Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Sunday, June 12, 2005

Countless studies have cleared fluoridation beyond doubt

Countless studies have cleared fluoridation beyond doubt
Jason Armfield

IN 1985, Michael Easley, a dentist and chief of dental health in Ohio, wrote that probably no medical or scientific advance has been the victim of as much abuse of the scientific literature as community water fluoridation.

Unfortunately, after two more decades of research vindicating both the effectiveness of water fluoridation and its safety, Dr Easley's comment is as relevant today as it was then.
There is now no scientific doubt that adding a small amount of fluoride to our water supplies is effective in reducing children's experience of decay in our country. One study after another, in Australia and overseas, has shown this to be the case. It is, therefore, always disappointing to read continued anti-fluoridationist rhetoric on what is now acknowledged as one of the 10 great public health achievements of the 20th century.

The rehashing of anti-fluoride rhetoric was recently showcased by Ross Fitzgerald in his piece, Trading Tooth Decay for Cancer, on The Australian's opinion page on May 26. His style of argument for opposing water fluoridation follows a well-worn path: First, anti-fluoride activists oppose the idea of fluoridating on the basis of not doing what "everyone else is doing", but then use instances of other countries not employing water fluoridation as an argument for why we shouldn't fluoridate our water. Second, they object to any research that shows water fluoridation to be effective, pointing out any possible flaw, real or contrived, but then twist the findings from the very same research to make an argument that favours their position. Third, they ignore the hundreds of studies showing either no health detriments, or showing health benefits, of water fluoridation, but then handpick studies that show a negative association and assume that the results are universal and causal – even when there's no evidence that this is the case. Fourth, they offer up a couple of supporters with university degrees to prove their legitimacy, and that they're not "nutcases", but then decry the vast majority of the scientific community as an "orthodoxy" to be challenged and fought against.

It's easy to believe in, or at least play along with a conspiracy theory. We might speculate that Elvis is still alive, or that aliens are being stored at Roswell, without it doing any real harm. More insidious conspiracy theories may, however, have darker consequences. In the 1964 Stanley Kubrick classic Dr Strangelove , General Jack D. Ripper set in motion a nuclear attack on Russia because he believed the communists were trying to steal his "manliness" by adding fluoride to the water, an explanation for his sexual impotence.

While the plot of Dr Strangelove may seem far-fetched, it is also far-fetched to claim that controlled community water fluoridation causes cancer, Alzheimer's Disease, Attention Deficit Disorder, mental retardation, arthritis, AIDS or any other of the grab-bag of conditions blamed on water fluoridation. There is simply no consistent evidence for these claims.

For example, despite the sensationalist title of Fitzgerald's article linking fluoride to cancer, the Cancer Council refutes this claim and reviews of studies have consistently found no link between cancer and water fluoridation.

Yet, such false claims are perpetuated by anti-fluoride campaigners as part of their various conspiracy theories with the consequence that in some areas of Australia, often those with some of the worst childhood tooth decay, children are denied the benefit of fluoridated water.

Fear is a big motivator of human behaviour and the anti-fluoride contingent therefore uses an incessant campaign of fear-mongering to prey on people's lack of knowledge of the relevant scientific literature.

Unfortunately, for most people, weighing up the various claims and counter-claims frequently proves difficult. The truth is often arrived at only through reading and understanding the hundreds of relevant scientific studies conducted in relation to fluoride and water fluoridation. It is here, however, that "experts" derided by people such as Ross Fitzgerald can serve a useful purpose.

Contrary to Fitzgerald and other anti-fluoride conspiracy theorists who would have you read only anti-fluoride propaganda, I would encourage people to seek out valid and impartial information.

Although people should ideally turn to relevant original articles such as those published by researchers at the Australian Research Centre for Population Oral Health at the University of Adelaide , it will be more convenient for most people to access the small number of very comprehensive scientific reviews of water fluoridation such as those published by the Australian National Health and Medical Research Council, the University of York or the Ontario Ministry of Health. These reviews, often commissioned by government agencies, are based only on scientific research, look at both benefits and potential concerns, and clearly underline both the effectiveness of water fluoridation and the lack of any consistent association with the litany of diseases and conditions thrown up by anti-fluoride campaigners.

Ironically, the anti-fluoride call for us to rebel against "orthodoxy" is, in the end, merely a desire for us to believe without question. And the price we pay is often the poor dental health of both children and adults in those remaining non-fluoridated areas of Australia. Jason Armfield is research officer at the Australian Research Centre for Population Oral Health, based at the Dental School of the University of Adelaide. Research Centre for Population Oral Health at the University of Adelaide Australian National Health and Medical Research Council University of York Ontario Ministry of Health