BTW NYCOF is not a dentist, she spends her days writing emails posted around the world opposing fluoridation.

Picker22

No human ever got tooth decay from lack of fluoride because the condition does not exist. You might think fluoride is an essential nutrient; but science says it is not.

Talk about Karma

Organized dentistry is at the forefront of PREVENTING more dental health practitioners from easing the oral health burden facing too many Americans. By protecting your monopoly instead of allowing dental therapists to work in the US, dentists have more to do with keeping low income people in dental pain than I do.

Denturists would like to work directly with the public. Organized dentistry fights that. Hygienists would like to work directly with the public. Organized dentistry fights that too.

What the Louisiana Dental Association was the most egregious. They created a law that disallows a willing dentist from bringing treatment to children in schools who otherwise won’t get any care

Organized dentistry’s battle to keep the tooth-whitening business out of malls is a clear example of greed coupled with too much power.

In point 5 “ineffective by” should read “unaffected in”

apologies ..

1. The Louisiana Medicaid paper is deemed fraudulent.

The editorial policies of MMWR are sufficiently rigorous and unbiased to qualify for indexing in the PubMed database. The quote you included from the publication was an Editorial Comment and is testimony to the scholarly and arms length editorial policies of the CDC publication. The lead author of the article was at Louisiana State University, not the CDC.

Of equal importance is the fact that water fluoridation’s dramatic impact on rampant caries in deciduous teeth has been confirmed by other studies. [ABCDN] Another Medicaid study from Louisiana published in a prestigious public dental health journal had very similar findings. [D]

2. Fluoride’s topical effect is a reason to not fluoridate.

The claim that fluoride’s effectiveness is principally topical has little implication for public water fluoridation policy because:

a. Water fluoridation is a proven public health intervention regardless of the scientific explanation of its effectiveness. There are no other cost effective options in the US.

b. Brushing with fluoride toothpaste is in fact both a topical and systemic application of fluoride. Some toothpaste is always swallowed. Thorough rinsing decreases effectiveness and effectiveness of tooth brushing correlates with plasma (i.e. swallowed) fluoride. Rinsing with a fluoride toothpaste slurry after brushing increases cavity prevention. [G]

c. Some of the known benefits of water fluoridation are possible only when fluoride is present during tooth development. [HIJKLM]

d. While the systemic effect may be more important, there is good evidence to support the importance of systemic effects. Fluoridated water consumed in childhood confirms a lifetime benefit. [M] The very quote you selected uses the phrase “mostly topical.” In truth this means 51% or more. Kumar’s recent article shows the systemic effect in action: fluorosis, obviously a systemic effect, protects teeth from cavities.

3. There are a lot of cavities in Detroit

Isolated factoids contain no useful information. Only studies designed to measure water fluoridation’s effectiveness are germane.

4. Fluoridation doesn’t prevent Early Childhood Caries

To my knowledge, no dental health expert believes water fluoridation prevents this disease. It is caused by poor parenting; children falling asleep sipping high sugar content fluids. Your listing it as a reason to oppose water fluoridation is typical of much of anti-fluoridation propaganda. You say something that is true and sounds convincing to the naive person, yet is totally unrelated to the debate.

5. A study showed Rural and Urban cavity rates equal.

From the Brunelle and Carlos study we know that simply measuring the presence of cavities does not demonstrate water fluoridation’s effect. This is precisely the mistake you and Yiamouyiannis made when you state that caries is shown to be ineffective by the first National Health and Nutrition Exam Survey data. Decayed, Missing, Filled Surfaces (DMFS) is a more sensitive and accurate measurement of the effect.

6. The Australian Study. . .Your conclusions are at odds with the authors who recommend that bottled water mandatorily contain fluoride so that the rural younger children are protected (the same teeth as were shown to be protected in the Louisiana studies).

————

The simple fact is that amongst professional public health and dental communities there is overwhelming agreement as to the propriety and effectiveness of water fluoridation. This is a transparent and irrefutable truth.

Large scale new implementation recently undertaken in California and Great Britain will bring many millions of additional people fluoridated water’s health benefits. While those who oppose water fluoridation are often politically effective at the local level, after 60 years it is clear that opponents have lost the intellectual scientific battle in the scientific forums most appropriate to these matters.

It is tragic that water fluoridation as debated by amateurs (as I consider both myself and NYCOF) is determining public water policy. Whenever the weight of good scientific evidence indicates that water fluoridation is a bad idea, public health professionals will acknowledge this and the practice will be abandoned.

Selective literature citations, and scientific non sequitur (i.e. cavity rates in Detroit) will often win politically with the general public, but until the antifluoridation beliefs succeed in forums of legitimate scientific debate, water fluoridation should and will continue.

Incidentally . . here is an international paper from Japan [F] which to quote: “The findings of this study conducted in 1987 in Japan parallel those reported by Dean et al. in the early 1940s”

Picker22

[A] J Public Health Dent. 1984 Spring;44(2):61-6. Caries patterns in Head Start children in a fluoridated community. Johnsen DC, Schultz DW, Schubot DB, Easley MW.

[B] Community Dent Oral Epidemiol. 1981 Jun;9 (3):112-6. Effect of fluoridation on the cost of dental treatment among urban Scottish schoolchildren. Downer MC, Blinkhorn AS, Attwood D.

[C] Community Dent Oral Epidemiol. 1988 Dec;16(6):341-4. Cost appraisal of a fluoride tablet programme to Manchester primary schoolchildren. O’Rourke CA, Attrill M, Holloway PJ.

[D] J Public Health Dent. 2000 Winter;60(1):21-7. Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97. Griffin SO, Gooch BF, Beltran E, Sutherland JN, Barsley R.

[E] Community Dent Oral Epidemiol. 1981 Jun;9(3):112-6. Effect of fluoridation on the cost of dental treatment among urban Scottish schoolchildren. Downer MC, Blinkhorn AS, Attwood D

[F] J Public Health Dent. 2000 Summer;60(3):147-53. The prevalence of dental caries and fluorosis in Japanese communities with up to 1.4 ppm of naturally occurring fluoride. Tsutsui A, Yagi M, Horowitz AM

[G] Swed Dent J Suppl. 1995;110:1-44. Toothpaste technique. Studies on fluoride delivery and caries prevention. Sjogren K.

[H] Aust Dent J. 1997 Apr;42(2):92-102. Prior fluoridation in childhood affects dental caries and tooth wear in a south east Queensland opulation. Teo C, Young WG, Daley TJ, Sauer H.

[I] Br Dent J. 2004 Oct 9;197(7):413-6; discussion 399. Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: The relationship with water fluoridation and social deprivation. Bardsley PF, Taylor S, Milosevic A.

[J] Br Dent J. 1994 May 7;176(9):346-8. Comparison of the effect of fluoride and non-fluoride toothpaste on tooth wear in vitro and the influence of enamel fluoride concentration and hardness of enamel. Bartlett DW, Smith BG, Wilson RF.

[K] J Dent Res. 1990 Feb;69 Spec No:751-5; discussion 820-3. Fluoride in caries prevention: is the effect pre- or post-eruptive? Groeneveld A, Van Eck AA, Backer Dirks O.

[L] Community Dent Oral Epidemiol. 2004 Dec;32(6):435-46. Relative effects of pre- and post-eruption water fluoride on caries experience by surface type of permanent first molars. Singh KA, Spencer AJ.

[M] Community Dent Oral Epidemiol. 1992 Apr;20(2):81-3. Caries experience in subjects 18-22 years of age after 13 years’ discontinued water fluoridation in Okinawa. Kobayashi S, Kawasaki K, Takagi O, Nakamura M, Fujii N, Shinzato M, Maki Y, Takaesu Y.

[N] Texas Department of Health (2000). Water fluoridation costs in Texas: Texas Health Steps (EPSTD-Medicaid). http://www.dshs.state.tx.us/dental/pdf/fluoridation.pdf (accessed July 24, 2008).

From Picker’s source:

The findings in this report are subject to at least four limitations. First, although the analysis showed an association between lower caries-related costs and residence in one of the five F parishes, the analysis did not measure the length or magnitude of the children’s exposure to fluoride. Some children classified as residing in NF parishes once may have resided in F parishes and vice versa. It also did not verify that the water systems serving the five F parishes maintained fluoride concentration at the optimal level. However, misclassification of exposure status would be more likely to reduce the observed effect of fluoridation. Second, if access to dental care were better in NF than in F parishes, children with decay who resided in F parishes would be less likely to seek restorative care, resulting in an underestimate of treatment costs in F parishes and an overstatement of water fluoridation’s benefits.