Review of fluoridation science

August 22nd, 2014 at 12:21 pm by David Farrar

Sir Peter Gluckman has released a review of scientific evidence on fluoridation.  It is a readable 67 page report and co-authored by the Royal Society of NZ.

Some useful extracts:

There is compelling evidence that fluoridation of water at the established and recommended levels produces broad benefits for the dental health of New Zealanders. In this context it is worth noting that dental health remains a major issue for much of the New Zealand population, and that economically and from the equity perspective fluoridation remains the safest and most appropriate approach for promoting dental public health.

The only side effect of fluoridation at levels used in NZ is minimal fluorosis, and this is not of major cosmetic significance. There are no reported cases of disfiguring fluorosis associated with levels used for fluoridating water supplies in New Zealand.

For the future:

Given the caveat that science can never be absolute, the panel is unanimous in its conclusion that there are no adverse effects of of any significance arising from fluoridation at the levels used in New Zealand. In particular, no effects on brain development, cancer risk or cardiovascular or metabolic risk have been substantiated, and the safety margins are such that no subset of the population is at risk because of fluoridation.

All of the panel members and ourselves conclude that the efficacy and safety of fluoridation of public water supplies, within the range of concentrations currently recommended by the Ministry of Heath, is assured. We conclude that the scientific issues raised by those opposed to fluoridation are not supported by the evidence. Our assessment suggests that it is appropriate, from the scientific perspective, that fluoridation be expanded to assist those New Zealand communities that currently do not benefit from this public health measure – particularly those with a high prevalence of dental caries.

There were five members of the expert panel, all professors in scientific fields. There were also three international reviewers from Australia, the UK and Ireland..

Tooth decay is responsible for significant health loss (lost years of healthy life) in New Zealand. The ‘burden’ of the disease – its ‘cost’ in terms of lost years of healthy life – is equivalent to 3/4 that of prostate cancer, and 2/5 that of breast cancer in New Zealand. Tooth decay thus has substantial direct and indirect costs to society.

That’s a stunning stat, I had not seen before.

Like many elements that affect human health, fluoride is beneficial in small amounts and toxic in excess. More than 500 years ago, the physician and alchemist Paracelsus first stated the basic principle that governs toxicology: “All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.” In other words, for substances that have beneficial effects on health, “the dose differentiates a poison from a remedy.” Fluoride clearly benefits dental health when used topically or ingested in small doses, but in very high doses it is poisonous, and has been used as a component of pesticides. Similar examples can be found among beneficial health promoting vitamins, including vitamin D, which in high doses is an effective rodenticide
used to eradicate rats and possums, and in humans can cause musculoskeletal and renal disease.

This is also a key quote to remember when the anti-brigade breathlessly go on about how fluoride is a toxin.

 

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36 Responses to “Review of fluoridation science”

  1. hj (7,062 comments) says:

    Speaking of science
    The mystery of the pause in global warming may have been solved. The answer seems to lie at the bottom of the sea
    http://www.economist.com/news/science-and-technology/21613161-mystery-pause-global-warming-may-have-been-solved-answer-seems?

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  2. Max S (21 comments) says:

    Fluoridation is still mass medication by the State and a violation of individual rights. I’m looking forward to Jamie Whyte’s condemnation of these findings.

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  3. mandk (1,015 comments) says:

    I like the bit that says: “Given the caveat that science can never be absolute”

    Does this mean we will never again hear the climate change zealots tell us that “the science is settled”?

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  4. Adolf Fiinkensein (2,914 comments) says:

    And on the lighter side,

    http://pickeringpost.com/glance/a-rise-in-dental-costs-/3686

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  5. freedom101 (509 comments) says:

    Oh DPF, get ready for WW3 on this one. No amount of evidence is about to change the views on both sides, although I am very pleased that this review has now been published. Hopefully it will make it a lot easier for councils to avoid the enormous costs of the futile engagement with the anti lobby.

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  6. stephieboy (3,379 comments) says:

    Fluoridation is no more medication than Chlorine and therefore the latter is a violation of human rights ?.
    Why stop there- food safety regulations, seat belts , Hospital res for hygiene and sanitation etc, etc.
    There is absolutely no evidence of the absurd claims of anti fluoride brigade of lower IQs, Osteosarcomas and other cancers etc.
    A sample from Tauranga ( non fluoridated ) and Auckland ( fluoridated ) populations would show otherwise. .

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  7. Tom Barker (145 comments) says:

    “Does this mean we will never again hear the climate change zealots tell us that “the science is settled”?”

    The majority of people who comment on this blog, even those whose science education stopped in primary school, feel they know more about climate change than Sir Peter Gluckman, the government’s science advisor. I wonder why that is.

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  8. Rufus (676 comments) says:

    Yet science can only say ” if we do this, that happens”.

    It cannot address the moral argument for fluoridation : the utilitarian “we’ll force you all to drink this crap to benefit some poor people’s teeth”.

    One the one hand the proponents of mass medication believe the issue of poor health is bad enough that they would like to see the government control this issue. On the other hand many of the same people support the rights of teenagers to screw around and applaud the government to “limit” the negative consequences (if we can be this crass) of STIs and teenage pregnancy by a propaganda campaign of “sexual education” and free contraception and free access to abortion.

    Can you not see the incongruity?

    Why does the government not give poor people free toothpaste?

    Why force me to drink medicine, or force me to pay rates for water I do not want to drink?

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  9. Fisiani (1,047 comments) says:

    Now that the science for Fluoride in New Zealand is settled we must take the bull by the horns and insist that all New Zealanders have a right to healthy fluorinated drinking water. This is far more important than having every drainage ditch of swimming pool quality. This is too important for ill informed town councillors to be swayed by crap downloaded by the bucketful via the crazies on the internet. Time for government to act.

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  10. Rufus (676 comments) says:

    Stephieboy – what does chlorine do? What does fluoride do?

    Making water safe to drink =/= tooth medicine.

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  11. lastmanstanding (1,300 comments) says:

    I wish the water contained fluoride when I was a kid growing up. Even though Mum was strict about sweet stuff by mid teens I had a mouth full of fillings as did most of those of my age. By contrast by 2 kids born early and mid 80s have no fillings at all and both have eaten sweet stuff.
    Suggest that a check of people of both generations would show the same results as my family.

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  12. Adolf Fiinkensein (2,914 comments) says:

    Let the Luddite pricks install rain water tanks and send their kids off to dentistry school.

    That’s what’s called vertically integrated business.

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  13. seanmaitland (501 comments) says:

    The one thing that the anti-fluoride crowd never manage to do, and always avoid at all costs, is to point out the mass cases of bone fluorosis and brain damage that would be happening if their claims were valid. Our health system would be inundated with the effects of it.

    Yet, they can’t even dig up a single case as evidence.

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  14. georgebolwing (978 comments) says:

    I don’t think the PM’s Chief Scientific Adviser has ever said that “the science of climate change is settled”. What he has said, in his 2010 paper “Climate change and the scientific process” is: “… the fundamental issue relating to climate change remains: is there a risk of a degree of climate change sufficient to affect our capacity to continue our way of life or compromise the global ecosystem? The balance of the relevant scientific literature over the past two decades suggests that there is indeed such a risk.”

    He also said in the same paper: “Although the risk to our future of not acting now is real, the scientific community has had and is having difficulty communicating both its uncertainty and the absolute need for action simultaneously.”

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  15. wreck1080 (3,956 comments) says:

    @maxs: you should go live in a cave.

    Those who are against fluoride should just go and buy bottled water….incidentally which probably contains fluoride anyway because it occurs naturally.

    The report seems a waste of space to me. Why do we need a study on studies? We already know fluoridation is perfectly safe.

    More interesting would be a report on the psychology of water fluoridation neurosis .

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  16. georgebolwing (978 comments) says:

    @Rufus

    What I hope this report will do is allow the two very different arguments surrounding fluoridation to proceed separately.

    This first, which this report addresses, is “is fluoride at the doses used in water supplies dangerous”, to which the answer appears to be no.

    The second, which you raise, is “given that fluoride at the doses used in water supplies is not dangerous, does it offend liberty to fluoridate water supplies”. On the grounds that it is benign, then I think the answer is no.

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  17. Rufus (676 comments) says:

    George bolwing –

    1. they’ll never say it is “safe’ or “not dangerous”. At best they can say “there is no known causal link between dosing at this level and observable disease/negative consequences”. Not saying the same thing at all, although that is what the propaganda will imply.

    2. so if something is “benign”, we can force people to drink it, pay for it?

    I suggest learning the 10 commandments is benign. Do you agree all school kids should be taught them? Why not?

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  18. Rufus (676 comments) says:

    “appears to be “no” is not the same as “is”, yet you have no problem making that jump.

    I suggest your own argument falls down right there.

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  19. eszett (2,426 comments) says:

    It cannot address the moral argument for fluoridation : the utilitarian “we’ll force you all to drink this crap to benefit some poor people’s teeth”.

    Again you could ask the same about chorine.

    It cannot address the moral argument for fluoridation : the utilitarian “we’ll force you all to drink this crap to benefit some poor people’s health because they are too lazy to boil their water”.

    That’s not a moral argument, that’s more framing the question.

    How about this: We add this in tiny amounts to the water so that everyone benefits from it

    No different from chlorine.

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  20. stephieboy (3,379 comments) says:

    Rufus (633 comments) says:
    August 22nd, 2014 at 1:04 pm

    Fluoridation prevents tooth decay
    Chlorine prevents harmful bacteria.
    Both are not drugs like phentonyl or morphine.
    There is no evidence that the current doses of fluoride is harmful whatsover.

    Auckland’s fluoridated water proves that and also comparing to say Tauranga’s non fluoridated water supply.

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  21. waikatosinger (94 comments) says:

    Pure water is toxic. It is tasteless and horrible to drink; it leaches minerals from the body and will eventually kill you if that is all you drink. The water we drink must have some sort of minerals in it to avoid this. We might as well put minerals like Flouride in there which have known beneficial effects on human health. Flouride also makes the water taste good. We used to have really nice tasting water in Hamilton until they took the Flouride out. Hopefully now Hamilton can get its Flouride back. That will mean that I won’t have to buy Flouride tablets any more to ensure that my son grows up with good teeth. People who don’t like the public supply can always install a roof tank or a filter. A minority shouldn’t be allowed to dictate to the majority what kind of water they have.

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  22. Max S (21 comments) says:

    Chlorine is not medication. It makes the water safe to drink. Fluoridation is specifically added to medicate people without their consent. I don’t want to buy bottled water. People who want to drink fluoridated should buy fluoride tablets.

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  23. stephieboy (3,379 comments) says:

    Max . S,

    Fluoride like chlorine is a chemical . The former is not used to treat e.g depression or infectious diseases. There is absolutely no evidence that Fluoride is ” medication “and is used as thus to drug and dope e.g the population of Auckland .

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  24. georgebolwing (978 comments) says:

    @ Rufus:

    What the report says (sorry for the long quote, but don’t want to be accused of quoting out of context):

    “A large number of studies and systematic reviews have concluded that water fluoridation is an effective preventive measure against tooth decay that reaches all segments of the population, and is particularly beneficial to those most in need of improved oral health.

    “Extensive analyses of potential adverse effects have not found evidence that the levels of fluoride used for community water fluoridation schemes contribute any increased risk to public health, though there is a narrow range between optimal dental health effectiveness and a risk of mild dental fluorosis. The prevalence of fluorosis of aesthetic concern is minimal in New Zealand, and is not different between fluoridated and non-fluoridated communities, confirming that a substantial proportion of the risk is attributable to the intake of fluoride from sources other than water (most notably, the swallowing of high-fluoride toothpaste by young children). The current fluoridation levels therefore appear to be appropriate.

    “This analysis concludes that from a medical and public health perspective, water fluoridation at the levels used in New Zealand poses no significant health risks and is effective at reducing the prevalence and severity of tooth decay in communities where it is used. Communities currently without CWF can be confident that this is a safe option that is cost saving and of significant public health benefit – particularly in those communities with high prevalence of dental caries.”

    And I have no problems with school children being allowed to read the bible.

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  25. seanmaitland (501 comments) says:

    @Rufus – so your best argument is a strawman about the Ten Commandments?

    Let me guess – you are a Green Party activist?

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  26. David Garrett (7,523 comments) says:

    I am amazed there are only 22 comments on this, and only one or two “but it’s a poison!” loonies.

    I too picked up on the “science is never settled” comment by Glucklman…and whoever referred to people whose science education ended in the fourth form completely misses the point. Isn’t Gluckman one of the loudest voices on climate change? Presumably then, some science can be settled but not others…

    lastmanstanding: My own family’s experience is a real lesson…fluoride was introduced to Gisborne when I was about four…all of my molars are crowned, and now the crowns are failing as the underlying teeth fail…my sister two years younger than me has about half the crowns I have…my youngest sister – who was born several years after fluoride was introduced, has none. Anecdotal evidence to be sure, but pretty convincing to me…and I took science – and then biology and chemistry – into the sixth form. I have no tertiary qualification in any of the sciences.

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  27. David Garrett (7,523 comments) says:

    Max S: Except, as I am sure you know, poor people have more important things to spend $10 a month on than fluoride tabs…and that’s if they have the nous to do so for their kids’ sake..

    (I live in the country, and have lovely tasting tank water… and the kids take a fluoride tab twice a day)

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  28. Max S (21 comments) says:

    David Garret. “Poor people” as you label them can always brush their teeth with a toothbrush and toothpaste. That would do much more good than drinking fluoridated water.

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  29. David Garrett (7,523 comments) says:

    Well Max, there you show your ignorance…or your obsession..topical fluoride – in toothpaste – is nowhere near as effective

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  30. Max S (21 comments) says:

    You’re showing your ignorance David Garrett. Topical application of toothpaste is far more effective. You’re also betraying the principals of the ACT Party, individual choice and responsibility.

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  31. Tanstaafl (28 comments) says:

    David Garrett says: “Well Max, there you show your ignorance…or your obsession..topical fluoride – in toothpaste – is nowhere near as effective”

    Sorry, David, your information is out-of-date. When fluoridation was introduced in the 1950’s, it was based on the theory that fluoride works systemically (by consuming it) , not topically. That’s why fluoride was delivered via drinking water. However, that theory was proved wrong in the 1990’s. It is now scientific fact that the primary benefit of fluoride comes from topical application (eg brushing with fluoride toothpaste) not from swallowing it.

    Don’t take my word for it, ask your dentist. Please ask him. This is not controversial. Every dentist who has graduated from dental school in the last 15 years or who has kept up with the latest research knows that the primary benefit from fluoride is topical.

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  32. Brian Marshall (204 comments) says:

    I just need to point out to the tin foil hat wearing brigade that it is not mass medication. If you live in an area with fluoride added to your council supplied water, don’t drink that water, get your own water supply.

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  33. Dennis Horne (2,403 comments) says:

    You couldn’t ingest enough fluoride in fluoridated water to kill you, the water would kill you first.
    http://en.wikipedia.org/wiki/Water_intoxication

    I am pleased to see this report. Keep the science coming, eventually the antis will find something else to worry about. Like the water content of fluoridated water.

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  34. publicwatchdog (2,796 comments) says:

    FYI Kiwibloggers!

    http://fluoridefree.org.nz/open-letter-prime-minister-john-key-dirty-politics/

    Open Letter to Prime Minister John Key – More Dirty Politics?

    Fluoride Free New Zealand is concerned with the secrecy surrounding the fluoridation review being led by pro-fluoridationists Peter Gluckman and Prof Skeg.

    Given the Ministry of Health’s uncooperative approach to engage in discussion and debate on this issue we are extremely concerned that there has been no transparency around this process. Without transparency any review sanctioned by the government alone without all stakeholders input will result in yet further decay in the trust of the public health system.

    The panel which had your approval has been kept secret until Wednesday 13 August 2014 when the ‘review’ was exposed by the Dominion Post. This is the first public exposure of the review yet it has been on-going for months.

    Given you gave your explicit approval for the review we are demanding answers to these questions:

    1 Who initiated the fluoridation review and when was it initiated?

    2 Who approved the fluoridation review?

    3 When was the announcement made to the public that the review was taking place?

    4 Who has been involved in the fluoridation review being led by Professors Gluckman and Skegg?

    5 Were any scientists or other professionals known to be opposed to fluoridation invited to be involved?

    6. Who will be asked to peer review the fluoridation review being led by Professors Gluckman and Skegg?

    An Official Information Act request has been made regarding these questions.

    Fluoride Free New Zealand calls for the secret Government review on fluoridation to be replaced by an independently chaired open public discussion so that full transparency on this issue is achieved.

    Fluoride Free New Zealand

    http://www.fluoridefree.org.nz

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  35. publicwatchdog (2,796 comments) says:

    http://www.occupyaucklandvsaucklandcouncilappeal.org.nz/

    OFFICIAL INFORMATION ACT REQUEST RE: FLUORIDATION OF PUBLIC DRINKING WATER SUPPLIES TO:
    1) THE PRIME MINISTER’S ‘CHIEF SCIENCE ADVISOR’ PROFESSOR SIR PETER GLUCKMAN
    __________________________________________________________________________________________________

    12 June 2013

    ‘Open Letter’ / OIA to Professor Sir Peter Gluckman from Auckland Mayoral candidate Penny Bright:

    “Upon what ‘science’ are you relying to support fluoride in water?”

    OFFICE OF THE PRIME MINISTER’S SCIENCE ADVISORY COMMITTEE

    Professor Sir Peter Gluckman, KNZM FRSNZ FMedSci FRS
    Chief Science Advisor

    Dear Professor,

    I read with interest your following ‘Media Release’:

    http://www.scoop.co.nz/stories/GE1306/S00035/sir-peter-gluckman-statement-of-flouride.htm

    “Media release

    12 June 2013

    “The science of fluoride in water is effectively settled. It has been one of the most thoroughly worked questions in public health science over many decades,” says Sir Peter Gluckman, the Prime Minister’s Chief Science Advisor.

    In a statement released today on the issue of fluoride in public water supplies, Sir Peter reiterates the scientific facts, saying “it is absolutely clear that at doses used in New Zealand to adjust the natural level to one that is consistent with beneficial effects (0.7-1.0mg/litre), there is no health risk from fluoride in the water.”

    So why is there any issue at all?

    Sir Peter points to the importance of the values debate around fluoridation, but warns that this should not be misrepresented as a scientific debate. …”
    _____________________________________________________________________________________________

    Can you please provide the information which confirms you have read the following research:

    1) http://www.hindawi.com/journals/jeph/2013/439490/

    “..chronic effects of fluoride involve alterations in the chemical activity of calcium by the fluoride ion. Natural calcium fluoride with low solubility and toxicity from ingestion is distinct from fully soluble toxic industrial fluorides …”
    “Industrial fluoride ingested from treated water enters saliva at levels too low to affect dental caries. Blood levels during lifelong consumption can harm heart, bone, brain, and even developing teeth enamel.

    The widespread policy known as water fluoridation is discussed in light of these findings. ….”

    2) http://www.slweb.org/50reasons.html

    50 Reasons to Oppose Fluoridation
    Dr. Paul Connett
    Professor of Chemistry
    St. Lawrence University, NY 13617
    ________________________________________________________________________________________________

    FYI – I have spent some hundreds of hours researching the decisions of the Ministry of Health and Watercare Services to use Waikato river water as a ‘raw’ source of drinking water supplies for the Auckland region.

    I respectfully suggest that you read the following document which I prepared for a meeting of the Auckland City Council Finance and Business Committee back in October 2002, so that you can understand why a number of persons, such as myself, do NOT trust either the Ministry of Health, or Watercare Services Ltd, when it comes to safeguarding public health and drinking water supplies.

    http://www.occupyaucklandvsaucklandcouncilappeal.org.nz/wp-content/uploads/2013/06/Waikato-Amended-ACC-Presentation-18-10-02.pdf

    FYI – as a 2013 Auckland Mayoral candidate, I do NOT support the fluoridation of public drinking water supplies.

    Penny Bright
    ‘Anti-corruption / anti-privatisation’ campaigner.

    _________________________________________________________________________________________________

    http://www.occupyaucklandvsaucklandcouncilappeal.org.nz/wp-content/uploads/2013/09/FLUORIDATION-OF-PUBLIC-DRINKING-WATER-SUPPLIES-OIA-REPLY-FROM-PMCSA-PETER-GLUCKMAN-12-June-2013-response-Penny-Bright-12-June-2013-OIA-request-5.pdf

    __________________________________________________________________________________________________

    In my considered opinion, this OIA reply from Professor Peter Gluckman proves he is not to be trusted.

    Penny Bright

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  36. V (744 comments) says:

    Whatever your view on this the idea of ‘medicating’ or delivering an accurate dose via the water supply is farcical. While I don’t think it does any harm it seems much better and more accurate to deliver fluroide via toothpaste or a fluoride tablet.

    It is a seductive argument however that by putting something in the water you’ll save the public health system $ in dental expenditures.

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  37. Dennis Horne (2,403 comments) says:

    V. If you don’t think it does any harm then clearly you accept the dose is accurate enough. Fluoridation is a democratic decision based on the science. People have a right to object but no right to tell lies in an attempt to frighten others.

    Penny Bright. There’s nothing quite as silly as a silly old woman. How could the authors possibly benefit from lying.

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