It is well known that the dental profession has been largely trapped by the paradigm of the “safety and effectiveness” of water fluoridation – and has been since the practice was first endorsed by the US Public Health Service in 1950. Less well known is the shield other disciplines, including the medical profession, have provided for this unethical and outdated practice. Former EPA risk assessor Bill Hirzy said it best,

‘They are riding a tiger and can’t get off.’
The Ecologist, 18 June, 2008

Today we provide a surprising and shocking example from researchers within one such discipline: pediatrics.

In our view, what we have here is a very upsetting betrayal of the public’s trust. Surely, the one place parents should find honesty and transparency is in a medical discipline which deals with protecting the health of the developing infant. If you can’t rely on your baby’s doctor to give sound medical advice on its diet and well-being who can you rely on? In turn, busy pediatricians should be able to rely on the information provided by researchers who publish in pediatric journals, as well as the editors who vet those articles for accuracy.

This did not happen in the case of the article Fluoride Use in Caries Prevention in the Primary Care Setting authored by Clark et al. and published in Pediatrics, the journal of the American Academy of Pediatrics, on November 30, 2020. Not only have the authors let their profession and the public down but so have the editors who approved this article.

Because my work with FAN involves managing our StudyTracker, NewsTracker, IQ studies, Government reports, FAN submissions, Mother-Offspring studies, NTP studies, TSCA trial, etc., I came across this article. I was shocked by its conclusions and did some research on the authors.

I found another article with the same title, published in the same journal in 2014, and with the same lead author.

In the table below is a comparison between key quotes from the article in question published in 2020 and the 2014 article. Very little has changed in these key passages over a space of 6 years but as most of our readers know, a huge amount has changed in fluoride research on the harms caused by fluoride, particularly fluoride’s neurotoxicity. None of this important research is acknowledged even though one study was published in 2019 in a journal well known to every pediatrician – JAMA Pediatrics (the Journal of the American Medical Association).

August 2014 Fluoride use in caries prevention in the primary care setting.	December 2020 Fluoride Use in Caries Prevention in the Primary Care Setting
Authors: Melinda B. Clark, MD, FAAP   and Rebecca L. Slayton, DDS, PhD   Affiliations not listed	Authors: Melinda B. Clark, MD, FAAP Dept. of Pediatrics, Albany Medical Center, NY Martha Ann Keels, DDS, PhD Dept. of Surgery and Pediatrics, Duke U., Durham NC; The Adams School of Dentistry, U. of North Carolina at Chapel Hill Rebecca L. Slayton, DDS, PhD Dept. of Pediatric Dentistry, School of Dentistry, U. of Washington, Seattle WA
“Despite overwhelming evidence supporting the safety [no reference given] and preventive benefits of fluoridated water, community water fluoridation continues to be a controversial and highly emotional issue. Opponents express a number of concerns, all of which have been addressed or disproven by validated research [no references given]. The only scientifically documented adverse effect of excess (nontoxic) exposure to fluoride is fluorosis.”	“Despite overwhelming evidence supporting the safety [no reference given] and preventive benefits of fluoridated water, community water fluoridation continues to be a controversial and highly emotional issue. Opponents express a number of concerns that have been addressed or disproven by validated research [no references given]. The only scientifically documented adverse effect of excess (nontoxic) exposure to fluoride is fluorosis.”
Finally, there have been many unsubstantiated or disproven claims [no reference given] that fluoride leads to kidney disease, bone cancer, and compromised IQ. More than 3000 studies or research papers have been published on the subject of fluoride or fluoridation.39 [the reference, also used in their 2020 paper, was published in 2007.] Few topics have been as thoroughly researched, and the overwhelming weight of the evidence—in addition to 68 years of experience—supports the safety and effectiveness of this public health practice.	Finally, there have been many unsubstantiated or disproven claims [no reference given] that fluoride leads to kidney disease, bone cancer, and compromised IQ. More than 3000 studies or research articles have been published on the subject of fluoride or fluoridation.47 [the reference, also used in their 2014 paper, was published in 2007.] Few topics have been as thoroughly researched as community water fluoridation, and the overwhelming weight of the evidence (along with over 75 years of experience) supports the safety and effectiveness of this public health practice.
Reference 39 Cheng KK, Chalmers I, Sheldon TA. Adding fluoride to water supplies. BMJ. 2007;335 (7622):699–702	Reference 47 Cheng KK, Chalmers I, Sheldon TA. Adding fluoride to water supplies. BMJ. 2007;335 (7622):699–702

 

What happened in the intervening years between the first article in 2014 and the second article in 2020?

From 2015 to 2020, 23 of the 67 studies associating fluoride exposure with lowered IQ in children were published, including three funded by the U.S. government. The studies merited no mention or words of caution in Clark et al.’s 2020 paper. Except for a few insignificant word changes in the 2020 article, the conclusions were the same.

Clark et al. stated in both papers:                                     

… there have been many unsubstantiated or disproven claims [no references given] that fluoride leads to kidney disease, bone cancer, and compromised IQ … and the overwhelming weight of the evidence [no references given] … supports the safety and effectiveness of this public health practice.

The three authors of the 2020 paper made no mention of the following:

• The National Toxicology Program’s (NTP) systematic risk assessment of fluoride’s neurotoxicty, was publicly released in October 2019, one full year before Clark et al.’s 2020 paper. NTP concluded “fluoride is presumed to be a cognitive neurodevelopmental hazard to humans.” It was peer reviewed by the National Academies of Sciences, Engineering and Medicine (NASEM) which recommended various changes. The NTP released a second draft in 2020 with the same conclusion. It is currently undergoing a second peer review by the NASEM.
   
• The three Mother-Offspring fluoride studies funded by the National Institute of Environmental Health Sciences (NIEHS) reported reduced IQ in children at exposure levels found in fluoridated communities (0.7 ppm fluoride) are: Bashash et al. 2017; Green et al. 2019; Till et al. 2020 (released in Nov 2019).
   
• No health risk assessment has ever been performed by any regulatory agency from the 1945-2020 for fluoride exposure to pregnant women, the fetus, or to formula fed-infants living in fluoridated communities.

How could the editors of this journal (Pediatrics), or the authors of the 2020 paper, be so uninformed when the Green et al. (2019) study appeared under their noses in the world’s leading pediatrics journal, JAMA Pediatrics?

The authors referenced this study in their 2014 & 2020 papers:

Under the section “Evidence Supporting Community Water Fluoridation” there are no references to the safety of fluoridation. The authors state, “The only scientifically documented adverse effect of excess (nontoxic) exposure to fluoride is fluorosis [no reference given].” The authors did add a reference to this statement, “More than 3000 studies or research papers have been published on the subject of fluoride or fluoridation.^39”

What the referenced study actually said:

The 2007 report by Cheng et al., in the British Medical Journal was titled Adding fluoride to water supplies. Here are some excerpts:

… Given the certainty with which water fluoridation has been promoted and opposed, and the large number (around 3200) of research papers identified,⁹ the reviewers were surprised by the poor quality of the evidence and the uncertainty surrounding the beneficial and adverse effects of fluoridation.

… Water fluoridation aims to reduce social inequalities in dental health,¹⁰ but few relevant studies exist. The quality of research was even lower than that assessing overall effects of fluoridation. The results were inconsistent—fluoridation seemed to reduce social inequalities in children aged 5 and 12 when measured by the number of decayed, missing, or filled teeth, but not when the proportion of 5 year olds with no caries was used.

… evidence on the potential benefits and harms of adding fluoride to water is relatively poor.

… There is no such thing as absolute certainty on safety … In the case of fluoridation, people should be aware of the limitations of evidence about its potential harms and that it would be almost impossible to detect small but important risks (especially for chronic conditions) after introducing fluoridation.

… Public and professional bodies need to balance benefits and risks, individual rights, and social values in an even handed manner. Those opposing fluoridation often claim that it does not reduce caries and they also overstate the evidence on harm.²¹ On the other hand, the Department of Health’s objectivity is questionable—it funded the British Fluoridation Society, and along with many other supporters of fluoridation it used the York review’s findings⁹ selectively to give an overoptimistic assessment of the evidence in favour of fluoridation.²² In response to MRC recommendations,¹³ the department commissioned research on the bioavailability of fluoride from naturally and artificially fluoridated drinking water. The study had only 20 participants and was too small to give reliable results. Despite this and the caveats in the report’s conclusion,²³ this report formed the basis of a series of claims by government for the safety of fluoridation.²⁴

 …Against this backdrop of one sided handling of the evidence, the public distrust in the information it receives is understandable…

Returning to the Clark et al 2020 article, it is disturbing that researchers writing in a journal dealing with health studies on infants should have so cavalierly overlooked key evidence that a practice they advocate has the potential to damage the brains of both the fetus and formula-fed infant. The same applies to the editors. Our children are not being protected.

Fundraising Update

Ellen has given just one example of her daily work which is so crucial to FAN's mission. Our educational campaign since 2000 has been grounded in the science with meticulous attention to detail. Please help us continue this work in 2021. No donation is too large (!) or too small.

Our current totals are $56,128 from 368 supporters. We are still rather short of both our goals with only a few days to go before our deadline of midnight Dec 31. All donations are tax-deductible.

How to Make a Tax-Deductible Donation:

• Online, using our secure server.
• Or by Check, payable to the Fluoride Action Network. Mail your check to:

Fluoride Action Network
c/o Connett
104 Walnut Street
Binghamton NY 13905
 

Thank you, 

Ellen Connett
Managing Director
Fluoride Action Network