Rebuttal: Dr. Deb Nalty, Monroe

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Fluoridation is a smart fix for big problem
By Deb Nalty, MD

Claim: “Everett, and the majority of the nation’s cities should be commended for committing to improve the oral health of all of their residents through community water fluoridation.”

Response: If we think about this statement in the context of the all the world’s great cities that do not fluoridate their water, we quickly realise that fluoridated communities are actually in the minority, in an international context. Click here for an explanation.

Claim: “Fluoridation is an effective, cost effective, and safe way to reduce tooth decay rates by about 25 percent.”

Response: We dealt with this same claim in our previous rebuttal, but will re-state nevertheless: “In chapters 6–8, we examined in detail the evidence for fluoridation’s benefits and found it to be very weak. Even a 20 percent reduction in tooth decay is a figure rarely found in more recent studies. Moreover, we have to remember that percentages can give a very misleading picture. For example, if an average of two decayed tooth surfaces are found in a non-fluoridated group and one decayed surface in a fluoridated group, that would amount to an impressive 50 percent reduction. But when we consider the total of 128 surfaces on a complete set of teeth, the picture—which amounts to an absolute saving in tooth decay of a mere 0.8 percent—does not look so impressive” (Connett, Beck & Micklem 2010, p. 251). For further information, click here.

Claim: “And every person in the community — young and old, rich and poor, those with insurance and those without — receive fluoride’s benefits by simply drinking water.”

Response: When the York Review authors looked for evidence to support this type of claim about reducing inequalities in dental health, their findings were as follows: “The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.”

Claim: “Every dollar invested in fluoridation saves around $38 in dental treatment costs.”

Response: Again, we dealt with this in our previous rebuttal, but if the truth needs to be re-stated, so be it: Proponents often use simplistic PR statements like, “for every dollar spent on fluoridation, $38 is saved in dental costs,” however such statements are based on inflated ‘benefits’ that ignore or understate the costs of any side effects. See: Connett, Beck & Micklem 2010, pp. 249-250.

Claim: “As a family physician I have seen patients from communities with and without water fluoridation. In my experience, those who receive the benefits of community water fluoridation have less decay and are much healthier.”

Response: According to Dr. Arvid Carlsson (Nobel Laureate, Medicine/Physiology, 2000), “Sweden rejected fluoridation in the 1970s… Our children have not suffered greater tooth decay, as World Health Organization figures attest.” In other words, if Dr. Nalty were practising in Sweden, she would not even be talking about water fluoridation, because teeth over there are just fine without it. Her anecdotal statement, therefore, is meaningless.

Claim: “Kids from non-fluoridated communities will not only have more cavities now but also are far more likely to have problems with oral health and face higher treatment costs throughout their life. Unfortunately, this is the probable fate of children in communities like Portland, Ore., that reject water fluoridation.”

Response: Fluoride’s mechanism (for ‘benefit’) is topical, not systemic (although its mechanism for damage is systemic). The evidence for ‘benefit’ from water fluoridation is very weak.

Claim: “Given decades of experience and countless studies proving it is safe.”

Response: The quality of the evidence, even after all these years, is poor. Numerous health issues remain unresolved. Therefore, no adequate margin of safety has been established, given that dose cannot be controlled and that measures of exposure from all sources vary widely, especially among high intake population subgroups. “Countless studies”? Connett, Beck & Micklem deal with this on page 251.

Claim: “There are more than 3,000 studies documenting the benefits of water fluoridation.”

Response: Click here.

Claim: “The U.S. Surgeon General and a host of public health experts including medical and dental groups like the American Academy of Pediatrics and the Institute of Medicine strongly endorse fluoridating water to improve oral health.”

Response: Endorsements do not represent scientific evidence. 50 Reasons #46.

Claim: “In fact, the Centers for Disease Control and Prevention (CDC) identified fluoridation as one of the Top 10 Public Health Achievements of the twentieth century.”

Response: 🙂 We always laugh when we hear this one. Click here to learn why.

Claim: “More than 200 million people throughout the U.S. have been receiving the health benefits of fluoride for decades and there have been absolutely no adverse effects. The practice is safe and effective — and we have more than 65 years of experience to prove it.”

Response: Refer to Thiessen 2011, pp. 3-12. Also see our Dr. James Beck post, under the sub-heading, The 2006 US National Research Council Report.

Claim: “Twenty years ago, Everett embraced one of the most beneficial public health measures of all time and voted to fluoridate. It was a good choice. Community water fluoridation is a wise investment that pays health dividends now and also in the future.”

Response: Click here.

Author: AFA Mildura

Administrator, Anti-Fluoridation Association of Mildura

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