4. Some 35 medical professionals have sent a letter (see below for text) to
Gordon Empey, DDS, MPH, the Oral Health Director of the Office of family
Health, Oregon Department of Heath Services, requesting that the department
circulate information to the public on the ADA/CDC recommendations that
fluoridated tap water NOT be used to make up baby formula. The urgency
expressed by these medical professionals is in sharp contrast to the efforts
by the CDC and the ADA to downplay the significance of this recommendation,
as becomes even more apparent in the Feb 7 article (see below) from the
Atlanta Journal Constitution.

More spin from the CDC.

The CDC wants to continue to cut its cake and keep it. It wants to live with
the contradiction of saying that fluoridation is not safe for babies while
holding onto the notion that fluoridation is safe for EVERYONE! Why? Because
for the Oral Health Division of the CDC (currently an unscrutinized arm of
government), it is more important to keep their fluoridation promoting
empire going, rather than protecting the health of the American people.

Here are some of the more juicy morsels of CDC spin from Oral Health
Director William Maas, who says, “Since the beginning we knew there was a
trade off between preventing tooth decay and enamel fluorosis.”  Indeed that
is true. But the trade off seen by Trendley Dean and others was that at 1
ppm only 10% of kids would get very mild dental fluorosis. Now 32% have
dental fluorosis (CDC, 2005) with about 4 percent developing ³moderate and
severe forms of the condition.² That is not a good trade off. For Dean even
mild dental fluorosis was not acceptable.

It is ironic that Maas should present the issue as one of parental choice
when he says, parents “need to consider the trade off and decide
accordingly” when neither he nor his employer (the CDC, or rather ADA¹s own
division at the CDC) are taking active and aggressive steps to get this
information to parents. Nor are they taking steps to encourage fluoridating
communities to provide alternative water supplies for this purpose. This is
particularly relevant for low income families, who are precisely the
families that they claim drives the water fluoridation program. They have
trapped these families with this program but now won¹t move to help protect
them from the risks.

But worse is the fraudulent way in which the CDC couches this trade off.
They say parents must ³weigh the risk of minor white flecking against the
potential protective benefits of early fluoride exposure against tooth
decay.² With respect to bottle feeding babies, this is fraudulent on two
counts:

Fraud 1: ³Minor white flecking² is a description of Dean¹s category which he
labeled ³questionable² dental fluorosis. Very mild dental fluorosis impacts
up to 25% of the tooth surface; mild up to 50% of the tooth surface and
moderate 100% of the tooth surface.

Fraud 2: Even the CDC itself (1999,2001) concedes that there is practically
no benefit to the enamel from fluoride exposure prior to the eruption of the
teeth. Thus, when parents unwittingly use fluoridated tap water to make up
formula they are only presenting their babies with risks and NO benefits.
Moreover, even while the CDC is only concerned with dental fluorosis as an
outcome to be avoided, there is wealth of information presented in the NRC
(2006) review which indicates that there are other risks to the baby¹s
developing tissues from exposing it to 250 times the level of fluoride which
is naturally present in mothers milk (0.004 ppm).

Another piece of deception from Maas comes when he says ³Children are at
greater risk … from improper use of toothpaste than from tap water.² The
attempt to claim different sources of fluoride responsible for different
levels of dental fluorosis is misleading when, in fact, it is the COMBINED
dose of fluoride from all sources that is causing the problem. The easiest
source to end, of course, is the unnecessary and willful fluoridation of the
public drinking water, with the multiplier effect of getting fluoride into
beverages and processed food made in fluoridated areas. Blaming toothpaste
and lack of parental control is a convenient way Maas uses to deflect
attention from the urgent need to end water fluoridation forthwith

Maas also bemoans the fact that “People still don’t realize how important it
is to control toothpaste use.”But whose fault is that, Dr. Maas? If this man
put a fraction of his time getting these warnings to health departments and
WIC programs (and perhaps even talking to the toothpaste manufacturers
themselves about their advertising huge swirls of toothpaste and flavoring
their toothpaste for kids with strawberry and bubble-gum flavor) that he
spends actively promoting mandatory statewide water fluoridation, parents
would not be so ill-informed.

Paul Connett

1. More spin from the CDC
     
Atlanta Journal Constitution
Wednesday 07 February 2007

CDC, dental group warn of too much fluoride for babies

By ALISON YOUNG

Health officials are recommending that parents who feed formula to their
babies consider using bottled water ‹ rather than tap ‹ when mixing it to
prevent a dental condition that causes subtle white marks on developing
teeth.

While emphasizing the significant benefits of fluoridated tap water in
preventing cavities, new recommendations from the Centers for Disease
Control and Prevention and the American Dental Association say parents need
to be aware of how much fluoride babies and young children are exposed to.

“Since the beginning we knew there was a trade off between preventing tooth
decay and enamel fluorosis,” said William Maas, director of CDC’s Division
of Oral Health.

Enamel fluorosis is a condition involving changes to the enamel surface of
teeth ‹ ranging from barely noticeable chalk-like white flecks and lines to
more severe pitting and staining. The condition occurs when children are
exposed to too much fluoride while their teeth are forming ‹ and mild forms
have been on the rise since the late 1980s.

Currently about one-third of U.S. children will develop very mild or mild
fluorosis ‹ which causes subtle white specks or lines on their adult teeth
that in most cases is not considered a cosmetic problem. About 4 percent
will develop moderate and severe forms of the condition, usually from
prolonged exposure to naturally high fluoride levels in some well water.

CDC has for years cautioned parents to limit the amount of fluoridated
toothpaste children use to no more than a pea-sized dollop because ingesting
the toothpaste during the first six years of their life ‹ while adult teeth
are forming ‹ had been linked to an increased risk of fluorosis.

Then last year, for the first time, a study indicated an association between
the use of infant formula and very mild and mild fluorosis, prompting the
CDC and the American Dental Association to put out new guidance. Infant
formula has not been associated with more severe forms of fluorosis.

“One of the more effective ways to reduce the already low fluoride levels
the youngest children are getting is looking at the reconstitution of
powdered or concentrated liquid formulas,” said John Stamm, a spokesman for
the American Dental Association and professor of dental ecology at the
University of North Carolina-Chapel Hill.

The issue isn’t the infant formula itself, but the water it’s reconstituted
with, Stamm and Maas said. For their size, babies consume a large percentage
of their body weight in fluoridated water when reconstituted formula is
their primary source of nutrition.

Ready-to-use infant formula has low levels of fluoride because companies
generally make it with demineralized water, and it is recommended by the
ADA. But ³most consumers prefer the lower price and convenience of powdered
formula or a concentrated liquid formula, which are mixed with tap water
before use.²

Most municipal water supplies in Georgia and across the country have added
low levels of fluoride for decades as a means of preventing tooth decay.
Fluoride, when it washes over teeth, stops the removal of minerals from
teeth by oral bacteria. The CDC considers fluoridating community water
supplies a highly safe and effective health measure.

Both the CDC and the ADA note that breastfeeding is best.

In a recommendation issued in November, the American Dental Association said
that for infants who get most of their nutrition from formula, parents
should use fluoride-free or low-fluoride bottled water to mix batches of
formula.

The CDC, which published its background paper on the formula issue in
December, said parents should check the fluoride level of their water
supply, then weigh the risk of minor white flecking against the potential
protective benefits of early fluoride exposure against tooth decay.

“They need to consider the trade off and decide accordingly,” Maas said.

Steven Adair, chairman of the department of pediatric dentistry at the
Medical College of Georgia, said most wells in Georgia have low levels of
fluoride, except some in coastal areas. Local water officials or dentists
can assist in getting water tested.

“If your household has fluoridated water and your child is taking
concentrated formula that’s reconstituted, if it’s economically feasible to
use bottled water to reconstitute it, that would be a good idea,” Adair
said.

Children are at greater risk, Maas noted, from improper use of toothpaste
than from tap water. For years the CDC has urged parents to be careful with
toothpaste to avoid children swallowing it and putting them at higher risk
of fluorosis.

Since 1996 toothpaste tubes have carried a warning that parents should
consult with a dentist or doctor before introducing a child younger than 2
to fluoridated toothpaste.

“People still don’t realize how important it is to control toothpaste use,”
Maas said.