Support Community Water Fluoridation – Trust the Experts Instead of Accepting the Arguments of Fluoridation Opponents (Summary)

I wish it were as easy to counter anti-fluoridation arguments as simply stating that virtually all claims made by fluoridation opponents (FOs) were flawed and erroneous (which they are). Unfortunately, those anti-F arguments are often presented using effective strategies that make them appear believable to many voters and elected officials. To effectively counter very simple anti-fluoridation arguments like “Fluoride is a poison that should never be put in drinking water” requires paragraphs of detailed explanations and supporting evidence to even have a chance at refuting the claim. This letter only provides an outline of reasons to distrust anti-fluoridation propaganda, but it is still 6 pages long. My detailed explanation (web link, pdf), complete with specific supporting evidence, is over four times longer.  If you are considering the possibility that anti-fluoridation arguments might have some validity, I hope you will at least read this outline of reasons to reconsider your position.

 

Community water fluoridation (CWF) has been an important public health measure since the early 1950s after it was first tested successfully in Grand Rapids, Michigan in 1945.  That initial test was the result of nearly 20 years of scientific investigation which provided evidence that exposure to fluoride ions (F) in drinking water at about 1 ppm appeared to significantly reduce the risk of tooth decay – while limiting the risk of dental fluorosis.  Since that discovery and the effectiveness of the Grand Rapids experiment, a number of countries have implemented CWF programs.  Based on the success of CWF, other F based dental health measures have been developed and successfully employed like fluoridated toothpaste, fluoride rinses and varnishes and, in some countries, fluoridated salt and milk.

 

However, there has been opposition to CWF since the beginning, and decisions on whether to fluoridate drinking water (or not) have usually been made in the U.S. and other countries by a majority of voters or government officials elected by the voters, not by a majority of science or health experts.  An important dilemma is that most of those voters and elected officials are not trained scientists &/or health professionals.  Consequently, the decisions of most voters and elected policy-makers concerning CWF are not (and cannot be) based on their personal evaluation of the relevant body of complex scientific evidence.

 

My contention in the following discussion is that the democratic process (if it is to produce legitimate science-based results beneficial to the population it is supposed to protect) requires an accurate, impartial consideration of topics by fair-minded, well-informed voters and elected officials.  The question I attempt to address in the discussion is:  If political decisions that impact public health issues based on complex scientific evidence are made by the majority of voters and elected officials who don’t have the training and experience necessary to personally evaluate the evidence, how can these individuals determine what the best decisions are regarding CWF – particularly when they encounter diametrically opposed, mutually exclusive arguments for and against CWF?  The same question and concerns are relevant to vaccination policies, climate-related decisions, education policies regarding young-earth creationism, implementing & following pandemic safety measures (wearing masks, social distancing, appropriate isolation, etc.), and other science-based issues that impact public policies and public health measures.


I am a scientist, and I have studied fluoridation issues for over 25 years.  I believe that anti-fluoridation arguments, tactics and the consequences to public health are dangerous, as are anti-vaccination arguments, ignoring science-based methods to limit the spread of a pandemic and the rejection of other science-based policies.

 

While researching drinking water related topics in the mid-1990s, I came across some anti-fluoridation literature, read it, and began to wonder if I should be concerned about the safety and effectiveness of CWF – which I and my family were drinking.  I had not previously encountered anti-fluoridation claims, so I embarked on an extensive investigation and evaluation of those claims and the tactics employed by FOs.  After months of examining the actual evidence and the specific arguments based on that evidence, I determined those allegations of harm were hugely exaggerated and were actually dangerous for public health – just as anti-vaccination claims and opinions, if believed and acted upon, can harm public health. 

 

I have actively and publicly engaged in countering anti-F arguments since 2015 when FOs launched a serious effort to stop fluoridation of Denver Water.  Fortunately, the Denver Water Board members carefully researched the issue, trusted the overwhelming majority of experts and the scientific consensus, and they voted to continue fluoridation.  Even after hearing a presentation by Paul Connett, one of the top anti-fluoridation activists, the Board concluded “Nothing has been presented to the Board or learned in our research that would justify ignoring the advice of these public health agencies and medical and community organizations, or deviating from the thoroughly researched and documented recommendation of the U.S. Public Health Service.
https://www.denverwater.org/sites/default/files/fluoride-board-resolution-august-2015.pdf


12 years earlier, the Fort Collins, CO City Council had to make a similar decision.  A ‘fluoride technical study group’ responsible for reviewing all evidence for/against CWF was created, The study group was presented with arguments from fluoridation opponents, yet the findings on CWF effectiveness, health risks, costs and other risks were all in favor of CWF – resulting in one of the more detailed CWF evaluations available.
https://www.fcgov.com/utilities/img/site_specific/uploads/fluoride-report030903.pdf

 

I am fully aware that there has been recent research since the Fort Collins decision and Denver fluoridation battle which FOs have presented to the public, allegedly as sufficient proof that CWF can reduce IQ and cause ADHD and other neurological problems – not to mention ongoing claims CWF causes arthritis, bone fracture, cancer, cardiovascular disease, diabetes, GI effects, hypersensitivity, kidney disease, male fertility and pineal gland issues, skeletal fluorosis and thyroid disease. (http://fluoridealert.org/issues/health/)

 

Anyone who is responsible for making decisions about CWF will probably have been sent hundreds of letters from FOs that provide reams of “conclusive evidence” that allegedly proves CWF is responsible for all the damaging health issues listed above in addition to claims that CWF amounts to the illegal addition of medication to the water supply that forces everyone to drink a poison.

 

Anyone who is responsible for making decisions about CWF will also have received letters from scientists and health professionals who claim that, despite the strongly held opinions and claims of FOs, the overall body of scientific evidence has continued to support the safety and effectiveness of fluoridation since 1945 when fluoridation was first tested.

 

Anyone who has encountered anti-fluoridation claims will understand that a significant proportion of the arguments consist of presenting evidence based on published studies that allegedly prove the claims that CWF is ineffective and actually causes serious damage to the health of those who drink it.  However, to personally understand and evaluate the validity of evidence provided by FOs requires significant science or health-care training and experience.  As noted earlier, most members of the public who are elected community decision makers and/or voters responsible for making choices on CWF and other science-based public health measures (like vaccination and how to cope during a pandemic) are not trained scientists or health care professionals.

 

My goal is to provide accurate facts, a description of anti-F tactics and convincing evidence in favor of accepting the conclusions of most relevant science and health experts (and the organizations that represent them) that CWF is a safe, effective, ethical science-based public health measure (like drinking water disinfection, vaccination programs and science-based methods for handling a pandemic) for reducing the risk of dental decay and protecting the health of citizens –– without having to present a detailed evaluation of the specific scientific evidence that has led to those science-based conclusions.  If you believe that most scientists and health care professionals responsible for public health care practices actually care about others, have relevant training and experience and try their best to make and promote effective, science-based decisions that will benefit their fellow citizens, I encourage you to read the following information.

 

An important fact:  There are two completely contradictory and mutually exclusive interpretations and presentation of the evidence regarding the safety and effectiveness of CWF: 

1.      Pro-CWF:  An important and ethical public health measure that significantly lowers risk of tooth decay and related health problems with no proven health risks that cause concerns.

2.      Anti-CWF:  An unethical method of forced medication that does not significantly reduce tooth decay
rates and significantly contributes to an increased risk of lower IQ, ADHD, cancer, thyroid problems, etc. – as referenced earlier.

·         The Pro-CWF and Anti-CWF conclusions are based on exactly the same scientific evidence which is available to those on both sides of the argument.  That creates a serious dilemma for non-scientists.


A Critical Question:  How can someone who is not a fully trained and experienced scientist &/or health professional specializing in fluoridation-related health issues (particularly those who are responsible for making decisions that impact the health and safety of members of their community) evaluate the accuracy and relevance of complex scientific evidence?  How can they determine which of the completely contradictory pro-CWF and anti-CFW claims are legitimate and should be followed for the benefit of their constituents &/or fellow citizens?

 

My answer:  Most people can’t – they must, at some level, depend on the evaluation and conclusions of someone they accept as a trustworthy expert; and that would either be a CWF supporter or opponent.

 

That leads to another important question to consider:  How can someone who is not a fully trained and experienced scientist &/or health professional determine who they should trust to present an accurate evaluation of the evidence – Pro-CWF or Anti-CWF representatives?  Do they toss a coin?  Do they immediately trust an expert whose conclusions align with their beliefs?  Or do they try to be as diligent and impartial as possible and carefully consider not only the conclusions presented, but who is presenting the conclusions, how the evidence is presented and the tactics used to present and support the conclusions.

 

This decision of who to trust for guidance on important, science-based issues is critical, not only for CWF and other health related issues like vaccination, other water treatment processes and how to deal with a pandemic, but all other science-based issues and controversies like evolutionary theory, GMO crops, fears of electromagnetic radiation, etc.  Hopefully a considered evaluation of important facts that apply to the proponents of both sides of the conflicting views will be undertaken before a decision is made about who should be considered a trusted scientific expert on CWF and on all other important science-based issues.  More information here

 

Below are some important facts and questions to encourage your trust and acceptance of Pro-CWF representatives of the well-established, 75-year scientific consensus that CWF is a safe and effective public health measure –– regardless of political persuasion and without resorting (initially anyway) to a detailed evaluation of the evidence –– over the Anti-CWF claims by that fluoridation is harmful and ineffective:  

1.      Fact – It is Important to Understand How Science-Based Conclusions are Made – and how they differ from conclusions based on NotScience beliefs (morals, religion, philosophy, laws, arts and politics).  I present an argument that it is critical to understand the difference between:

a.      scientists who dispute an established scientific consensus and use legitimate, relevant, accurately presented, reproducible scientific evidence to convince relevant experts the consensus needs changing, and

b.      those who don’t have the evidence to change the scientific consensus, abandon the scientific communities and try to change public opinion instead.

2.      Fact CWF is recognized a safe and effective public health measure by the World Health Organization and over 120 other major and respected science and health organizations worldwide, including in the U.S., Canada, Britain, Europe, Australia, New Zealand and other countries. 

3.      Fact – Even mainstream science and health organizations that don’t publicly endorse CWF do not post warnings against CWF or publicly state that CWF causes any of the health issues claimed by FOs. 

a.      FOs resort to threats of legal action against organizations that have publicly supported CWF instead of working within the constraints of scientific protocol to present legitimate evidence (if available) that could change the scientific consensus that CWF is a safe and effective public health measure.

4.      Fact – In stark contrast to the widespread support for CWF by respected science and health organizations worldwide –– and the hundreds of thousands of scientists and health professionals they represent –– I am aware of no major, recognized science or health organizations that have publicly stated CWF is harmful or ineffective, and there are relatively few scientists and/or health care providers that support the anti-fluoridation conclusions.
** In fact, I have only found a few alternative science/health organizations that accept the anti-fluoridation opinions as legitimate. The few I have found that promote a public anti-fluoridation policy are listed below.  These organizations often also subscribe to other ‘medical’ notions that don’t conform to mainstream medical practices.  Examples in the full document:

a.      Vocal, high-profile fluoridation opponents who aggressively promote the anti-fluoridation agenda frequently will also oppose other science-based practices like vaccination, and they are often prone to promoting various conspiracy theories to support their beliefs.  Some vocal FOs (with references to evaluations of their opinions) are described in the full document.

b.      There is absolutely no evidence that most (or even a significant number of) science and health professionals oppose CWF, even though opponents of CWF (and others who hold views contrary to a scientific consensus) are frequently extremely vocal about their beliefs, very eager to share their opinions with others, and will do whatever they can to promote their beliefs. 
In fact: The heavily promoted
FAN Professionals Statement to End Water Fluoridation, initiated in 2007 actually confirms the outlier status of FOs.  By December 2018 only 4,804 signatures had been collected out of the millions of working and retired medical, dental and scientific professionals in the world. Broken down by profession, out of those 4,804 signatures, only 0.19% of the 200,000 dentists, 0.06% of the 219,000 dental hygienists, 0.06% of the 950,000 physicians, 0.03 % of the 3 million registered nurses, 0.03% of the 310,000 pharmacists and 0.01% of the 4.5 million PhD holders in the United States signed the petition – in over 10 years of actively promoting the petition.

5.      Two extremely important questions to consider based on the above facts:  If the arguments and claims of FOs are a scientifically accurate interpretation of the evidence and are presented correctly, fairly and truthfully:

a.      Q1 – Why do the major science and health organizations in the world (and the hundreds of thousands of members they represent) continue to support CWF and not the anti-fluoridation opinions?

b.      Q2 – Why do only a relatively small number of trained and experienced scientists &/or medical professionals support the anti-fluoridation agenda and beliefs?

c.       My Answer:  The decision to dismiss the interpretation of available evidence supporting a scientific consensus that is accepted by most scientists in the world requires trusting in one’s strongly-held, inflexible beliefs instead of the relevant scientific consensus.  That conviction demands requiring that the evidence be selected, interpreted and presented to support those beliefs.
As noted previously, in order to change a scientific consensus, legitimate new scientific evidence must be presented to experts in the relevant scientific community sufficient to initiate change.  For over 70 years, FOs have been completely unable to provide a single confirmed, convincing, legitimate, reproducible, scientific study to support their claims that drinking optimally fluoridated water is ineffective or harmful to health – that includes recent F/IQ studies aggressively promoted by FOs.. The scientific consensus that fluoridation is safe and effective has not changed. 
The arguments and claims of FOs are not based on an impartial, accurate &/or truthful representation of the 75-year body of scientific evidence.

6.      Another critical question to consider:  Since there are only a relatively few scientists and health professionals, virtually no mainstream scientific organizations, a few alternate health groups and some questionable supporters of the anti-fluoridation arguments that CWF is dangerous and ineffective –– and it can be easily demonstrated that the available ant-fluoridation ‘evidence’ is presented inaccurately –– how is it possible that FOs are often successful in their efforts to ban or stop community water fluoridation?
** My Answer:  FOs (and others who oppose widely-accepted science-based conclusions) are extremely dedicated, vocal and persistent in their mission to end CWF (or challenge other accepted science-based conclusions).  There are a number of often successful tactics employed by FOs and other anti-science activists to “adjust” public opinion and encourage members of a community to actively and vocally oppose an accepted scientific conclusion.

7.      Fact: The anti-science tactics employed by FOs (and others who dismiss an established scientific consensus) to try and convince members of the public to trust their proclamations that CWF is dangerous, unethical and ineffective over the conclusions of mainstream science and health professionals must be exposed so they can be understood and dismissed by rational, caring members of the public:

a.      As described earlier, FOs completely ignore the scientific consensus if possible, dismiss it as an irrelevant farce if confronted with it and avoid working within the scientific community to provide legitimate scientific evidence (which does not exist) necessary to change the consensus.

b.      FOs Hijack the Democratic Process

c.       FOs Employ Fear Mongering to Try and Change Public Opinion and Spread Discord:  Fear is an extremely powerful motivator of public opinion, and FOs exploit the complexity of fluoridation science and the power of fear to drive their anti-science, fear-mongering campaign. 

d.      FOs Employ Gish Gallop:  Another very common tactic of anti-science activists is Gish Gallop, “a technique used during debating that focuses on overwhelming an opponent with as many arguments as possible, without regard for accuracy or strength of the arguments.

e.      FOs claim accidents with some link to fluorine happen, so CWF should be banned:

f.        FOs “Create A Veneer of Science to enhance the appeal of their claims”:   FOs (like all anti-science activists) conduct questionable studies, reference (cherry-pick) poor quality studies, inconclusive studies &/or studies that are irrelevant to CWF as 'proof' their opinions are valid, and they deliberately distort conclusions of legitimate scientific evidence before spinning it out to the public.

g.      FOs Blur the Boundary Between Ethics and Science to Fabricate False Moral Arguments:  For example, FOs portray CWF as a medication that constitutes an immoral violation of one’s personal freedom by forcing a medication on unwilling members of the public.

h.      FOs Employ the Freedom of Choice Argument and claim CWF constitutes forced mass medication (or intentional poisoning) –– Anyone drinking public water should have a choice regarding any chemicals they are exposed to. 

i.        FOs Claim Most of the World doesn’t Fluoridate their Water & Decay Rates Have Fallen Both in Countries that use CWF and Those that Don’t.   This is another example of the selective presentation of actual evidence. 

j.        FOs Make Public, Libelous Claims against the scientists and health care professionals who disagree with them, sowing confusion and encouraging public distrust of the scientific processes and the science and health communities.  

k.       FOs Make Out-Of-context, Irrelevant, Misleading Presentations of Article/Study Conclusions:  Unless one takes the time to review and understand every claim made by FOs, one will never know what content has been taken out of context to create a false or misleading claim – it is wise to consider all ‘evidence’ for anti-F claims ‘modified’ in some manner since the overwhelming majority of relevant experts do not accept the anti-fluoridation interpretations and presentations as valid.

8.      Bottom Line:  If you have read this far, I appreciate your willingness to examine arguments for trusting the overwhelming majority of scientists and health professionals and the scientific consensus over the outlier, anti-fluoridation opinions.  I hope I have provided sufficient evidence, without a detailed examination of hundreds of studies, to cast serious doubt on the arguments and tactics of FOs.  As previously noted, I began my investigation of the risks and benefits of CWF because of concerns from reading anti-fluoridation arguments. I had, and still have, no predisposition either for or against CWF, and I have absolutely nothing to gain or lose because of my position on CWF.  I am simply concerned about the accurate representation of scientific evidence, whether it relates to CWF, vaccination, evolution, climate change, and other topics where extremely strong personal beliefs often dictates what someone will believe instead of an impartial evaluation of the relevant body of evidence.  During my years of investigation I found no evidence that even strongly suggested CWF didn’t reduce the risk of dental decay (particularly in disadvantaged communities) or that it lowered IQ and/or caused numerous health problems.  If I had, I would not continue to be a CWF supporter – and I would certainly not try to convince others that support of CWF is an important public health measure that should be supported.
There are dozens of factors that can increase or decrease the risk of dental decay. All methods known to increase risk should be minimized and all methods that reduce the risk (including fluoridation) should be implemented. Only those who care mostly about their personal choices/freedom and nothing about improving public health would insist that an effective method of reducing the risk of dental decay and related health issues not be implemented.
 A more detailed explanation of the topics outlined above: (web link, pdf)

 

Respectfully, Randy Johnson, MS

 

Legitimate Science vs. Anti-Science – Additional Fluoridation References:
  1. 2018 Fluoridation Facts - American Dental Association
  2. American Fluoridation Society
  3. British Fluoridation Society
  4. Open Parachute - Ken Perrott
  5. Professor Dave: Lies People Tell About Water – Part 1: Water Fluoridation
  6. "Just a Theory": 7 Misused Science Words
  7. When PublicAction Undermines Public Health: a critical examination of antifluoridationist literature
  8. Michael W. Easley, DDS, MPH:
  9. Quackwatch, Tactics of FOs
  10. Some anti-science-related images

 

Weight of Science

 

 

Scientists will find the truth because they are committed to finding it, and they know if they screw up, other scientists will be more than willing to debunk their shoddy findings. Lone, “one scientist” discoveries are rare. Most factual conclusions are the product of many individuals and groups checking and cross-checking each other.  Dave McMillan