FAN Bulletin 890

November 11, 2007

Dear All,

Some of the most fanatical pushers of fluoridation seem to thrive in Australia and New Zealand. Below are two items to illustrate this.

First, is the text of the brochure published by the NHMRC in Australia to which I referred in yesterday’s bulletin. It reads like an apologia from the ADA. Not a single reference is given to support their claims of safety or effectiveness. While a full report is promised sometime in the future one has to question the motives of those who would put out such a brochure before putting out a supporting document. Maybe they have more confidence in their spin than they do in their science.

The second item comes from fluoridation fighters in New Zealand in response to a request I made to them to identify the pushers of fluoridation in their islands and any quotes that they could dig up from them. Many thanks to Don Church, Mary Byrnes, Mark Atkins, Bill Wilson, Imelda Hitchcock, Yvonne McDonald, Bruce Spittle and David Tranter for their input into this summary.

May I request opponents of fluoridation in other countries (especially Australia, Canada, Ireland, Israel, and the UK) to do likewise (the NZ report is a good model) and if you are from the United States to do it for your individual states. No huge hurry, but I think it is a useful exercise to review the caliber of the people we are up against. Many thanks.

We should remember that neither Australia nor New Zealand has done any significant health studies (the only tissue they study is teeth) so all the health studies they review come from outside the country. However, they are very selective about which reviews they use. Thus, when officials in OZ and NZ are presented with the NRC’s 2006 painstaking landmark review of fluoride’s toxicology consisting of 507 pages containing over 1000 references, they merely shrug it of as if it had never happened. It will be very interesting to see to what extent the NHMRC has analyzed the health effects covered in the NRC review.

The NHMRC brochure

>From the chicken scratch on the NHMRC brochure it would appear that they have largely ignored fluoride’s impacts on the brain, the endocrine system, and the kidney, as well as the early symptoms of fluoride’s bone damage which is identical to the early symptoms of arthritis. Of particular concern is their apparent passing over of one of fluoride’s most worrying effects: the lowering of thyroid function. This is especially serious omission for Australia, since fluoride strikes hardest on the thyroid gland of people with borderline iodine deficiency. Australia has a huge problem with borderline and outright iodine deficiency. It also has a huge problem with depression (one in five) which is a symptom of pre-clinical hypothyroidism.

To gloss over health problems for any practice is irresponsible, but to do so when it pertains to a practice which is being forced on people – often against their will – is utterly outrageous.

When the NHMRC brochure authors refer to skeletal effects they state that “Fluoridation at 0.6 to 1.1 mg/L may lower overall fracture risk compared to both no fluoridation and fluoridation at levels well above those experienced in Australia.”  I suspect that they are referring to the paper from Li et al. (2001) which found more overall fractures in two Chinese villages with fluoride levels less than 1 ppm compared to the control village at 1 ppm. But if this is the paper that backs up this claim, then it is worrying that they have failed to point out that in this same study hip fracture rates in the elderly doubled in the two villages at 1.5 ppm – 3.5 ppm, and tripled in the village at 4.3 ppm and over. While the latter result was the only statistically significant increase, the overall trend seems to be linear and real. Which brings me to what appears to be a key absence in the NHMRC “analysis”: namely a discussion of Margin of Safety.

No one can deny that fluoride damages health. The NRC (2006) review makes that abundantly clear. The key argument is whether there is an adequate margin of safety between the levels at which effects occur and doses received in a human population drinking uncontrolled amounts of water and getting fluoride from a multitude of other sources. In addition, such a margin of safety needs to protect the whole population (not just the average healthy adult) which includes the very young, the very old, the very sick, people with impaired kidney function and those with poor nutrition, including those with borderline iodine deficiency.

Unless a review of safety provides a solid discussion of what constitutes an adequate margin of safety to cover this situation it is simply not worth the paper it is printed on.

Simply stressing what effects have been observed or not observed at 0.6 – 1.1 mg/liter is utterly simplistic and would only be appropriate if each person was given one liter of such water each day and told not to drink any more, and not get fluoride from any other source. It also assumes that in the study in question the researchers have covered the full range of sensitivity in the human population. Studies are seldom this large and thus a margin of safety calculation is essential.

A typical response to such comments is, “Well country X has been fluoridating for over 40 years and if there was a problem we would have seen it by now!” Such a response would only make sense if country X had set about doing studies to see if there had been any problems. Again Australia has not, even though the NHMRC itself in 1991 suggested that they do so. If you don’t look, you don’t find. The NHMRC 1991 suggestions included asking Australian health authorities to investigate the numerous “anecdotal” stories of some individuals being sensitive to fluoride. No Australian health authority has done this. It will be interesting to see if the NHMRC discusses this again in its 2007 review.

As far as effectiveness is concerned I will also be anxious to see how the NHMRC authors deal with Armfield and Spencer’s 2004 report of findings from South Australia that there was no significant difference in tooth decay in the permanent teeth of children who had drunk fluoridated water all their lives and thus who had drunk bottled water or tank water. And how they can continue to support forcing this practice on people after it has been conceded by leading dental researchers as well as the CDC that fluoride works on the outside of the tooth (topical) and not from inside the body (systemic).

One last comment. I notice they refer to “fluoride-deficient water.” I wonder if they would also refer to “fluoride-deficient breast milk”  after all 0.004 ppm is considerably lower than the average level in unfluoridated water. But who needs nature’s guidance on these matters when we have the NHMRC to look after us?

Paul Connett
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The NHMRC brochure from Australia

NHMRC Public Statement
The Efficacy and Safety of Fluoridation 2007

The aim of a recent NHMRC systematic review of fluoride and health was to synthesise high level evidence in relation to the efficacy and safety of different forms of fluoridation, with emphasis on those able to be delivered as a widespread public health initiative. Methods of fluoride delivery reviewed were water, milk, salt and topical agents such as toothpaste and gels, though the evidence for water fluoridation is the most extensive.

Water Fluoridation

The aim of water fluoridation is the adjustment of the natural fluoride concentration in fluoride-deficient water to that recommended for optimal dental health. The figure below shows the dates of introduction of water fluoridation to Australian capital cities, target fluoride levels and percentage of the population who have access to fluoridated water.

NHMRC Recommendation

Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride. It is recommended that water be fluoridated in the target range of 0.6 to 1.1 mg/L, depending on climate, to balance reduction of dental caries and occurrence of dental fluorosis.

Additional Information

Infant Formulae

Recent Australian research does not show an association between use of infant formulae and dental fluorosis. The critical period for development of dental fluorosis is after the first twelve months of life, by which time the majority of Australian children have ceased exclusive formula consumption.

Measurements were made of 49 samples of formula available at supermarkets, finding that the fluoride concentrations have fallen considerably to allow reconstitution with fluoridated water.

Fluoride supplements, including toothpastes

When using the parameter of ‘fluorosis of aesthetic concern’ (in contrast to ‘any fluorosis’), there was no statistical significance between those using fluoride toothpaste and controls. Australia has been at the forefront of the use of a low fluoride children’s toothpaste by children up to the age of six years, including giving advice on the appropriate use of
toothpaste. This has been associated with significant reductions in the prevalence of any fluorosis (especially very mild and mild fluorosis) in Australian children.

Risks associated with Fluoridation

Fluorosis

There is consistent evidence that water fluoridation results in the development of dental fluorosis, however the majority of dental fluorosis is not considered to be of  ‘aesthetic concern’. The prevalence of fluorosis has been significantly reduced with more appropriate use of other fluoride sources.

Skeletal effects

Water fluoridation at levels aimed at preventing dental caries has little effect on fracture risk. Fluoridation at 0.6 to 1.1 mg/L may lower overall fracture risk compared to both no fluoridation and fluoridation at levels well above those experienced in Australia.

There is currently no evidence to determine the impact of milk and salt fluoridation, or other fluorides used to prevent dental caries, upon fracture risk and osteoporosis.

Cancer

There is no clear association between water fluoridation and overall cancer incidence or mortality. The evidence shows variations on either side of the effect, however only two studies present statistically significant results, one showing an increase and one a decrease in cancer incidence.

Other

There is insufficient evidence to reach a conclusion regarding other possible negative effects of water fluoridation. There is currently no evidence available to determine the other possible negative effects of milk, salt or topical fluoride supplementation.
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Fluoridation pushers in New Zealand

Introduction.

According to Bill Wilson, as regards the movers and shakers of Fluoridation promotion in NZ, the two previous Ministers of Health (Annette King and Pete Hodgson) come high on the list. These Ministers claimed that local councils are really responsible for implementation, but the Ministry is there pulling the strings. They have done this via the District Health Boards.

These District Health Boards (DHB) are locally elected but the Minister appoints four additional members from whom the chairperson is chosen. These four plus the pro-F people on the DHB are usually sufficient to hold the reins of power. Each DHB has an employee whose sole job is to push fluoride. Any time they can the DHBs try to quash any move to stop fluoridation - this happened recently when a councillor on the Auckland City council put forward a motion that fluoridation be stopped.

Bill Wilson writes about the Auckland meeting: “I was allowed 5 minutes which, after my protests, was increased to seven and a half minutes, to speak for the motion. The DHB had 3 speakers plus the wife of one of the councillors spoke against the motion. The wife was an ex-dental nurse!”

Annette King

According to Mark Atkins (Wellington) the main driver in NZ for several years was “Health Minister Annette King, an ex dental assistant, which supposedly makes her an international expert on fluoridation. It was she who wrote in a letter to Sylvia Cole of Wairoa (Sylvia was instrumental in getting the council to reverse its vote to fluoridate) that ‘no reputable scientists agreed with Dr Paul Connett’s views on fluoridation’. When I listed a number of scientific opponents and asked for her evidence that they were not reputable she ran and hid behind the Ministry (even though it was personal letter from her to Sylvia). The Ministry admitted that perfectly reputable scientists held views opposing fluoridation and there was legitimate scientific controversy over the issue ‘like all health issues.’”

Yvonne McDonald adds that at the 3rd N.Z. Fluoridation Forum – Annette King stated that:

“I do not need to remind this meeting of the enormous wealth of evidence demonstrating the effectiveness of fluoridating water as an equitable and cost-effective public health measure that can reduce decay in children by as much as fifty percent.”

“Anti-fluoridationists are vociferous, and understandably, communities and local authorities find themselves in a difficult situation when the information gulf between pro and anti-fluoridationists is so wide”

“The forum has developed strategies to counter anti-fluoridation claims” and “the Ministry continues to fund research into effective strategies for promoting fluoridation”.

Pete Hodgson

Yvonne adds this about another Minister of Health, Pete Hodgson, who in a reply to her letter (dated 18/05/03) asking whether the Government intended sending a representative to the ISFR Conference held in Dunedin on the South Island (Bruce Spittle- please don’t grind your teeth) “The International Society for Fluoride Research is not a reputable body so the Government will not be sending a representative.”  

Pete Hodgson also dismissed arguments against fluoridation as “scam science on the internet.”

The current Minister of Health is David Cunliffe, and it is not sure if he will be pushing the party line. According to Mary Byrne, the current staff at the Ministry seem to have been thrown in disarray by the ADA warning (Nov 9, 2006) to parents not to use fluoridated tap water to make up baby formula. She writes:

“Robin Whyman is the Ministry of Health’s Chief Advisor of Oral Health. He and a policy analyst named Sally Gilbert seem to be the only ones inside the Ministry of Health National Office that know anything about fluoridation.  When I rang earlier this year to talk about the ADA and CDC infant formula/fluoride warning, the policy analyst who I first spoke to thought I must be joking or that I had read some bogus web site and that this couldn’t possible be what the ADA and CDC were saying. However, the other policy analyst that he said would know about it was Sally Gilbert and since she was in a meeting the only other person they (the MOH staff) could find who also would know about it was Robin Whyman. As it turned out he was in a meeting too. Probably with Sally Gilbert trying to think up what to do about this warning!!”

Mark Atkins on Dr. Terry Cuttress and ESR

Another promoter is Dr Terry Cuttress. He worked for WHO for decades and seems to have devoted his whole life to Fluoridation. Unlike Hardy Limeback, he cannot accept he is wrong. He is much like Martin Lee (see below) in his statements. He is the Ministry of Health’s hired gun - when they want a report telling them they can ignore things like the York Review (McDonagh et al., 2000) they get good ole Terry to write them. Alternatively, their other hired gun is ESR - Environmental and Scientific Research (see below).

According to Mary Byrne (Petone) Terry Cuttress is now writing up a report with ESR to counter the ADA Nov 9 baby formula warning and continue their claims of why it doesn’t apply to NZ. Mary writes:

“ I met Terry Cuttress at a public meeting of about 80 people in Lower Hutt in 1999. I had said in my talk that fluoride accumulates in the bones. At question time he said that fluoride did not accumulate in the bones and where was I getting that rubbishy sort of information from (or something along those lines).   I was flabbergasted and held up the MOH pamphlet they had sent to every household in Petone which said that fluoride accumulates in the bones makes them more dense. And Cuttress is the guy still writing up reports for the government.”

ESR

This is a privatized spin off from the former Government Scientific Research department. They have a $10 million a year income (conflict of interest?) from the Ministry of Health. In 2000 (after the York Review was published), ESR  produced a “review” which failed to meet the terms of reference, and looked at only 18 population studies, which were limited to hip fracture, cancer, and fluorosis. Here is an indication of how biased their report was. They gave both a pro and anti-F study the exact same critiques of methodological flaws (word for word) but concluded that we must totally reject the anti but still count the pro as a study in favour of Fluoridation.

I have an email effectively acknowledging they did a “hatchet job” on a NZ hip fracture study by Al Murieb. They found an excuse to remove the data that showed an increase in fluoridated areas, and then concluded that because the remaining data showed no difference there wasn’t one!
 
Others have filed you in on Martin Lee (see below). A critique of his bogus study is on ourweb site. (Mark Atkins)
 
Dr. Martin Lee,

According to Jackie Douglas, Martin Lee, Principal Dentist, Christchurch District Health Board, has promoted fluoridation throughout the South Island, which has included his legendary media attacks on opponents. These include:

publicly stating that opponents use the same tactics as Al Queda,
saying at a Westland District Council meeting that all those who oppose fluoridation are akin to “believers in aliens, and that Elvis is still alive.”
More recently, Lee labeled us all in the media as “Luddites.”  

Imelda Hitchcock adds, “In the Timaru Herald on 12 August, 2000, he  said the following; “The anti-fluoridation people are like the George Speight of the health world. They’re hijacking the democratic process.”

Martin Lee also said in letter to our local paper that “Mrs Hitchcock is not an expert on matters pertaining to fluoridation or oral health, and seems to have quite a lot of trouble both getting her facts right and in making fair and reasonable comparisons on the subject. Read with caution”.

However, Don Church put him in his place in a reply letter to the paper saying: “Mrs Hitchcock got her facts right. I find nothing wrong with Mrs Hitchcock’s figures. Indeed it is Dr Lee who seems to be at odds with the Department of Health statistics”. Don supplied the true statistics.

David Tranter tells us that, “Martin Lee has stated in public meeting that there is absolutely no evidence of harm whatsoever from fluoridation.”

Yvonne McDonald adds, “Yes indeed - Dr Martin Lee  is one of New Zealand’s prime movers and shakers. I could fill a book with his recorded ramblings but a couple to be going on with:
 
In the Christchurch Star (November 2003) Lee blamed the influx of anti-fluoridation letters on “a few misinformed lay people supported by an international group of single issue fanatics in the face of overwhelming scientific evidence and common sense”.

He also stated “it strained credibility to rally against fluoridation when you only had to look at Ireland, the U.K. public health system and Australia (bar Queensland) for examples of countries running successful fluoridation schemes”

Lee also stated that, “What the public needs to realize is that there is no serious scientific controversy.”
 
>From a Christchurch DHB “Health First” publication (2006) imploring people to write to the City Council and tell them to fluoridate the water, Lee writes,  ”Tell the council not to worry about the anti-fluoridationists. While they make a fair bit of noise, and like all good pressure groups have credible looking web-sites, they’re just the health version of the Flat Earth Society”.
 
Dr. Daniel Williams

Don Church, of Ashland, adds another name to the list. He writes: “Dr Daniel Williams also of Christchurch District Health Board is also constantly lobbying councils within Canterbury and Westland but at least he doesn’t make personal derogatory remarks and so, in that sense, is more a “gentleman” than Dr. Martin Lee.