Analysis: Fluoridation to Go Forward For Discussion on October 1

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fluoride-water

It had become one of the more divisive issues in the community, but despite that or perhaps because of that, there was one thing both sides agreed on Tuesday night – the council needed to go forward with the proposal to fluoridate the city’s water supply at the October 1, 2013, Davis City Council meeting.

City staff, perhaps sensing the need to cool down discussions, had recommended delaying the item until after the completion of the water project.

Staff states that they “feel” that “it would be appropriate to move Council consideration of whether to add fluoridation until after the DWWSP is constructed and has been operating at least a year. This will allow the Council to accurately assess the initial and ongoing cost for fluoridation that would be borne by the ratepayers.”

On June 27, 2013, the City of Davis Water Advisory Committee (WAC) voted to recommend to the City Council to add fluoride to the drinking water. As staff notes, during the course of the WAC deliberation, information regarding the range of potential capital, operations and maintenance cost were discussed.

Staff writes, “The estimations of capital cost to add fluoride to the City’s deep wells varies greatly depending on each well site and the type of chemical that is used to achieve fluoridation.”

As staff noted at the time, “In order to evaluate the cost of adding fluoride, two sources of information were used. One was 2009 cost estimates from Sacramento County and the other was a cost estimate for two of our deep wells, completed on June 18, 2013.”

Based on that, staff calculated, “The cost to add fluoride to our deep wells is estimated to be between $92,000 and $454,900 per well site. So to equip all six deep wells, the total cost would be between $837,000 and $2,067,400.”

However, putting off the decision, in a way, forces the worst of all worlds.  As we noted, the problem is that, as long as the issue of fluoridation hangs over the water project, the water project itself – facing lawsuits and a possible initiative – might be in trouble.

While the two sides agreed on nothing substantive on Tuesday night, they agreed on moving forward with the proposal as scheduled.

“I do not agree with anything the previous speakers have said except one item, and that’s that you should go forward and consider this and make your decision now,” said Alan Pryor at Tuesday’s meeting.  Mr. Pryor has been among the more outspoken opponents of the project.

Meanwhile, Tia Will, a local obstetrician/gynecologist as well as member of the Vanguard Editorial Board, stated, “It’s nice to see that Alan and I agree on something in this matter, and that’s that I’m very strongly in favor of you sticking with the October timeline for making a decision.”

Putting off the decision until after the project would simply allow the decision to fester and it might influence the water supply project, as we noted earlier this week.

As “Medwoman” noted, “It seems to me that your argument, with which I happen to agree, that delaying the decision has risks, ignores the fact that the surface water project only becomes ‘safer’ if the council decides against fluoridation.”

Medwoman is completely correct here.  That may well end up being a factor that leads the council to oppose fluoridation.

Dan Wolk has publicly supported the project – but thus far he is the only one.

In a piece that appeared in the Davis Enterprise and was co-authored by Julie Gallelo, the executive director of First 5 Yolo, and Art Pimentel, the former mayor of Woodland, Mr. Wolk and others argued, “Since the mid-20th century, community water fluoridation – the careful adjustment of naturally occurring fluoride levels in water to strengthen tooth enamel and reduce dental decay – has proved to be an effective preventative public health measure, reducing tooth decay by about 25 percent over a lifetime, per the American Dental Association.”

“Across the nation, more than 70 percent of people utilize community fluoridation, according to the Centers for Disease Control,” they write. “In California, fluoridation is mandated by state law, if funds are available. And, right next door, the citizens of West Sacramento, Vacaville and Sacramento, to name a few, enjoy the benefits of fluoridated water every day. Pediatricians in Davis prescribe fluoride drops to parents to give to their children.”

“Today, Yolo County’s public health community – dentists, pediatricians, public health officials and every major, local health care provider – is united in support of community water fluoridation in Davis and Woodland,” they continue. “These are the folks who are on the front lines of combating dental disease. They know what policies work and what do not.”

They argue, as well, that “cost should not be a reason to reject fluoridation.”

But cost is not the only factor.

Brett Lee has looked into alternative delivery methods, including the idea of mobile dental units to treat disadvantaged kids, an idea that at least two other members of the council have privately told me has merit.

There are critical questions that have emerged, not only about the cost-effectiveness of the issue, but about its efficiency.  How much are we spending for a product to be added to water that will largely return to the water supply, only to need to be removed before discharge?

How much fluoride will actually get on the teeth of those children who most need it?

We have not seen sufficient studies to suggest an answer.  We do have the comparative studies that show that, in communities with fluoridation and those without fluoridated water, the decay rates are basically the same and follow nearly identical trendlines.

Finally, there are concerns about how safe adding fluoridation to the drinking water really is.  And, while it is true that two-thirds of all communities have fluoridated drinking water, a number have recently discontinued the practice.

Many of the children most in need of fluoridation are either consuming beverages that have sugar, or bottled water rather than tap water.

The bottom line, it appears, for several councilmembers we spoke to privately is that this issue is contentious, there is no certainty that it will solve the problems that face the community and have rightly been brought forward, and it poses a risk to the surface water project.

In short, we do not believe there are three votes in favor of fluoridation at this time.

However, this conversation has not been fruitless.  There appears to be a real commitment by council to deal with the issue of underprivileged children and tooth decay, and it would not surprise us to see one of the alternative proposals being examined more fully by council.

Of course, no one other than Dan Wolk and Brett Lee have made these comments public and we will have to see how the October 1, 2013, meeting unfolds.

—David M. Greenwald reporting

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About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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104 thoughts on “Analysis: Fluoridation to Go Forward For Discussion on October 1”

  1. medwoman

    [quote]We do have the comparative studies that show that in communities with fluoridation and those without fluoridated water, the decay rates are basically the same and follow nearly identical trendlines.[/quote]

    Much re posting and commenting on the graphs showing the identical trend lines for communities with and without fluoridation has been made primarily by those attempting to prove that water fluoridation does not work. What these graphs actually demonstrate, is that multiple fluoridation strategies will work. Fluoride works whether it is administered by direct application by skilled providers ( the most expensive prevention strategy),
    by OTC products, by drops, or by ingestion through a number of means including water through the ultimate direct application medium, one’s own saliva.

    The problem that we have on the local level is that despite this issue having been raised again and again in our community, there has not been the political or economic will to address the important health care issue of dental decay to date. I have seen one proposal from one council member, Brett Lee, attempting to address this issue through voluntary donation, and a counter proposal that we tax to provide alternative dental care. My concerns about these alternatives are:
    1) What is the estimated cost to cover how many people ? Fluoridation of the water supply covers everyone who chooses to consume the water. And there is no mandate to do so.
    2) Who is going to implement this alternative since the people most responsible for provision of the care, namely Communicare have already stated their preference based on their known limitations ?
    3) What is the guarantee that such a program will be continued, even if piloted ?

    I know that the time is short. However, I think an honest assessment of this issue would include a rigorous examination of the limitations of the proposed alternatives, or the development of more robust alternatives by the members of the CC prior to a vote.

  2. B. Nice

    [quote]Many of the children most in need of fluoridate are either consuming beverages that have sugar or bottled rather than tap water.[/quote]

    It’s sad the sugared beverages are often cheaper then milk or water. Maybe the government could divert some of the money it spends on corn subsidies and put it into dental care and education.

  3. Growth Izzue

    Ryan, not at all, but that’s besides the point. If Obamacare is going to provide free fluoride for children in areas where the water is not fluoridated why are we even talking about it as an issue?

  4. B. Nice

    [quote] If Obamacare is going to provide free fluoride for children in areas where the water is not fluoridated why are we even talking about it as an issue?[/quote]

    Because it’s not just about cost, it’s about ease of access. (i.e. getting kids to the doctor, getting prescriptions filled, remember to give children fluoride).

  5. Growth Izzue

    [quote]Because it’s not just about cost, it’s about ease of access. (i.e. getting kids to the doctor, getting prescriptions filled, remember to give children fluoride). [/quote]

    Oh, you mean parents acting responsibly. So would you also want us to provide healthy meals to each child’s home and to go into their homes and make sure that the parents are feeding them properly?

  6. B. Nice

    “Oh, you mean parents acting responsibly. So would you also want us to provide healthy meals to each child’s home and to go into their homes and make sure that the parents are feeding them properly?”

    Two points:
    Unfortunately not all parents do not act responsibly, and children pay the price. As a society I think we should so what we can to help these kids

    You implied in your argument that getting fluoride to kids was just about the cost. I’m stating that there are more factors to consider (wether you agree with them or not) then just cost. .

  7. tleonard

    Medwoman wrote:

    [quote]Much re posting and commenting on the graphs showing the identical trend lines for communities with and without fluoridation has been made primarily by those attempting to prove that water fluoridation does not work. What these graphs actually demonstrate, is that multiple fluoridation strategies will work. Fluoride works whether it is administered by direct application by skilled providers ( the most expensive prevention strategy),
    by OTC products, by drops, or by ingestion through a number of means including water through the ultimate direct application medium, one’s own saliva.[/quote]

    No, these graphs demonstrate that water fluoridation is not the cause of decreasing decay rates. That is all that they demonstrate. That’s it. It is inaccurate to state that “What these graphs actually demonstrate, is that multiple fluoridation strategies will work.” These graphs do not demonstrate that at all.

  8. JustSaying

    Would you two indicate what charts you’re discussion. The one I remember that compared other countries was used to show that lots of places without added water fluoridation have just fine teeth, thank you, but slid over the fact that alternative application methods were being used.

  9. David M. Greenwald

    [quote]Fluoride treatment for kids who don’t have fluoride in their water is covered under the Affordable Care Act[/quote]

    It’s also covered under Medi-Cal. What’s your point?

  10. David M. Greenwald

    ” So would you also want us to provide healthy meals to each child’s home and to go into their homes and make sure that the parents are feeding them properly?”

    You are aware at Title 1 schools they provide kids with two meals. I’ve read numerous stories in other areas where those are often the only meals kids get.

  11. tleonard

    [quote]Would you two indicate what charts you’re discussion. The one I remember that compared other countries was used to show that lots of places without added water fluoridation have just fine teeth, thank you, but slid over the fact that alternative application methods were being used. [/quote]

    Here is my Vanguard piece regarding those graphs:[url]https://davisvanguard.org/index.php?option=com_content&view=article&id=7309:letter-from-dr-terri-leonard-to-wac-on-floridation&catid=60:water&Itemid=92[/url]

    As I wrote in the comments section of that article, the graphs and tables are convincing evidence that systemic (ingested) fluorides, such as fluoride added to water or salt, are not the reason for the decrease in dental caries rates in industrialized nations because nations that do not add fluoride to their water or salt are experiencing the same decrease in dental caries rates as nations that do. The graphs and table beg the question as to what indeed is the real reason for the decrease in dental caries rates in industrialized nations, since this decrease is clearly not due to ingested fluoride. The data in the graphs and table indicate that water and salt fluoridation are not the reason for declining dental caries rates.

  12. medwoman

    JS

    I am out so responding is difficult. Yes those are the graphs I was referencing. And where I am is just coming from my dentist who is into part of the fluoridation group, but who does favor fluoridation.

  13. Growth Izzue

    [quote]It’s also covered under Medi-Cal. What’s your point? [/quote]

    So why are you crying for ways to fund fluoridation to the underprivileged when it’s supplied for free under both Obamacare and Medi-cal?

  14. Growth Izzue

    [quote]You are aware at Title 1 schools they provide kids with two meals. I’ve read numerous stories in other areas where those are often the only meals kids get. [/quote]

    I thought we were talking about Davis here?

  15. JustSaying

    Yes, theses are the charts I remember. Thanks, Don.

    I was curious then was what is reflected in the chart with “no water or salt fluoridation” countries. What accounts for these reductions in tooth decay? It cannot be the absence of water or salt fluoridation since there’s presumably never been fluoride added to their water or salt.

    Something must be happening in Iceland, Italy, Finland, Sweden, Japan, etc., since 1970 that would account for their improving records.

    I can’t imagine that it’s taken until now to “beg the question as to what indeed is the real reason for the decrease in dental caries rates in industrialized nations.” Hasn’t someone been curious enough to study what differences there have been in diets, medical care or other factors that could account for the reductions in different countries’ rates.

    In any case, it is not true that these charts “indicate that water and salt fluoridation are not the reason for declining dental caries rates” in the countries that have one or the other. None of them show the cause of the declines.

    I suspect there’s more to this story than we’re being led to believe.

  16. Ginger

    Ryan Kelley: [quote]Growth Izzue – so you are solidly in support of the Affordable Care Act?[/quote] So in order to point out one small aspect of an incredibly overarching and complicated law you must therefore be “solidly in support” of that law? Wow.

    B.Nice: [quote]Because it’s not just about cost, it’s about ease of access. (i.e. getting kids to the doctor, getting prescriptions filled, remember to give children fluoride).[/quote] That is too often the excuse for enacting sweeping legislation that affects everyone. Let’s look at the irresponsible parents/citizens and because they might make bad decisions, let’s take away the decision making powers of [b][i]everyone[/i][/b].

  17. B. Nice

    [quote]I thought we were talking about Davis here?[/quote]

    Last year 4 Elementary schools in Davis qualified for Title I funding, Birch Lane, MME, Patwin, and North Davis.

  18. David M. Greenwald

    “I thought we were talking about Davis here?”

    My world doesn’t stop at the borders of Davis and there’s no reason to believe it doesn’t happen here as well.

  19. David M. Greenwald

    “Let’s look at the irresponsible parents/citizens and because they might make bad decisions, let’s take away the decision making powers of [b][i]everyone[/i][/b].”

    By the same token, I don’t think kids should be forever held accountable for the actions of their parents. So at some point we as a society need to step in. I think the question is where and how, rather than whether.

  20. David M. Greenwald

    “Last year 4 Elementary schools in Davis qualified for Title I funding, Birch Lane, MME, Patwin, and North Davis.”

    It was a little eye opening to me that we lost breakfast for our nephew this year when we moved him from Patwin to Pioneer. But fortunately, we can afford to buy him breakfast.

  21. Growth Izzue

    [quote]My world doesn’t stop at the borders of Davis [/quote]

    Well, get off your high horse because we’re talking about fluoridating water in Davis, not Timbuktu.

  22. Growth Izzue

    [quote]Because Growth, I’m concerned that despite some funding availability, kids are not getting the medical attention they need. [/quote]

    Underprivileged parents can also buy fluoridated toothpaste with their foodstamp EBT cards, I don’t think it costs much if any more than regular toothpaste.

  23. David M. Greenwald

    My horse these days is an old Honda with a car seat in the back. There are amazing worlds even without Davis that most people do not know about. There are poor kids living in this city who rely on the free meals to eat and there are kids whose parents who might not be diligent enough to take advantage of the services that they have available and I don’t think the kids should be punished for that.

  24. B. Nice

    [quote]That is too often the excuse for enacting sweeping legislation that affects everyone. Let’s look at the irresponsible parents/citizens and because they might make bad decisions, let’s take away the decision making powers of everyone.[/quote]

    This is one of many factors that I should be considered in this debate. Also I look at helping kids as good “reason” to pass some legislation, not an “excuse” too.

  25. Growth Izzue

    David, I think you’re trying to make an issue of something that’s not really a big problem, just like you and others did with the plastic bags. The solutions are right there and they cost next to nothing.

  26. B. Nice

    [quote]Underprivileged parents can also buy fluoridated toothpaste with their foodstamp EBT cards, I don’t think it costs much if any more than regular toothpaste.[/quote]

    Yes, but then they would actually have to brush their kids teeth with this toothpaste on a regular basis.

  27. B. Nice

    [quote]David, I think you’re trying to make an issue of something that’s not really a big problem, just like you and others did with the plastic bags. The solutions are right there and they cost next to nothing.[/quote]

    I don’t think you are grasping how bad some kids have it, even in Davis.

  28. Growth Izzue

    [quote]Yes, but then they would actually have to brush their kids teeth with this toothpaste on a regular basis. [/quote]

    Oh Heaven forbid, you mean brush them or teach their kids to brush their own teeth like the rest of us do or did (my kids are all moved out).

  29. Ginger

    [quote]By the same token, I don’t think kids should be forever held accountable for the actions of their parents. So at some point we as a society need to step in. I think the question is where and how, rather than whether.[/quote] But how can you possibly take away kids being “forever held accountable for the actions of their parents?” That’s the name of the parenting game…you raise your kids to the best of your ability. Mistakes will be made and psychiatrists will have a new slew of patients.

    But seriously…there are parents who aren’t diligent about making their kids exercise, eat vegetables, work hard in school (heck, even GRADUATE from high school), wash behind their ears, etc. Should the government “step in” there so the kids aren’t “punished” by the actions of their parents?

    At what point do we just acknowledge that humans aren’t perfect, parents are humans, so really they shouldn’t be raising their kids at all. Like Melissa Harris-Perry said, your kids don’t really belong to you anyway.

    PS: I’m worried about how do to get fluoride onto the teeth of kids who don’t have fluoridated toothpaste, don’t get fluoride treatments, [i][b]and[/b][/i] don’t drink tap water! Should we leave those kids to languish and forever accountable for the actions of their parents? HOW are we going to step in and take care of them soTHEY won’t be punished for their parents lack of diligence?

  30. David M. Greenwald

    “David, I think you’re trying to make an issue of something that’s not really a big problem”

    It’s a huge problem and we end up paying for it later when the kids start getting into trouble.

  31. Growth Izzue

    [quote]I don’t think you are grasping how bad some kids have it, even in Davis. [/quote]

    I think you’re grasping at having some program put in place that is hardly needed, using poor parents as a scapegoat.

  32. David M. Greenwald

    “Oh Heaven forbid, you mean brush them or teach their kids to brush their own teeth like the rest of us do or did (my kids are all moved out).”

    And your not an alcoholic, or meth addicted, or self-medicating depression, in a broken hope, etc.

  33. B. Nice

    [quote]I think you’re grasping at having some program put in place that is hardly needed, using poor parents as a scapegoat.[/quote]

    These parents who are unable/unwilling to care for their children (it’s not about being poor, I know a lot of wonderful poor parents), ARE the reason, are the major reason, I’d consider supporting the fluoridation program, if not for them, I’d be solidly ambivalent.

  34. JustSaying

    “Underprivileged parents can also buy fluoridated toothpaste with their foodstamp EBT cards….”

    Growth Izzue, your arguments always very compelling to me. But, sometimes I wonder if you don’t just make up stuff enhance your case.

    (According to USDA’s FNS) “SNAP benefits can only be used for food and for plants and seeds to grow food for your household to eat. SNAP benefits cannot be used to buy:

    –Any nonfood item, such as pet foods; soaps, paper products, and household supplies; grooming items, toothpaste, and cosmetics
    –Alcoholic beverages and tobacco
    –Vitamins and medicines
    –Any food that will be eaten in the store
    –Hot foods”

  35. B. Nice

    [quote]So being that Davis has never fluoridated its water why didn’t you and David advocate for fluoride not being administered by bad parenting before this?[/quote]

    Two things:

    First, this issue was not on my radar. Now that it is and there has been a lot of community discussion regarding it, I’m reading and learning and listening and blogging to better understand the arguments being made by both sides.

    Second, I’m not advocating for fluoride, but I do think the welfare of the kids of the above mentioned parents (who could be rich, poor, or somewhere in between) should be considered when making a decision on the issue.

  36. Ernesto

    Melanoma is a dangerous disease, yet these poor children may not be learning proper sun protection skills.

    I propose we add sunscreen to the water as well.

    And what if they get lice due to bad hygiene practices?

    We must add disinfecting shampoo to the water also.

    And what of athlete’s foot? A most unpleasant affliction!

    [quote]But distinguished Ernesto, sunscreen and shampoo are meant to be applied topically, not drunk. [/quote]

    Same with fluoride, it’s meant to be applied topically, not swallowed. In fact you’re supposed to call a doctor if your kid swallows too much fluoride toothpaste.

  37. B. Nice

    [quote]Same with fluoride, it’s meant to be applied topically, not swallowed. [/quote]

    My pediatrician just renewed my kids fluoride tablets which they are supposed to chew and swallow.

  38. Alan Miller

    [quote]“I’m worried about how do to get fluoride onto the teeth of kids who don’t have fluoridated toothpaste . . . HOW are we going to step in and take care of them so THEY won’t be punished for their parents lack of diligence?”[/quote]

    I suggest government subsidized Kool-Aid packets along with a child-targeted ad campaign. Kids will be lured by the sweetness to beg their parents to mix the powder with Davis tap water, yielding a duplication of the majority of US kid’s inexplicably contradictory daily ingestion: corporate-supplied concentrated sugar/sweetener and government-funded, corporate-supplied fluoride from agricultural chemical waste. Cheers!

  39. Alan Miller

    [quote]an alcoholic, or meth addicted, or self-medicating depression, in a broken hope[/quote]

    Fluoride! Cures alcoholism, meth addiction, depression and a bad childhood!

  40. Growth Izzue

    [quote]“So it wasn’t a problem for the last 50 years? Why didn’t you speak up then? ”

    David

    I wasn’t born 50 years ago? [/quote]

    Now you’re just playing foolish. Okay, let me put it to you very simply. Davis hasn’t ever had fluoride in its water and I’ve been reading your blog for 5 or 6 years and I don’t remember you ever once writing about a problem that kids weren’t getting fluoride because of bad parents until just recently when the issue of fluoride being added to our water emerged.

  41. medwoman

    JustSaying

    [quote]I suspect there’s more to this story than we’re being led to believe.[/quote]

    I think that you can be sure that is the case when two highly intelligent people like Rich Rifkin on one side and Alan Pryor on the other are saying essentially that this is a no brainer each with regard to their own conclusion.
    What that leads me to believe is that it is likely much more complicated than either would have you believe.

    I would like to provide you with my perception of the “more to the story than we’re being led to believe”

    What is not being mentioned by the opponents, and what I may have been negligent in pointing out, is just how complex this issue really is. As with any health and wellness issue, prevention of dental decay is multifactorial. There are some factors that cannot be changed, there are others in which the individual plays a major role, and there is a third category in which the help of a health care professional is critical.

    Let’s start with those that cannot be changed by the individual.
    1) Genetic and familial predisposition. The child gets from his parents a tendency to have very strong, decay
    resistant teeth….or not. No possibility for intervention.
    2) Location. Some kids are fortunate enough to grow up in areas where there exists in their water supply just
    the right amount of fluoride. These kids have very strong decay resistant teeth and no fluorosis. Too much
    fluoride in the water, fluorosis with the degree largely dependent upon the amount of fluoride. We have good
    evidence that fluoride researchers from multiple countries have demonstrated that

  42. David M. Greenwald

    Growth: That’s fair. But you have read my comment about our nephew and his tooth decay just before he turned 7, that was three years. That’s really when this first got on my radar. So really my eyes have been open for three years. As I stated, I don’t think fluoridating the water is the answer, but it is a concern.

  43. medwoman

    JustSaying

    My response part two since my initial post was obviously too long.

    2 continued) We have good evidence that fluoride researchers from multiple countries have demonstrated that
    fluoride at

  44. medwoman

    Ok David or Don, I am having a problem.

    I have twice entered a more comprehensive response to JustSaying and for some reason I am unable to post.
    Your recommendations ?

  45. medwoman

    David

    [quote] I don’t think fluoridating the water is the answer[/quote]

    I think this is part of the problem with this discussion. No one else believes that is is the exclusive answer either.
    We believe it to be a critical component of “the answer”.

  46. B. Nice

    Medwomen from what I can tell the kids who would most benefit from fluoride are ones growing up in a household similar to mine. Where their teeth get brushed, and flossed, and ACT is used on a daily basis, their sugar intake is limited, and they make it to the dentist 1-2 a year. Adding Fluoride to the water would give kids like these them an extra boost of protection.

    I’m not convinced that it can make a significant impact on kids whose dental hygiene and diet is extremely poor. Do you see it having a significant impact on these kids if these other factors remain the same? Or do you see it’s value as one piece of bigger puzzle.

  47. Ginger

    [quote]And your not an alcoholic, or meth addicted, or self-medicating depression, in a broken hope, etc.[/quote] THIS is my basic point. We are going to enact sweeping legislation that takes away parenting rights for ALL parents to cover the most extreme cases?

    And any meth addicted parent who can’t buy fluoridated toothpaste (which is cheaper than the fluoride free versions) probably is making far worse parenting decisions than purchasing Tom’s of Maine rather than Crest.

    If the concern is that EBT cards can’t be used for toothpaste, hopefully the fact that taxpayers are buying their food will leave enough left over to buy it. You can get a tube of toothpaste for a dollar or two.

    I’m not ANTI-fluoridation, I’m just not a fan of pointing to extreme cases and using that as an excuse to take away choices from the other 99%.

  48. B. Nice

    “I’m not ANTI-fluoridation, I’m just not a fan of pointing to extreme cases and using that as an excuse to take away choices from the other 99%”

    I would guess that a lot more then 1% of the kids in this town are receiving poor dental hygiene care, for various different reasons.

  49. Don Shor

    Here is what medwoman has been trying to post:
    “I suspect there’s more to this story than we’re being led to believe.”

    I think that you can be sure that is the case when two highly intelligent people like Rich Rifkin on one side and Alan Pryor on the other are saying essentially that this is a “no brainer”, each with regard to his own conclusion. What that leads me to believe is that it is likely much more complicated than either would have you believe.

    I would like to provide you with my perception of the “more to the story”.

    What is not being mentioned by the opponents, and what I may have been negligent in pointing out, is just how complex this issue really is. As with any health and wellness issue, prevention of dental decay is multifactorial. There are some factors that cannot be changed, there are others in which the individual plays a major role, and there is a third category in which the help of a
    health care provider is critical.

    Let’s start with those that cannot be changed by the individual:

    1) Genetic and familial predisposition – The child gets from the parents a tendency to have very strong, decay resistant teeth …..or not. No possibility for intervention.

    2) Location – Some kids are fortunate enough to grow up in areas where there exists just the right amount of fluoride naturally occurring in their water supply. These kids have very strong, decay
    resistant teeth and no fluorosis. Too much fluoride can result in varying degrees of fluorosis. We have good evidence from multiple countries that

  50. medwoman

    Ginger

    [quote]We are going to enact sweeping legislation that takes away parenting rights for ALL parents to cover the most extreme cases? [/quote]

    I am really unclear about your point. How do you think that anyone’s parenting rights are being taken away.
    You are not being forced to drink or serve fluoridated water to your family. You can certainly purchase bottled water if you feel strongly about it. As I have pointed out on several occasions to Frankly who claims this is
    “forced medication”, there is no government agency that is going to monitor your intake of city water to ensure that you are consuming your fair share of it.

    But much more importantly I do not believe that you have an accurate perception of the magnitude of the problem of tooth decay in our community. I have provided what I consider to be some critical information gathered over the past several years by CommuniCare which demonstrates that far more than 1% of our children are affected or at risk.

    [img][IMG]http://i744.photobucket.com/albums/xx86/robertcanning/DentalHealthslide_zps0522afc1.jpg[/IMG] ([url]http://s744.photobucket.com/user/robertcanning/media/DentalHealthslide_zps0522afc1.jpg.html[/url])[/img]

    Or you can view the whole slideshow at: http://city-council.cityofdavis.org/Media/Default/Documents/PDF/CityCouncil/Water-Advisory-Committee/Agendas/20130425/Item-5-materials-submitted-by-presenters.pdf

  51. Don Shor

    “I suspect there’s more to this story than we’re being led to believe.”
    I think that you can be sure that is the case when two highly intelligent people like Rich Rifkin on one side and Alan Pryor on the other are saying essentially that this is a “no brainer”, each with regard to his own conclusion. What that leads me to believe is that it is likely much more complicated than either would have you believe.
    I would like to provide you with my perception of the “more to the story”.
    What is not being mentioned by the opponents, and what I may have been negligent in pointing out, is just how complex this issue really is. As with any health and wellness issue, prevention of dental decay is multifactorial. There are some factors that cannot be changed, there are others in which the individual plays a major role, and there is a third category in which the help of a
    health care provider is critical.
    Let’s start with those that cannot be changed by the individual:
    1)Genetic and familial predisposition – The child gets from the parents a tendency to have very strong, decay resistant teeth …..or not. No possibility for intervention.
    2)Location – Some kids are fortunate enough to grow up in areas where there exists just the right amount of fluoride naturally occurring in their water supply. These kids have very strong, decay
    resistant teeth and no fluorosis. Too much fluoride can result in varying degrees of fluorosis. We have good evidence from multiple countries that

  52. Don Shor

    “I suspect there’s more to this story than we’re being led to believe.”
    I think that you can be sure that is the case when two highly intelligent people like Rich Rifkin on one side and Alan Pryor on the other are saying essentially that this is a “no brainer”, each with regard to his own conclusion. What that leads me to believe is that it is likely much more complicated than either would have you believe.
    I would like to provide you with my perception of the “more to the story”.
    What is not being mentioned by the opponents, and what I may have been negligent in pointing out, is just how complex this issue really is. As with any health and wellness issue, prevention of dental decay is multifactorial. There are some factors that cannot be changed, there are others in which the individual plays a major role, and there is a third category in which the help of a
    health care provider is critical.
    Let’s start with those that cannot be changed by the individual:
    1)Genetic and familial predisposition – The child gets from the parents a tendency to have very strong, decay resistant teeth …..or not. No possibility for intervention.
    2)Location – Some kids are fortunate enough to grow up in areas where there exists just the right amount of fluoride naturally occurring in their water supply. These kids have very strong, decay
    resistant teeth and no fluorosis. Too much fluoride can result in varying degrees of fluorosis. We have good evidence from multiple countries that

  53. Barbara King

    Medwoman wrote: “Some kids are fortunate enough to grow up in areas where there exists in their water supply just the right amount of fluoride. These kids have very strong decay resistant teeth and no fluorosis. Too much
    fluoride in the water, fluorosis with the degree largely dependent upon the amount of fluoride.”

    “Just the right amount of fluoride” in their water and NO fluorosis? Where?

  54. Don Shor

    Found the problem. Here you go:

    “I suspect there’s more to this story than we’re being led to believe.”
    I think that you can be sure that is the case when two highly intelligent people like Rich Rifkin on one side and Alan Pryor on the other are saying essentially that this is a “no brainer”, each with regard to his own conclusion. What that leads me to believe is that it is likely much more complicated than either would have you believe.
    I would like to provide you with my perception of the “more to the story”.
    What is not being mentioned by the opponents, and what I may have been negligent in pointing out, is just how complex this issue really is. As with any health and wellness issue, prevention of dental decay is multifactorial. There are some factors that cannot be changed, there are others in which the individual plays a major role, and there is a third category in which the help of a
    health care provider is critical.
    Let’s start with those that cannot be changed by the individual:
    1)Genetic and familial predisposition – The child gets from the parents a tendency to have very strong, decay resistant teeth …..or not. No possibility for intervention.
    2)Location – Some kids are fortunate enough to grow up in areas where there exists just the right amount of fluoride naturally occurring in their water supply. These kids have very strong, decay
    resistant teeth and no fluorosis. Too much fluoride can result in varying degrees of fluorosis. We have good evidence from multiple countries that less than or = 1ppm is safe.
    In any event, children are not in a position to decide to move. So no room for intervention there.
    Next, let’s consider the factors on which the individual can have an impact through their individual choices :
    3)Dietary choices – There is universal agreement that sugary foods and beverages are not good for us and contribute to dental decay. The same public health community that favors fluoridation
    are amongst the most active advocates for healthier dietary choices. These are the same folks who are in the lead in parental and child education with regard to healthier practices such as
    prolonged breast feeding, drinking water instead of sweetened beverages, and healthy snacks and dietary choices instead of sweets. Unfortunately especially at the pre and elementary school
    level, children are largely under the influence of their parents and will follow their lead if the parents are making poor choices.
    4)Dental hygiene – Again, there is agreement that it is the responsibility of the parent to teach and ensure that the child is practicing good dental hygiene. Unfortunately many parents either lack
    the information, or are less than paragons of virtue in ensuring that their children are following best dental hygiene practices. This burden falls especially hard on parents whose financial
    circumstances force them to work long hours just to feed and house their children.
    Finally the factors that require either the help of a medical/dental provider or public health intervention:

  55. Don Shor

    5)Fluoride – It is accepted that fluoride applied topically reduces cavities. The opponents believe that ingestion is not effective. This view contradicts the finding that children from areas of
    natural fluoride in the water supply get less cavities than those with negligible fluoride. It also discounts the mechanism of action of ingested fluoride. Fluoride molecules, whether applied
    topically on a sporadic basis or whether applied continuously to the surface of the teeth through the omnipresence of saliva, act at the level of the tooth surface. Our local pediatricians and
    dentists do not seem to be conflicted about the efficacy of ingestible fluoride since they prescribe it in the form of drops and chewable tablets. A point I had never previously considered was
    brought to my attention by a dentist whose opinion is that fluorosis is actually more commonly seen in children whose parents may go overboard with the prescription
    6)Regular visits to the dentist : I would personally favor this for everyone from around the time of eruption of the first baby tooth. Unfortunately, our society has not opted for universal health care.
    This is a shame not only for the welfare of the individual but for the health of our community and society as a whole. One thing I think we could all agree on is that prevention is far less
    expensive than treatment of a condition once it has occurred. Dental care is no exception. It costs much less to prevent a cavity than it does to treat one. It is much, much less expensive to
    treat the cavity than it is to lose a tooth to dental decay. And there is an even greater differential to prevent the decay than to treat an abscess or need bone grafting at some point due to
    tooth loss. So we end up spending far more in the long run fixing a common and potentially dangerous medical condition than we would preventing it in the first place.
    Of course, for those who keep misrepresenting the proponents position as a “band aid” or falsely claiming that we consider it a panacea, I have stated before and will reiterate, I consider water
    fluoridation just one part, but an essential part of a preventive health strategy within the very limited health care structure we have adopted as a society.
    Although this was not my article, I will be happy to address questions.
    Tia Will
    aka medwoman

  56. Ginger

    [quote]You are not being forced to drink or serve fluoridated water to your family. You can certainly purchase bottled water if you feel strongly about it.[/quote] I can? If you saw my budget you’d know that is not an option to us. It’s a bit, “Let them eat cake!” from where I’m standing.

    So, yeah. It does take away my choices as a parent.

  57. GreenandGolden

    As per usual on health issues, Medwoman is making sense. Ginger, who’s parenting will be taken away by fluoridation? I grew up in Riverside in the 1950s. We had fluoridation. My sibs and I have very few cavities and no fluorosis. My parents were thankful for fluoridation. They were right wing Republicans and never believed that fluoridation was any sort of threat. They saw it as a blessing that kept their kids teeth healthy and safe from communism.

  58. Growth Izzue

    [quote]You are not being forced to drink or serve fluoridated water to your family. You can certainly purchase bottled water if you feel strongly about it.[/quote]

    Or, people that feel strongly about it have several different ways of application without forcing fluoride into everyone’s water in the entire city. Why should it be that the people who prefer their water to be free of fluoride are forced to buy bottled water?

  59. Growth Izzue

    [quote]You are not being forced to drink or serve fluoridated water to your family. You can certainly purchase bottled water if you feel strongly about it.[/quote]

    Medwoman, what if an underprivileged poor person doesn’t want their family to ingest fluoridated water and they can’t afford to buy bottled water? Is that just going to be too bad for them?

  60. medwoman

    GI and Ginger

    I think you are making a reasonable point. I believe that reasonable point is minor compared to the number or people who stand to benefit. I do not hear anyone adamantly objecting to the 0.3 ppm that are found in our current water supply. With every public decision that is made, there should be a risk/benefit analysis. I firmly believe that in this case the benefits so far outweigh the potential risks that the decision to fluoridate is warranted.

    I am sure that there are some people who would argue that public water should not be chlorinated either.
    I happen to disagree precisely because I believe that the benefits out weigh any potential risks to individuals who may have some form of hypersensitivity. In this instance most people would agree that the public good outweighs the individual risk. I happen to feel the same way about fluoride based on the preponderance of the evidence.

  61. JustSaying

    Thanks, medwoman, for the info. I need to spend some time with this, but a couple things jump out:

    1.) The exams reflected in the slides seem especially valuable since we don’t need to keep arguing whether we’ve got a local problem that needs some action. Now, I wonder which of the cities studied now have fluoridated water, if any? (Davis, Esparto, Knights Landing, Woodland, Winters or West Sacramento?)

    2.) What is the health problem with fluorosis? I’ve notice only one person with it (a relative whose mother was pregnant in Fairbanks), a naturally over-fluoridated place back then). But, it’s no longer noticible after a minor dental bleach job. Is there also some hidden disease eating away at his internal organs or something?

    3.). Does fluoridated water provide any benefits other than reducing tooth decay?

  62. brianriley429

    @Growth Izzue: If people choose to live in Davis, and if the citizens agree, democratically, to fluoridate the water (through city council reps’ decisions or through referendum), then that is not “force”. It’s people’s choice to live here or not.

  63. Barbara King

    Why the reported big drop in visible decay in Davis from 2008-2009 to 2009-2010?

    The change in the order of the cities (Woodland is on the far left for 2008-2009, Davis is on the far left in 2009-2010) and the fact that both of the far left numbers are quite close for 2008-2009 and 2009-2010 have made me wonder for some time if the names in these charts got accidentally jumbled.

  64. Barbara King

    Another possibility is that such a drop in Davis really did happen, at least in part as as result of First 5 starting to fund access to dental care in Communicare, Salud, etc. in 2008.

  65. Barbara King

    Just Saying: The only Yolo County community that fluoridates its water is West Sacramento.

    Their 2009 Consumer Confidence Report says, “In may of 2008 the city began fluoridating the drinking water. A fluoride range of 0.8-1.2 ppm mg/l (primary mcl is 1.4 mg/L) is added to the drinking water.” You can see their whole report here: http://www.cityofwestsacramento.org/civica/filebank/blobdload.asp?BlobID=4374

    West Sacramento started fluoridating during the same year that First 5 Yolo started funding access to dental care at several places in the county, including Salud Clinic in West Sacramento.

  66. Growth Izzue

    [quote]@Growth Izzue: If people choose to live in Davis, and if the citizens agree, democratically, to fluoridate the water (through city council reps’ decisions or through referendum), then that is not “force”. It’s people’s choice to live here or not. [/quote]

    Let’s vote then, I have no problem with that. I’m pretty sure how it will turn out.

  67. medwoman

    JustSaying

    1. Davis- not currently fluoridated, considering
    Woodland – not currently fluoridated, considering
    West Sac – recently fluoridated
    Esparto / Knight’s Landing /Winters – not fluoridated, however, I have not been able to find out about the
    amount of fluoride in their water supply.

    2. Fluorosis describes a spectrum of changes in the enamel of teeth ranging from barely detectable white areas
    of discoloration through a severe condition in which there is marked discoloration with even the possibility
    of erosion of the surface enamel. These changes are dose dependent and there is no significant
    demonstrated risk at less than 1 ppm. For the vast majority of effected people dental decay with cavity
    formation is the far more serious condition and is much more prevalent in our society. There is not any
    evidence that fluoride at demonstrated safe levels poses any significant increased risk to internal organs.

    3. This is a controversial issue. For the 30 years that I have been practicing, a debate has gone back and forth
    about whether fluoride represents a protection against or a risk for osteoporosis. As with virtually
    everything else in medicine, I believe that this is probably dose dependent. A very small amount of fluoride
    seems to offer some protection against osteoporosis while too much has been demonstrated to contribute to
    increased bone fragility. Our FDA has not approved fluoride for osteoporosis treatment, however some
    doctors in Europe prescribe low dose fluoride as a treatment for osteoporosis. So my honest answer is, I
    don’t know. I am unaware of any other potential health benefit.

  68. medwoman

    For another point of view regarding Barbara King’s piece to the Enterprise this letter was sent in response to the editor. The author has kindly allowed me to post it here.

    Reading Barbara King’s “Special to the Enterprise” gave me an idea for a new line of business for me: As the son of an engineer, I could be called upon by Governor Brown to provide evidence regarding the safety and efficiency of the new Bay Bridge.

    Well, of course that is silly and so is relying on the supposed stance of 81 year old Andrew Young, “son of a dentist” to provide advice on the health and social justice benefits of fluoridation. (Mr. Young is indeed the son of a dentist, who graduated from dental school in 1921.)

    On April 22nd of this year Surgeon General Regina Benjamin, a noted African American clinician, endorsed community water fluoridation at the National Oral Health Conference in Huntsville, Alabama. She cited the prior endorsement of previous Surgeon General, Director of CDC and prominent African American clinical leader David Satcher, MD/PhD in continuing the support of a succession of Surgeons General over the past 50 years.

    She said: “As then-Surgeon General David Satcher noted in Oral Health in America: A Report of the Surgeon General (May 2000), community water fluoridation continues to be the
    most cost-effective and practical way to provide protection from tooth decay in a community. The U.S. Centers for Disease Control and Prevention has recognized fluoridation as one of 10 great public health achievements of the 20th Century.”

    Obviously, the poor and underserved in our community do not have the same kind of access to restorative dental care as the rest of the better resourced community. And even if they did, we would still want to fluoridate because it is a cost effective, clinically effective PREVENTIVE measure to improve oral health. Although my dentist is a nice guy, I don’t like to sit in the dental chair any more than I have to. And there is no reason to assume others do, either.

    So, let’s get past the silly and do the only intelligent and just thing: Use a preventive/public health approach and fluoridate Davis’ water! It’s good for all of us!

  69. brianriley429

    @Growth Izzue: The point about democracy is that the 49% or less that doesn’t get there way on an issue needs to go along with the decision, just as if the decision was unanimous. That’s how democracy works. This includes decisions made by duly elected representatives like members of a city council. So you shouldn’t say: “I have no problem with that” only when you think the outcome will match your preference.

  70. Barbara King

    Medwoman wrote about fluorosis: “These changes are dose dependent and there is no significant
    demonstrated risk at less than 1 ppm.”

    From the “NCHS Data Brief
    Number 53, November 2010
    Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004″

    “Prevalence of dental fluorosis was higher among younger persons and ranged from 41% among adolescents aged 12-15 to 9% among adults aged 40-49.”

    “Adolescents aged 12-15 in 1999-2004 had a higher prevalence of dental fluorosis than adolescents aged 12-15 in 1986-1987.”

    This data brief is available here: http://www.cdc.gov/nchs/data/databriefs/db53.htm

  71. medwoman

    Barbara King

    Again, no gradation is made with regard to the degree of fluorosis. I do not trivialize the possibility of fluorosis, however, I remain convinced that tooth decay with its potential for infection, loss of teeth, gingival disease and eventually bone loss is the much greater issue. I do not deny fluorosis as a potential outcome of over fluoridation, but again we are talking about a level of 0.7 ppm which is significantly below the generally agreed upon safe level of less than or equal to 1ppm.

  72. medwoman

    One more thought. I do not claim to know all the reasons for Barbara’s questions about the data presentation.
    I cited this for one reason only. Ginger had made the statement that dental caries was likely to affect approximately one % of the population and this is demonstrably not true any way you look at the numbers.

    I find that these days, where virtually everyone the middle and upper economic groups tends to take for granted having that “perfect smile”. There is a tendency to believe that people who do not have access to this kind of dental care must be some how to blame or perhaps not worthy of care as GI seems to imply at times. Or to believe that there are not enough people that this applies to to worry about. I do not believe either position has merit.

  73. tleonard

    medwoman, water fluoridation does not prevent dental caries. Please provide the double blind studies that prove it’s efficacy. You can’t, because there aren’t any. You have stated that one cannot design such a study in a community where the municipal water supply has been fluoridated. But such a response is evasive. Some sort of double blind study [i]could [/i]be designed to demonstrate whether water fluoridation is efficacious, but such a study has never been performed.

    I will repeat what I have written before:

    It is irresponsible to continue promoting fluoridation when studies indicate thyroid function may be lowered at 2.3 ppm, IQ in children may be lowered at levels as low as 1.9 ppm (or at 0.9 ppm if there is borderline iodine deficiency), and hip fractures in the elderly may be increased at levels as low as 1.5 ppm. Unless all of the relevant studies have been shown to be fatally flawed, there is clearly no adequate margin of safety to protect the whole population from these effects.

    Fifty percent of the daily intake of fluoride is absorbed by and accumulates in bone. An important study from China (Li et al.,2001) indicates practically no margin of safety sufficient to protect a whole population with a lifelong consumption of water at 1 ppm from hip fracture.

    It is important to remember that we are talking about mass medication, not a drug that is prescribed after due consultation with an individual patient. A risk of harm estimated at, say, 1 in 10,000 may be entirely acceptable in the case of an individual patient. In fact, we accept far higher risks of undesirable side effects if we are seriously ill. But if we are giving a drug to nearly 400 million people worldwide, that risk translates into 40,000 cases of harm from one cause. The risks for some harms due to fluoridation are probably much higher.

    Proponents and opponents of fluoridation carry different burdens of proof. Proponents need to have conclusive proof of substantial benefit and very strong evidence for an extraordinarily low risk of harm. They have neither. For opponents, it should suffice to show that there is an identifiable risk of serious harm. Even small risks are indefensible when deliberately imposed on a large population. This is common sense, but it eludes the proponents of fluoridation, who continue to talk about small risks as if they are acceptable.

    The onus is on proponents to demonstrate that there is an adequate margin of safety between the doses that cause harm and the huge range of doses that may be experienced by those drinking uncontrolled amounts of fluoridated water and at the same time receiving unknown amounts of fluoride from other sources. And, such a margin of safety should be large enough to protect everyone in society, not just the average person. The very young, the very old, those with poor nutrition, and those with impaired kidney function are more susceptible to fluoride’s harmful effects.

  74. Growth Izzue

    brianriley429
    [quote]@Growth Izzue: The point about democracy is that the 49% or less that doesn’t get there way on an issue needs to go along with the decision, just as if the decision was unanimous. That’s how democracy works. This includes decisions made by duly elected representatives like members of a city council. So you shouldn’t say: “I have no problem with that” only when you think the outcome will match your preference. [/quote]

    No sheeet, but thanks anyway for the lesson on democracy. LOL. Who said I have problem with that if it’s voted on by the public. Now when elect reps vote on something we all have to go by their decision unless there’s a referendum which causes a community vote which is also how democracy works.

  75. JustSaying

    “Proponents and opponents of fluoridation carry different burdens of proof. Proponents need to have conclusive proof of substantial benefit and very strong evidence for an extraordinarily low risk of harm. They have neither. For opponents, it should suffice to show that there is an identifiable risk of serious harm. Even small risks are indefensible when deliberately imposed on a large population.”

    While this sounds like “common sense” on the surface, we accept and live with all kinds small risks imposed on large populations for the greater good.

    Think of all the warning labels on wide variety of products or every decision about whether to put a certain traffic signal device at an intersection, etc. There almost always are trade-offs to be carefully considered, not absolutes that end discussion because one side has an overwhelming burden and the other has almost none.

    —-

    “medwoman, water fluoridation does not prevent dental caries.”

    What studies do you provide to support this definitive claim? Are they “double blind” studies?

    Do you feel there’s never been any studies offered that support the concept that fluoridation reduces caries? Or, are you simply saying that you won’t believe study results because you only accept “double blind” studies?

  76. medwoman

    tleonard

    [quote]Please provide the double blind studies that prove it’s efficacy. You can’t, because there aren’t any. You have stated that one cannot design such a study in a community where the municipal water supply has been fluoridated. But such a response is evasive. Some sort of double blind study could be designed to demonstrate whether water fluoridation is efficacious, but such a study has never been performed. [/quote]

    You and I are both aware that there are not large, controlled, double blinded, prospective studies regarding fluoridation of municipal water supply. My responsive is factual, not evasive. There are a number of areas within medicine where this type of gold standard study cannot be conducted. In some cases the reasons are ethical.
    In other cases the limitation is physiologic. In still other cases the reasons are logistical. As I am sure that you know all this, I will provide an example of each for those who are not familial with these kinds of studies.

    1) Ethically limited. Such a study cannot be continued if, during the preliminary investigation, a predetermined
    level of adverse outcomes is reached before the study is completed.
    2) Physiologic. One could not design a large, prospective, double blinded study on women who had had
    hysterectomies vs those who had not since the women and / or her doctors would know that a hysterectomy
    had been performed.
    3) Logistical. Similar to number two, you cannot conduct this type of experiment on fluoridation since the entire
    municipality must have available the knowledge that the water supply is fluoridated. This is a matter of law
    and public information. It is not a perverse desire on the part of the public health community to not conduct
    studies.
    This is where other types of studies come in to play such as longitudinal observational studies.

    To respond to the remainder of your post. You and I simply disagree about whether or not the risks you are citing have been demonstrated. I do not believe that any of those potential risks amount to more than speculation. The studies are about much higher doses. Even the authors of a number of those studies cite 1ppm as the “safe” level and in one study from your own reference site, the author Bhatnager quoted 1ppm as the level he considered so safe, that he used that level in a treatment protocol for individuals suffering from acute fluoride overdose. I am not using this information to advocate for the use of fluoridation for any purpose other than tooth decay prevention, but to point out that you, likely unintentionally, are misrepresenting what these studies do and do not demonstrate.

  77. medwoman

    tleonard

    [quote]Even small risks are indefensible when deliberately imposed on a large population. This is common sense, but it eludes the proponents of fluoridation, who continue to talk about small risks as if they are acceptable. [/quote]

    This sounds like “common sense”, but as we all know, common sense can be in error. One example comes to mind. Before the use of seat belts in cars was mandated, there was a lot of debate about whether or not they should be mandated. Some of the arguments were philosophic, but at least one argument was about a very small but real associated risk. What if, the opponents said, in a serious crash one of the seat belt mechanisms failed and the occupant was trapped and unable to exit a burning car. On the surface this sounds like a legitimate, numerically small but real concern that might affect someone at some time. So the argument went that no potential risk was allowable, even to prevent the large numbers of automobile related ejection or forward momentum related deaths. Fortunately, this was an area in which the statistics and crash dummy experiments told the real story and the legislation went forward with appropriate safe guards on release mechanisms.

    There is no such thing as “no risk” in life. Some small risks are clearly worth taking in terms of demonstrated benefit. I am sure we agree on this. Where we disagree is where the risk/benefit ratio lies. I believe that it is well demonstrated to lie on the side of fluoridation, you disagree.

    There is nothing evasive or disingenuous or sneaky or conspiratorial here. We simply read and interpret the information differently. In my desire to understand this issue I like you have read extensively. Because I have great access to my colleagues from multiple specialties I have consulted with 5 pediatricians, one perinatologist, two other ob/gyns, one endocrinologist, one neurologist, one allergist, and one oncologist and none of them feel that there is any significant demonstrated risk to individuals within their area of expertise at the proposed dosing level.

  78. tleonard

    medwoman, since you bring up the people that you have consulted with who do not “feel that there is any significant demonstrated risk to individuals within their area of expertise at the proposed dosing level,” I would like to point out that Fluoride Action Network’s “Professionals Statement to End Water Fluoridation” has been signed by 4521 medical, dental, scientific, and environmental professionals as of September 13, 2013.

    This statement calls for an end to fluoridation and a call to legislators in fluoridating countries to hold hearings to determine why, after the release of the landmark National Research Council report in 2006, aggressive promotion of fluoridation continues.

    From the FAN website: The signers represent a remarkable coming together of those concerned about fluoride: doctors practicing conventional medicine and those pursuing alternative treatments and the public health and the environmental health communities. All believe that public health policy should be determined honestly with full attention paid to sound science and to ethical principles.

    According to Dr. Paul Connett, the Executive Director of FAN, “What we are seeing here is the judgment of professionals across the world, not trapped by a ‘fluoridation belief system,’ that the information on the health effects contained in the National Research Council report of 2006, together with a growing number of peer reviewed studies showing that fluoridation has only weak or no benefits, leads to one conclusion: the meager benefits do not outweigh the serious risks and fluoridation must be stopped.”

    Connett adds, “Now our task is to get health officials, regulators, and the media to exercise due diligence in this matter and seriously examine the information presented in the Professionals’ Statement. Fluoridation will only end in the US when officials in the Oral Health Division of the CDC are forced to defend, under oath, their zealous promotion of this practice. They appear to be oblivious to its ineffectiveness and the dangers it poses to the American people – and people in the handful of other fluoridated countries.”

    Those who promote fluoridation can no longer claim that they represent a single “authority” on this matter. The signers include:

    559 MD’s (includes MBBS)
    517 PhD’s – includes DSc, Doctor of Science; EdD (Doctor of Education); DrPH (Doctor of Public Health)
    360 Dentists (DDS, DMD, BDS)
    172 ND’s (Doctor of Naturopathic Medicine)
    103 Lawyers (JD, LLB, Avvocato)
    99 Pharmacists (Pharm.D, B. Pharm, DPh, RPH)

    Signatories Include:

    Magda Aelvoet, MD, Former Minister of Public Health, Belgium
    Rosalie Bertell, PhD, Regent of the Board, International Physicians for Humanitarian Medicine, Geneva, Switzerland
    Arvid Carlsson, Nobel Laureate for Physiology or Medicine, 2000.
    Theo Colborn, PhD, co-author, Our Stolen Future
    Ken Cook, President, Environmental Working Group (EWG)
    Pat Costner, PhD, retired Senior Scientist, Greenpeace International
    Ingrid Eckerman, MD, MPH, President, Swedish Doctors for the Environment (LFM), Stockholm, Sweden
    Sam Epstein, MD, author, “Politics of Cancer” and Chairman, Cancer Prevention Coalition
    Doug Everingham, former Federal Health Minister, Australia
    Lois Gibbs, Executive Director, Center for Health, Environment, and Justice, Goldman Prize Winner (1990), Falls Church, VA
    Andy Harris, MD, former national president, Physicians for Social Responsibility, Salem, OR
    Vyvyan Howard, MD, PhD, Past President, International Society of Doctors for the Environment
    Robert Isaacson, PhD, Distinguished Professor of Psychology Emeritus, State University of New York at Binghamton
    Stephen Lester, Science Director, Center for Health, Environment, and Justice
    Hardy Limeback, PhD, DDS, Former President, Canadian Association of Dental Research
    William Marcus, PhD, Former chief toxicologist of the EPA Water Division, Boyds, MD
    Peter Montague, PhD, Director of Environmental Health Foundation
    Raul Montenegro, PhD, Right Livelihood Award 2004 (known as the Alternative Nobel Prize), President of FUNAM, Professor of Evolutionary Biology, National University of Cordoba, Argentina
    Ted Schettler, MD, Science Director, Science and Environmental Health Network
    Kathleen M. Thiessen, PhD, Senior Scientist. SENES Oak Ridge, Inc.

  79. tleonard

    medwoman, regarding large, controlled, double blinded, prospective studies on fluoridation of municipal water supplies, you state “you cannot conduct this type of experiment on fluoridation since the entire
    municipality must have available the knowledge that the water supply is fluoridated.This is a matter of law and public information.” Yes, obviously. Double blind studies would not be performed on a municipality. But my point is that double blind studies have not been performed [i]at all[/i], on [i]any [/i]volunteer group.

  80. Frankly

    medwoman has been working hard here. My sense is that she is fighting her own internal conflict over this issue… a growing sense that she is pushing something proven to be more harmful than beneficial. But, just like those southern, uneducated, bible-belt conservatives that believe the earth was formed 6,000 years ago, she is having a hard time letting go of her long-standing beliefs. She is not alone in her profession with this opinion. But (and hold on because this point will surely invoke a strong response) she is in good company as doctors in general are prone to overprescribing medication. Intentions are good, but then what about that road paved with good intentions?

    We should not be debating this issue. It is clear that the times have changed. We have the data. There is no proof that fluoride in the water reduces dental carries. There is proof that excess fluoride ingested causes fluorosis and other health problems.

    So, why have industrialized countries’ incidents of dental carries fallen to almost exactly the same low levels over the last 50 years… regardless of whether they added fluoride to their water or not? I think there are three primary reasons:

    [b]1. The access to, and interest in, fluoride in dental hygene products.[/b]

    Go stand in the aisle in the supermarket and count the number of dental hygene products containing fluoride. These products are agressively and constantly advertised and marketed to the masses. The development of artificial sweetners has allowed product companies to make candy-flavored toothpaste that young children don’t protest. And related to this is another problem – one that my wife and I had raising our two children – we could not easily prevent the kids from swallowing the candy-flavored toothpaste… something that might explain the mild fluorisis that both of them had.

    [b]2. The access to information about dental hygene.[/b]

    Brought to us by the champions of social justice, we have added health ed cirriculim to all public education programs. Celebrate the fact that it has actually worked in helping education people how to take care of their own teeth.

    [b]3. The acess to dental care providers.[/b]

    Dental care access and quality has steadily improved over the years. Today, in the US, there are several entitlement programs that help low-income families get access to dental care. In California there has been the Healthy Families program. Now we have Obamacare.

    Most progressive industrialized countries have stopped adding fluoride to the water. They have just studied the data and made an objective decision. Just like for our plastic bag ban, Davis should develop some anxiety that we are falling behind our progressive brethren and move to ensure we have a strong seat at the “good progressive” table.

  81. Ginger

    Medwoman: [quote]Ginger had made the statement that dental caries was likely to affect approximately one % of the population and this is demonstrably not true any way you look at the numbers. [/quote] Yeeeeeeah…I didn’t say anything [i]remotely[/i] like that. I was speaking to a series of comments mostly by DG that children in extreme cases (such as his example of meth addicts) are the responsibility of society and that we should “step in” so these children aren’t ” forever held accountable for the actions of their parents.”

    While I don’t disagree we should help these children, I DO NOT think public policy affecting 100% of the population should be based upon these extreme cases.

    What I said specifically was:
    [quote]I’m just not a fan of pointing to extreme cases and using that as an excuse to take away choices from the other 99%. [/quote]

    The term “dental caries” wasn’t anywhere in my entire comment, in fact. I can’t begin to imagine HOW my words could be so incredibly misinterpreted.

    GreenandGolden: [quote]Ginger, who’s parenting will be taken away by fluoridation? I grew up in Riverside in the 1950s. We had fluoridation. My sibs and I have very few cavities and no fluorosis. My parents were thankful for fluoridation. They were right wing Republicans and never believed that fluoridation was any sort of threat. They saw it as a blessing that kept their kids teeth healthy and safe from communism.[/quote] I didn’t say parenting would be taken away. I said CHOICE will be taken away. Glad your right-wing Republican parents kept you safe from communism via your dental health. Sounds like you had an interesting childhood. 😉

  82. medwoman

    Frankly

    Please don’t ever leave the Vanguard. The entertainment value of your posts alone is enough to keep me engaged. First I get to learn from you daily about what I really think and feel and now today we have an insightful look into my personal internal conflicts !

    The grain of truth behind your analysis of Tia’s psyche is if you mean by
    “Conflict” able to see pros and cons of proposals and arguments as opposed to seeing issues as black and white you are correct. On the other aspects of your post, we are in disagreement. I will address the separately.

  83. medwoman

    “Having participated in many discussions about many topics here, there continues to be a gap I have not been able to fill explaining why otherwise very intelligent and caring people on this blog would be so adamant about blocking economic development projects that would clearly benefit residents and the city. Here is what I have come up with to fill that gap. They are afraid that Davis’s politics will change.”

    I think this anecdote supports the point made by the dentist I spoke with.
    The point was made that fluoridation of the water to safe levels is actually the safer option since parents cannot stop their children from swallowing toothpaste or may inadvertently give too much in the form of drops or chewables.

  84. Frankly

    [i]Please don’t ever leave the Vanguard.[/i]

    Same same medwoman. You provide me great entertainment too.

    Are you suggesting that we prevent children from brushing or otherwise ingesting fluoride from toothpaste and chewable tablets and instead rely solely on our drinking water to deliver the drug? If you are advocating this, I think it is a useless position because you cannot prevent companies from putting fluoride in these products, and you will not win combating Madison Ave for brainwashing the masses that they NEED these products. If you are not advocating this, then your position is still useless because the toothpaste still tastes like candy to the kids and they are still going to swallow some. So, if you put it in the water, you are causing even greater risk that our tiniest residents are going hit toxic levels and develop fluorosis or even worse problems.

    I know you care about children. Do you really think it is wise to add toxicity risks to the majority of Davis children (because the majority in this town are affluent and provide dental hygiene products and instruction to their children), only to provide dubious and unproven benefit to a minority… especially when there are other better approaches for not only reducing the incidents of dental decay, but also teaching these children to take care of their teeth for life? Let’s say you win and the council screws up again like they did on the plastic bag ban… these kids at the lower socioeconomic levels will more often move around to other communities that maybe do not have fluoride in the water. But since you succeeded in passing on the message that they don’t need to care since medwoman will safe them, they have not yet developed good hygiene habits that they will carry with them.

    This is that old “feed a fish, teach a fish” debate. You and others cannot seem to get out of the way of that soft bigotry of low expectations that provides you and emotional connection to save people from their own bad decisions. You want to REALLY save people? Start investing in education that helps them save themselves. True, you might start running out of social justice causes to satiate your need to save others, but then maybe with all that extra time you can take up the game of golf and come out and play a round or two with GI and me!

  85. Growth Izzue

    [quote]maybe with all that extra time you can take up the game of golf and come out and play a round or two with GI and me! [/quote]

    LOL, I’ll spot her 2 strokes a hole and buy the beer.

  86. medwoman

    Frankly

    [quote]If you are not advocating this, then your position is still useless because the toothpaste still tastes like candy to the kids and they are still going to swallow some[/quote]

    No, because I think it is the responsibility of the parent not to provide their children “candy flavored ” toothpaste and then they wouldn’t have to worry about swallowing excess. I know its possible. I did it.

    [quote]Do you really think it is wise to add toxicity risks to the majority of Davis children [/quote]

    No. I absolutely don’t. And I don’t believe that this adds significant toxicity risks. That is my interpretation of the data. And just for clarity, I am not protecting any “long standing belief”. The issue of fluoride had not hit my radar screen until my very recent appointment to the Health Council As a matter of fact, I was a skeptic since my only in depth exposure to the fluoride literature was with regard to osteoporosis. We do not use it for either osteoporosis prevention or treatment in this country unlike in some areas of Europe. It was only after reading extensively on the issue ( mostly original articles ) that I came to feel that the very real benefit outweighs the potential ( not proven ) risks.

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