Ken Perrott is the respected editor of very excellent open parachute on SciBlog. Sciblogs is an initiative of the Science Media Centre, an independent source of expert comment and information for journalists covering science and technology in New Zealand.

73 COMMENTS

  1. Now watch the PRATTS dealt with in John’s post and comment stream get regurgitated by the same authors in this one.

  2. A comment before the misinformation starts coming in.

    There is not one major health organizations that is against fluoridation:
    https://www.facebook.com/notes/making-sense-of-fluoride/what-do-the-experts-say/549093185129030
    http://www.ilikemyteeth.org/wp-content/uploads/2011/03/RespectedOrgs-noPics_v2a.pdf

    It isn’t classed as a medicine:
    https://www.facebook.com/notes/making-sense-of-fluoride/why-fluoride-water-is-not-classed-as-a-medicine-under-the-medicines-act-medsafe/563797943658554

    It is a beneficial trace element:
    https://www.facebook.com/photo.php?fbid=584604234911258

    This is all the ways that fluoridation helps:
    https://www.facebook.com/photo.php?fbid=650523068319374

    It does not weaken bones but can in fact strengthen them:
    Effects of treatment with fluoride on bone mineral density and fracture risk–a meta-analysis
    http://www.ncbi.nlm.nih.gov/pubmed/17701094
    “Fluoride treatment increases spine and hip BMD, depending on treatment duration. Overall there was no effect on hip or spine fracture risk. However, in subgroup analyses a low fluoride dose (< or =20 mg/day of fluoride equivalents) was associated with a significant reduction in fracture risk."

    Israel did not ban water fluoridation:
    https://www.facebook.com/photo.php?fbid=655804924457855

    Ignore the poor studies instead go straight to the systematic review. A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Which means it removes the bias from conclusions.

    Here is 4 systematic reviews, which shows the efficacy and safety of water fluoridation:

    Griffin, S. O., Regnier, E., Griffin, P. M., & Huntley, V. (2007). Effectiveness of fluoride in preventing caries in adults. Journal of Dental Research, 86(5), 410-415.
    http://www.ncbi.nlm.nih.gov/pubmed/17452559

    Yeung, C. A. (2008). A systematic review of the efficacy and safety of fluoridation. Evidence-based dentistry, 9(2), 39-43.
    http://www.nhmrc.gov.au/guidelines/publications/eh41

    Parnell, C., Whelton, H., & O’Mullane, D. (2009). Water fluoridation. European Archives of Paediatric Dentistry, 10(3), 141-148.
    http://link.springer.com/article/10.1007/BF03262675

    Rugg-Gunn, A. J., & Do, L. (2012). Effectiveness of water fluoridation in caries prevention. Community Dentistry and Oral Epidemiology, 40(s2), 55-64.
    http://www.ncbi.nlm.nih.gov/pubmed/22998306

    More peer reviewed papers and their conclusions if you are interest:
    https://www.facebook.com/notes/making-sense-of-fluoride/peer-reviewed-research-on-fluoride/549094861795529

  3. Great article but I think you’re wasting your time. You’re dealing with people who treat this as their religion. Facts won’t matter. Prepare for a wave of personal attacks and abuse.

    • It’s generalizations like this that aren’t really producing anything valuable. There are a large cross section of individuals who have varying reasons for opposing fluoridation. I don’t generalize all pro-fluoridation advocates – unless you’re telling me that you’re all hired by the government and spreading disinformation to protect your jobs? 😛

  4. The flouridation debate is one of the few areas where left leaning and right leaning people work together in complete harmony against the mindless stupidity that is enforced water flouridation. I am very happy to work with anyone of any political persuasion on this topic.

    • The chlorination debate is one of the few areas where left leaning and right leaning people work together in complete harmony against the mindless stupidity that is enforced water chlorination. I am very happy to work with anyone of any political persuasion on this topic.

      Science denial: Only the labels change.

  5. Some areas of the world have been artificially fluoridated for over 50 years, others have never been fluoridated. Given the sample size and the length of time, if fluoride caused the many maladies the anti-fluoride brigade say it does then we would see statistical variance in these maladies of these fluoridated communities vs. non-fluoridated.

    We don’t see this. Fluoridated communities have the same IQ rates, same cancer rates and the same health concerns as non-fluoridated communities. There is no variance. Ask an anti-fluoride person to show you the harm – they can’t do it.

      • Have a read of the Fluoride Debate I had with Paul Connett http://openparachute.wordpress.com/fluoride-debate/.

        He used that graph several times. I pointed out it was deceptive by taking the Irish data and showing that it included both fluoridated and non-fluoridated data together. When plotted separately they showed a clear beneficial effect of fluoride.

        So I find the use of that figure disingenuous. No one denies there are a number of factors involved in the improvement of oral health – but that graph cannot “prove” that fluoride is ineffective.

        Interestingly, in the debate Paul kept avoiding the Irish graph I produced pretending not to understand. Only in his last article did he concede what it showed – but of course discussed it no further. I have no doubt he will continue to use the graph in the same old way – I think that dishonest.

  6. Great article Ken. Sanity prevails, scientific facts should never be an ideological issue.

    If the left can’t accept the science around fluoridation how can we ever rebut the climate-change deniers on the right?

    • @ Tamati – this is not a Left-Right argument. You will pro and anti flouride folk on both the Left and the Right.

      I’m on the Left and I’m pro-flouridation, until good, solid, peer-reviewed evidence points to the contrary. Then I will change my mind.

      • From my research i’d agree with both of you, though in the context of New Zealand you’ll find the overwhelming majority are from the hard left so in the context of this blog Tamati makes an excellent point.

        It’s generally a different story across the ditch though, much of the anti-f noise is coming from rural gun loving government hating libertarians.

        For someone that studies ideology it’s a fascinating contrast.

    • Climate deniers don’t like it when I hijack their arguments with a simple label change and employ it in the use of anti-vaccination or anti-flouridation.

      Nor do anti-fluoridationists appreciate it when I take their rationalizations, mess with the labels and put it in the mouth of a climate denier.

      The methodology of a science denier is the same. The way they disseminate their talking points is the same. It has to be. All the various myriad science denier communities have the same problem. They have rejected the mainstream and all the work it represents.
      So they all independently reach for the same inevitable solutions.
      Aging contrarians, cherry picking, speaking tours in a church basements, vanity press books, blogs, PRATT’s, conspiracy theories, anomoly hunting and more blogs.
      It’s always the same.

      If the arguments you use and the tactics you use (with a simple label change) slot in nicely with the climate deniers out there, then you are no better that them.
      If you use an argument then you endorse it.
      If you reject the scientific consensus on “A” then you don’t get to complain when they reject the scientific consensus on “B” using your own methodology.

  7. Great article Ken, pity the anti’s will skip to the end (tl:dr) and just load up personal abuse.

    Here’s hoping John has courage to address his misrepresentations and set the record straight, the oral health care of New Zealand’s most disadvantaged children should not be a political football.

  8. Thanks for keeping the debate going Ken. The MOH and DHB have a policy of never discussing fluoridation in public so good on you and the two or three other Fluoride pushing activists for keeping this issue in the public eye.

    For the record here is letter that Professor Connett’s talks of in his presentation:

    The “smoking gun” letter.

    This letter was obtained by Colquhoun who used the Official Information Act 1982 to obtain all the files pertaining to the Hastings-Napier trial from Department of Health files (1951-1973) now held in National Archives, Wellington. This letter from GH Leslie, the Director of the Division of Dental health of the NZ government, was found in those files and was reprinted in the paper by Colquhoun and Wilson (1999). The letter was written in 1962, some eight years into the ten-year Hastings-Napier trial. Here is the letter:

    12, October 1962
    Mr. Swann,

    I have delayed acknowledging receipt of Dr. Roche’s letter to you and replying to your minute in the hope that I would by now be able to give a positive reply to your enquiry. I still cannot.

    No one is more conscious than I am of the need for proof of the value of fluoridation in terms of reduced treatment. It is something which has been concerning me for a long time. It is only a matter of time before I will be asked questions and I must have an answer with meaning to a layman or I am going to be embarrassed and so is everyone else connected with fluoridation. But it is not easy to get. On the contrary it is proving extremely difficult. Mr. Espia is conferring with Mr. Bock and Mr. Ludwig and I am hopeful that in due course they will be able to make a practical suggestion.

    I will certainly not rest easily until a simple method has been devised to prove the equation fluoridation = less fillings

    (G.H. Leslie)
    Director
    Division of Dental Health

    Thanks again Ken.

    • Kane, thanks for your dutiful posting of the out of context letter I referred to. Now, as you seem to want to put information on the table, perhaps the references to the papers summarising the findings of the Hastings project should also be on the table.

      If you are genuinely interested in the truth you will no doubt now get hold of them and read them?

      Healy, W.B.; Ludwig, T.G.; Losee, F. L. (1961). Soils and dental caries in Hawke’s Bay, New Zealand. Soil Science, 92(6), 359–366.

      Ludwig, T. G. (1958). The Hastings Fluoridation project I. Dental effects between 1954 and 1957. New Zealand Dental Journal, 54, 165–172.

      Ludwig, T. G. (1959). The Hastings fluoridation project: II. Dental effects between 1954 and 1959. New Zealand Dental Journal, 55, 176–179.

      Ludwig, T. G. (1962). The Hastings fluoridation project III-Dental effects between 1954 and 1961. New Zealand Dental Journal, 58, 22–24.

      Ludwig, T. . (1963). Recent marine soils and resistance to dental caries . Australian Dental Journal, 109–113.

      Ludwig, T. G. (1965). The Hastings fluoridation project V- Dental effects between 1954 and 1964. New Zealand Dental Journal, 61, 175–179.

      Ludwig, T. G. (1971). Hastings fluoridation project VI-Dental effects between 1954 and 1970. New Zealand Dental Journal, 67, 155–160.

      Ludwig, T. G.; Healy, W. B.; Losee, F. L. (1960). An association between dental caries and certain soil conditions in New Zealand. Nature, 4726, 695–696.

      Ludwig, T.G.; Healy, W. B. (1962). The production and composition of vegetables in home gardens at Napier and Hastings. New Zealand Dental Journal, 58, 229–233.

      Ludwig, T.G.; Pearce, E. I. F. (1963). The Hastings fluoridation project IV – Dental effects between 1954 and 1963. New Zealand Dental Journal, 59, 298–301.

      • Thanks Ken. Great reading. Given you live in Hamilton, are a literal fountain of knowledge on fluoridation did you make a submission to the tribunal in Hamilton?

        You’ll note that the tribunal had all the main players for the Fluoride pushers. Whyman, Dumble, etc. Were you amongst this panel of experts that lost that debate?

        By the way have any of your Making Sense Fluoride pushing team attended any Professor Connett presentation? If so did they ask a question of him or are you hiding like the DHB and MOH?

        Thanks again Ken. The DHB and MOH strategy has been to keep a cone of silence on the fluoridation issue. I appreciate you defending this toxic waste. Someone has to.

        • Kane, I did attend one of the Fluoride Free meetings in Hamilton. But the chairman announced that he was not allowing questions from the floor so I left. No point relaly.

          As for the Hamilton Hearings – very few people were actually aware of them. Since I became aware I have noticed the anger from Hamiltonians and scientifically minded people has resulted in far more awareness and a desire to prevent such hijacking of councils in the future (as well as the referendum result which was a slap on the council’s hand).

          Consequently groups like Making Sense of Fluoride have formed – that can only be a good thing.

          However, Kane, as you are in to attacking me for not “asking question of ” or “debating” Paul Connett here is a proposal.

          I challenge you to a public discussion of the fluoride issue. What is yoiur response – yes or no?

          If you are prepared to have a public discussion we can take it form there and organise details.

          Put up or ….?

        • “By the way have any of your Making Sense Fluoride pushing team attended any Professor Connett presentation?”
          Pushing? Not so much, more for defending the science.
          But yes some of us did attend and we have a bit to say on that which we will post later on.

        • Kane, care to share with us how you knew about the Hamilton hearings? I notice that you made both a written submission and oral one so you must have been familiar with what was happening.

          1: Do you follow closely the decisions of the Hamilton City council, even though you don’t live here? Did you know where to go in what part of their basement to see the notice about the hearings.

          2; Or did you know because you are part of the fluoride action network and took part in organising people to make submissions (even provided them with the text of those submissions).

          Seems really strange to me that so many anti-fluoridationists knew all about the submission process even though many of them live elsewhere, even outside the country let alone Hamilton. Whereas ordinary citizens were oblivious.

  9. I must admit I am pleasantly surprised to see you take a much more unbiased take on this, Ken. A lot of the vitriol and spite that seems to emanate from this issue seems to overshadow the importance of the conflicts in science and the floating question mark that is fluoridation.

    I upvoted your comment KANE, it appears that it has come as a downvote (although this could be just a dash). A lot of anti-fluoride sympathisers are simply not happy with the MOH and DHB’s rather poor attempts to justify this practice to a understandably confused and unsure public. More effort needs to be put into this issue so we don’t end up with bias, we get all the facts, and we can make an informed decision. Until such a time I feel we should opt on the safer option – “If in doubt, keep it out.”

    • Considering the well documented doubt over organic produce, Logan, do you think we should use that slogan to demand that we ban sale of organic produce in NZ?.

      That graph I presented above looks pretty convincing – much more so than the evidence produced by anti-fluoridation activists.

      • Again, you mistake the crucial problem I have with fluoridation – the issue of choice. I don’t have to buy organic food if I believed in a correlative graph that you produced. Regardless of choice I will be subjected to fluoride in the water – because it’s everywhere.

        • “Again, you mistake the crucial problem I have with chlorine – the issue of choice. I don’t have to buy organic food if I believed in a correlative graph that you produced. Regardless of choice I will be subjected to chlorine in the water – because it’s everywhere.”

          • Now you have mentioned chlorine, well I do have a problem with that in our water but may have a bigger problem without it being present in the town supply reticulated water.

            It is a matter of balancing options.

      • Logan, that is a separate issue – you are diverting.

        You were advancing a naive version of the precautionary principle with your “if in doubt, leave it out.”

        I repeat, considering the data in the figure do you think we should ban the sale of organic foods?

        After all the figure is pretty convincing, isn’t it? Much more convincing than, for example, Paul Coonett’s continual harping on poor quality studies relating to IQ.

    • “I must admit I am pleasantly surprised to see you take a much more unbiased take on this, Ken. A lot of the vitriol and spite that seems to emanate from this issue seems to overshadow the importance of the conflicts in science and the floating question mark that is the alleged link between tobacco and cancer. I upvoted your comment KANE, it appears that it has come as a downvote (although this could be just a dash). A lot of smokers are simply not happy with the MOH and DHB’s rather poor attempts to justify the practice of introducing anti-smoking laws to a understandably confused and unsure public. More effort needs to be put into this issue so we don’t end up with bias, we get all the facts, and we can make an informed decision. Until such a time I feel we should opt on the safer option – “If in doubt, keep it out.””

      Yes, doubt. So much doubt.

    • A lot of anti fluoride activists probably are not happy with the M.O.H and the D.H.B.s ongoing world wide reseach from quality peer reviewed papers the give an unbiased view on fluoride. The anti fluoride groups cant fight just plain truth. If it was that bad, the fault would have been found long ago, But no one has been hidden away to die slowly out of the public eye from fluoride, the research says that the cancer/i.Q/any other desease, is not a concern in fluoridated areas as opposed to non fluorideated areas,and there has been 70 years to prove otherwise, And nothing. All they can do is find obscure reports from suspect sources, that they can alter to push their own agenda ,and hope nobody reads the source paper, and push the dental fluorosis issue with pictures from high natural fluoride areas that show conditions that will never be seen in NZ, because of the strict controls on fluoride that is used in this country

  10. Thank you, Ken, for this sane, rational, logical, reasonable article – which doesn’t appeal to the conspiracy and “now-you’re-in-the-know” whispering that the anti-fluoride people tend to slop into.

    We need more people like you.

    • Ken has his detractors too though. He must have upset Hamilton Councillor Dave MacPherson.

      Ken – you are unfortunately an arrogant scientist that thinks this issue is just about science. It is also about politics, morals and (in my opinion) primarily about public health, which I have a fair bit of experience in. I reject your science-centred approach, noting also – which you continue to ignore, that there is science on both sides of this issue, and that even Peter Gluckman states it is no longer a science issue. If you are unhappy that local government is judging on what you regard as a science issue, then go and complain to the successive Govts that have required local govt to make this decision for their communities, don’t complain to those handed the hot potato! If me calling a spade a spade is rude, then tough. Go to someone that will bow and scrape before your science degree – because you won’t get me to be insincere and tell you what you want to hear if I don’t agree with it.
      Dave Macpherson

      I personally appreciate that Ken is defending the toxic waste being forced on people. The DHB and MOH have had a policy of never speaking publicly and openly about fluoridation. Good on you Ken.

      • Yes, poor old Dave did make a fool of himself last year didn’t he. Withdrew from Mayoral race because of lack of support and forced to back down on his opposing to fluoridation.

        • Kane Titchener sure does seem obsessed Hamilton’s fluoridation debate.

          In fact his whole family seems obsessed, during the Hamilton tribunal process (of which many of us were unaware was even taking place) Kane and 4 other Titcheners participated. Makes me wonder what merit there is in a tribunal process that allows 5 unqualified activist Titcheners from out of town to participate!

  11. I’m reminded of all those misinformed people who claim the theory of evolution is JUST a theory when I read a well balanced scientific article like this one.

    • I’m reminded of all those misinformed people who claim the theory of evolution is JUST a theory when I read a well balanced scientific article like this one.

      There’s a very strong overlap.
      Science denier PRATT’s are endlessly recycleable.

      •CA110. Evolution will soon be widely rejected.
      •CA111. Many current scientists reject evolution.
      •CA111.1. Over 300 scientists express skepticism of Darwinism.
      •CA113. Quote mining
      •CA202. Evolution has not been proved.
      •CA250. Scientific findings are always changing.
      •CA310. Scientists find what they expect to find.
      •CA320. Scientists are pressured not to challenge established dogma.
      •CA321.1. Scientists’ conclusions are motivated by money.
      •CA325. Creationists are prevented from publishing in science journals.
      •CA340. Evolutionists do not accept debate challenges.

      Etc, etc, etc.
      Plenty more where that came from. Just take out the evolution bit and insert the flouridation bit.

      • That’s my point, Andy’s, it is a scientific theory but not JUST a theory in the layman’s sense of the word.
        See Cedric’s Claim 201. As you well know Karl Popper tells us science must be falsifiable.

        • It is a theory but it is not just a theory. Yes that makes sense

          I think evolution does satisfy the Popperian ideals of falsifiability.

          Is anyone else confused?

          • Andy’s,
            In one of your previous posts, on an unrelated subject, you made a point of telling me what YOU defined as “belief”. Why is it now so hard for you to accept that the word “theory” can have a different meaning to different groups of people?

            • I’m not sure what unrelated topic you are referring to

              I am not proposing that “creationism” is a scientific theory if it doesn’t fit the principles of the scientific method.

              I just don’t understand why evolution is different to any other scientific theory

              We mostly accept gravity, although we don’t understand it at the quantum level. We still refer to “the theory of gravity”, however

              • See #6. for a layman’s definition…
                the·o·ry (thē′ə-rē, thîr′ē)
                n. pl. the·o·ries
                1. A set of statements or principles devised to explain a group of facts or phenomena, especially one that has been repeatedly tested or is widely accepted and can be used to make predictions about natural phenomena.

                2. The branch of a science or art consisting of its explanatory statements, accepted principles, and methods of analysis, as opposed to practice: a fine musician who had never studied theory.

                3. A set of theorems that constitute a systematic view of a branch of mathematics.

                4. Abstract reasoning; speculation: a decision based on experience rather than theory.

                5. A belief or principle that guides action or assists comprehension or judgment: staked out the house on the theory that criminals usually return to the scene of the crime.

                6. An assumption based on limited information or knowledge; a conjecture.

                Your previous post…
                AndyS says: December 2, 2013 at 5:16 pm I reserve words like “belief” to religions like Christianity and Climatology. The 97%/98% figure is irrelevant to the politicalisation of science, and is based on erroneous reasoning anyway. Even I would be part of that 98% VA:F [1.9.22_1171]Rating: -5 (from 5 votes) YogiBare says: December 2, 2013 at 6:01 pm How are we meant to know you only believe in #3? belief [bɪˈliːf] n 1. a principle, proposition, idea, etc., accepted as true 2. opinion; conviction 3. religious faith 4. trust or confidence, as in a person or a person’s abilities, probity, etc climatology the science that studies climate or climatic conditions 2%? – See more at: https://thedailyblog.co.nz/2013/12/02/climate-change-and-socialism/#sthash.dpcfm5sn.dpuf

  12. I’m not sure why this debate has become so extreme (maybe it’s because it’s about our kids) but it has been really unhelpful. My own experiences with mine and my children’s teeth is that flouride can help with teeth and that the best way is to apply it directly to the teeth as opposed to putting it in the stomach.

    We found this out the hard way unfortunately so I wish everyone would step back a bit, take a deep breath and climb out of their trenches because it’s very hard to find objectivity anywhere.

    The situation is not helped by people on both sides of the fence who’s careers depend on the position they have taken. This is especially an issue with people high up in government organisations who have completely absorbed the values of those organisations.

    I also struggle with people who come to the debate to defend ‘science’. Both sides of the debate are using science to push their arguements and I think the need to ‘defend science’ is an emotional position rooted in the need for a stable and orderly world. I completely understand that a world where you can’t always trust government institutions is a worrying place but unfortunately that is the world we live in.

    For the record, I would rather have the choice about what is in my drinking water.

    • “I’m not sure why this debate about the dangers of smoking has become so extreme (maybe it’s because it’s about our kids) but it has been really unhelpful. My own experiences with mine and my children’s smoking is that smoking hasn’t done us any harm and it helps us all relax after a hard day. I wish everyone would step back a bit, take a deep breath and climb out of their trenches because it’s very hard to find objectivity anywhere. The situation is not helped by people on both sides of the fence who’s careers depend on the position they have taken. This is especially an issue with people high up in government organisations who have completely absorbed the values of those organisations and are trying to impoe draconian laws against smoking. I also struggle with people who come to the debate to defend ‘science’. Both sides of the debate are using science to push their arguements and I think the need to ‘defend science’ is an emotional position rooted in the need for a stable and orderly world. I completely understand that a world where you can’t always trust government institutions is a worrying place but unfortunately that is the world we live in. For the record, I would rather have the choice about what I choose to smoke.”

    • My career as a dentist does NOT depend on fluoride in the water, in fact I might make more money if it was taken out, but I support it.

    • Aaron, I think if you read my article carefully you would see I am not advocating trench warfare – although I agree that some people see it that way (Paul Connett presented an interesting war metaphor in last nights talk, for example.) what I am actually advocating is that feather than cherry pick arguments and data to confirm ones’s bias we should look at all the data and approach it intelligently and critically.

      Some people, especially the anti-fluoride and anti-vaccination brigade are using science like a drunk uses a lamppost – more for support than illumination. I am arguing against that way of using science. How you interpret that as “an emotional position rooted in the need for a stable and orderly world” is beyond me.

      As for your implication that I have a career depending on my “position” re fluoridation – that is silly. I am actually retired and my interests are, as I said, in opposing bad science, misinformation and distortions about the science. Your implication is a cop out.

      One would be naive to always trust governments and their institutions. But one would be even more naive to always trust political activists. In this case I am talking about the natural supplement and health practitioners and specifically their people in the anti-fluoride movement.

      Always approach their claims critically and look for all the evidence.

      • Thanks Ken. Great insights.

        I would encourage everyone to listen to Ken on the radio. As per usual he doesn’t present the evidence to continue fluoridation.

        http://www.95bfm.co.nz/assets/sm/214416/3/getsometeeth.mp3

        I see why Ken wouldn’t want to debate fluoridation with Professor Paul Connett. Ken seems all at sea when he is asked to present his side of the argument. Good on you for keeping this debate in the public domain Ken.

        The MOH and DHB have had a policy of ‘No discussion on Fluoridation at ALL’.

        • Where have you been, Kane? How are you not aware of my debate with Paul Connett – see http://openparachute.wordpress.com/fluoride-debate/?

          Perhaps you should spend some time reading the articles between Paul and me in that exchange (over 200 pages) before commenting further.

          Have not hear a recording of the interview yoiu quote – but yes, painflully aware that I was geven extremely little time and the interviewer did not ask a specific question. Nor have I hear Paul’s much longer interview by the same guy.

    • (Response to Aaron) Fair enough. Science can only advise our policy decisions. It isn’t an immutable truth that we must follow

      Even if the evidence is “overwhelming” that Fluoride is harmless and beneficial, there are other issues such as personal choice, cost/benefit, etc, that need to be considered.

  13. An anecdote.
    The Willis St dental clinic ( Murder House ) that you may have attended Ken, had 144 chairs with attendant nurses. Most of those chairs were occupied with primary school aged clients in consecutive appointments.

    A few years after fluoridation in Wellington the numbers of appointments dropped even though the child population varied little.

    By the mid 70s the number of chairs had been reduced to less than 30 and the schedule of appointments were changed to suit busing of clients from their schools. This meant there were gaps between appointments which also started later and finished earlier each day.

    Was there magic in the air.

    • Well remember the Murder House. Am ashamed to admit I engineered a way of avoiding the place from quite a young age after my dental nurse changed. Much to my regret as I suffered horribly from tooth decay after that.

    • @ John W: Indeed. I vividly recall Newtown Primers – a byword for rampant caries – in the 1960s, around the time fluoridation of Wellington water supplies began. There were colossal numbers of cavities. Poor little kids: many of them trailed back for appointments week after miserable (for them) week.

      I worked in low-decile schools, both in non-fluoridated areas and fluoridated areas. The difference was stark; not just in numbers of cavities, but where on the tooth surface they were more likely to be found. What we used to term “class v” cavities were a constant presence in the non-F areas, as was recurrent decay around filling margins.

      When it arrived in NZ, fluoridated toothpaste made some difference in the non-F areas, but unfortunately, many children brushed irregularly or not at all, and fluoride toothpaste wasn’t initially as widely-available as it now is. Then, as now, poverty made it difficult for families to afford toothbrushes and toothpaste.

      When I moved to a low-decile school in a fluoridated area, the difference in decay rates was startling. There were many fewer cavities; much of the decay was confined to deciduous teeth, and the dreaded “class v” cavities had all but disappeared. I recall a colleague remarking that there was as much plaque on the teeth as there had been in the non-F areas, but once it was cleaned off, there was no cavitation, and often not even any demineralisation.

      Yet these children were also poor; many brushed infrequently, they had sporadic access to fluoride toothpaste and their diets left much to be desired. Water fluoridation had worked its magic on them; they had a much easier time of it when coming for dental visits.

      It’s worth pointing out that fluoride isn’t completely absent from water supplies in NZ; unfortunately, it occurs at levels too low to be efficaceous in preventing caries. Hence the desirability of adjusting levels, so as to bring about the desired improvements in caries prevalence. The benefits of water fluoridation are lifelong: I and many others can attest to this.

      The notion that the benefit of fluoride can be supplied solely by means of topical application and toothpaste is a counsel of perfection. The variable access to publicly-funded dental care services, along with difficulties of compliance, mean that poor families will often miss out. This is where water fluoridation comes into its own.

  14. “Confirmation bias is only human – we all do it. One has to work hard to overcome it but political activism doesn’t help. Paul doesn’t work in a scientific community, he is executive Director of the Fluoride Action Network (FAN). I can understand the effect on Paul of being surrounded by people whose group thinking encourages this bias – unlike a scientific community where peers routinely critically assess and comment on one’s ideas and work. It is much harder for a political activist, especially a leader, to change his or her ideas, or admit mistakes – to follow the evidence – than it is for a working scientist.”

    How true is that! But there is nothing new under the sun, Ken. Writing in his famous “Reflections on the Revolution in France” in 1792, the great Anglo-Irish statesman Edmund Burke described the members of the newly elected Third Estate as follows: “Among them, indeed, I saw some of known rank, some of shining talents; but of any practical experience in the state not one man was to be found. The best were only men of theory. But whatever the distinguished few may have been, it is the substance and mass of the body which constitutes its character, and must finally determine its direction. In all bodies, those who will lead must also, in a considerable degree, follow. They must conform their propositions to the taste, talent, and disposition of those whom they wish to conduct: therefore, if an assembly is viciously or feebly composed in a very great part of it, nothing but such a supreme degree of virtue as very rarely appears in the world, and for that reason cannot enter into calculation, will prevent the men of talents disseminated through it from becoming only the expert instruments of absurd projects. If, what is the more likely event, instead of that unusual degree of virtue, they should be actuated by sinister ambition and a lust of meretricious glory, then the feeble part of the assembly, to whom at first they conform, becomes, in its turn, the dupe and instrument of their designs.”

    The more things change, the more they stay the same!

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