Article for rebuttal
Lismore fluoride decision sparks dental concerns
ABC News | 15 Aug. 2013
[Related article: Lismore Council decision prompts call for fluoride intervention]
Point #1: “Doctor Brendan White from the far north coast division of the NSW Dental Association said an independent study found two-thirds of the community supports fluoridation.”
Response: Firstly, the study is not provided for the reader to independently verify the claim. The ABC expects us to blindly accept the ‘authority’ of the NSW Dental Association (sorry ABC, we don’t play that game). Secondly, even if the study were genuine, that means one third of the community is either undecided on fluoridation, or does not want fluoridation imposed upon them. According to the Universal Declaration on Bioethics and Human Rights:
“Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information… In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual’s informed consent” (1).
Water fluoridation is both a preventive and therapeutic intervention, with its proponents expressly claiming the measure to be a preventive and direct treatment for the disease of tooth decay (2). As noted by Meng (2008):
“The Universal Declaration on Bioethics and Human Rights emphasizes the principle of autonomy to protect the human rights of the human subjects involved in any public health activities and epidemiological research. As a practical guideline, obtaining informed consent is strongly recommended” (3).
Having not obtained informed consent from community members, the NSW Dental Association and Dr. White are using the media to pressure Council to impose a measure that would directly contravene the Declaration. Ergo, they would be well-advised to carefully consider their legal options before continuing along this line. All the makings of a class action law suit are in place here.
Neither the Council, nor the local water authorities, nor the ADA or its individual members are authorised to violate the human right of informed consent to treatment. Doing so could see one or all of these parties prosecuted by any member of the community from whom informed consent was not obtained.
For this reason, we also extend this legal notice to Council, as fair warning about the ethical implications of that which Dr. White and his fear-mongering cronies are advocating.
Point #2: “We have a crisis in the community, we have a solution that is equitable and is extremely safe, and we’ve presented this and we’ve just lost it.”
Response: After examining the world-wide literature, the York Review (2000) concluded that the evidence for fluoridation reducing inequalities in dental health is – even after decades of community exposure – “of poor quality, contradictory and unreliable” (4). Dr. White’s claim, therefore, is scientifically dubious, at best. Neither did the review team conclude that fluoridation is safe:
“The review did not show water fluoridation to be safe. The quality of the research was too poor to establish with confidence whether or not there are potentially important adverse effects in addition to the high levels of fluorosis. The report recommended that more research was needed” (5).
In 2006, the National Research Council added to the health uncertainties. Its report raised the possibility that, “various fluoride species or complexes (especially fluorosilicates and aluminofluorides) present in tap water” may have biological effects (6) – including, but not limited to, hypersensitivity reactions in certain individuals (7) (8); that fluorides can, “increase the production of free radicals in the brain through several different biological pathways,” which may “act to increase the risk of developing Alzheimer’s disease” (9); and that, “fluoride is likely to cause decreased melatonin production and to have other effects on normal pineal function, which in turn could contribute to a variety of effects in humans” (10); among other things. The report also cited biomonitoring of the population as inadequate (11).
In 2010, Barbier et al. confirmed the potential toxicity of fluoride on biological systems and processes:
“In the last decade, interest in its undesirable effects has resurfaced due to the awareness that this element interacts with cellular systems even at low doses. In recent years, several investigations demonstrated that fluoride can induce oxidative stress and modulate intracellular redox homeostasis, lipid peroxidation and protein carbonyl content, as well as alter gene expression and cause apoptosis. Genes modulated by fluoride include those related to the stress response, metabolic enzymes, the cell cycle, cell–cell communications and signal transduction… It is important to highlight that fluoride must be actively considered as a potent toxic compound in the field of toxicology, both in epidemiologic/ecological research and in fundamental or applied research” (12).
Cheng et al. (2007) had previously warned of the insidious nature of chronic toxicity and the risks it may pose to the population at large, once a fluoridation scheme is introduced:
“In the case of fluoridation, people should be aware of the limitations of evidence about its potential harms and that it would be almost impossible to detect small but important risks (especially for chronic conditions) after introducing fluoridation” (13).
The risk of chronic toxicity is acknowledged in the literature; fluoride’s molecular biochemistry is an active area of research; and many health effects have been cited as areas of concern. Yet, with all the above considered, Dr. White and his dental lobby cronies advocate that Council should impose this measure upon the local community, without informed consent (1) or dosage control (14).
They are on very shaky ethical ground, whilst their claims are scientifically questionable, at the very least. If they insist on gambling with the health of their community, whilst riding roughshod over the basic human right of informed consent to treatment, they would, as previously stated, be well advised to consider their potential legal liability.
Point #3: “Our motivation is simply to reduce decay, (and) we need this in our area.”
Response: Is tooth decay/dental caries a disease? – Yes; Is water fluoridation advertised as a treatment or preventive measure for this disease? – Yes; Is treatment or prevention of disease a medical intervention? – Yes (15); Is the right to informed consent to treatment enshrined as a basic human right? – Yes (1); Have Dr. White, the Council, the ADA or anyone else obtained the legal informed consent to treatment from all community members? – No; What are the consequences for treating people without their informed consent? – Serious (16).
In addition, it should be noted, that the ADA’s fear mongering about increased decay rates without fluoridation, is, like the rest of their propaganda, unsupported by evidence. Post-cessation studies do not support this contention (17) (18) and national decay rates have fallen regardless of fluoridation status, as Cheng et al. highlight:
“Although the prevalence of caries varies between countries, levels everywhere have fallen greatly in the past three decades, and national rates of caries are now universally low. This trend has occurred regardless of the concentration of fluoride in water or the use of fluoridated salt” (13).
Australian researcher, Dr. Mark Diesendorf had revealed the same trend in 1986 (19). In other words, the evidence demonstrates that fluoridating drinking water is unnecessary. Historical observations can also attest to this fact (20).
Thus, the suggestion that a non-fluoridation status will inevitably lead to increased tooth decay, is fraudulent and misleading. It is designed to induce public health fear, especially amongst Councillors, for the explicit purpose of influencing Council to fluoridate water supplies indefinitely.
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