Despite the emotional arguments of the politicians who supported fluoridation, the science is unequivocal, fluoridation is the best and cheapest solution to maintain the dental health of the entire population
We bring to the readers of the website the scientist the findings of the investigation conducted by Tom Sade andOriginally published on Sharp Thinking Blog of Gilad Diamant.
recently We were informed Because the Minister of Health Yael German decided to completely ban the fluoridation of water in Israel, contrary to the recommendations she received from many professional parties who examined the issue. Is there a connection between the health minister's decision and health considerations?
The review will deal exclusively with in the scientific aspect-healthy of fluoridation. It will not deal with ethical and social issues, such as whether it is right to "impose" a health solution on the general public.
The post is long, to encompass the subject from all sides. It is recommended to read the whole thing in order to get the full picture regarding fluoridation. opened In the history of fluoridation, we will continue with the explanation of The chemistry and mechanism of action of fluoridation, an explanation that is required for the purpose of the discussion on efficiency and safety Fluoridation. Let's take a look at the review Key arguments from the opponents to fluoridate
The history of drinking water fluoridation
The year is 1901. A young dentist named Frederick McKay opened a dental clinic in Colorado Springs, Colorado. Much to his surprise he discovered that many of the city's residents Brown spots on the teeth, a phenomenon that was not documented in the medical literature of that time. Like any good scientist, McKay began investigating the intriguing phenomenon. At first he failed to arouse interest in the subject among the other dentists and researchers. In 1909 he was joined by a well-known dentist - Dr. Greene Vardiman Black, who was the father of surgical dentistry in the USA. The two studied the strange spots for six years (until Black's death) and came to two main insights:
A. The brown spots on the teeth were caused by abnormal development of the tooth enamel. They found that adults whose teeth have already fully developed are not at risk of developing stains on their teeth. On the other hand, children who are waiting for the appearance of their permanent teeth are at high risk of the appearance of stains.
B. They found that brown teeth are surprisingly immune to decay and tooth decay.
McKay speculated that there was some substance in the water that caused the stains and their protective effect, but Black was not convinced. After Black's death, McKay continued to investigate the strange brown spots to find out what was causing them.
In 1923, McKay came to Oakley, Idaho (Oakley, Idaho) to check new cases of brown spots on the teeth of local children. According to reports, the stains began to appear shortly after the construction of a new community water pipe. Although McKay found nothing unusual in the water, he recommended discontinuing the use of the tube. The residents of Oakleigh heeded his recommendation. After several years, the spots stopped appearing among the Oakley children. The result strengthened his hypothesis a bit, but McKay still didn't know what in the water was causing the stains. The mystery was solved a few years later.
In the city of Bauxite, Arkansas (Bauxite, Arkansas) the brown spots appeared, but in a city very close to it the spots did not appear. McKay tested the towns water, but to no avail. His publications caused another scientist named H. and. Churchill (HV Churchill) to test the water in the bauxite using advanced laboratory tests that were not accessible to McKay. The tests showed that it was in the water An abnormal amount of fluoride. Churchill addressed McKay in January 1931 in a five-page letter detailing the results of the tests. For several months, McKay collected water samples from areas where the stains appeared and gave them to Churchill for examination. In all the water samples were found Abnormal concentrations of fluoride. The mystery of the brown spots and what causes them has been solved.
Later, in 1931, the dentist Dr. Henry Trendley Dean (H. Trendley Dean), who was the head of the dental health department of the American National Health Organization, joined the study of the phenomenon. He wanted to check the limit doses at which fluoride in water does not cause the spots to appear. At the end of the thirties, with the help of modern technologies for that time, Dean was able to discover that a concentration of 1 mg of fluoride per liter of water causes the appearance of light spots in only a small part of the population. Now he wanted to test whether fluoride had a protective effect against caries as suggested by McKay and Black's tests. In 1944, a multi-year study began in the city of Grand Rapids, Michigan (Grand Rapids, Michigan), which was the first city in the world to artificially fluoridate its drinking water. The study lasted about ten years and more than 30,000 of the city's children participated in it. The study showed that fluoridation reduced caries cases by about 60% [1].
The study is considered a breakthrough in the study of dentistry and an important milestone in the war against caries, a war in which dentists were at a disadvantage until the discovery of fluoride and its effect on the disease [2].
Following the success of the research, other cities in the United States and other parts of the world began to fluoridate their water. Today, hundreds of millions of people around the world enjoy artificially fluoridated water.
The chemistry of drinking water fluoridation
In the previous part we understood what brought communities around the world to start fluoridating their water. In this part we will understand what fluoride is, what caries is and what is the mechanism by which fluoride helps prevent caries.
What is fluoride?
Fluorine (F) is a chemical element from the halogen group. In nature it is found as a negative (-F) also called fluoride, or as part of a compound. Fluoride is chemically very similar to hydroxide, one of the ions that make up tooth enamel. Fluoride is found in a compound with other elements, for example calcium, phosphorus and sodium. When such a compound comes into contact with water it breaks down, and the fluorine ion and the other elements in the compounds are dissolved in the water.
Fluoride can reach drinking water naturally and artificially. In some places in the world and in the country the drinking water naturally fluoridated, because the water source in the area is rich in fluoride that came from rocks. The degree of this natural fluoridation varies and can be below the recommended amount, at the recommended amount or much above it. In artificial fluoridation of the drinking water, fluoride is added to the water up to the desired dose, or the dose is reduced if there is an excess of fluoride in the water.
There are two main sources of fluoride for artificial fluoridation: the first is hexafluorosilicic acid (H2SiF6), a byproduct of the fertilizer industry. The other is sodium fluoride (NaF), a natural mineral that can be mined from the Earth's soil. It can also be produced by certain chemical treatment with acid. Mining sodium fluoride is expensive and polluting, so usually acid is used in the artificial fluoridation process. When the acid is put into water, it breaks down and its various components are dissolved in water in a process called hydrolysis [3].
A fluorine ion from different sources has the same chemical properties. That is, a fluorine ion derived from sodium fluoride and a fluorine ion derived from hexafluorosilicic acid chemically identical. When evaluating the safety and effectiveness of fluoride consumption in drinking water, there is no need to consider the source of the fluoride as a relevant factor. However, it is necessary to consider the safety of the other components of the acid, because they also dissolve in water. Later, we will deal with the question of the safety of these ingredients.
According to the Ministry of Health, the recommended fluoride concentration in water in Israel is 1 mg fluoride per liter of water, or one fluoride particle for every million water particles [4]. To achieve this level of fluoridation, it is customary in Israel to add hexafluorosilicic acid to the water at a ratio of 1.25 mg of acid per liter of water. This is how the fluoride concentration of 1 mg fluoride per liter of water is achieved, with the hydrogen and nitrogen in the acid making up the remaining quarter mg.
Water fluoridation in this way is one of many fluoride treatments. The various treatments are divided into two types according to the nature of their absorption and action.
Systemic fluoridation versus external fluoridation
The first type is direct absorption of the fluoride into the body, a process known as "systemic fluoridation". Systemic fluoridation is achieved by fluoridation of drinking water, salt or milk, or direct consumption of fluoride through drops or pills. The fluoride passes through the digestive system and reaches the blood circulation and from there to the organs of the body. Most of the fluoride is not absorbed by the body at all and 60%-80% of it is excreted through the urine. 99% of the fluoride remaining in the body is absorbed by the hard tissues which are the bones and teeth. The minimal amount that remains accumulates in the soft tissues. As a result, the fluoride also reaches the saliva in low concentrations.
Brushing with fluoridated toothpastes, using fluoridated mouthwash and other fluoride therapies that do not include fluoride ingestion constitute the second type called "external fluoridation", for obvious reasons. This type of treatment temporarily increases the fluoride concentration in saliva, depending on the frequency of the treatment.
What is tooth decay?
The tooth consists of three main parts: in the inner part is the tooth pulp - a tissue of blood vessels and nerves responsible for the sensation in the tooth and its blood supply. Above it is the layer of the tooth (dentin), which is a hard layer that connects the pulp and the outer layer of the tooth, the enamel. The enamel layer consists mainly of molecules called hydroxyapatite and is the densest tissue in the body. The enamel layer protects the softer and more vulnerable layers that are underneath it.
Tooth decay is caused by bacteria in the oral cavity. Caries bacteria break down sugars in order to extract from them energy which they use for growth and reproduction. A byproduct of the breakdown of sugars is acid, which the bacteria secrete into the oral cavity. The same acid breaks down the enamel and dentin. This process creates "holes" in the teeth and may lead to infection and necrosis in the tooth pulp and the underlying bone. The disease is very common in the Western world, while in the USA it is the most common childhood disease, by a considerable margin from the others [5].
How does fluoride in water prevent tooth decay?
It does this through three main mechanisms:
First, when absorbed systemically, the fluoride is assimilated into the tooth enamel and strengthens it. The fluoride replaces the hydroxide ion in the enamel and slightly changes its structure. As a result, the enamel becomes denser and more resistant against the bacterial acids. This effect only happens during the development phase of the tooth and before it exits the oral cavity and only when the fluoride is systemically absorbed into the body.
Second, the increase in fluoride concentration in saliva causes the re-assimilation of fluoride in the enamel (remineralization). In addition, enamel reinforced with fluoride in this way undergoes faster remineralization than enamel that is not reinforced in this way.
Finally, the caries bacteria absorb the fluoride from the saliva into their cells. It in turn damages their metabolism, meaning their ability to digest sugar. This reduces the production of acid that eats away at tooth enamel.
In the past, it was thought that the systemic absorption of fluoride in the tooth enamel was the main preventive factor. Today it is known that the main mechanism by which fluoride prevents caries is the second mechanism - the remineralization mechanism. This effect is granted externally from the saliva to the enamel and not from within the body, systemically.
Although the main protection is given externally, water fluoridation, which is systemic fluoridation, is still important because it also includes the benefits of external fluoridation; Any consumption of fluoridated water temporarily increases the concentration of fluoride in saliva, just like brushing your teeth, or rinsing your mouth with fluoride water.
In addition to these, the beneficial effect of different types of fluoridation is Cumulative effect. There are several reasons for this.
The first reason is that the fluorine is Passive prophylaxis. Unlike brushing your teeth, there is no need to perform any action, there is no need to know how to perform it correctly and there is no need to consult a dentist for this. All that is needed to receive the benefits of water fluoridation is to drink fluoridated water. This allows even those who do not brush their teeth properly to benefit from the protection of fluoride therapy.
Another reason is that water fluoridation constitutes Complementary treatment for external protection which is granted from fluoride preparations such as toothpastes, or mouthwash preparations. Fluoridation provides uniform, small and constant protection throughout the day, depending on the frequency of drinking fluoridated water. In contrast, the external fluoride products provide great and one-time protection at critical moments, such as after a meal or before bed.
Finally, external fluoridation methods have their advantages. Brushing teeth, for example, removes the bacterial layer from the teeth in the act of brushing, an effect that other forms of fluoridation do not have. All these cause that different fluoride treatments prevent caries more effectively when they are given together, compared to a situation where each of them is given separately.
If we accept the protection that fluoride gives to the teeth for the maintenance and cleaning of the house, then the systemic fluoridation is equivalent to the general maintenance of its cleanliness. In contrast, external fluoridation is equivalent to a thorough cleaning of the house at the weekend. Both methods are necessary in order to keep the house clean in the best possible way, just as the two methods of receiving fluoride are necessary to maximally maintain tooth health [8-6].
The evidence for the effectiveness of fluoridation
In the previous part we learned what fluoride is, what caries is and how using the former prevents the latter. But how much does fluoride use really reduce caries? What is the evidence for the effectiveness of fluoridation? What do the studies show?
Studies from the fifties, sixties and seventies of the twentieth century showed that water fluoridation prevents caries to a very large extent, between 50%-70%, such as the study in Grand Rapids mentioned earlier [1]. Newer studies and reviews indicate a much less impressive effect, of between 15%-30% [7-9].
What could be the reasons for the lower observed effect in the new studies?
- population mobility - The population today is very mobile compared to those years. People migrate much more between fluoridated and non-fluoridated areas, which reduces the effect that is revealed when comparing the residents of the different areas.
- Mobility of "fluoridated" food - Today, fluoridated areas give a "halo" effect to non-fluoridated areas in that food produced there and containing a higher amount of fluoride is also sold in non-fluoridated areas.
- Availability of products that contain fluoride - Fluoride supplements, fluoridated toothpastes, mouthwashes that contain fluoride and many other products exist in abundance today. Since they were not in use then and because they provide protection in addition to that provided by fluoridation of drinking water, the relative effect is reduced even more.
- The quality of the studies - The initial studies were conducted many years ago, and their methodological quality is poor compared to the more recent studies. There may have been a bias in the results in favor of fluoridation.
Either way, studies show that The fluoridation of drinking water has a significant effect in preventing caries [8,10].
The main advantage of fluoridation is that it is a passive preventive treatment for the entire population, with an emphasis on the weak populations. In Western countries, as we go down in socio-economic indicators, we see an increase in the number of victims of caries [3,11]. The various preventive treatments besides fluoridation rely on visits to dentists, active use of various products in the right way and oral hygiene education. The availability of these methods of prevention to a person is according to his income, this is in contrast to fluoridation, which is uniformly available to the entire population. No wonder, therefore, that the benefit of drinking water fluoridation increases as we go down the socioeconomic scale [3]. Fluoridation can be seen as a social preventive treatment, which reduces the gaps in the socio-economic scale, at least in terms of dental health.
Another advantage of water fluoridation is that it is in a very cheap solution. According to a study by the US Center for Communicable Diseases (CDC), drinking water fluoridation costs less than a dollar per year per person, when the population whose water is fluoridated exceeds 20,000 inhabitants. She saves dental treatments costing between 20 and 40 dollars for every dollar invested in her. According to the same study, fluoridation pays back its cost many times over in eighty communities with over 5,000 people in every scenario, even in the worst. In smaller communities it recovers its cost in all but the worst scenario [12]. Another, more recent, similar study conducted in Australia showed similar and even better results [13].
Drinking water fluoridation was found as a highly effective solution even compared to other prevention methods. A large study conducted in the 14s in the United States found that water fluoridation is much more effective in preventing tooth decay than other community preventive methods based on preventive treatments in schools [XNUMX].
The evidence for the safety of fluoridation
Fluoridation of drinking water is effective in preventing caries and is also a cheap preventive policy. But is it safe and without dangers?
The fluoride levels found in fluoridated drinking water can cause only one known harm - Fluorosis of the teeth. These are white to brown spots on the tooth enamel and its abnormal development. Only an expert can detect fluorosis at a low level, at medium levels it is considered an aesthetic problem only and when it is severe it is considered a health problem. (Nice anecdote: the common test for the severity of fluorosis is based on an index named after Dr. Dean, one of the pioneers of research in the field).
It is very rare that artificially fluoridated water causes severe fluorosis of the teeth. According to a report by the Center for Disease Control of the United States from 2010, less than 1999 percent of the population of the United States suffered from this problem in the years 2004-15 [1994]. According to a broad review of the relevant scientific literature from 40, only 60% of all dental fluorosis cases (mild to severe) are caused by drinking water fluoridation. In 16% of cases it is due to other factors [XNUMX] which include the ingestion of fluoride products intended for external use (such as toothpastes) at the critical age of tooth development, improper or excessive use of fluoride products for consumption (such as drops or pills), and more.
A report by the American National Research Council (NRC) from 2006 found that severe fluorosis almost does not appear in places where the water is fluoridated at a concentration of 2 mg per liter (twice the usual in Israel), and it is becoming more common as the concentration of fluoride in the water increases [2] . Data from other health organizations (including the World Health Organization) and similar reviews of the scientific literature show similar numbers [17-3,7,18].
In conclusion, Fluoride in the concentration used in artificial fluoridation has not been associated with any other damages other than fluorosis. At much higher concentrations, additional potential damages were found such as fluorosis of the skeleton and an increase in the risk of fractures and various neurological injuries. We will return to this topic in a moment.
The arguments of the opponents
Drinking water fluoridation is accepted by many health organizations, led by the World Health Organization (WHO) as an effective, safe and cheap way to prevent tooth decay [20]. The United States Center for Disease Control (CDC) ranked drinking water fluoridation as one of the ten most important health inventions of the twentieth century, along with vaccines, seat belts, and infectious disease control [21].
If the scientific consensus that supports the fluoridation of drinking water is so extensive, why are there so many opponents of it?
The overwhelming majority of fluoridation opponents come from non-professional and non-scientific circles. These are arguments that do not hold water (Pun intended) when they are examined from a scientific angle. Opponents of fluoridation use a variety of tactics to influence the public and to change the minds of decision makers on the issue. Since there are many arguments, and since the paper is too short to address them all, we will focus on the central ones.
Taking studies out of context
Opponents of fluoridation often cite studies that supposedly find a connection between fluoridation of drinking water and a host of damages and diseases, such as nerve damage, damage to the thyroid gland, damage to memory, damage to brain development in children, fluorosis of the skeleton and an increase in the risk of fractures. At the center of their arguments is the report of the American National Research Council (NRC) from 2006. The report mentions the harms of fluoride From a natural source in a much higher concentration than the concentration used in artificial fluoridation. The report does not deal with recommendations regarding artificial fluoridation, but with natural concentrations higher than recommended (2-4 times) and it states this in black and white [22].
Another study that the opponents like to cite is the "Harvard study" - a systematic review of the scientific literature that found a connection between high fluoride concentration in water and damage to the IQ index in children. Here too, the researchers No conclusions are drawn about artificial fluoridation of drinking water, but regarding high fluoride concentrations in water and their effects [23]. The fluoride concentrations in the studies included in the review were 2-11 times higher than the concentrations used in Israel. In fact, in most studies a comparison was made to people who consumed water with a fluoride concentration of 0.5-1 mg per liter - similar to the concentration in artificial fluoridation. That is, the studies have shown in practice that a concentration of fluoride such as that used in artificial fluoridation in Israel is safe, while a concentration many times higher than that is not safe.
Also, most studies did not control for other factors that could affect the results of the experiment, such as socioeconomic status or exposure to fluoride from other sources. Not only were opponents wrong and wrong; Articles in the popular media on the topic of fluoridation also mentioned the studies as those that show damages that the fluoridation of drinking water causes [24,25].
"The poison is in the dose". In toxicology there is the famous saying "The Dose Makes the Poison", according to which a substance is considered poisonous only in certain doses. A substance may be harmful in certain doses and neutral or even beneficial in other doses. Water, for example, is harmful in high doses (to the point of death) but there is no dispute about its necessity in appropriate doses. So is fluoride. The effect is not directly proportional to the quantity. Half the amount does not necessarily mean half the damage.
Claims about the hexafluorosilicic acid
Opponents of fluoridation claim that the use of industrial waste is fundamentally wrong, and that dangerous chemicals are introduced into our drinking water. The argument is wrong for two reasons:
First, from a logical point of view, the argument stands on chicken's knees. A fallacy is made in the argument called "turning to nature". The fallacy is committed when it is claimed that something is not good for humans because it is unnatural. in real, Not everything that is natural is good for humans and not everything that is artificial is harmful. There are many examples of this - cyanide, a substance that kills in fairly low doses, is naturally found in many fruits. Animal venom, poisonous plants - the list of natural substances harmful to humans is long. On the other hand, many medicines that are "unnatural" save lives when reading these very lines. In the end, everything we consume is actually chemicals, "natural" or not. There is no difference between "natural" atoms of any element or compound and "artificial" atoms of the same element or compound.
Second, the argument is chemically incorrect. As explained before, the acid is not in the water at all. When the acid comes into contact with the water, it breaks down into its components: nitrogen, hydrogen and fluoride. Even if miraculously the acid did not break down in the water, it is not toxic in the doses in which it is put into the water. How do you know that? In toxicology, it is customary to use the LD50 index when you want to check the degree of lethality of a substance. This is the index that checks what amount of the tested substance will kill 50% of the subjects. The LD50 index of hexafluorosilicic acid is 125 mg per kg of body weight [26]. In a quick calculation, a person weighing 75 kg would have to drink thousands of liters of water to be poisoned by the acid in 50% of the cases. All this is assuming and the person survives the toxicity of sodium, nitrates and other minerals found in the water. Furthermore, consuming about XNUMX percent of this amount of water at one time is enough to cause death, even without any other substance dissolved in it.
In addition to this failed claim, the opponents maintain that the acid contains many heavy and toxic metals and these are also introduced into our drinking water. The source they provide is Photocopy of a document of KIL (Chemicals for Israel) fertilizers, detailing what the acid contains that it supplies to the Ministry of Health [27]. Apparently, the document is alarming. It turns out that arsenic, mercury, lead and a host of heavy metals and toxic substances are in the acid. However, the opponents of fluoridation forget to mention that the concentration of these metals After soaking in water It is null and cannot cause damage. (Remember the cyanide found naturally in the fruits we eat?)
For example, according to the document, arsenic is found in a concentration of up to 400 mg per kg of acid. If the acid is dissolved in a concentration of 1.25 mg per liter of water, this means that we have about 500 mg of arsenic in a million liters of water, or 0.0005 mg of arsenic per liter of water. This is an infinitely lower concentration than the maximum concentration recommended by the Environmental Protection Authority of the United States, which is 0.01 mg per liter [28]. A toxic metal found in the acid in the same amount as arsenic is lead, whose maximum concentration in water allowed according to the standard of the same organization is 0.015 mg per liter [29]. in both cases The amount of metals in the water is twenty times lower than the most stringent standards.
In conclusion, the mere fact that it is an artificially produced chemical is no indication of harm. Even the existence of metals in zero concentrations does not cause harm. The only element at play here is the public's fear of the unknown, a fear that stems from ignorance and associative thinking.
Cherry picking for studies
Opponents of fluoridation like to "collect" studies that support their opinion and ignore those that do not. This tactic is called cherry picking.
A good example of this is a single study that found a connection between the fluoride concentrations common in fluoridation and bone cancer. The opponents ignore a review [7] done in the field which discredited the results of 26 studies, as well as the review of the study by the European Union Health Organization and the Australian Department of Health [3,30].
In addition, from one observational study it is very difficult, if not impossible, to draw conclusions about causation (that is, that one thing causes something else), and this is because such studies do not test a relationship of causation, but only a statistical correlation, and they do not control for factors that may bias the results .
In epidemiology, when there are no intervention studies, conclusions are drawn from systematic reviews of the observational studies. This is a review that does a statistical analysis of a number of studies on the topic under review. It examines the general trend arising from the relevant scientific literature and is less vulnerable to biases and flaws that can be caused when conclusions are drawn from a single study.
In short, to get an overall picture regarding the effectiveness and safety of any drug or medical procedure You have to look at all the evidence in the field, while weighing the quality of each evidence, that is, giving greater weight the higher the quality of the evidence. What is wrong to do is to look at one specific piece of evidence that supports a certain opinion and ignore all the evidence that contradicts it, and this is exactly what the opponents of fluoridation do - they focus on the exception and not on the whole.
Fluoridation as a controversial topic among the scientific community
The website of the main opponents of fluoridation - Fluoride Action Network, has a list of 4,396 signatories who oppose the fluoridation of drinking water (as of this writing) [31]. It should be noted that of them, only about 8% (349) are dentists. This is a drop in the sea of dentists in the world, whose number must be hundreds of thousands. The other signatories have advanced degrees in non-relevant fields, nurses, and practitioners of alternative medicine. Toxicologists and epidemiologists who deal with public health and medical research are the relevant authority when it comes to the dangers of fluoridation and its effectiveness, but it is not specified on the website how many of the degree holders have a doctorate in epidemiology or toxicology and how many of them are engaged in active research in the field.
In contrast, the American Dentists Association collected a list of organizations that support fluoridation, about 125 in number, most of them from the United States. The meaning of the numbers is that for every three dentists who oppose, there is an entire organization that supports fluoridation [32]. It should be noted that not all organizations are organizations that specialize in dentistry, but a significant part of them are from the fields of general health, epidemiology, toxicology and other related fields.
In the following article, scientists one by one refute the claims of the opponents of fluoridation from the world of academia and beyond [33] - "When public action undermines public health: a critical examination of antifluoridationist literature".
In other words, The scientific consensus supports the fluoridation of drinking water unequivocally. There is really no disagreement among the scientific community on the subject of fluoridation.
A small gap between a safe dose and a harmful one
It is argued against fluoridation that the difference between an optimal dose and a harmful dose is not great. Well:
A. Apparently, the difference the absolute It is not big - between 1 and 4 mg per liter, only 3 mg is separated, but in terms of ratio The quantities are a large quantity times four. In this context, it is important to understand that water fluoridation is carried out by very precise means, with the possibility of monitoring the smallest abnormalities; Water testing (in Israel at least) is done daily [38]; And in any case, a one-time exposure to a somewhat excessive dose cannot cause any harm. The chance that an anomaly on such a scale will occur, and over a long period of time, is zero.
B. The argument shows that opponents recognize that fluoridation in the right dose is not harmful. This is in contradiction to their other claims. In doing so, they try to grasp the stick at both ends.
Eating the piping
Opponents claim that the addition of the hexafluorosilicic acid corrodes the water transport pipes, which introduces toxins and heavy metals into the drinking water. The claim is false and not supported by the evidence. As mentioned before, the acid breaks down in contact with the water in the fluoridation process even before it reaches the pipeline. [34,35].
Damage to the thyroid gland
Opponents of fluoridation claim that water fluoridation damages the thyroid gland and causes it to be underactive. They cite the US National Science Commission (NRC) report mentioned earlier as the source for this claim. In the report, a review of the studies in the field was made, and at all, it was not found that fluoridation at a concentration of 1 mg per liter or a concentration close to it has an effect on the thyroid gland [36]. Only one study was an exception to the rule - a study from China where the concentration was 0.88 mg per liter and hypothyroidism was indeed discovered among the subjects. What was strange about this study is that the fluoride concentration found in the subjects' urine was 2.56 mg per liter, almost three times the amount consumed in water. The body does not produce fluoride naturally, and from this it can be concluded that the subjects received a large amount of fluoride from a source other than the drinking water.
Danger of cumulative overconsumption
Opponents of fluoridation claim that the public consumes fluoride from other sources indirectly, such as from vegetables and fruits that have been irrigated with fluoridated water, which may lead to a situation of excessive consumption of fluoride. This argument ignores the fact that The other fluoride sources are already included in the calculation conducted by the health organizations regarding the optimal concentration of fluoride in water [37].
European countries do not fluoridate
Opponents of drinking water fluoridation point out that in many European countries it is not customary to fluoridate drinking water.
First of all, a "look at what's happening in other countries" type of argument is problematic due to the simple fact that the exact same tactic can be used to to support In fluoridation, simply by mentioning the 400 million residents of countries that do fluoridate water, such as the United States, Australia, Brazil and Singapore. The same argument supporting two opposing positions is a very weak argument.
And why don't they really fluoridate the water in many European countries? There are a variety of reasons for this: in many European countries it is simply not economical to fluoridate the drinking water, because many cities obtain their drinking water from many water sources and it is very expensive to fluoridate each source separately. There are countries where the water is naturally fluoridated and therefore there is no need for artificial fluoridation. Other countries have decided to fluoridate the salt or the milk, and in the rest it is customary to use other fluoride treatments, such as drops and pills, so adding another source of fluoride is unnecessary. Finally, there are countries where the ban is ethical or legal and does not refer at all to the safety, effectiveness or necessity of fluoridation.
Therefore, the fact that fluoridation of drinking water is not practiced in most European countries is not relevant to the issue of safety, efficiency or cost of fluoridation.
Summary
We briefly reviewed the history of drinking water fluoridation, continued with basic explanations about the chemistry of fluoride, the structure of the teeth, the caries disease that attacks them and the mechanisms by which fluoride helps prevent caries. After that, we reviewed the evidence regarding the effectiveness and safety of fluoridation and prepared a selected collection of the arguments of the opponents of fluoridation and providing an answer to each of them.
We have seen that, contrary to the claims of the opponents, fluoridation of drinking water is a cheap, effective and safe method of fighting tooth decay. At the community level, it is second to none. It is especially beneficial to those belonging to the lower socio-economic status and saves the community a lot of money and pain. We learned that water fluoridation is at the heart of the scientific consensus, well supported by evidence, and many health organizations support its implementation without reservation.
The arguments of the opponents are not scientific arguments. The dispute on the subject is only political and social.
Editor's note
Gilad Diamant, editor of the "Sharp Thinking" blog, joins the thanks that Tom gave in the original post to the members of the "Sharp Thinking" Facebook group who helped in collecting the material for the investigation, as well as to Ido Hadi, Adam Levin, Dean Katz and Rodna Goltz for their constructive comments.
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for further reading:
- A shorter and lighter post onRoey Tsezana's blog - On fluoride, ministers and friends
- A comprehensive and up-to-date review of the subject, including references to hundreds of studies, published by the New Zealand government.
- Much more information can be found on the website of the British Fluoridation Society
Sources
- Arnold F a. Grand Rapids fluoridation study; results pertaining to the eleventh year of fluoridation. American Journal of Public Health and the Nation's Health 1957;47:539–45.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1551218/ - National Institute of Dental and Craniofacial Research. The Story of Fluoridation. NIDCR Webpage. 2011;
http://www.nidcr.nih.gov/oralhealth/topics/fluoride/thestoryoffluoridation.htm - Scientific Committee on Health and Environmental Risks. Critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water. 2011.
http://ec.europa.eu/health/scientific_committees/environmental_risks/docs/scher_o_139.pdf - Ministry of Health of the State of Israel. Fluoride, Ministry of Health
http://www.health.gov.il/Subjects/Dental_health/information/Pages/fluorides.aspx - Bratthall D, Petersen P, Stjernswärd J. Oral and Craniofacial Diseases and Disorders. In: Disease Control Priorities in Developing Countries. 2nd edition. 2006.
http://www.ncbi.nlm.nih.gov/books/NBK11725/ - American Dental Association. Benefits. In: Fluoridation Facts. 2005. p. 10.
http://www.ada.org/4378.aspx - Holloway PJ. Systematic review of public water fluoridation. Community dental health 2000;17:261–2
http://www.york.ac.uk/inst/crd/fluores.htm - Armfield JM. Community Effectiveness of Public Water Fluoridation in Reducing Children's Dental Disease. Public Health Rep 2010;125:655–664.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925001 - Kumar JV, Adekugbe O, Melnik T a. Geographic variation in Medicaid claims for dental procedures in New York State: role of fluoridation under contemporary conditions. Public health reports (Washington, DC: 1974) 2010;125:647–54.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925000 - American Dental Association. Benefits. In: Fluoridation Facts. 2005. p. 14.
http://www.ada.org/4378.aspx - Dye B a, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, Eke PI, Beltrán-Aguilar ED, Horowitz AM, Li CH. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital and health statistics Series 11, Data from the national health survey. 2007;:1–92.
cdc.gov/nchs/data/series/sr_11/sr11_248.pdf - Griffin SO, Jones K, Tomar SL. An economic evaluation of community water fluoridation. Journal of Public Health Dentistry 2001; Spring:78–86.
http://www.cdc.gov/fluoridation/pdf/griffin.pdf - Campain AC, Mariño RJ, Wright FAC, Harrison D, Bailey DL, Morgan M V. The impact of changing dental needs on cost savings from fluoridation. Australian Dental Journal 2010;55:37–44.
http://dx.doi.org/10.1111/j.1834-7819.2010.01173.x - Klein SP, Bohannan HM, Bell RM, Disney JA, Foch CB, Graves RC. The cost and effectiveness of school-based preventive dental care. American Journal of Public Health 1985;75:382–391.
http://dx.doi.org/10.2105/AJPH.75.4.382 - Beltrán-Aguilar E, Baker L. Prevalence and severity of dental fluorosis in the United States, 1999-2004 [Internet]. CHS data brief, no 53. Hyattsville, MD: National Center for Health Statistics. 2010;
http://www.cdc.gov/nchs/data/databriefs/db53.htm - Lewis DW, Banting DW. Water fluoridation: current effectiveness and dental fluorosis. Community Dentistry and Oral Epidemiology 1994;22:153–158.
http://ncbi.nlm.nih.gov/pubmed/8070242 - Committee on Fluoride in Drinking Water, National Research Council. Prevalence of Severe Enamel Fluorosis in Relation to Water Fluoride Concentrations. In: Fluoride In Drinking Water, A Scientific Review Of EPA's Standards 2006. The National Academies Press; 2006.p. 112–114.
http://www.nap.edu/openbook.php?record_id=11571&page=112 - Chilton J, Dahi E, Lennon M, Jackson P. Fluoride in drinking-water. 2006.
http://www.who.int/water_sanitation_health/publications/fluoride_drinking_water_full.pdf - Palmer CA, Gilbert JA. Position of the Academy of Nutrition and Dietetics: the impact of fluoride on health. Journal of the Academy of Nutrition and Dietetics. 2012;112:1443–53.
http://www.ncbi.nlm.nih.gov/pubmed/22939444 - Fawell, K. Bailey, J. Chilton, E. Dahi, L. Fewtrell, Y. Magara, Fluoride in drinking-water. World Health Organization (WHO), 2006.
http://www.who.int/water_sanitation_health/publications/fluoride_drinking_water/en/ - Centers for Disease Control and Prevention. Ten Great Public Health Achievements — United States, 1900-1999. 1999; Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm
- Committee on Fluoride in Drinking Water, National Research Council. Introduction. In: Fluoride in Drinking Water: A Scientific Review of EPA's Standards. The National Academies Press; 2006. p. 14.
http://www.nap.edu/openbook.php?record_id=11571&page=14 - Choi A, Sun G. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environmental Health... 2012;1362:1362–1368.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491930 - Shir-raz Y. Investigation: What makes dangerous fluoride in our water? 2007;
http://www.ynet.co.il/articles/0,7340,L-3445244,00.html - Kathy Dorr An article about the fluoridation of drinking water on Channel 1. 2013;
http://www.youtube.com/watch?v=4c-SE_rWy6Y - Haneke KE, Carson BL. Review of Toxicological Literature. 2002
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.195.3737&rep=rep1&type=pdf - Moor Segmon. Photocopy of a document showing a typical analysis of hexafluorosilicic acid. 2011;
http://hayeruka.files.wordpress.com/2011/05/d797d795d79ed7a6d794.png - Environmental Protection Agency. Fact Sheet: Drinking Water Standard for Arsenic. 2012;
http://water.epa.gov/lawsregs/rulesregs/sdwa/arsenic/regulations_factsheet.cfm - Environmental Protection Agency. Lead and Copper Rule. 2012;
http://water.epa.gov/lawsregs/rulesregs/sdwa/lcr/index.cfm - Yeung C. A systematic review of the efficacy and safety of fluoridation. Evidence-based dentistry. 2008;
http://www.nature.com/ebd/journal/v9/n2/abs/6400578a.html - Fluoride Action Network. Professional Statement.
http://www.fluoridealert.org/researchers/professionals-statement - American Dental Association. Compendium. In: Fluoridation Facts. 2005. p. sixty nine.
http://www.ada.org/4378.aspx - Armfield JM. When public action undermines public health: a critical examination of antifluoridationist literature. Australia and New Zealand Health Policy. 2007; 4.
http://www.publish.csiro.au/paper/HP070425 - Centers for Disease Control and Prevention, Fluoridation of Drinking Water and Corrosion of Pipes in Distribution Systems Fact Sheet. 2013.
http://www.cdc.gov/fluoridation/factsheets/engineering/corrosion.htm - Ministry of Health, drinking water fluoridation: the facts
http://www.health.gov.il/Subjects/Environmental_Health/drinking_water/fluoridation/Documents/BSV_haflaraWater.pdf - Committee on Fluoride in Drinking Water, National Research Council. Prevalence of Severe Enamel Fluorosis in Relation to Water Fluoride Concentrations. In: Fluoride In Drinking Water, A Scientific Review Of EPA's Standards 2006. The National Academies Press; 2006.p. 224-267.
http://www.nap.edu/openbook.php?record_id=11571&page=224 - Environmental Protection Agency. Fluoride: Exposure and Relative Source Contribution Analysis. 2010.
http://water.epa.gov/action/advisories/drinking/upload/Fluoridereport.pdf - Public Health Regulations (sanitary quality of drinking water and drinking water facilities), 2013-XNUMX
http://www.health.gov.il/LegislationLibrary/Briut47.pdf
52 תגובות
You guys are funny, obviously fluoridation is not good. 1. They invade your body, good cannot come out of it. Those who want to drink fluoridated water please add it to their drinking water. Arrogance, rapacity and invasion of the individual's sphere cannot be justified by scientific arguments. 2. Those who want their opinion to be "scientifically" justified need some money and that's all, a scientific opinion today is subject to the budget and not to the absolute "truth", you know "researchers need to eat too" and benzene burners do not work on air (which by the way is the only thing in the economy that still free and therefore it is so polluted) I really do not underestimate the scientific method, but it belongs to the exact sciences. Biology is not an exact science but a probabilistic science. So please calm the horses down and don't forget the rights of the individual. 3. The motive for fluoridation is also economic because public health is also budgeted. Did you understand? 4. Since it is clear to a person with common sense that "everything is interest" then the individual must take care of his own interests and not believe the one who hits him with research papers while putting his hand in his pocket. So please, in this case there is no need for "sharp thinking", open eyes are needed. You put into your body someone else's budgetary savings on you. Basically, the public is being exploited, the excuse this time is in the name of science. But if you ignore the truth, it's simple: foreign substances are being introduced into your body. There is no difference between fluoridation and air pollution and food pollution. The water should be clean, the air clean, the food clean. A person should be responsible for his body, no? So you are an animal and you deserve to be treated like a cow in a barn by asking her what she wants or thinks, but using power manipulation in the case of animals and manipulation in the case of humans. full health.
Hello Tom, what is your attitude towards Dr. Dean Burke's research and claims?
Boil water in a clean kettle... it won't accumulate toxins???
1. I didn't claim that you claimed otherwise, it's enough *that you didn't say it*.
2. That's not what you said in the article. In the article you brought the figure of XNUMX percent as proof that this is a rare phenomenon.
3. Counting organizations, which you brought as proof of the scientific consensus, is not relevant. Positions of various government ministries are not proof of *scientific* consensus.
4. You do not reject the Harvard study that found a negative effect of twice the concentration that is put into water on IQ, but you still state that there is no danger in fluoridation with full confidence and try to influence public opinion to accept your position while labeling your opponents as unscientific. wow As a scientist, are you so sure that concentration x causes a certain effect on an organism so complex in an experiment that it is unlikely that half of it will cause the same effect? Is it so inconceivable? Is the repeatability of these experiments so accurate? Is the repeatability of experiments with microorganisms so accurate?
you know not So I don't understand where you have the audacity to belittle those who doubt it so much. Actually, I got it. It's not that you're just pointless and therefore have the urge to write "I'm scientific, you're not" every two lines. This is the heart of the matter. It's not just that all these groups sound like preachers. Spreading the love of science is one thing, but spreading the supremacy of scientists over the ignorant population is another, and even the other way around.
rest your mind I didn't come to change her. But if there is one embarrassed person who couldn't understand why he shouldn't worry about something that does seem worrisome to him, but the condescending tone and the propaganda you hurled at him managed to scare and undermine him, if someone like that read my response and regained the confidence to consider things for himself - I'm satisfied.
The problem is not with the fluorine at all, it actually helps and does not harm in these doses. The real problem is the chlorine that is put in the water against bacteria. This chlorine is much more harmful relatively in the doses that are used today. It has been proven to be carcinogenic in higher doses..
Hi Amir, first of all, note that this is "Yaden", not Davidson. You got a little confused.
I will answer you with your permission, section by section:
1. True and I never claimed otherwise in the article.
2. The rate of fluorosis in Israel is much smaller than stated in the post, as for example can be seen in the following study commissioned and funded by the Ministry of Health:
http://info.org.il/teeth4all/?cat=3
Having said that, even if the rate of severe fluorosis was higher, it is still a matter of proper risk management, because the benefits gained from fluoridation far outweigh its disadvantages.
3. Water fluoridation is at the heart of the scientific consensus. Even in countries that do not fluoridate their water, the professional authorities recognize that it is an effective and safe method for preventing tooth decay. Enough sources from professional and large organizations such as the CDC, the WHO, ministries of health of various countries, etc. were brought to support this claim.
4. First, I do not reject the conclusions that follow from the Harvard study. I argued that nothing can be concluded from it regarding the safety of fluoridation for two main reasons:
A, the doses are too high.
B, there was no control over various factors that might have influenced the result.
Second, the chance that the amount of fluoride in the water will double for a long period of time is zero. Mekorot, for example, continuously monitors the water it supplies. Any deviation is corrected immediately.
http://www.mekorot.co.il/Heb/newsite/Solutions/WaterQualityandSecurity/Pages/WaterQualityandSecurityContinousMonitoring.aspx
Regarding the tone - sorry if you didn't like it. I tried to stay to the point and address most of the main arguments raised against fluoridation. I disagree with your opinion that the article dealt with issues that are not scientific - the cost of the procedure and its benefits can be judged scientifically and are therefore part of the scientific arguments for and against fluoridation.
In conclusion, I wasn't too impressed with your review and I couldn't get anything concrete out of it to edit the article. Try to improve arguments and maybe you will be able to convince.
Adi
Don't mess with your mind. Read the links, understand them, then comment.
I wonder how much Litzman paid you to fart this bastard????
Fast and pleasant cancer for all those who fall into the trap
Publishing such an article in Davidson is scandalous, as it gives a sense of scientific authority to the article even though there is none. I would like to know if the editor supports such an article and why, and if he understands the consequences of publishing an article on the official website of the Davidson Institute on the public debate.
If we look at the data presented in the article itself, there is no way to establish that there is no scientific position that says unequivocally that "fluoridation is the best and cheapest solution to maintain the dental health of the entire population".
1. Fluoridation prevents tooth decay by 15-30%. This is significant, but not a rate that prevents the problem exceptionally - in any case, additional measures are needed.
2. Fluoridation causes 40% of the cases of fluorosis, which is found in less than XNUMX% of the population, this is a very high rate of patients. Therefore, the conclusion of the author of the article that "it is very rare that artificially fluoridated water causes severe fluorosis of the teeth" is simply not true. The fact that this whole paragraph is called "evidence for the safety of fluoridation" says everything about the scientific nature of the article.
3. Fluoridation as a controversial issue: I don't know how to say this to the learned writer, but science is not counting organizations that support some position. The position of the vast majority of these organizations is simply copied from one to another simply because they do not research the issue themselves. A certain (and limited!) importance would be obtained from the statistics of scientists active in the subject. The dissenting article cited in this paragraph is signed by one scientist.
In other words, ending the paragraph with the words "In other words, the scientific consensus supports the fluoridation of drinking water unequivocally. There is really no disagreement among the scientific community on the subject of fluoridation." is not true
4. In the paragraph "gap between a safe and harmful dose" the writer abandons any minimal integrity. For example, the Harvard study mentioned before in the paragraph "taking studies out of context" is rejected by the author on the grounds that they used it in concentrations between 2-11 times greater than the concentrations used to fluoridate the water. Therefore, the question is whether it is possible for the fluoride concentration to increase twice - everyone will judge whether this seems unreasonable to them. The writer goes on to state that raising this concern, that regulation of the fluoride level is suboptimal, means that the opponents recognize that an optimal fluoride concentration is not dangerous, and therefore contradicts their other claims. I will leave it to the readers to determine whether this claim stands up to scrutiny.
I would like to point out in general that the article gives off an unpleasant feeling of condescension, and often emphasizes how scientific it is and the opponents are not. I was not convinced of that. A significant part of the arguments put forward in the article against fluoridation are highly scientific, even if some of them turn out to be incorrect. On the other hand, many of the author's arguments are not scientific at all (counting organizations, price, social benefit) even though he states that he will not engage in such arguments.
In general, when someone comes across a "scientific" article that, instead of dealing with the subject itself, is mainly concerned with emphasizing that it is scientific and its opponents are not and finds the time to preach about "looking at all the evidence" (da?) and uses the headlines to refer to the quality of the opponents and promote his own positions - he should question Many in both the conclusions and the motivation of the writer (and I will leave it to the readers to decide what kind of motivation would lead to such behavior).
None of this is to say that I am against fluoridation, I mainly referred to this article and accessed the sources in a limited way - I am not an expert in the field. But there is no doubt that after reading the article I tend to think that fluoridation is problematic and that things should be examined scientifically and seriously before supporting such a widespread practice.
walking dead
I suggest you see how they "invented" the food pyramid in the USA.
It should also be noted that when there are capitalists with an interest on one side, there are usually capitalists with a different interest (or even the opposite) on the other side. So the claim that she did not surrender or was influenced by capitalists is not necessarily true.
Wondering
The Minister of Health wanted to ban placing salt shakers on tables in restaurants. This does not make any health sense for a number of reasons. Therefore, I would not state that she was properly consulted.
It is not clear how such a topic comes up for discussion among people who are not experts in the field. It is certain that the Minister of Health consulted more qualified experts than most of the participants here in the discussion (and more than me for sure). The very fact that she decided to stop buying the material from interested parties (sell it) shows that she did not give in or was influenced by capitalists. You might also want to add antibiotics to bread to fight infectious diseases?
Next topic: Is it worth sending a spacecraft to comet P67 or comet P68? what do you think?
Almond
A little knowledge is very dangerous. Stopping fluoridation hurts the poor. The rich have money for dentists.
Adding fluoride to water reduces the incidence of caries by something like a third, and does not pose any practical risk.
Just thought I should tell the facts...
The Minister of Health also wanted to ban the serving of cooking salt in restaurants. Knowledge is not her strong suit...
Nonsense, the mineral water sellers and maybe even the dentists want a living so they arranged for themselves with the help of Sarah who was infected with a false public panic.
Stopping fluoridation helps the poor who don't have money to buy mineral water. The supporters of fluoridation do not drink water from the tap, because they know exactly what poisons are there. Fluorides, mercury and lead are just a small part of the list. They accumulate in the body and cause damage even if their original concentration in the water is small. It is not clear how a substance that before this was diverted as a toxic substance to Ramat Hovav, suddenly found its way into our drinking water. It is very good that they stopped fluoridating and banned the continuation of fluoridation. It's time to stop poisoning ourselves.
What do you say, miracles…
Filed a lawsuit against the state because the state fluoridates the drinking water? About NIS 4 billion?
Wow... apparently there really is something to complain about... 🙂
Another thing, no less important, that no one here mentioned:
Fluoride in drinking water probably makes tomatoes (of course - after washing with water) tastier.
Same with cucumber. After washing in water with a little fluoride, the cucumber comes out greener. And of course tastier.
Not to mention the rice... how much crispier and tastier it is after mixing it with fluoride... just lick your fingers (with residual fluoride).
Moses
You say difficult things - and not true. The organizations "pushing" for fluoridation are not economic entities. Especially in Israel - the organizations they are against are clearly doing it for money. I refrain here from mentioning the names of those who filed a class action lawsuit against the state on the subject of fluoridation, for fear that I will be accused of defamation. I'll just say that the claim is for NIS 4 billion!!!
The scientific community follows the economic interest, the opponents of fluoridation have no economic interest, so many doubts, risks, and proofs of increasing morbidity as a result of fluoridation, so many options to fight dental disease without poisoning the public, such as brushing with hydrogen peroxide or drinking soda, keeping basic The mouth, and not eating sugar in quantities, are all scientifically proven things to prevent tooth decay and the risk of oral diseases. But there is no money in spreading this knowledge, on the contrary, a loss of money for the big companies. So they convince us that a person who drinks a liter of water a day and a person who drinks 4 liters a day receive an equal dose and their weight does not matter, in short money changes the basis of logical thinking and this is just an example, it's just a pity for all the fools who walk blindly in the dark after all those with interests who are ready to turn worlds upside down in order to inject more A little poison to our water and food for another handful of dollars. They themselves will drink mineral water or snowmelt water from the Alps.
The scientific community follows the economic interest, the opponents of fluoridation have no economic interest, so many doubts, risks, and proofs of increasing morbidity as a result of fluoridation, so many options to fight dental disease without poisoning the public, such as brushing with hydrogen peroxide or drinking soda, keeping basic The mouth, and not eating sugar in quantities, are all scientifically proven things to prevent tooth decay and the risk of oral diseases. But there is no money in spreading this knowledge, on the contrary, a loss of money for the big companies. So they convince us that a person who drinks a liter of water a day and a person who drinks 4 liters a day receive an equal dose and their weight does not matter, in short money changes the basis of logical thinking and this is just an example, it's just a pity for all the fools who walk blindly in the dark after all those with interests who are ready to turn worlds upside down in order to inject more A little poison to our water and food for another handful of dollars. They themselves will drink mineral water or snowmelt water from the Alps.
Amit
I have given links here to several studies that prove you wrong. If you read them, you will realize that you are wrong.
Caries treatment, like any disease, should be targeted. Just as it would be unthinkable to add statins to drinking water for heart health, there is no reason to fluoridate drinking water.
The Ministry of Health is more than welcome to finance or subsidize instead fluoride treatments for anyone interested in it, there is no need to give the treatment to the entire population and more drinking water. Will anyone agree to buy "mineral water" with added fluoride? I'm in Doubt.
A question for everyone:
Which of the parties participating in the discussion can say that the opinion he holds is not biased?
Who can honestly say to himself what is the impulse that drives him in this matter?
Is this the desire to discover the truth or is it the desire for the truth to be revealed as the same as the position he holds?
what do you think?
A question for everyone?
Which of the parties participating in this discussion can honestly say that his opinion is not biased?
Who can honestly say what is the real drive driving him?
Is it the desire to discover the truth, or the desire to discover that the truth corresponds to the position he holds?
what do you think?
Benjamin
http://telem.openu.ac.il/courses/c20237/caries-dn.htm
First article I found, old. According to the author, the main factor is heredity.
Imagine that it turns out that the health and nutritional status of the mother during pregnancy and breastfeeding also has an effect
We may reach a situation where the majority of the two diseases cannot be prevented in advance,
And of course also how to deal with the holes in the teeth
I was convinced.
But we probably live in a cyclical reality
In which "barbarians" constantly attack the culture
And the knowledge that has been gained has led to blood and death - and from time to time as well
"Winning" her. This is what happens when
Parents refuse to vaccinate their children and so in this case.
The question "What is your name" is from the basic principles of
Democracy, but absurdly, it flows
for the fields of science and public health. now left
The question is how to deal with the Christian "holes".
occasionally in the protection of public health.
Miracles You have the right to be loved without hurting another. You give examples of mortal danger and it is demagoguery.
If you want a government that is your father and mother go live in North Korea.
The government should allow information and that every citizen should have the option of a toothbrush and toothpaste, including subsidies - yes.
You wrote ""Fluoride in toothpaste is the most effective and cheapest way to provide fluoride for tooth protection" - what is the basis for this statement?" You don't do cherry picking for research, it's a thousand points in drawing conclusions in science, that's what reviews are for
According to the review of the European Union 2011 SCHER (summary of the chapter on the effectiveness of fluoride in the prevention of tooth decay, p. 31):
No obvious advantage appears in favor of water fluoridation compared with topical prevention. The effect of continued systemic exposure of fluoride from whatever source is questionable once the permanent teeth have erupted. SCHER agrees that topical application of fluoride is most effective in preventing tooth decay. Topical fluoride sustains the fluoride levels in the oral cavity and helps to prevent caries, with reduced systemic availability. The efficacy of population-based policies, eg drinking water, milk or salt fluoridation, as regards the reduction of oral-health social disparities, remains insufficiently substantiated.
http://ec.europa.eu/health/scientific_committees/environmental_risks/docs/scher_o_139.pdf
There is no "significance" for public water fluoridation, the English review from 2000 that WHO and SCHER cite speaks of maybe 15% effectiveness and that is also not certain because the studies are all at a low level (50 years!).
And with all the data that indicate potential damages (there is a lack of research) and no special problem in countries that do not fluoridate. There is no reason to fluoridate the water. The Scottish model (a previous comment linked to it) showed that there are much, much more effective, cheap and proven models for treating children's teeth.
safkan
No - it is not acceptable to say "he who does not brush his teeth is his problem, no one should solve it".
Anyone who doesn't wear a seat belt in a car - that's their problem. A biker who doesn't wear a helmet is his problem. Whoever consumes hard drugs is his problem. Whoever does not lock the house is his problem. Whoever drives 200 km/h on an empty road is his problem.
doesn't work like that. One of the functions of the government is to protect the poor from themselves.
You wrote "Fluoride in toothpaste is the most effective and cheapest way to provide fluoride for tooth protection" - what is the basis for this statement? Here are four studies that show this is not the case:
http://www.ncbi.nlm.nih.gov/pubmed/20873280
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6037a2.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989299/
http://www.ncbi.nlm.nih.gov/pubmed/9608443
I know that no one will bother to read the articles - so: what is found in them is that even with toothbrushes, the fluoridation of the drinking water is very important.
The author of the article did his homework. It's annoying that "I think" comments are written here.
Apologies for the relief errors. It would be better if I wrote on a writing pad and then copy paste from there. too late to fix. Maybe another time I will upload an edited version without errors.
In most European countries there is no fluoridation of drinking water. A country that wants systemic fluoridation (not necessarily for the teeth) can add fluoride to basic foods or provide them separately, the materials are quite cheap if they are issued through a national health system since they are minerals whose price is negligible.
The fluoride in toothpaste is the most effective and cheapest way to provide fluoride for tooth protection. There is plenty of fluoridation in the cheapest toothpastes. The one who doesn't brush his teeth is his problem, no one should solve it.
Improving dental health through fluoride and in general can be if the state makes sure that there are cheap simple toothbrushes (not Hocus Pocus toothbrushes at Hocus Pocus prices).
The state can also force the cheap sale of high-fluoride pastes, not for brushing but for applying on the teeth-gum connection line. At the moment the prices are high for no reason, because the basic materials are cheap. The protection of the tooth-gum connection line is much more effective for protecting the teeth because most tooth falls are usually when there is root caries.
As for dental treatments for children in need. I doubt their quality, since they are made in this heat and at a low level (what's more, most of them need to be inspected and renewed, otherwise the crumbling and cracked filling only accelerates tooth decay).
Apart from that, individuals need to take care of calcium-restricted food, both with regard to the teeth (which grow and become resistant only during childhood) and with regard to bone growth until puberty (bones without enough calcium are brittle and brittle, possibly also vulnerable to rheumatic inflammations, but not sure about that).
Clear and sharp article. Regarding the benefit (ie convincing the unconvinced) I don't know. It is stronger than them.
It reminds me of the movie shutter island: after the hero's shocking confrontation with the facts, he comes to terms with his past and realizes that he built a psychosis for his people to protect himself from reality.
It lasts five minutes…
James Bond 007:
The link in the Wikipedia source is broken. The EPA does define that the ultimate goal is to have no arsenic in the water at all, but he himself announces that this is not realistic. Not only does water naturally contain 0.001-0.012 mg of arsenic per liter of water, removing such small amounts is not a simple task at all.
I would appreciate it if you could provide a link to a study showing that even at a concentration of 0.00017 mg of arsenic per liter of water there is some danger to humans. The World Health Organization says itself that at such low concentrations, linear or non-linear extrapolations are neither possible nor reasonable given the current biological knowledge that exists. What's more, when they do a linear extrapolation, the estimates are not what is written in Wikipedia, but slightly higher.
Finally, according to the NSF data, according to US standards, they were able to find arsenic in the water at all only when they diluted the acid at a concentration 10 times higher than the maximum allowed concentration. Even then the concentrations were much lower than the standard and stood at a median of 0.15 *microgram*. This means that when using these standards, an amount of arsenic that is more than 10 times smaller is added to the water, an amount equal to 0.015 micrograms, or 0.000015 mg per liter. What's more, I have no idea what standard is used in Israel. If I remember correctly, the standard is a European standard and it is even stricter than the American standard, but I am not sure. I will check and get back with an answer.
http://www.nsf.org/newsroom_pdf/NSF_Fact_Sheet_on_Fluoridation.pdf
http://www.who.int/water_sanitation_health/dwq/chemicals/arsenic.pdf
You have a mistake in the chapter on heavy metals and hexafluorosilicic acid and the risk.
According to the EPA (link in the article) the safe level of arsenic and lead is zero.
The 0.01 for arsenic is a compromise, which is based on an old study by the WHO, at the time they did not have more accurate equipment.
More recent studies by the WHO show that even a level of 0.00017 over a period of time leads to poisoning.
https://en.wikipedia.org/wiki/Arsenic_poisoning#Drinking_water
The author of the article is almost desperate for the water to be fluoridated but after a short reading I was convinced of the opposite
Maybe this is a reverse psychology article?
For political text:
So maybe you will also suggest that those who want to drink should drill a well for themselves, and the "weaker layers" will remain thirsty? And the same for roads, police, army, etc.?
The problem in our country is that most of those who go into politics are from another weak society - weak in morals, in education, in wisdom. This has many bad consequences that affect the majority of the population except those who are close to the plate, i.e. the "strong layer".
A political text
What an unfortunate response…. Where to begin?
You urgently explained (!) what the purpose of fluoridation is, preventing dental problems in the weaker sections. And you gave the dumbest solution imaginable - free treatment for the dental problems that are a direct result of the lack of fluoride in the water 🙂 🙂 🙂
You wrote "the fact that there are people who don't brush their teeth is a fact" - every idiot understands from this (from what you said, and rightly so) that the solution must be through drinking water. what are you saying Ah, you're right, not every moron gets it ……
Who even talked about the education in the field of the Minister of Health? We all know what the minister's education is (first degree in history, second in business administration - in geometry it must come out as "R and F A"....).
You wrote "Or do you have more important things to do than improving and even saving people's lives?" ... An hour ago I left an operating room and participated in saving the life of one woman. I'm not a doctor, and my education is in a different field, but my field of practice is exactly saving lives. Unlike you probably.
In any case, those who push the agenda are (usually) those who oppose fluoridation. Factual - fluoridation helps a lot, and is not harmful.
Spring.
Those who "want to keep their health" - let them keep their health.
Those who want to maintain their health without having fluoride added to their tap water - can't! Because some stakeholders decided to do fluoridation.
You want fluoride in the water - go buy fluoride and mix it in your glass of water.
That there are people who don't brush their teeth is a fact. Another fact is that these people - most of them - come from a weakened population.
That is, if the fluoridation helps then it only helps those weak layers.
And in order to treat dental problems in these populations, without harming the rest of the population, other solutions are proposed. Like for example free dental care for children from a young age. (The adults can receive a toothbrush and toothpaste donation and start taking care of their hygiene after not doing it for years).
So don't try to impose your (leftist) agendas on others under the guise of "science".
Another thing: "...what's more, it's easy to see who has an interest - dentists, who want more income." – What!?
Are you claiming that dentists will lose their livelihood if drinking water fluoridation continues?
Are you serious? And you still call what you do "science"...
Miracles
I guess you understand better what health is, than the minister of health... Well let's go…. But, if you understand more than her why is she a health minister and you write a poor talkback on the internet about health? What is it, because of politics? Or do you have more important things to do than improving and even saving human lives?
If bottled water is a thousand times more expensive than tap water, then why do you send those who want to maintain their health to pay a thousand times more (or pay for a dentist?)
MouthHole How much is tap water and bottled water? How much does clean salt and iodized salt cost?
How much water and how much salt does a person consume per day for the cost calculation?
Ravid - you can also buy non-fluoridated water.
Just saying
Nissim Iodine is a nutritional supplement that the body cannot function without. And you can also easily buy unfortified salt.
There is a precedent for what the Minister of Health is doing: the Scottish government also rejected the dubious practice of fluoridating drinking water, instead they launched a national program called Childsmile that is much cheaper than fluoridation, does not endanger anyone and gives great results.
http://www.bbc.com/news/uk-scotland-24880356
Yoshi
All is well and good, but a great many people do not brush their teeth, and therefore, in Israel, fluoridation is still necessary.
And allow me one question. What do you think about adding iodide to table salt?
You are missing the social issue here. Those who cannot afford to buy fluoridated water, all the more will not be able to pay for the very expensive dental treatments that are saved from them due to the fluoridation of the water.
It makes a lot of sense.
I'll be honest, I don't understand anything in this area.
My common sense says that it is arrogance for the sake of thinking that we know for sure that the addition of fluoride in water, in one dose or another, is not harmful. The human body contains countless different systems and mechanisms - many of which we still do not know.
Can we know for sure how fluoridation affects each and every one of these mechanisms? of course not. Let's not be reckless.
Most of the research tools we have today are very crude. They know how to measure almost only "significant" results such as death, cancer, fractures, etc. They do not know how to accurately measure small effects, such as effects on ability to concentrate, energy and fatigue, emotional states and more.
This is also often done with very crude tools, that is, in statistical studies. Studies that show a statistical relationship between two factors but do not explain the processes that create the relationship between the two factors.
What does fluoridation offer? Does she offer a solution that halves the chance of dying from cancer? Does it offer to double the lifespan?
No, she's just offering to help with corrosion protection.
So I make sure to brush everyday, floss, reduce sweets and foods that stick to the teeth and visit the dentist once in a while.
I really hope that the author of the article is right and that fluoride only does good and does no harm, but as long as I have no certainty, I prefer to be careful about oral hygiene, than to do experiments on myself.
Those who want to participate in the experiment can do so on their own accord.
If I lived in a third world country I might think differently. I don't believe in absolute solutions. There is the best solution according to the prevailing conditions.
Too little and too late. The minister has already decided. The discussion on the matter took place on the Internet for years, including articles on television, etc. Where have you been until today?
Raviv Tel Aviv
I would suggest you refer to the content of the article here, and the sources of information. Unlike the Minister of Health, the author of the article did his homework.
The Minister of Health also tried to pass a law that prohibits restaurant owners from providing salt shakers. Like fluoridation - there are many prejudices against salt, and many studies in favor of salt.
Father, there were two serious scientific reviews on the subject that all other reviews are based on: the English York review from 2000 and the American NRC review from 2006.
The York review experts published a refinement of their review in 2003. Read what they write:
http://www.york.ac.uk/inst/crd/fluoridnew.htm
And this is what the chairman of the NRC review experts, emeritus professor of pharmacology and toxicology John Dohl, concluded in an interview with Scientific American in 2008
"What the committee found is that we've gone with the status quo regarding fluoride for many years - far too long, really - and now we need to take a fresh look" Doull says. "In the scientific community people tend to think this is settled. I mean, when the US surgeon general comes out and says this is one of the 10 greatest achievements of the 20th century, that's a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on. I think that's why fluoridation is still being challenged so many years after it began. In the face of ignorance, controversy is rampant".
The science of fluoridation is on chicken knees. It is irresponsible to fluoridate the water with such bad science.
The coercion is for people to be healthy. We owe our longevity and quality of life to all these decisions, forcing health is not a bad thing.
In such cases, when it comes to a minority of opponents, I suspect that they are tainted by vested interests, and it is also easy to see who has an interest - dentists, who want more income.
What is the expertise of the article writer?
A review written for Health Minister German by Dr. Hardy Laimbeck, Professor Emeritus and former Director of Preventive Dentistry at the Faculty of Dentistry, University of Toronto and an expert on fluoridation praises the decision of the Minister of Health to cancel fluoridation.
http://www.e-med.co.il/emed/new/usersite/content.asp?CatID=1&ContentID=476738
Here is a revolutionary idea:
Instead of having such an emotional debate about it, in order to force the rest of the people to do something, let's just not force it.
I think the decision is excellent, because it is free. People who do not want fluoridation are not forced. Something that also includes the fact that they are unable to obtain non-fluoridated tap water, and also that they pay for fluoridation from their taxes against their will.
Instead, the situation should be such that those who want fluoridation will pay for it out of their own pocket. That is, suppose he buys fluoridated water bottles. This is in contrast to the situation that existed until now, where everyone paid for fluoridation from taxes and it was imposed on them, then those who did not want it, in addition to the fluoridation they had already paid for, they had to pay more to buy water without fluoridation.
It just does not make sense.