Response to ‘No conclusive proof of negative benefits’

Lloyd Mudiwa, Irish Medical Times, 12th June 2015

 http://www.imt.ie/news/latest-news/2015/06/conclusive-proof-negative-effects.html

Can someone please start thinking rationally here, please? The objective of fluoridation of public water supplies is to prevent dental decay - a purely medicinal function. So the correct stratagem is first to determine whether or not it actually is beneficial to dental health. If it’s not, end of argument - you stop. There’s no further excuse to continue with the treatment, and looking for adverse side effects is simply a waste of time and money.

Only if it does function as claimed, and the medical benefits are significant, is it then rational to look at other potentially adverse health outcomes. So the entire decision rests on that simple first principle of medicine -do no harm. If it works, then check it out further - if it doesn't then abandon it and find another intervention that does. work

So does fluoridation actually work as claimed? Here we start to go around the same tired old circuit, Virtually all investigations into this controversial field rely on epidemiological evidence which is, by modern standards and definition, not first class evidence. It doesn't hold a candle to the Gold Standard highly structured research protocols used in toxicological studies under closely controlled conditions.

The York Review of 2000 lamented the absence of high quality evidence for the claimed benefits of fluoridation, conceding that ‘the best available evidence’ appeared to suggest that they might exist. But that was the ‘best’ of a pretty poor bunch of evidence to start with - that’s ‘best’ in the sense that it was derived from the best of a poor collection of works. Yet that unfortunate wording has provided proponents with all the ammunition they needed to misuse the York Review’s evidence ever since. That’s not how science should be treated, especially when it’s dealing with public health interventions on a very large scale.

If you want to see just how far this misuse of data has gone in this field, you couldn't do better than check out the recent review of water fluoridation from Britain’s Public Health England. This apparently authoritative analysis relies on the National Surveys of Oral Health on children, carried out periodically by our National Health Service. In fact those surveys are utterly worthless. They rely on calculations of dental decay and damage that are derived from sample sizes so small that the derived estimates are statistically meaningless. Certainly they cannot be used to support any interventional policy decisions, and the claim that they do is mischievous, to put it mildly!

The statistical fraud underlying in such bureaucratic strategies is breathtaking, yet this document is now relied upon by Health Authorities attempting to justify their obsession with fluoridation on the spurious grounds that ‘research’ evidence supports that policy, when it manifestly does not. The whole charade is a political scam to continue the pressure to fluoridate yet more water supplies.

So it’s time to stop arguing about those possible adverse side effects - they’re irrelevant. There is, still, no conclusive evidence that it works, so just stop doing it. No medicinal intervention should be continued after the course of treatment is completed (which is of course, why it is now claimed that fluoridation benefits even the edentate elderly!) or else it is found not to work. To do so is a serious violation of medical ethics, and can even lead to lawyers knocking at the office or surgery door.

Douglas Cross CSci, CBiol, FRSB

AM Institute of Advanced Studies, Basel, Switzerland.