Do we need a new fluoride debate?

I think we do. Something like the good faith scientific exchange I had with Paul Connett four years ago (see Connett & Perrott, 2014 – The Fluoride Debate).

After all, there have been a number of important scientific reports since then. They may have been thrashed out (and thrash is sometimes the operative word) in one of the “anti-fluoride” or “pro-fluoride” internet silos but there has yet to be a proper discussion.

I have been trying to get one going for a while. Paul Connett is no longer interested and everyone else on the “anti-fluoride” side seems unwilling. However, Bill Osmunson who recently replaced Paul Connett as director of the Fluoride Action Network has been contributing to the discussion on several of the posts here. He seems to be the obvious choice for a discussion partner and I  asked him if he is willing to participate in another scientific exchange of the sort I had with Connett.

So far he has not responded – but as he has made some relevant critiques of several recent scientific papers in these discussion contributions I think it is relevant to bring that discussion into the formal blog posts. Otherwise, some important points will just be lost because they are buried deep in the discussion threads.

Here I respond to criticisms Bill makes of two recent studies which looked for evidence of the influence of community water fluoridation (CWF) on IQ and cognitive deficits in general. I urge Bill Osmunson to respond to my points in a format which can be presented as a blog post here........................................

1. Bill Osmunson DDS, MPH Director, Fluoride Action Network | October 12, 2017 at 9:55 am |

   Ken,
   I would be pleased to discuss fluoride and health.
   The topic has several streams of evidence.
   In order to make a “judgment,” we need to consider all streams of evidence, not just one. . . such as neurotoxicity, rather inclusive of all.
   A. What dosage of fluoride is beneficial . . if any?
   B. What is the range of fluoride exposure in the population without supplementation? What is the difference which should be supplemented?
   C. What government agency is charged with determining the dosage to achieve the benefit?
   D. What is the optimal tooth fluoride concentration which demonstrates a reduction in dental caries? And the serum fluoride concentration to achieve the optimal tooth fluoride concentration? And the optimal total exposure (dosage) of fluoride to achieve both the serum and tooth fluoride concentration?
   E. What quality of research will we accept as evidence of benefit?
   F. What margin of safety is acceptable?
   G. What percentage of the public harmed is acceptable?
   H. What is the measured evidence of cost savings?
   I. What are the potential risks from excess fluoride exposure and at what dosage and at what age?
   J. What are the synergistic effects of other chemicals and fluoride? For example, it appears there is a curve of “benefit” from fluoride as the concentration changes. Excess fluoride causes caries. And the caries rates change with a change in the calcium and magnesium rates in the water. If we are to adjust the chemicals in water to reduce dental caries, we need to also adjust fluoride based on calcium and magnesium concentrations.
   k. What are the genomic factors which create greater or lesser sensitivity to fluoride?
   After all, if there is little or no benefit, any potential risk or expense is unacceptable. If the benefit is significant, then greater risk to some should be considered.
   Perhaps terms should be clearly defined. For example, the term “endemic” is used for a disease or condition found “in people.” Often the term is used for communities with high fluoride exposures, water, coal, tea, etc. However, fluoride can be abundant in water, foods, air, soil, etc. When referring to water, virtually all water has some fluoride. Water fluoridation is the “adjustment” of existing or “endemic” fluoride concentration to achieve a water fluoride concentration, not an individual dosage of fluoride. Does the term “endemic” mean “found in people” or “found in the person” or “found in the community” or “found in the country?” Fluoride is found virtually everywhere. At what individual or range of dosage(s) is fluoride considered “endemic?”
   Probably more points to consider, but these are some of the streams of evidence for discussion.
   

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2. Ken | October 12, 2017 at 12:09 pm |

   Thanks for agreeing to an online discussion, Bill. If you send me your response to this post, including any new arguments you wish to make, I will put it up as a separate post. Of course, I will not make any changes except for those required by formatting. I have emailed you about this.
   Look forward to a fruitful exchange of views and a good scientific discussion of the issue.