In February 2011, Dr. Paul Connett visited Mildura, our home town, to articulate the scientific and ethical case against fluoridation, for the benefit of our community. During his public presentation, he conveyed his excitement at the then recent news that Calgary (Alberta CA) had decided to end fluoridation, after 20 years. Dr. Connett’s Case Against Fluoride co-author, Dr. James Beck, had played an instrumental role in the victory.
Now, in 2013, Dr. Beck, a professor emeritus of medical biophysics at the University of Calgary, is once again having to defend his community from the pro-fluoridation Zealotry.
On May 22, Rob Breakenridge, a radio host, published an article in the Calgary Herald in which he claimed, “ending fluoridation was a rotten idea… The evidence that council made a mistake in 2011 is strong and compelling.” In this article, of course, Mr. Breakenridge drags out all the old pro-fluoridation “chestnuts.” Luckily, for the people of Calgary, Dr. Beck has once again risen to the challenge to defend their health, and their ethical dignity.
In support of Dr. Beck
Since Dr. Beck has already adequately refuted the claims of Mr. Breakenridge, we see no need to provide our usual rebuttal of the pro-fluoridation position. Instead, we will offer some references to supplement and support Dr. Beck’s points – for the benefit of readers.
Dr. Beck: “I suggest that those who voted to stop fluoridation expected fewer adverse effects associated with swallowing fluoride and other products of hydrofluorosilicic acid (the industrial grade chemical that was used to fluoridate Calgary’s water).”
In 2006, the US National Research Council noted that some people “might be sensitive to the effects of silicofluorides,” and recommended further studies to determine “which fluoride chemicals can cause hypersensitivity.” Thus, Dr. Beck is correct to draw attention to this chemical, as posing potentially unique risks to health in the context of artificial water fluoridation.
We suggest visiting our Fluoridation Chemicals page for further information on hydrofluorosilicic acid. We also recommend consulting Connett Beck & Micklem (2010, Chapter 3) for additional discussion.
Medical ethics & autonomy
Dr. Beck: “And I suppose they would expect the certainty that the residents of Calgary would have a significant control over their own medication, a control denied by fluoridation, and a matter of medical ethics and human rights.”
In 2000, Dr. Hardy Limeback, then Head of Preventive Dentistry at the University of Toronto explained that, “The issue of mass medication of an unapproved drug without the expressed informed consent of each individual must also be addressed. The dose of fluoride cannot be controlled. Fluoride as a drug has contaminated most processed foods and beverages throughout North America. Individuals who are susceptible to fluoride’s harmful effects cannot avoid ingesting this drug. This presents a medico-legal and ethical dilemma.”
In 2007, Cheng et al. explained the principle in the European context: “Under the principle of informed consent, anyone can refuse treatment with a drug or other intervention. The Council of Europe Convention on Human Rights and Biomedicine 1997… states that health interventions can only be carried out after free and informed consent. The General Medical Council’s guidance on consent also stresses patients’ autonomy, and their right to decide whether or not to undergo medical intervention even if refusal may result in harm. This is especially important for water fluoridation, as 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.”
For a general overview of this issue, we recommend FAN’s Medical Ethics page and Dr. Connett’s Mildura segment titled, Fluoridation is a poor medical practice. For a more detailed reading, we recommend Connett, Beck & Micklem (2010, Chapters 1–2).
Ineffectiveness & post-cessation data
Dr. Beck: “So we are left to weigh the purported findings or impressions of two dentists taken from their personal practices against the systematic collections of data from millions of patients. That more abundant and more systematically gathered data indicate no substantial prevention of cavities by fluoridated water and no increase in the incidence of cavities after stopping fluoridation, as determined by comparison of cities stopping it with cities continuing it.”
Regarding post-cessation studies, as highlighted by Connett, Beck & Micklem (2010), “There is no evidence that where fluoridation has been started and stopped in Europe there has been a rise in tooth decay. Indeed, two studies published in 2000, from Finland and the former East Germany, show that tooth decay continued to decline after fluoridation was halted. There have been similar reports from Cuba and Canada’s British Columbia. The ADA claims that in cases where fluoridation has been halted and no increase in tooth decay observed, other steps have been taken to fight tooth decay. Whether or not that is the explanation, European countries have clearly demonstrated that there are other ways of reducing tooth decay without forcing everyone to take a medicine in their drinking water” (p. 33). “There now have been at least four modern studies showing that when fluoridation was halted in communities in East Germany, Finland, Cuba, and British Columbia (Canada), tooth decay rates did not go up” (p. 250).
In our recent post, titled Trimming John Timmer, we covered the issue of the poor evidence underpinning water fluoridation. To restate for the record, in support of Dr. Beck’s contention: When the University of York 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” (Exec. Sum., Conclusions). Three years later they reiterated, “We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide” (CRD 2003). 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” (Cheng et al. 2007). 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” (Awofeso 2012, p. 6).
It may also interest our Australian readers that Australian researcher, Dr. Mark Diesendorf wrote in 1986 that, “Large temporal reductions in tooth decay, which cannot be attributed to fluoridation, have been observed in both unfluoridated and fluoridated areas of at least eight developed countries over the past thirty years. It is now time for a scientific re-examination of the alleged enormous benefits of fluoridation.”
In his critique of the York Review in 2000, Dr. Connett draws attention to Diesendorf’s work as follows: “I was surprised that Mark Diesendorf’s seminal paper printed in Nature in 1986 was not in the list of papers included in the analysis, although it was considered. I appreciate that this paper would be characterized as a review paper but within this paper the author cited a large number of studies which indicated that there were large reductions in dental caries occurring in numerous non-fluoridated communities in Australia, Denmark, Holland, New Zealand, Norway, Sweden, UK and the US. Thus he drew upon a large and important data base and yet only 7 of the 63 references cited by Diesendorf were considered, and only 2 of these made it into the final analysis. Even though meta-analysis of the type performed by the York team exclude review papers, because of the dangers of including and counting the same data twice, authors of meta-analysis are required to comb through review papers to see if there are studies referenced which should be included. Thus, I find the non-inclusion of most of the studies on which Diesendorf derived his important work, a serious omission. More so, since Diesendorf showed that in several cities in Australia the DMFT values continued to fall after the maximum benefit would have accrued from water fluoridation” (3.2.4).
For a more detailed discussion on tooth decay data, we recommend viewing the following presentations: Connett 2011 & Connett 2012. We also suggest FAN’s Tooth Decay page, where one can find information on Topical vs. Systemic Effects; Tooth Decay in F vs. NF Countries; and Modern Fluoridation Studies.
The 2006 US National Research Council Report
Dr. Beck: “The claim of safety is also erroneous. The most comprehensive evaluation of the scientific literature on possible adverse effects was done by a panel of 12 scientists for the National Research Council of the United States and reported in 2006. It found association of using water containing fluoride — water with various concentrations of fluoride, including concentrations comparable to those in fluoridated tap water — with several abnormalities. Those abnormalities included thyroid disease, dental fluorosis and hip fracture, among others. And they found probable adverse effects not proven, but certainly indicating that further research is needed. The degree of certainty of adverse effects depends on what groups within the population are considered. Groups more susceptible to particular effects include infants, diabetics, persons with kidney disease and the elderly. These groups constitute sizable fractions of a population of 1.3 million. The failure of fluoridation of tap water to control the dose a person gets, and the fact that fluoride is accumulated in several tissues throughout life in a fluoridated city, are also major problems.”
Below, we have listed all page numbers for the individual research recommendations of the NRC Panel, as well as some key comments and expert clarifications. We suggest viewing Dr. Limeback’s clarifications first, as he describes how this report has been misrepresented.
It is also important to understand the relevance of this report in the context ‘margin of safety,’ which centres around the all-important distinction between ‘concentration and dose’ (refer to our Glossary). Also be sure to acknowledge the intake variations within High Intake Population Subgroups. As pointed out by Thiessen (2011, p. 4), “The NRC (2006) identified several sizeable subgroups of the U.S. population that require special consideration due to above-average fluoride exposures, increased fluoride retention, or greater susceptibility to effects from fluoride exposures.”
For these reasons Carton (2006, p. 163) concludes, “The amount of fluoride necessary to cause these effects to susceptible members of the population is at or below the dose received from current levels of fluoride recommended for water fluoridation. The recommended Maximum Contaminant Level Goal (MCLG) for fluoride in drinking water should be zero.”
Fluoride in Drinking Water: A Scientific Review of EPA’s Standards
Board on Environmental Studies and Toxicology, Committee on Fluoride in Drinking Water
National Research Council, National Academy of Sciences
The Australian NHMRC
Dismissal of the NRC Report
CDC Statement (1999)
Dr. Beck: “Breakenridge cites the Centers for Disease Control and Prevention and its dated overstatement on fluoridation.”
Again, we covered this in a previous post. Nevertheless, to support Dr. Beck, we hereby re-state as follows: “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.” The fact is that the CDC’s Oral Health Division has no independent expert oversight enforced upon it, yet it has a huge stake in promoting water fluoridation.
To learn more about the dangers of allowing the tooth-obsessed dental lobby to dictate fluoridation policy, click here.
In his most recent article, Dr. James Beck, MD, PhD, displays the admirable qualities of scientific integrity and moral fortitude in the face of big industry pressure, bureaucratic propaganda and willful ignorance. These are the very same qualities that resulted in Calgary’s rejection of fluoridation in 2011, and with the leadership of professionals like Dr. Beck and others, the good people of Calgary seem well-equipped to once again reject the ethically and scientifically bankrupt practice of water fluoridation.