Compiled response by Dr. Steven Slott to Dr. Hardy Limeback’s online comments, "Town opts to stick with fluoride (Beacon Star, June 5), here are some basic facts that may not have been considered.", June 2014
http://www.parrysound.com/opinion-story/5674715-parry-sound-council-should-learn-more-about-fluoridation-reader/

Comments by Dr. Hardy Limeback,   BSc PhD DDS
Comments by Dr. Steven Slott, DDS

1. The chemicals used to fluoridate drinking water are impure. They are industrial waste liquids (usually hydrofluosillicic acid) collected from the smokestack scrubbers of the phosphate fertilizer industry and they are contaminated with trace amounts of cancer-causing elements such as arsenic. Dilution gets these contaminates down to permissible levels, but studies show they are still harmful even at those levels.
Fluoridated water at the tap meets all Standard 60 certification requirements of the National Sanitary Foundation (NSF), as mandated by the EPA. Standard 60 certification requires that no contaminant in water from the tap, be in excess of 10% of the EPA maximum allowable level of safety (MCL) for that contaminant. A complete list of the contents of fluoridated water at the tap, including precise amounts of any detected contaminants and the maximum mandated allowable levels of each may be found: http://www.nsf.org/newsroom/nsf-fact-sheet-on-fluoridation-chemicals
.

2.  Fluoride, unlike chlorine, is added to treat people, not the water. It is, therefore, considered a drug.
Optimal level fluoride is not considered a "drug" by anyone other than antifluoridationists. This argument has been repeatedly attempted in US courts by antifluoridationists. No court of last resort has ever ruled in favor of this ploy.
The dosage of this drug cannot be controlled.
There are no "dose" issues with fluoridation. Water is fluoridated at 0.7 mg/liter. So, for every liter of water consumed, the fluoride intake is 0.7 mg. An extreme 6 liters of fluoridated water intake per day equals 4.2 mg "dose" of fluoride intake per day from water. The CDC estimates that of the total daily intake, or "dose", of fluoride from all sources including dental products, 75% is from the water. Thus as 4.2 mg is 75% if the total daily intake from all sources, the total daily intake, or "dose" from all sources would be 5.6 mg for an individual who consumed an excessive 6 liters of fluoridated water per day.
The IOM established daily upper limit of fluoride intake from all sources, for adults, before adverse effects will occur, short or long term, is 10 mg. Thus, even the 6 liter per day consumer of water will still only take in a daily "dose" of fluoride that is slightly more than half the upper limit before adverse effects. The range of safety between the miniscule few parts per million fluoride that are added to existing fluoride levels in your water, is so wide that "dose" is not an issue. http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/ULs%20for%20Vitamins%20and%20Elements.pdf  

People who don’t’ want to consume it have not given informed consent. Even people who don’t’ want vaccinations can opt out.

The concept of informed consent applies to treatment rendered. If antifluoridationists consider drinking a glass of water to be a "treatment" of some sort, requiring "informed consent", then they would need to obtain such "consent" from themselves and give it to themselves prior to "administering" a glass of water to themselves. Obviously this is ridiculous. No one is forced to consume fluoridated water. Everyone is as free to "opt out" of consuming this water as they are to "opt out" of vaccinations.
Fluoride has certain adverse health effects especially in susceptible people, like people with kidney disease. Unlike chlorine, which dissipates, fluoride concentrates when water is boiled.
There is no valid, peer-reviewed scientific evidence of any adverse effects of optimally fluoridated water on those with kidney disease. "Because the kidneys are constantly exposed to various fluoride concentrations, any health effects caused by fluoride would likely manifest themselves in kidney cells. However, several large community-based studies of people with long-term exposure to drinking water with fluoride concentrations up to 8 ppm have failed to show an increase in kidney disease."
https://www.kidney.org/atoz/pdf/Fluoride_Intake_in_CKD.pdf
When added to infant formula, fluoridated water causes dental fluorosis, irreversible spotting of the permanent teeth.
Reconstituting powdered formula with optimally fluoridated water risks mild to very mild dental fluorosis, a barely detectable effect which causes no adversity on cosmetics, form, function, or health of teeth. As Iita, Kumar, et al. have demonstrated mildly fluorosed teeth to be more decay resistant, many consider this effect to not even be undesirable, much less adverse.
http://jada.ada.org/content/140/7/855.long The Association Between Enamel Fluorosis and Dental Caries in U.S. Schoolchildren Hiroko Iida, DDS, MPH and Jayanth V. Kumar, DDS, MPH
One study showed that children with even mild fluorosis have lowered IQ.
There are children with all kinds of traits who have lowered IQ. There are children with all kinds of traits who have high IQs. An attempt to imply that fluoridated water causes lowered IQ because of such a correlation is ludicrous.

3.  Nowadays, fluoridation saves maybe 0.5 to 1.0 fillings over 40 years. Parry Sound will spend $5,000 a year in chemicals and who knows how much in upgrades/maintenance of equipment to save a maximum of 6,000 fillings. According to Dr. Chirico, $190,000 X 40 = $7.6 million in dental costs will be saved. But this represents more than $1,200 per filling. Clearly something is wrong with this math.
Dr. Limeback is affirming here that fluoridation does indeed prevent dental decay, in direct contradiction to the claims of antifluoridationists who assert that it does not. Thus, it is a matter of how much prevention occurs, not whether or not it occurs.
Even if one accepts Dr. Limeback's assumption that fluoridation prevents decay in one tooth surface only, he is presuming that one filling in a permanent tooth during childhood will last an entire lifetime, with no further decay of the tooth around the filling, breakage of the tooth due to undermining of tooth structure during decay removal, or breakage of the filling itself. Even if the decayed tooth is appropriately restored, this tooth can require numerous fillings over a lifetime, including full crown restoration, and possible root canal therapy, all as a direct result of the decay in that one surface, which Dr. Limeback has stated that fluoridation would prevent.
Also a presumption of Dr. Limeback is that the decay which could have been prevented by fluoridation will be treated in time to avoid further destruction of that tooth, and others, directly resultant of that one surface of decay. An entire dentition can be lost due to one untreated cavity in one tooth. Given the overwhelming problem we have with untreated dental decay, it is obvious that the assumption that prevention of one cavity will save, over a lifetime, but the cost of one filling......is a gross underestimation.

4.  The cost of fluoridation never includes the cost of treating dental fluorosis or the cost of defending against lawsuits (see http://www.cambridgetimes.ca/news-story/4882028-woman-goes-to-court-over-fluoridation/). Councillors should be aware that by making the decision themselves to fluoridate instead of holding a referendum, they are opening themselves up personally to lawsuits.
A. The only dental fluorosis in any manner attributable to optimally fluoridated water is mild to very mild. This level of dental fluorosis requires no treatment. Thus, there is no such cost to consider.
B. Legal threats have been made, or implied by antifluoridationists constantly through the decades. They have had no success because they have no merit. Anyone who does buy into such legal threats should decide whether they would rather be in concert with the overwhelming consensus of respected science and healthcare, including the past 5 US Surgeons General, the Deans of the Harvard Schools of Medicine Dentistry, and Public Health, and over 150 of the most highly respected healthcare and healthcare-related organizations in the world......or have only the support of activist groups which have not one, single, respected organization in the world which supports their position.

5.  Councillor Marshall fears that removing fluoride will cause an adverse health effect (presumably a significant increase in dental decay). All the recent literature does not support this.

6.  Sid (sic) effects from too much fluoride ingestion are not trivial. Councillor Marshall said people were basing their decisions on “pseudoscience and articles found on social media sites.”
There is a tremendous amount of good peer-reviewed science published on the toxicity of fluoride, including my own, which is not considered pseudoscience.
There is no valid, peer-reviewed scientific evidence of adverse effects of optimal level fluoride.

7.  Dr. Chirico advises that a “selective review of the literature, (it) should never be used to inform decision-makers.” I agree. For 60 years public health has selective reviewed only the profluoridation literature.
I agree. For 60 years public health has selective reviewed only the profluoridation literature." Because the peer-reviewed scientific literature supports fluoridation does not mean that this literature is "profluoridation", nor does it mean that there is any valid evidence against fluoridation which has been ignored. It simply means that the valid, peer-reviewed scientific literature supports water fluoridation.

8.  Our committee of experts spent 3.5 years to look at the fluoride toxicity literature. I would suggest Parry Sound continue to learn more about fluoridation. The council can always change its mind.
More education is always welcome. However, such education should be obtained from legitimate, respected sources of accurate information. Filtered and edited information posted on biased antifluoridationist websites and blogs does not qualify as such.
The 2006 NRC Committee on Fluoridation in Drinking Water, of which Dr. Limeback was a member, was charged to evaluate the adequacy of the EPA primary and secondary MCLs for fluoride, 4.0 ppm and 2.0 ppm respectively, to protect against adverse effects.  The final recommendation of this Committee was for the primary MCL to be lowered from 4.0 ppm.  The sole reasons cited by the Committee for this recommendation were the risk of severe dental fluorosis, bone fracture, and skeletal fluorosis, with chronic ingestion of water with a fluoride content of 4.0 ppm or greater.  Nothing else.