Tuesday, May 5, 2009

American Dental Association - Grab the money- QUICK!

This is a letter recently sent to my brother, Luke, who works as a dentist in Eugene, Oregon.
His response follows:

Dear ODA Member,

Proposed budget cuts threaten to eliminate the state's already limited Oregon Health Plan dental coverage for low-income adults. It is critical to have as many dentists as possible explaining the need for keeping adult dental benefits in the Standard OHP package to members of the Oregon Legislature Joint Ways and Means Committee. Beginning tomorrow the Joint Ways and Means Committee will be traveling to your city. The first stop is in Bend tonight and then Ashland on Thursday! The third meeting is Friday May 1st in Eugene at 1:00pm.

This is an opportunity for you to share the importance of oral health and explain why it is critical to maintain oral health coverage in the state budget. Dentistry's record of disease prevention, early prevention and cost control show the value of good oral health care. Good oral health is essential to overall health!

Please gather your peers and plan to attend the Ways and Means Committee tomorrow tonight at Southern Oregon University. More information on the meeting can be found below. If you have any questions or would like assistance with talking points please contact me at bhamilton@oregondental.org or 503.218.2010.

If you do attend please contact me with feedback from the meeting.

Thank you, Brett

*****************************************

From: luke gambee
Date: Sun, May 3, 2009 at 9:28 PM Subject:
RE: Protect OHP Adult Dental
To: bhamilton@oregondental.org

While I believe it is critical to maintain oral health coverage, I believe that coverage is the responsibility alone of the individual. I do not believe this should be a federal or state responsibility, but rather the stewardship belongs to the individuals, families and local communities in that order.

While I can understand the desire to have an umbrella for children in cases of parental neglect or ignorance, the long term results of adult medical and dental benefits is loss of responsibility by the patient to own up to his own stewardship and instead passes that on to the tax-payer, whose burden is already at servitude levels.

Again, it is a form of legalized plunder to shift the responsibility for dental health from the individual to the taxpayer by way of popular vote and I will always object to legislative intervention in this matter

Sincerely, Luke Gambee DMD

Can we be done with the swine flu already? Guess not, still have piles of Tamiflu to sell

So I just read that Obama and Rumsfield are big stockholders in Tamiflu. Incidentally, the stockpiles of Tamiflu that many governments have (bought approx 3 years ago for another pandemic I'm sure) expire soon as Tamiflu has a 3 year shelf life. ConVENient. So now they need to "restock" their Tamiflu supplies.

People on Tamiflu: The 17-year-old jumped in front of a large truck on a busy road after walking outside his housebarefoot and in pajamas during a snowstorm. The 14-year-old jumped to his death from the balconyof a ninth-floor flat. Later, a teenage girl wasnarrowly prevented from jumping to her death from a window within days of starting a course of theflu drug. By November 2005, it had been reported that 12 Japanese children had died while on the drug and others had experienced hallucinations,encephalitis and other symptoms

The Swine Flu or the FDA: Which Is More Dangerous to Your Health?
By John W. Whitehead May 4, 2009

In a 2005 article in the Village Voice entitled "Capitalizing on the Flu," James Ridgeway predicted that a "flu pandemic would sparkenough fear to make it a greed pandemic." As Ridgeway observed, "With a worldwide market estimated at more than $1 billion, there's big money in a flu plague." In fact, the pharmaceutical industry has gone to great lengths through its lobbying and government contracts to ensure that it will get a goodpiece of the plague pie. Now with the swine flu set to become a global pandemic, Big Pharma is raking it in.

Responding to the somewhat hysteria-induced demand for drugs to protect against the swine flu, pharmaceutical companies have ramped upproduction of Tamiflu and Relenza, two anti-viral drugs being touted for their ability to fight the flu. Eleven million doses of the flu-fighting drugs, about one-quarter of what has been stockpiled by the U.S. government, have already been sent to the states. News media sycophants, in typical fashion, havetaken up the hew and cry over Tamiflu's life-saving properties. Yet little is being said about the very real dangers that these drugs, particularly Tamiflu, pose to your health and mental welfare.

First approved by the U.S. Food and Drug Administration (FDA) in 1999, Tamiflu was promoted as a drug that could significantly reduce the length and severity of influenza. These claims even prompted the U.S. government to purchase 20 million doses of Tamiflu--at a cost of $2 billion--in the event that a bird flupandemic occurred. The Pentagon followed suit, paying a whopping $58 million in July 2005 for treatments of U.S. troops around the world. However, problems with Tamiflu had already begun to surface as early as 2004 when it was alleged that the drug was causing some of its users to manifest very unusual behavior.

For example, during the 2004 and 2005 flu seasons, two teenage boys committed suicide within hours oftaking Tamiflu. The 17-year-old jumped in front of a large truck on a busy road after walking outside his house barefoot and in pajamas duringa snowstorm. The 14-year-old jumped to his death from the balcony of a ninth-floor flat. Later, a teenage girl was narrowly prevented from jumpingto her death from a window within days of starting a course of the flu drug. By November 2005, it had been reported that 12 Japanesechildren had died while on the drug and others had experienced hallucinations, encephalitis and other symptoms.

Despite these alarming reports, the FDA opted not to issue a warning about the drug's potential for causing abnormal behavior. Instead, the FDA issued a warning about Tamiflu's potential for producing skin rashes. It wasn't until reports surfaced of more than 100 new cases of delirium, hallucinations andother abnormal psychiatric behavior in children treated with Tamiflu that the FDA changed course and required Roche, the Swiss company that makes the drug, to include a warning label cautioning patients, doctors and parents to look out for strange behavior in anyone taking the drug.

However, Tamiflu is not the only drug to be suspected of having psychiatric side effects. There have been a disconcerting number of drugswhich, although cleared by the FDA for use in treating epilepsy, asthma, influenza, obesity and smoking, are now believed to contribute to suicidal behavior.Thus, there is good reason why the FDA has increasingly been viewed as one of the most corrupt agencies within the U.S. government.

TheFDA is suspected of causing high drug prices, keeping life-saving drugs off the market,allowing unsafe drugs on the market because of pressure from pharmaceutical companies and censoring health information about nutritional supplements and foods. One of its most vocal critics is Dr. DavidGraham, currently the Associate Director of the FDA's Office of Drug Safety. In his estimation, the FDA is "responsible for 140,000 heartattacks and 60,000 dead Americans. That's as many people as were killed in the Vietnam War." His words offer an insider's perspective on the fatal role he believes the FDA played in thousands of heart attacks and deaths caused bythe pain medication Vioxx--a medication the FDA approved and initially failed to warn of its potential effects. The Vioxx debacle was broughtto America's attention when Congress was presented with evidence showing that among the estimated 20 million users of Vioxx, hundreds ofthousands had died or suffered heart attacks as a result of taking the drug.

Other drugs approved by the FDA and later found to cause harm include dexfenfluramine, a diet drug whose post-marketing data indicated anincreased risk of pulmonary hypertension, and troglitazone, a diabetes drug that carried with it the risk of liver failure and was laterpulled from the market. Yet as Graham has pointed out, "Rarely will they keep a drug from being marketed or pull a drug off the market."The delays in taking action on problematic drugs was addressed by Dr. Sidney Wolfe, director of the Public Citizen's Health Research Group, in astatement before the Institute of Medicine Committee in January 2006: "In too many instances, serious post-marketing safetyproblems identified by the Office of Drug Safety have not been acted upon because of resistance from FDA management and from the review divisionthat originally approved the drug."

The pharmaceutical companies also bear the responsibility--and the blame--for unsafe drugs being approved and sold to the American public."The FDA assumes the drug is safe and now it's up to the company to prove that the drug isn't safe," remarked Graham. "Well, that's ano-brainer. What company on earth is going to try to prove that the drug isn't safe?"It should come as no surprise that the pharmaceutical companies have the federal government in their hip pocket. According to a m2008 report from the Center for Public Integrity, the pharmaceutical industry has spentmore than $1 billion on federal lobbying and campaign donations over the past decade. Indeed, Washington is so overrun with drug lobbyiststhat Sen. Charles E. Grassley (R-Iowa) once remarked, "You can hardly swing a cat by the tail in Washington without hitting apharmaceutical lobbyist."

Furthermore, as CPI pointed out, the drug industry's investments in Washington have paid off handsomely, resultingin a series of favorable laws on Capitol Hill and tens of billions of dollars in additional profits. "It is by now well-known that the drug companies provide huge sums of cash to politicians--$133 million to federal candidates since 1998,according to the Center for Public Integrity, with upwards of $1.5 million going to Bush, the top recipient," writes James Ridgeway in theVillage Voice. "The industry operates an elaborate lobby in Washington that in 2004 spent $123 million and employed an army of 1,291 lobbyists, more than half of whom were former federal officials." Those numbers have increased dramatically in the past five years.

For example, in the first nine months of 2008 alone, the pharmaceutical industry reportedly shelled out $171.1 million on lobbying and was on trackto exceed what it had spent the year before.However, while the drug industry has in the pastinvested more of its funds on Republicancandidates (they received $89.9 million in campaign contributions between 1998 and 2005), its lobbyists have in recent years been workinghard to gain favor with the Democrats. As the Washington Post reports, "To strengthen their position, drug firms and their trade groups have been transforming their Washington operations by hiring top Democratic lobbyists to gain access to new committee chairmen, bolstering Democraticpolitical donations and spending millions on public relations campaigns to overcome an image, indicated in recent surveys, that the industry puts profits ahead of patients."

Certainly, this collusion between the pharmaceutical industry and the government should come as no surprise to anyone who keepsup with the news and the rampant corruption in the halls of Congress. But there are dire ramifications from Big Pharma's stranglehold onthe U.S. government. As James Ridgeway writes in his recent article in Mother Jones, "Swine Flu: Bringing Home the Bacon," there are "winners aswell as losers in every high-profile outbreak of infectious disease. First and foremost among them, of course, is Big Pharma, which can alwaysbe counted on to have its hand out wherever human misery presents an opportunity to rake in some cash."

Clearly, Big Pharma are the winners here. Stockprices for pharmaceutical companies involved in the production of Tamiflu and Relenza have already jumped dramatically. And investors arealready salivating at the prospect of the government insuring against future outbreaks byincreasing its stockpiles of the drugs, as well as spending more on grants and funding for research.What remains to be seen, however, is who will be the biggest loser.

Socialized Medicine

The Honorable Ron Wyden
405 E. 8th Suite #2020
Eugene, OR 97401

Senator Wyden:

My name is Carden Gambee and I’m writing you from Glendale, AZ although I am a registered voter in Junction City, Oregon. I am finishing my first year of Medical School, and while I have written you a few times, I have yet to write about something that I feel very close to seeing as I am spending basically every waking hour studying for tests in preparation to serve as a physician, probably in Oregon at some point in the near future. T

his has to do with the idea that socialized healthcare is the answer to our healthcare problems here in America as well as the fact that congress and the O’Bama administration is trying to sneak fast-track language back into the budget that would provide for the socialized healthcare.

I hope I am not too late in expressing the very common opinion that this is not the answer. Besides the trickery of putting this fast track language back in the budget after removing it a few weeks ago due to public pressure, and besides the fact that this budget is going to put myself, my children and my children’s children hopelessly in debt, history has shown us that it just doesn’t work. I have family in Canada, as well as close friends who have seen first hand how socialized medicine benefits almost no-one, other than the insurance companies. My brother is a dentist in Eugene, and he sees the same thing when it comes to giving out free care. There are many problems and I will enumerate just a few:

1) Handouts are rarely appreciated or cared for. People get the idea that someone “owes” them and this just instills the attitude that we don’t have to work for anything in life. My brother has seen this as patients that come in to get their “free” care are the most demanding and rude to his staff. While this may not be the case across the board, it still stands that we value what we work for much more than what is given to us as a handout.

2) As my basketball coach told our team many times, “There is NO free lunch.”
The fact is that with the fed printing up all this money and “buying” up debt, we have this idea that money grows on trees. We are being enslaved by this process and as our representative you have the opportunity and duty to help put an end to it.

3) Lines to get care in Canada are ridiculous. I use Canada as an example because this is the type of system that so many who are clueless to how it really works compare us to. People are dying every day, waiting months to get in for a simple office visit. People are sick that shouldn’t be, but doctors’ hands are tied. This system simply does not work.

If you want to make a difference, start with the McCarran-Ferguson exemption that permits insurance companies to engage in behavior permitted to other industries by antitrust law, forming giant conglomerates to fix prices that make it impossible for competitors to enter the marketplace. End Medicare price controls, allowing physicians and patients to negotiate prices, cutting out the pricey middleman insurance companies. Stop tax discrimination against individually owned sickness insurance and allow individuals to purchase sickness insurance across state borders to avoid costly mandates by states. Lastly, expand health savings accounts by removing barriers so that Americans are able to pay for medical bills with before tax money. These are some ideas that will put us in the right direction. Expanding government control and ability to regulate a private industry never helped anyone.

Sincerely,

Carden Gambee
1st Year Medical Student, Midwestern University

The Role of our Representatives in Congress

TO: US Senator James Risch
FROM: Jared and Courtenay Ellison (jc.ellison8@gmail.com)
SENT: {ts '2009-04-24 13:37:36'}
SUBJECT: General - Constitutional Issues

MESSAGE:
Senator Risch, We have made a simple observation that is really starting to grate on our nerves. Each time a constituent goes to your website to write a letter of correspondence regarding current legislation, or personal opinion, you offer a list of topics to be the "subject" of the letter. Several of you will not allow a message to be sent unless there is a subject declared. Is there some reason that you do not list the "Constitution" as one of your options (besides "other")" This should be a first option.

There are so many issues that are discussed that really should only be labeled as Constitutional, or not Constitutional. I f we get in the habit of checking legislation against the Constitution (the document you swore to defend and uphold) the state of our beloved country would be nowhere near the deplorable state we find it in.

It is really quite simple; is an issue Constitutional or not, yes or no. End of discussion. Lack of this consideration on your part is very telling as to your devotion to the sacred freedoms so many of us hold dear. As our representative, we would like you to list the Constitution as a subject point to be chosen with correspondence. We would also recommend you give consideration to this inspired document before even the interests of your constituents.

Sincerely,

Jared & Courtenay Ellison

Fluoridation..........to do or not to do

One of many articles about fluoride. My brother and sister-in-law recently graduated from dental school have discussed recent research that showed that an oral rinse with fluoride got the same result as taking it internally, without the bad side effects.

Knowing that fluoride is in so many products we ingest, even in our canned goods, we have come to the conclusion that we are getting more fluoride than we would ever want. Trying to figure out a water system that would eliminate the fluoride from that as well.

Negative effects of fluoride on thyroid, soft tissues of our bodies, even our brains is enough to help us try to steer clear from fluoride as much as possible. My dad has been talking for years about the harm fluoride causes.

WHY I CHANGED MY MIND ABOUT WATER FLUORIDATION
John Colquhoun* © 1997 University of Chicago Press

Former Advocate
To explain how I came to change my opinion about water fluoridation, I must go back to when I was an ardent advocate of the procedure. I now realize that I had learned, in my training in dentistry, only one side of the scientific controversy over fluoridation. I had been taught, and believed, that there was really no scientific case against fluoridation, and that only misinformed lay people and a few crackpot professionals were foolish enough to oppose it. I recall how, after I had been elected to a local government in Auckland (New Zealand's largest city, where I practised dentistry for many years and where I eventually became the Principal Dental Officer) I had fiercely — and, I now regret, rather arrogantly — poured scorn on another Council member (a lay person who had heard and accepted the case against fluoridation) and persuaded the Mayor and majority of my fellow councillors to agree to fluoridation of our water supply.

A few years later, when I had become the city's Principal Dental Officer, I published a paper in the New Zealand Dental Journal that reported how children's tooth decay had declined in the city following fluoridation of its water, to which I attributed the decline, pointing out that the greatest benefit appeared to be in low-income areas [1]. My duties as a public servant included supervision of the city's school dental clinics, which were part of a national School Dental Service which provided regular six-monthly dental treatment, with strictly enforced uniform diagnostic standards, to almost all (98 percent) school children up to the age of 12 or 13 years. I thus had access to treatment records, and therefore tooth decay rates, of virtually all the city's children. In the study I claimed that such treatment statistics "provide a valid measure of the dental health of our child population" [1]. That claim was accepted by my professional colleagues, and the study is cited in the official history of the New Zealand Dental Association [2].

INFORMATION CONFIDED
I was so articulate and successful in my support of water fluoridation that my public service superiors in our capital city, Wellington, approached me and asked me to make fluoridation the subject of a world study tour in 1980 — after which I would become their expert on fluoridation and lead a campaign to promote fluoridation in those parts of New Zealand which had resisted having fluoride put into their drinking water.

Before I left on the tour my superiors confided to me that they were worried about some new evidence which had become available: information they had collected on the amount of treatment children were receiving in our school dental clinics seemed to show that tooth decay was declining just as much in places in New Zealand where fluoride had not been added to the water supply. But they felt sure that, when they had collected more detailed information, on all children (especially the oldest treated, 12-13 year age group) from all fluoridated and all nonfluoridated places [3] — information which they would start to collect while was I away on my tour — it would reveal that the teeth were better in the fluoridated places: not the 50 to 60 percent difference which we had always claimed resulted from fluoridation, but a significant difference nonetheless. They thought that the decline in tooth decay in the nonfluoridated places must have resulted from the use of fluoride toothpastes and fluoride supplements, and from fluoride applications to the children's teeth in dental clinics, which we had started at the same time as fluoridation.

Being a keen fluoridationist, I readily accepted their explanation. Previously, of course, we had assured the public that the only really effective way to reduce tooth decay was to add fluoride to the water supply. WORLD STUDY TOUR My world study tour took me to North America, Britain, Europe, Asia, and Australia [4]. In the United States I discussed fluoridation with Ernest Newbrun in San Francisco, Brian Burt in Ann Arbor, dental scientists and officials like John Small in Bethesda near Washington, DC, and others at the Centers for Disease Control in Atlanta. I then proceeded to Britain, where I met Michael Lennon, John Beale, Andrew Rugg-Gunn, and Neil Jenkins, as well as many other scientists and public health officials in Britain and Europe. Although I visited only pro-fluoridation research centers and scientists, I came across the same situation which concerned my superiors in New Zealand. Tooth decay was declining without water fluoridation.

Again I was assured, however, that more extensive and thorough surveys would show that fluoridation was the most effective and efficient way to reduce tooth decay. Such large-scale surveys, on very large numbers of children, were nearing completion in the United States, and the authorities conducting them promised to send me the results.

LESSON FROM HISTORY
I now realize that what my colleagues and I were doing was what the history of science shows all professionals do when their pet theory is confronted by disconcerting new evidence: they bend over backwards to explain away the new evidence. They try very hard to keep their theory intact — especially so if their own professional reputations depend on maintaining that theory. (Some time after I graduated in dentistry almost half a century ago, I also graduated in history studies, my special interest being the history of science — which may partly explain my re-examination of the fluoridation theory ahead of many of my fellow dentists.)

So I returned from my study tour reinforced in my pro-fluoridation beliefs by these reassurances from fluoridationists around the world. I expounded these beliefs to my superiors, and was duly appointed chairman of a national "Fluoridation Promotion Committee." I was instructed to inform the public, and my fellow professionals, that water fluoridation resulted in better children's teeth, when compared with places with no fluoridation. Surprise: Teeth Better Without Fluoridation?

Before complying, I looked at the new dental statistics that had been collected while I was away for my own Health District, Auckland. These were for all children attending school dental clinics — virtually the entire child population of Auckland. To my surprise, they showed that fewer fillings had been required in the nonfluoridated part of my district than in the fluoridated part. When I obtained the same statistics from the districts to the north and south of mine — that is, from "Greater Auckland," which contains a quarter of New Zealand's population — the picture was the same: tooth decay had declined, but there was virtually no difference in tooth decay rates between the fluoridated and non fluoridated places. In fact, teeth were slightly better in the nonfluoridated areas.

I wondered why I had not been sent the statistics for the rest of New Zealand. When I requested them, they were sent to me with a warning that they were not to be made public. Those for 1981 showed that in most Health Districts the percentage of 12- and 13-year-old children who were free of tooth decay - that is, had perfect teeth - was greater in the non-fluoridated part of the district.

Eventually the information was published [4]. Over the next few years these treatment statistics, collected for all children, showed that, when similar fluoridated and non-fluoridated areas were compared, child dental health continued to be slightly better in the non-fluoridated areas [5,6]. My professional colleagues, still strongly defensive of fluoridation, now claimed that treatment statistics did not provide a valid measure of child dental health, thus reversing their previous acceptance of such a measure when it had appeared to support fluoridation. I did not carry out the instruction to tell people that teeth were better in the fluoridated areas. Instead, I wrote to my American colleagues and asked them for the results of the large-scale surveys they had carried out there. I did not receive an answer.

Some years later, Dr John Yiamouyiannis obtained the results by then collected by resorting to the U.S. Freedom of Information Act, which compelled the authorities to release them. The surveys showed that there is little or no differences in tooth decay rates between fluoridated and nonfluoridated places throughout America [7]. Another publication using the same database, apparently intended to counter that finding, reported that when a more precise measurement of decay was used, a small benefit from fluoridation was shown (20 percent fewer decayed tooth surfaces, which is really less than one cavity per child) [8]. Serious errors in that report, acknowledged but not corrected, have been pointed out, including a lack of statistical analysis and a failure to report the percentages of decay-free children in the fluoridated and nonfluoridated areas [7]. Other large-scale surveys from United States, from Missouri and Arizona, have since revealed the same picture: no real benefit to teeth from fluoride in drinking water [9, 10]. For example, Professor Steelink in Tucson, AZ, obtained information on the dental status of all schoolchildren – 26,000 of them – as well as information on the fluoride content of Tucson water [10]. He found: "When we plotted the incidence of tooth decay versus fluoride content in a child's neighborhood drinking water, a positive correlation was revealed. In other words, the more fluoride a child drank, the more cavities appeared in the teeth" [11]. From other lands — Australia, Britain, Canada, Sri Lanka, Greece, Malta, Spain, Hungary, and India — a similar situation has been revealed: either little or no relation between water fluoride and tooth decay, or a positive one (more fluoride, more decay) [12-17]. For example, over 30 years Professor Teotia and his team in India have examined the teeth of some 400,000 children. They found that tooth decay increases as fluoride intake increases. Tooth decay, they decided, results from a deficiency of calcium and an excess of fluoride [17].

CAUSE OF DECLINE IN TOOTH DECAY
At first I thought, with my colleagues, that other uses of fluoride must have been the main cause of the decline in tooth decay throughout the western world. But what came to worry me about that argument was the fact that, in the nonfluoridated part of my city, where decay had also declined dramatically, very few children used fluoride toothpaste, many had not received fluoride applications to their teeth, and hardly any had been given fluoride tablets. So I obtained the national figures on tooth decay rates of five-year-olds from our dental clinics which had served large numbers of these children from the 1930s on [18]. They show that tooth decay had started to decline well before we had started to use fluorides (Fig. 1).

Also, the decline has continued after all children had received fluoride all their lives, so the continuing decline could not be because of fluoride. The fewer figures available for older children are consistent with the above pattern of decline [18]. So fluorides, while possibly contributing, could not be the main cause of the reduction in tooth decay. So what did cause this decline, which we find in most industrialized countries? I do not know the answer for sure, but we do know that after the second world war there was a rise in the standard of living of many people. In my country there has been a tremendous increase in the consumption of fresh fruit and vegetables since the 1930s, assisted by the introduction of household refrigerators [19].

There has also been an eightfold increase in the consumption per head of cheese, which we now know has anti-decay properties [19, 20]. These nutritional changes, accompanied by a continuing decline in tooth decay, started before the introduction of fluorides. The influence of general nutrition in protection against tooth decay has been well described in the past [21], but is largely ignored by the fluoride enthusiasts, who insist that fluorides have been the main contributor to improved dental health.

The increase in tooth decay in third-world countries, much of which has been attributed to worsening nutrition [22], lends support to the argument that improved nutrition in developed countries contributed to improved dental health. Flawed StudiesThe studies showing little if any benefit from fluoridation have been published since 1980. Are there contrary findings? Yes: many more studies, published in dental professional journals, claim that there is a benefit to teeth from water fluoride. An example is a recent study from New Zealand [23], carried out in the southernmost area of the country [23].

Throughout New Zealand there is a range of tooth decay rates, from very high to very low, occurring in both fluoridated and nonfluoridated areas. The same situation exists in other countries. What the pro-fluoride academics at our dental school did was to select from that southern area four communities: one nonfluoridated, two fluoridated, and another which had stopped fluoridation a few years earlier. Although information on decay rates in all these areas was available to them, from the school dental service, they chose for their study the one non-fluoridated community with the highest decay rate and two fluoridated ones with low decay rates, and compared these with the recently stopped fluoridated one, which happened to have medium decay rates (both before and after it had stopped fluoridation). The teeth of randomly selected samples of children from each community were examined.

The chosen communities, of course, had not been randomly selected.

The results, first published with much publicity in the news media, showed over 50 percent less tooth decay in the fluoridated communities, with the recently defluoridated town in a "middle" position (see left side of Fig. 2). When I obtained the decay rates for all children in all the fluoridated and all the nonfluoridated areas in that part of New Zealand, as well as the decay rates for all children in the recently defluoridated town, they revealed that there are virtually no differences in tooth decay rates related to fluoridation (see right side of Fig. 2). When I confronted the authors with this information, they retorted that the results of their study were consistent with other studies. And of course it is true that many similar studies have been published in the dental professional literature.

It is easy to see how the consistent results are obtained: an appropriate selection of the communities being compared. There is another factor: most pro-fluoridation studies (including this New Zealand one) were not "blind" — that is, the examiners knew which children received fluoride and which did not. Diagnosis of tooth decay is a very subjective exercise, and most of the examiners were keen fluoridationists, so it is easy to see how their bias could affect their results. It is just not possible to find a blind fluoridation study in which the fluoridated and nonfluoridated populations were similar and chosen randomly.

EARLY FLAWED STUDIES
One of the early fluoridation studies listed in the textbooks is a New Zealand one, the "Hastings Fluoridation Experiment" (the term "experiment" was later dropped because the locals objected to being experimented on) [24]. I obtained the Health Department's fluoridation files under my own country's "Official Information" legislation. They revealed how a fluoridation trial can, in effect, be rigged [25]. The school dentists in the area of the experiment were instructed to change their method of diagnosing tooth decay, so that they recorded much less decay after fluoridation began.

Before the experiment they had filled (and classified as "decayed") teeth with any small catch on the surface, before it had penetrated the outer enamel layer.After the experiment began, they filled (and classified as "decayed") only teeth with cavities which penetrated the outer enamel layer. It is easy to see why a sudden drop in the numbers of "decayed and filled" teeth occurred. This change in method of diagnosis was not reported in any of the published accounts of the experiment.

Another city, Napier, which was not fluoridated but had otherwise identical drinking water, was at first included in the experiment as an "ideal control" — to show how tooth decay did not decline the same as in fluoridated Hastings. But when tooth decay actually declined more in the non-fluoridated control city than in the fluoridated one, in spite of the instructions to find fewer cavities in the fluoridated one, the control was dropped and the experiment proceeded with no control. (The claimed excuse was that a previously unknown trace element, molybdenum, had been discovered in some of the soil of the control city, making tooth decay levels there unusually low [26], but this excuse is not supported by available information, from the files or elsewhere, on decay levels throughout New Zealand).

The initial sudden decline in tooth decay in the fluoridated city, plus the continuing decline which we now know was occurring everywhere else in New Zealand, were claimed to prove the success of fluoridation. These revelations from government files were published in the international environmental journal, The Ecologist, and presented in 1987 at the 56th Congress of the Australian and New Zealand Association for the Advancement of Science [27]. When I re-examined the classic fluoridation studies, which had been presented to me in the text books during my training, I found, as others had before me, that they also contained serious flaws [28-30].

The earliest set, which purported to show an inverse relationship between tooth decay prevalence and naturally occurring water fluoride concentrations, are flawed mainly by their nonrandom methods of selecting data. The later set, the "fluoridation trials" at Newburgh, Grand Rapids, Evanston, and Brantford, display inadequate baselines, negligible statistical analysis, and especially a failure to recognize large variations in tooth decay prevalence in the control communities. We really cannot know whether or not some of the tooth decay reductions reported in those early studies were due to water fluoride.

I do not believe that the selection and bias that apparently occurred was necessarily deliberate. Enthusiasts for a theory can fool themselves very often, and persuade themselves and others that their activities are genuinely scientific. I am also aware that, after 50 years of widespread acceptance and endorsement of fluoridation, many scholars (including the reviewers of this essay) may find it difficult to accept the claim that the original fluoridation studies were invalid. That is why some of us, who have reached that conclusion, have submitted an invitation to examine and discuss new and old evidence "in the hope that at least some kind of scholarly debate will ensue" [31].

However, whether or not the early studies were valid, new evidence strongly indicates that water fluoridation today is of little if any value. Moreover, it is now widely conceded that the main action of fluoride on teeth is a topical one (at the surface of the teeth), not a systemic one as previously thought, so that there is negligible benefit from swallowing fluoride [32]. Harm from Fluoridation The other kind of evidence which changed my mind was that of harm from fluoridation. We had always assured the public that there was absolutely no possibility of any harm. We admitted that a small percentage of children would have a slight mottling of their teeth, caused by the fluoride, but this disturbance in the formation of tooth enamel would, we asserted, be very mild and was nothing to worry about.

It was, we asserted, not really a sign of toxicity (which was how the early literature on clinical effects of fluoride had described it) but was only at most a slight, purely cosmetic change, and no threat to health. In fact, we claimed that only an expert could ever detect it.

HARM TO TEETH So it came as a shock to me when I discovered that in my own fluoridated city some children had teeth like those in Fig. 3. This kind of mottling answered the description of dental fluorosis (bilateral diffuse opacities along the growth lines of the enamel). Some of the children with these teeth had used fluoride toothpaste and swallowed much of it. But I could not find children with this kind of fluorosis in the nonfluoridated parts of my Health District, except in children who had been given fluoride tablets at the recommended dose of that time.

I published my findings: 25 percent of children had dental fluorosis in fluoridated Auckland and around 3 percent had the severer (discolored or pitted) degree of the condition [33]. At first the authorities vigorously denied that fluoride was causing this unsightly mottling. However, the following year another Auckland study, intended to discount my finding, reported almost identical prevalences and severity, and recommended lowering the water fluoride level to below 1 ppm [34]. Others in New Zealand and the United States have reported similar findings. All these studies were reviewed in the journal of the International Society for Fluoride Research [35].

The same unhappy result of systemic administration of fluoride has been reported in children who received fluoride supplements [36]. As a result, in New Zealand as elsewhere, the doses of fluoride tablets were drastically reduced, and parents were warned to reduce the amount of fluoride toothpaste used by their children, and to caution them not swallow any. Fluoridationists would not at first admit that fluoridated water contributed to the unsightly mottling — though later, in some countries including New Zealand, they also recommended lowering the level of fluoride in the water.

They still insist that the benefit to teeth outweighs any harm. WEAKENED BONES Common sense should tell us that if a poison circulating in a child's body can damage the tooth-forming cells, then other harm also is likely. We had always admitted that fluoride in excess can damage bones, as well as teeth. By 1983 I was thoroughly convinced that fluoridation caused more harm than good. I expressed the opinion that some of these children with dental fluorosis could, just possibly, have also suffered harm to their bones [Letter to Auckland Regional Authority, January 1984]. This opinion brought scorn and derision: there was absolutely no evidence, my dental colleagues asserted, of any other harm from low levels of fluoride intake, other than mottling of the teeth.

Six years later, the first study reporting an association between fluoridated water and hip fractures in the elderly was published [37]. It was a large-scale one. Computerization has made possible the accumulation of vast data banks of information on various diseases. Hip fracture rates have increased dramatically, independently of the increasing age of populations. Seven other studies have now reported this association between low water fluoride levels and hip fractures [38-44]. Have there been contrary findings? Yes; but most of the studies claiming no association are of small numbers of cases, over short periods of time, which one would not expect to show any association [45, 46].

Another, comparing a fluoridated and a nonfluoridated Canadian community, also found an association in males but not in females, which hardly proves there is no difference in all cases [47]. Our fluoridationists claim that the studies which do show such an association are only epidemiological ones, not clinical ones, and so are not conclusive evidence. But in addition to these epidemiological studies, clinical trials have demonstrated that when fluoride was used in an attempt to treat osteoporosis (in the belief it strengthened bones), it actually caused more hip fractures [48-52].

That is, when fluoride accumulates in bones, it weakens them.

We have always known that only around half of any fluoride we swallow is excreted in our urine; the rest accumulates in our bones [53, 54]. But we believed that the accumulation would be insignificant at the low fluoride levels of fluoridated water. However, researchers in Finland during the 1980s reported that people who lived 10 years or more in that country's one fluoridated city, Kuopio, had accumulated extremely high levels of fluoride in their bones — thousands of parts per million — especially osteoporosis sufferers and people with impaired kidney function [55, 56]. After this research was published, Finland stopped fluoridation altogether. But that information has been ignored by our fluoridationists.

BONE CANCER? An association with hip fracture is not the only evidence of harm to bones from fluoridation. Five years ago, animal experiments were reported of a fluoride-related incidence of a rare bone cancer, called osteosarcoma, in young male rats [57]. Why only the male animals got the bone cancer is not certain, but another study has reported that fluoride at very low levels can interfere with the male hormone, testosterone [58]. That hormone is involved in bone growth in males but not in females. This finding was dismissed by fluoridation promoters as only "equivocal evidence," unlikely to be important for humans.

But it has now been found that the same rare bone cancer has increased dramatically in young human males — teenage boys aged 9 to 19 — in the fluoridated areas of America but not in the nonfluoridated areas [59]. The New Jersey Department of Health reported osteosarcoma rates were three to seven times higher in its fluoridated areas than in its nonfluoridated areas [60]. Once again, our fluoridationists are claiming that this evidence does not "conclusively" demonstrate that fluoride caused the cancers, and they cite small-scale studies indicating no association.

One study claimed that fluoride might even be protective against osteosarcoma [61]; yet it included only 42 males in its 130 cases, which meant the cases were not typical of the disease, because osteosarcoma is routinely found to be more common in males. Also, the case-control method used was quite inappropriate, being based on an assumption that if ingested fluoride was the cause, osteosarcoma victims would require higher fluoride exposure than those without the disease. The possibility that such victims might be more susceptible to equal fluoride exposures was ignored. All these counter-claims have been subjected to critical scrutiny which suggests they are flawed [62, 63]. Nonetheless, the pro-fluoride lobbyists continue to insist that water fluoridation should continue because, in their view, the benefits to teeth outweigh the possibility of harm. Many dispute that assessment.

OTHER EVIDENCE OF HARM There is much more evidence that tooth mottling is not the only harm caused by fluoridated water. Polish researchers, using a new computerized method of X-ray diagnosis, reported that boys with dental fluorosis also exhibit bone structure disturbances [64].

Even more chilling is the evidence from China that children with dental fluorosis have on average lower intelligence scores [65, 66]. This finding is supported by a recently published animal experiment in America, which showed that fluoride also accumulated in certain areas of the brain, affecting behavior and the ability to learn [67]. Endorsements Not Universal Concerning the oft-repeated observation that fluoridation has enjoyed overwhelming scientific endorsement, one should remember that even strongly supported theories have eventually been revised or replaced. From the outset, distinguished and reputable scientists opposed fluoridation, in spite of considerable intimidation and pressure [68, 69].

Most of the world has rejected fluoridation. Only America where it originated, and countries under strong American influence persist in the practice. Denmark banned fluoridation when its National Agency for Environmental Protection, after consulting the widest possible range of scientific sources, pointed out that the long-term effects of low fluoride intakes on certain groups in the population (for example, persons with reduced kidney function), were insufficiently known [70]. Sweden also rejected fluoridation on the recommendation of a special Fluoride Commission, which included among its reasons that: "The combined and long-term environmental effects of fluoride are insufficiently known" [71].

Holland banned fluoridation after a group of medical practitioners presented evidence that it caused reversible neuromuscular and gastrointestinal harm to some individuals in the population [72]. Environmental scientists, as well as many others, tend to doubt fluoridation. In the United States, scientists employed by the Environmental Protection Agency have publicly disavowed support for their employer's pro-fluoridation policies [73].

The orthodox medical establishment, rather weak or even ignorant on environmental issues, persist in their support, as do most dentists, who tend to be almost fanatical about the subject. In English- speaking countries, unfortunately, the medical profession and its allied pharmaceutical lobby (the people who sell fluoride) seem to have more political influence than environmentalists.

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