Paul connett fluoride in drinking water compressed by Christian Kießling

The Case Against Water Fluoridation Paul Connett, PhD Director, Fluoride Action Network FluorideALERT.org Curaรงao, Jan, 2014

Introduction  I

have spent 28 years fighting incineration (and promoting more sustainable ways of handling waste) (1985-present)  This has taken me to 49 states in US, 7 provinces in Canada and 60 other countries

Sostenibilitaâ&#x20AC;&#x2122;

Between 1985 and 1995

We (Work on Waste, USA) helped to stop over 300 incinerators from being built in North America

EFFECTING CHANGE Is like driving a nail through a piece of wood

EFFECTING CHANGE Experts may sharpen the point

But you need the hammer of public opinion to drive the nail home

 I

have spent 17 years fighting water fluoridation first as a professor of chemistry specializing in environmental chemistry and toxicology, and now as director of the Fluoride Action Network.  This research effort culminated in the publication of The Case Against Fluoride in October, 2010.

.. .. .. . Look A New c c ie n ti fi a t th e S e Ev id e n c . .. .. ..

Book published by Chelsea Green October, 2010

T H E CASE AGA I NS T

Fluoride How Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep It There

PAU L C O N N E T T, P h D James Beck, MD, PhD | H. Spedding Micklem, DPhil

Can be ordered on Amazon.com

Contains 80 pages of references to the Scientific literature

James Beck, MD, PhD, A retired professor of Physics from Calgary

HS Micklem, D Phil (Oxon) A retired professor of Biology from Edinbrgh

Outline of my presentation 1. Why fluoridation should not have started. 2. 7 Ugly facts that have emerged since 1990 that should have ended fluoridation. 3. Better alternatives to fight tooth decay 4. Communities ending fluoridation 5. Resources

Part 1. Why Fluoridation should never have started

1. We should never use the public water supply to deliver medicine. WHY? 2. You can’t control who gets the medicine. 3. You can’t control the DOSE people get. 4. It violates the individual’s right to informed consent to medicine.

5) There is no reason to swallow fluoride a)  Fluoride is NOT a nutrient. b)  There is not a single process inside the human body that needs fluoride to function properly, however 6) Fluoride is a known toxic substance that interferes with many fundamental biochemical functions In other words: it doesn’t do any good to swallow fluoride and it has the potential to cause harm

7) Nature has given us a very clear indication that the baby needs NO or VERY little fluoride for healthy development. The level of fluoride in mothersâ&#x20AC;&#x2122; milk is EXTREMELY LOW (0.004 ppm, NRC , 2006, p. 40)

8) A bottle-fed baby in a fluoridated community (0.7 â&#x20AC;&#x201C; 1.2 ppm) is getting 175-300 times the fluoride dose that nature intended. Who knows more about what the baby needs â&#x20AC;&#x201C; nature or those who promote fluoridation?

9) In addition to posing risks to the babyâ&#x20AC;&#x2122;s developing tissues, because fluoride accumulates in the bones it poses LIFELONG risks in the form of arthritis and increased bone fractures in the elderly (especially HIP fractures)

10) The fluoridating chemicals used are not the pharmaceutical grade chemicals used in dental products, but are industrial waste products. These chemicals are obtained largely from the scrubbing systems of the phosphate fertilizer industry. One of the contaminants is ARSENIC.

9) (CONT.) ARSENIC According to the US EPA arsenic is a human carcinogen for which there is no safe level. Thatâ&#x20AC;&#x2122;s why they set the MCLG for arsenic at ZERO. We should not KNOWINGLY add ANY arsenic to the drinking water.

Part 2 6 Ugly facts that should have ended fluoridation (An ugly fact can destroy a beautiful theory, Aldous Huxley)

Prelude to Ugly Fact #1 Between 1980 and 1990 A number of articles began to appear in major journals indicating that there was very little difference in tooth decay between fluoridated and non-fluoridated communities

Ugly Fact # 1 In 1990 the NIDR survey was published. This survey (1986-87) examined the teeth of over 39,000 children in 84 communities

NIDR - Brunelle and Carlos (1990) ď Žâ&#x20AC;Ż Brunelle

and Carlos compared DMFS (= decayed, missing and filled permanent tooth SURFACES) between children who had spent all their lives in a Fluoridated Community with those who had spent all their lives in a NonFluoridated community (Table 6)

There are 4 or 5 surfaces per tooth and when all the childâ&#x20AC;&#x2122;s permanent teeth have erupted there are a total of 128 surfaces.

Decayed Missing and Filled surfaces (DMFS)

There are 4 surfaces to the top six and bottom six cutting teeth and 5 surfaces on all the other teeth. 128 tooth surfaces in all.

Brunelle and Carlos (1990) (Table 6)

2.8 DMFS

The largest US survey of tooth decay

3.4

2.8

DMFS

Brunelle and Carlos, 1990

3.4

2.8

DMFS

Average difference (for 5 - 17 year olds) in DMFS = 0.6 tooth surfaces

Not only was this saving very small (0.6 of one tooth surface) but it was not even shown to be statistically significant!

BEWARE OF EXAGGERATION In the abstract of this paper. Brunelle and Carlos donâ&#x20AC;&#x2122;t mention the actual saving of 0.6 of a tooth surface. Instead they report it as a percentage saving. They write: Children who had always been exposed to community water fluoridation had mean DMFS scores about 18% less than those who had never lived in a fluoridated communityâ&#x20AC;Śthe results suggest that water fluoridation has played a dominant role in the decline of caries and must continue to be a major prevention methodology.

BEWARE OF EXAGGERATION Describing the 0.6 of one tooth surface as an 18% saving is mathematically correct: 0.6 / 3.4 x 100 = 18% But it is misleading to the average person. Sometimes civil servants working for health agencies in countries that support fluoridation make even worse exaggerationsâ&#x20AC;Ś

Queensland Healthâ&#x20AC;&#x2122;s promotion of mandatory statewide fluoridation) (2007)

Queenslanders were told Fluoridated Townsville has 65% less tooth decay than Non-Fluoridated Brisbane



“ In Townsville, water supplies have been fluoridated since 1964, resulting in 65% less tooth decay in children than those in Brisbane”

Qld Health newspaper ads Dec 2007

How did they get the 65% less decay ?

“ Teeth exposed to fluoridated water” Qld Health 2007

“ Teeth without exposure to fluoridated water” Qld Health 2007

UGLY FACT #2

Warren et al. (2009) (the Iowa study) find no relationship between the amount of fluoride ingested by children and level of tooth decay

The authors state: These findings suggest that achieving a caries-free status may have relatively little to do with fluoride intakeâ&#x20AC;Ś Warren et al., 2009

UGLY FACT #3

Probably explains Ugly Facts #1 and 2 In 1999, the CDC concedes that the predominant benefit of fluoride is TOPICAL not SYSTEMIC.

CDC, MMWR, 48(41); 933-940, Oct 22, 1999 

Fluoride’s caries-preventive properties initially were attributed to changes in enamel during tooth development... However, laboratory and epidemiologic research suggest that fluoride prevents dental caries predominantly after eruption of the tooth into the mouth, and its actions primarily are topical…

If fluoride works primarily on the outside of the tooth not from inside the body

Why swallow fluoride and expose every tissue of the body to a toxic substance, when you can brush it on your teeth and spit it out? And why put it in the drinking water and force it on people who donâ&#x20AC;&#x2122;t want it?

Ugly Fact # 4

Ugly Fact # 4 The U.S. National Research Council 3-year review (NRC, 2006) clearly shows that fluoride can cause harm at relatively low levels and there are many unanswered safety questions.

NRC (2006) review gives an exposure analysis (see Chapter 2) that shows that subsets of U.S. population drinking F -water (including bottle-fed infants) are exceeding EPAâ&#x20AC;&#x2122;s safe reference dose (0.06 mg fluoride/kg bodyweight/day)

See Figure 2-8 on page 85 (NRC, 2006) ď Žâ&#x20AC;Ż FIGURE

2-8 shows estimated average intake of fluoride from all sources, at 1 mg/L in drinking water for various age ranges

NRC(2006) review Showed that there are many unanswered safety questions about fluoride and recommended that more research should be done

NRC(2006) review Showed that fluoride (they did not look at fluoridation per se) can cause several harmful effects at relatively low levels.

NRC (2006) Review I argue that the levels, which cause harm, indicate that there is no adequate margin of safety to protect everyone drinking fluoridated water (see IQ discussion later)

Ugly Fact # 5 In 2010, the U.S. Centers for Disease Control and Prevention (CDC) published dental fluorosis figures that confirm that American kids are being hugely over-exposed to fluoride

Context on Dental Fluorosis Early promoters thought that at 1 ppm F they could reduce tooth decay and limit dental fluorosis to 10% of children in its very mild form.

CDC (2010) Beltrรกn-Aguilar et al. Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004

41% of ALL American children aged 12-15 (average from both fluoridated and non-fluoridated communities) had dental fluorosis

CDC, 2010

41%

Impacts up to 25% of tooth surface

Very Mild Dental Fluorosis

CDC, 2010

41%

Impacts up to 50% of tooth surface

Mild Dental Fluorosis

CDC, 2010

41%

Impacts 100% of tooth surface

Moderate- Severe Dental Fluorosis

A KEY QUESTION When fluoride is damaging the babyâ&#x20AC;&#x2122;s growing tooth cells (causing dental fluorosis) what is it doing to its other developing tissues?

Ugly Fact # 6 There is extensive evidence that fluoride damages the brains of animals and humans

Over 40 animal studies show that prolonged exposure to fluoride can damage the brain. 19 animal studies report that mice or rats ingesting fluoride have an impaired capacity to learn and remember. 12 studies (7 human, 5 animal) link fluoride with neurobehavioral deficits 3 human studies link fluoride exposure with impaired fetal brain development 37 out of 43 published studies show that fluoride lowers IQ

To access any of these brain studies

1) Go to FluorideALERT.org 2) Click on RESEARCHERS 3) Click on Health Data Base 4) Click on Brain Effects Or go direct to FluorideALERT.org/issues/ health/brain

Xiang et al. (2003 a,b)   

  

Compared children in two villages ( <0.7 ppm versus 2.5 - 4.5 ppm F in water) Controlled for lead exposure and iodine intake, and other key variables (NOTE: both lead exposure and low iodine also lower IQ). Found a drop of 5-10 IQ points across the whole age range The whole IQ curve shifted for both males and females

Xiang et al. (2003 a,b) MALES

The Harvard review  Choi

et al (the team included Philippe Grandjean) did a meta-analysis of 27 studies comparing IQ in high versus low fluoride villages .  The study was published in Environmental Health Perspectives (published by NIEHS)

Harvard meta-analysis of 27 studies  The

Harvard team acknowledged that there were weaknesses in many of the studies, however…

 …the

results were remarkably consistent   In 26 of the 27 studies there was lower average IQ in the high versus low-fluoride villages.  Average IQ lowering was about 7 IQ points.

Promoters claim that the fluoride levels in the High Fluoride villages were so high that they are not relevant to fluoridation programs?   THIS

IS NOT TRUE. In at least six of the studies the high fluoride village had concentrations less than 3 ppm   These studies offer no adequate margin of safety to protect all children drinking uncontrolled amounts of fluoridated water

11 of the 37 IQ studies found an association between lowered IQ and fluoride levels in the urine

Xiang finds an association between lowered IQ and PLASMA fluoride levels Xiang et al., 2011

Ding et al. 2011

Xiang (2012). Childrenâ&#x20AC;&#x2122;s IQ versus Levels of fluoride in the serum (children from both villages combined, personal communication with Paul Connett) . The higher the levels of fluoride in the plasma the lower the levels of IQ.

A Margin of Safety Analysis for Lowered IQ

Nine of the studies in the Harvard Review found a lowered IQ at less than 3 ppm.

In Six of these studies the lowering of IQ in the High-fluoride villages was statistically significant

I am going to remove the study by Lin et al., 1991 because it is complicated by the iodine situation

We are left with five ss studies where the highfluoride village contained 1.8; 2.0; 2.38; 2.5 and 2.9 ppm respectively

For this Margin of Safety analysis we will select the study with the lowest concentration where lowered IQ (harm) was found

STEP 1. Estimating the range of doses a child would get drinking fluoridated water at 1.8 ppm

STEP 1. Estimating the range of doses a child would get drinking fluoridated water at 1.8 ppm i) If the child drank 0.5 liters of water per day the dose would be 1.8 mg/L x 0.5 L/day = 0.9 mg/day

STEP 1. Estimating the range of doses a child would get drinking fluoridated water at 3 ppm i) If the child drank 0.5 liters of water per day the dose would be 1.8 mg/L x 0.5 L/day = 0.9 mg/day ii) If the child drank 1.0 liters of water per day the dose would be 1.8 mg/L x 1 L/day = 1.8 mg/day

STEP 1. Estimating the range of doses a child would get drinking fluoridated water at 1.8 ppm

RANGE = 0.9 â&#x20AC;&#x201C; 3.6 mg/day

RANGE = 0.9 – 3.6 mg/day STEP 2. The LOAEL would be 0.9 mg/ day. The NOAEL would be 10 x less than the LOAEL The NOAEL = 0.09 mg/day

STEP 3. Applying a safety margin. The default safety factor when going from a small study group to a large population is 10. We will divide the NOAEL 0.09 mg/day by 10 = 0.009 mg/day SAFE DOSE sufficient to protect everyone in a large population = 0.009 mg/day

STEP 4. Estimating how much water they could drink (ignoring other sources). Using the safe dose of 0.009 mg/day children should not drink more than 9 ml (0.009 L) per day of fluoridated water at 1.0 ppm (or 6 ml at 1.5 mg/liter) 0.009 L/day x 1 mg/liter = 0.009 mg/day. 0.006 L/day x 1.5 mg/liter = 0.009 mg/day.

In other words in order to protect all children (including the most sensitive) drinking fluoridated water at 1.5 ppm they should not drink more than a few teaspoons of water per day. This could go up to 60 ml (half a glass of water) IF the NOAEL was close to the LOAEL

Protecting our babies from fluoride

Safe dose for a 7 kg baby  To

calculate safe dose for a baby we have to take into account bodyweight  Supposing the safe dose for 20 kg child was 0.009 mg Fluoride per day  Safe dose for a 7 kg baby =0.009 mg/ day multiplied by bodyweight ratio 7/20 = 0.009 x 7/20 = 0.00315 mg/ day

Breast–fed versus bottle-fed baby  Breast-fed

baby   drinking 800 ml at 0.004 mg/L  =

0.8 L x 0.004 mg/L = 0.0032 mg/day  We estimated safe dose for a 7 kg baby as 0.00315 mg/day – so a bottle fed baby is OK as far as lowered IQ is concerned.

Breast–fed versus bottle-fed baby  Bottle-fed

baby  drinking 800 ml at 1.5 mg/L  =0.8L x 1.5 mg/L =1.2 mg/day  1.2 mg/day divided by 0.00315 mg/ day = 400 TIMES SAFE DOSE to protect the most sensitive baby in a large population from lowered IQ.

Dr. Philippe Grandjean Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain. The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us. (Harvard Press Release)

IQ and population Number of Kids With a Specific IQ

100

IQ and population Number of Kids With a Specific IQ

Mentally handicapped

100

Very Bright

IQ and population Number of Kids With a Specific IQ

95 100

Ugly Fact # 7 Fluoridation may actually be killing a few young boys each year Bassin et al., 2006

Osteosarcoma  Bassin

found that young boys exposed to fluoridated water in their 6th,7th or 8th years, had a 5-7 fold increase in developing osteosarcoma by the age of 20, compared to non-exposed boys.  Her 2006 study has never been refuted.  The study promised by Douglass (Kim et al., 2011) failed to do so.

Part 3 Better Alternatives for fighting tooth decay

The vast majority of countries do NOT fluoridate their water

97% of Western European population now drinks Non-Fluoridated Water Austria Belgium Denmark Finland France Germany Greece Iceland

Italy Luxembourg Netherlands Northern Ireland Norway Scotland Sweden Switzerland

97% of Western European population now drinks Non-Fluoridated Water

Austria* Belgium Denmark Finland France* Germany* Greece Iceland

Italy Luxembourg Netherlands Northern Ireland Norway Scotland Sweden Switzerland*

*Some fluoridate their salt

According to WHO data tooth decay in 12-year-olds is coming down as fast in F as NF countries

SOURCE: World Health Organization. (Data online)

Better Alternatives If you want fluoride use fluoridated toothpaste (96% toothpaste sold in US is fluoridated) Better still use XYLITOL toothpaste. Xylitol toothpaste has been used for over 30 years in Finland Give Xylitol mints (not chewing gum) to kids in school (e.g. Wichita, Kansas). Give free toothbrushes and free toothpaste to low-income families (e.g. Scotland)

A recent BBC report from Scotland   “A

scheme to encourage nursery children to brush their teeth has saved more than £6m in dental costs, according to a new study.   Childsmile involves staff at all Scottish nurseries offering free supervised toothbrushing every day.   It emphasises the importance of toothbrushing and helps parents establish a healthy diet from the earliest stage.

Scotland  The

programme was launched in 2001 and costs about £1.8m a year.  Glasgow researchers found that the scheme had reduced the cost of treating dental disease in five-yearolds by more than half between 2001 and 2010.

Better Alternatives   Most

of tooth decay is concentrated in lowincome families   Most distressing tooth decay is baby bottle tooth decay   Low-income families need better diet and better dental education   LESS SUGAR! MORE BRUSHING!   Less sugar means less tooth decay and less OBESITY…less diabetes, fewer heart attacks (education = a good investment!)

Summary   1.

Fluoridation is a bad medical practice: you can’t control DOSE, or who gets the medicine and it violates the individual’s right to informed consent.   2. Fluoride is not a nutrient.   3. Fluoride can interfere with many aspects of biochemistry   4. The level of fluoride in mothers milk is very low (0.004 ppm). A bottle-fed baby in Curacao could get 370 times more fluoride.

Summary   5.

The evidence of any benefit is weak (Brunelle and Carlos, 1990; Warren et al., 2009 and WHO figures for different countries).   6. Point 5 is best explained by the fact that the predominant benefit is TOPICAL not SYSTEMIC (CDC, 1999 and 2001).

Summary   7.

Today children are getting far too much fluoride – see dental fluorosis prevalcnce.   8. Fluoride can damage the brain and there are 37 studies that have found a statistically significant reduction in IQ associated with fluoride exposure as low as 1.8 ppm.   9. Fluoride accumulates in the bone and may cause osteosarcoma in young men and over a lifetime may cause arthritic symptoms and increased hip fractures.

Summary   10.

There are better alternatives that are proving successful in many non-fluoridated countries e.g. Scotland.   In short, the RISKS to the brain and the bones far outweigh the small BENEFIT to the teeth. Lower tooth decay can be achieved in low-income families with alternative methods, which do not involve exposing the whole body to fluoride and do not involve governments forcing it on citizens who don’t want it.

Summary   We

need EDUCATION not FLUORIDATION to fight tooth decay and obesity.   We need to get Dentistry out of the public water supply and back into the dental office or dental clinic.   It is TIME TO END FLUORIDATION IN CURACAO!

Part 4. More on IQ studies Communities ending fluoridation

Since 2008, over 130 communities in Australia, Canada, New Zealand and the U.S have stopped fluoridation 4 million people have been liberated!

3. May 21, Portland Oregon voted 61% to 39% to reject fluoridation despite being outspent 3 to 1. The promoters spent nearly $1 million â&#x20AC;&#x201C; which included paying several groups $20,000 for their support!

1. Nov 2012, Queensland lifted mandatory requirement 2. April 2013, Israel MOH announces lifting of mandatory requirement in one year

More Part on IQ5. studies

RESOURCES

www.FluorideALERT.org click on the RESEARCHERSâ&#x20AC;&#x2122; button top right on home page

National Research Council (2006)

.. .. .. . Look A New c c ie n ti fi a t th e S e Ev id e n c . .. .. ..

Book published by Chelsea Green October, 2010

T H E CASE AGA I NS T

Fluoride How Hazardous Waste Ended Up in Our Drinking Water and the Bad Science and Powerful Politics That Keep It There

PAU L C O N N E T T, P h D James Beck, MD, PhD | H. Spedding Micklem, DPhil

Can be ordered on Amazon.com

Contains 80 pages of references to the Scientific literature

Please watch the 29 minute DVD Professional Perspectives on Fluoridation Can be viewed ONLINE at www.FluorideALERT.org

Please watch the 20 minute DVD TEN FACTS on FLUORIDE PLUS BOOKLET at www.FluorideALERT.org

EXTRA SLIDES

Part 6 The bad science that is used in the promotion of fluoridation

The science supporting fluoridation has been very poor   1)

There has been NO investigation of a possible relationship (in F-countries) between fluoridation &   a) Arthritis;   b) Hypo-thyroidism;   c) Alzheimer’s disease;   d) lowered IQ;   e) behavioral problems in children;   f) earlier onset of puberty or   g) bone fractures in children

The science supporting fluoridation has been very poor ď Žâ&#x20AC;Ż2)

There has been NO attempt in any fluoridated community to investigate the many complaints by citizens that they are super-sensitive to fluoride exposure and suffer symptoms that are reversed when they avoid fluoride.

Dr. Peter Cooney  Dr.

Peter Cooney, the Chief Dental Officer of Canada, told an audience in Dryden, Ontario (April 1, 2008),   I walked down your High Street today, and I didn’t see anyone growing horns, and you have been fluoridated for 40 years!

John Doull (chairman, NRC, 2006 Review)

What the committee found is that we’ve gone with the status quo regarding fluoride for many years —for too long really—and now we need to take a fresh look . . .



John Doull (chairman, NRC, 2006 Review)

In the scientific community people tend to think this is settled. I mean, when the U.S. surgeon general comes out and says this is one of the top 10 greatest achievements of the 20th century, that’s a hard hurdle to get over…



John Doull (chairman, NRC, 2006 Review)  But

when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on.



Scientific American, Jan 2008.

The science supporting fluoridation has been very poor   3)

There has been NO attempt to reproduce studies of harm found in countries with high natural levels of fluoride   4) The absence of study is being used to suggest the absence of harm   5) There has never been a single randomized clinical trial (RCT = the Gold Standard for Epidemiology) to demonstrate the effectiveness of water fluoridation

Fluoridation has become a belief system which has undermined decision-making in the public health community

Fluoridation is a belief system   Fluoridation

has never been a science-based practice (certainly not good science).   The tactics of promoters reveal this: a) they use endorsements (i.e. authority) in place of primary science   and b) they attack the credibility of opponents with many personal attacks.   Such tactics would not be necessary if the primary science was on their side.

Some examples of unprofessional tactics, poor science and biased reviews   1)

ADA White paper (1979)   2) CDC (1999)   3) Queensland Health (2007) promotion   4) Health Canada (2008) expert panel biased

ADA White Paper (1979) Individual dentists must be convinced that they need not be familiar with scientific reports and field investigations on fluoridation to be effective participants and that non- participation is overt neglect of professional responsibility.

CDC (1999) In October 1999, the CDC claimed that fluoridation was one of the great public health achievements of the 20th century. But this statement (and all statements on fluoridation from the CDC) comes from the Oral Health Division – consisting of about 30 – largely dentally trained personnel – whose mission is to promote fluoridation.

CDC (1999) This claim was based on a report written by two people. One a dentist who had not published anything on fluoridation before and the other an economist. This report was not externally peer-reviewed. It was six years out of date on the health studies cited for safety. The evidence cited to demonstrate effectiveness was trivial and embarrassing (see Figure 1).

CDC MMWR, October 22, 1999

SOURCE: World Health Organization. (Data online)

Queensland Healthâ&#x20AC;&#x2122;s promotion of mandatory statewide fluoridation) (2007) discussed above

Health Canadaâ&#x20AC;&#x2122;s expert panel (2007) In 2007 Health Canada selected a panel of six experts to review the literature of fluoridationâ&#x20AC;&#x2122;s safety and effectiveness Of the 6 panelists chosen FOUR were dentists well-known for their promotion of fluoridation. The review was a self-fulfilling prophecy.

The dental lobby has controlled this debate for far too long. There are more tissues in the body than teeth! It is time to get dentistry out of the public water supply and back into the dental office.