Was the NHMRC hoodwinked
about Water fluoridation?
by Heimen Julius
Through Google I found on the Internet "Review of water fluoridation and fluoride intake from discretionary fluoride supplements." This is a report prepared to formulate recommendations to the Health Advisory Committee (HAC) of the National Health and Medical Research Council (NHMRC). Although it dates from 1999 and has written over all its pages "ARCHIVED", whatever that means, it is the most recent report concerning the NHMRC and water fluoridation that I have found during August 2006.
Reading through it gave me the impression that the Recommendations do not accurately reflect the contents of the report. While the Recommendations state to maintain the current level of water fluoridation, many parts in the report would seem to suggest something quite differently.
General facts on fluoride
In chapter two, page 1, of this review we are told that fluorine is the thirteenth most abundant element in the Earth's crust. Also, that it rarely occurs as the pure element, but is normally found as the fluoride ion of inorganic and organic fluorides. We are also told that fluoride compounds in the air rank third among air pollutants. They originate from soil dust, industrial gases and the burning of coal. And less relevant to Australia, fluoride gasses are also released from volcanos.
Given these details, it is peculiar that the toxicity of fluoride was left out. Only the persistent reader who makes it to chapter seven finds what should have been upfront in chapter two: fluoride's severe toxicity.
Chapter seven, page 1, tells us that the lethal dose is in the range of 2 - 5 gram sodium fluoride (NaF). And that without treatment death occurs in 2-4 hours. There is even a Certainly Lethal Dose (CLD) given of 2.2 - 4.5 g (a teaspoon) for a 70 kg adult.
This toxicity information is in line with what one finds in The Merck Index: 'severe symptoms have occurred from ingestion of less than one gram; death from 5 to 10 g.' So, the information of chapter seven tells us that fluoride is even more toxic than is indicated in The Merck Index.
It does not seem that any conclusions were drawn from this toxicity. Agreed, acute toxicity is well under control, with only part per millions (ppm) in drinking water. But what about chronic toxicity and unnecessary toxic overload?
Ingestion of fluoride
Chapter four, page 1, tells us that fluoride in water is readily absorbed and peak plasma concentrations are reached within 60 minutes. Also, that over 80% of the fluoride ingested each day is absorbed and that less than 20% of the amount is excreted with the faeces. Moreover, the major proportion of fluoride bound in teeth and skeleton has a biological half-life of several years. Which means that once fluoride ingestion stops, it takes several years to reduce this pile-up of fluoride by half.
So, with daily ingestion fluoride tends to accumulate inside the body and over time the body's internal environment becomes more and more toxic. This is confirmed at page 2 where is stated that serum fluoride levels rise with increasing age. This is further illustrated at page 3 of this chapter by mentioning a research by Torra et al. They found that significantly higher serum fluoride levels were present in elderly healthy subjects than in younger subjects from the same low-fluoride area in Spain.
So, no matter what people do, it seems it is impossible to evade fluoride ingestion one way or the other.
At this point it is helpful to refer to The Merck Manual of Diagnosis & Therapy where is clearly stated that no fluoride deficiency has ever been induced. Given the fact that fluorine is the thirteenth most abundant element in the Earth's crust and that even in a low-fluoride area in Spain fluoride accumulates inside people's body, fluoride-deficient areas (as Recommendation 6 suggest) do not exist.
There is also another reason why a fluoride deficiency is impossible. Fluoride's toxic effect is due to its interference with enzyme systems, which are the facilitators of biochemical reactions. No enzymes, no biochemical reactions, which are the corner stones of all life processes. So, how could there be a deficiency for a substance that plays havoc with life processes at all levels? Obviously, any talk of fluoride deficiency is crackpot science.
A visible symptom of low level fluoride poisoning is mottled teeth, also called dental fluorosis. This is only one of the many adverse health effects of chronic fluoride poisoning. Mottled teeth is a defect of the dental enamel and it has been established that dental fluorosis in its advanced stages is conducive to dental decay.
This was acknowledged on page 12 of chapter 7 where under the sub-heading: 'The effect of an increase in the prevalence of dental fluorosis' is stated that 'higher caries experience has been reported for children with moderate to severe fluorosis.'
On page 16 of chapter seven we are told that 'the prevalence of fluorosis of any degree is approximately 30% in non-fluoridated areas to 50% in fluoridated areas.' The reason that even in non-fluoridated areas 30% mottled teeth are found is because fluoride has penetrated the whole food supply. So, many people ingest increased levels of fluoride no matter what.
Despite this situation Recommendation 1 states: 'Maintain the current level of fluoridation of reticulated drinking water supplies between the optimal levels of 0.6 ppm and 1.1 ppm subject to climatic variation. Clearly, this does not reflect the contents of the report. Besides, where is the rationale of this recommendation as on page 15 of chapter 7 is roundly admitted that 'excessive fluoride intake would appear to be common.'
Another aspect of this recommendation is the bogus accuracy of water fluoridation. In 1980 the then West German Society of Water and Gas Experts considered it not possible to deliver a controlled dose of fluoride to each house through the public water supplies. And there are no reasons to assume that it would be any different in Australia. But the lack of accuracy does not stop there. Dr Arvid Carlsson, a Nobel Prize Scientist in medicine and physiology stated on water fluoridation:
'In modern pharmacology it's so clear that even if you have a fixed dose of a drug, the individuals respond very differently to one and the same dose. Now in this case you have it in the water and people are drinking different amounts of water. So, you have huge variations in the consumption of this drug. So, it's against all modern principles of pharmacology. It's so obsolete I don't think anybody in Sweden, not a single dentist, would bring up this question in Sweden anymore.'
In other words the optimal fluoride concentration in drinking water dentists fuss about does not exist. It would seem the less fluoride in drinking water, the better. Fluoride intake in Australia is way out of control: 30% of people with dental fluorosis in areas without water fluoridation. Think of it! And remember, mild fluorosis leads to more advanced states of fluorosis and this leads directly to dental decay.
The ruinous effect on teeth of ingesting fluoride is further illustrated by the Hong Kong experience, as told in chapter 7 on page 11. Prior to the introduction of water fluoridation in 1962, no dental fluorosis was found in Hong Kong.
Then among 12 year olds born in 1969 and 1970, more than 80% of permanent teeth disclosed opacities (early stages of dental fluorosis) and approximately 40% of children had evidence of hypoplasia affecting 4 to 12 teeth (Hypoplasia means here arrested development of teeth which remain below normal size or in an immature state).
How come that none of these findings in the report are reflected in the recommendations?
Topical use of fluoride
The reason why most of the report does not make any sense is spelled out in chapter two on page 2:
'the presumed mechanism of action of fluoride in preventing caries was thought to be systemic as a result of incorporation into the tooth enamel during its formation. Subsequently, it has been shown that the major anticaries actions of fluoride are topical.'
This means that it was thought that by ingesting fluoride (systemic), it would be incorporated into tooth enamel and make this more resistant to decay. Subsequently it has been found that this is not the case and that the main action of fluoride is on the surface of the tooth (topical). In other words fluoridated toothpaste is adequate.
Let me quote more extensively from a publication from the US Centers for Disease Control and Prevention, the Morbidity and Mortality Weekly Report of 22 October 1999/ vol.48/No.41.pp.933-936/7-940. Under the sub-heading Biological Mechanism is stated:
'Fluoride's caries-preventive properties initially were attributed to changes in enamel during tooth development because of the association between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. However, laboratory and epidemiologic research suggest that fluoride prevents dental caries predominantly after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children. These mechanisms include 1) inhibition of demineralisation, 2) enhancement of remineralization, and 3) inhibition of bacterial activity in dental plaque.'
A website that gives a listing of scientific researches that confirm the topical effect of fluoride is: http://www.fluoridealert.org/health/teeth/caries/topical-systemic.html
Given the severe toxicity of fluoride it remains unclear why the NHMRC has only archived the 1999 report, and not replaced it with a clear statement that ingestion of fluoride is inadvisable as fluoride's toxic nature is detrimental to health, including oral health.
The topical effect of fluoride is also confirmed by research showing that the general decline in tooth decay in the so called Western World has occurred everywhere irrespective of the presence or absence of water fluoridation. This has been ascribed to the widespread use of fluoridated toothpaste. A case in point is Europe where drinking water is not fluoridated, fluoridated toothpaste is widely used and oral health is good. A listing of many articles and papers on these findings can be found at: http://www.fluoridealert.org/health/teeth/caries/who-dmft.html
What research has the NHMRC relied on?
The long list of researches stretching twenty years back, showing that only topical application can have some beneficial effect on oral health, raises the question what kind of research the NHMRC has been relying on for advocating water fluoridation. My guess is that this is promotional fake research.
In New Zealand it was found (1986) that oral health is largely determined by socioeconomic background. The explanation is that affluent people have in general better nutrition and a better education. They know the importance of looking after their teeth. And, they teach their children at a young age that daily brushing (removal of plaque) is the way to go. People in the lower socioeconomic bracket have poorer nutrition and are less aware of the importance of daily brushing. Therefore they do not instruct their children consistently. Hence the poorer dental health in that group.
The promoters of water fluoridation are using these findings. They mix various socioeconomic backgrounds to suit their purpose. And so they produce 'research' reports always showing much better oral health in fluoridated areas than in non-fluoridated areas.
The Townsville - Brisbane study is a case in point. Townsville has water fluoridation for many years by now. Brisbane has no water fluoridation. And what did they find? Yes, Townsville had much better oral health than Brisbane. But when you have a closer look at these studies (two studies: one 0 to 3 years of age; and one 3 to 6 years of age, if I remember it well) you find anonymous teeth.
At the beginning of these studies everything was done correctly. They selected specific groups according to age, gender, socioeconomic background and what not, for each town. They examined their teeth and then did a statistical analysis. And guess what? The figures they put on the table after the statistical analysis are impossible to relate back to any of the carefully selected groups. So, from the statistical hoopla onwards you are dealing with anonymous teeth. This enables the promoters to mix and match socioeconomic backgrounds to suit their purpose.
Modern analyses have corrected earlier studies and found that there are no statistical differences in dental decay among children from fluoridated and non-fluoridated areas. In other words water fluoridation is ineffective in protecting teeth from decay. See: http://www.fluoridealert.org/health/teeth/caries/fluoridation.html
This website shows moreover that termination of water fluoridation did not result in increased dental decay and that poor oral health is more a feature of poverty than anything else. In relation to poverty, the website called: Fluoride intake and sky-rocketing fluorosis rates at: http://www.fluoridation.com/flteeth.htm makes the point that in general under-nourished children are at a much higher risk of developing dental fluorosis than any other child. (How could this be anything different? Poor nutrition means greater vulnerability to toxins) And this is followed by more dental decay as page 12 of chapter 7 told us: more caries in children with moderate to severe fluorosis.
So, if the NHMRC has been relying on fake research, then they have been living in a fantasy world. One thing remains strange. The promoters are always limiting their promotional 'research' to dental cavities, they never include dental fluorosis as a precursor to more dental decay in assessing oral health. So, their evaluations are incomplete and inaccurate. Surely the NHMRC could have noticed that ignoring damaged dental enamel is an unscientific way of evaluating oral health?
Who were the authors of this report?
The members of the Review Group who wrote this report from 1999 were:
Prof. JT Ahokas Director, Key Centre for Applied and Nutritional Toxicology, Royal Melbourne Institute of Technology, Melbourne.
Dr L Demos Department of Epidemiology and Preventive Medicine, Monash University, Melbourne.
Mrs DC Donohue Key Centre for Applied and Nutritional Toxicology, Royal Melbourne Institute of Technology, Melbourne.
Dr S Killales Department of Epidemiology and Preventive Medicine, Monash University, Melbourne.
Prof. J McNeil Director, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne.
Dr CJ Rix Department of Applied Chemistry, Royal Melbourne Institute of Technology, Melbourne.
In her book 'Fluoride in Australia - a case to answer' (1986) Wendy Varney describes the financial interest of the Australian dental establishments in promoting water fluoridation. This is a matter of research grants and funding from big business with vested interests in water fluoridation. See: http://www.rag.org.au scroll down to Fluoride click, and go to Vested interests in water fluoridation.
Could it be, given the discrepancies in the recommendations and the contents of this review that the above named institutions are in the same boat?
And what about the National Health and Medical Research Council itself? Why has an archived review from 1999 still not been updated with a paper taking into account modern scientific research?
An updated view from the NHMRC regarding water fluoridation should include the many adverse health effects scientific research has found from ingesting fluoride. A very good compilation of scientific research can be found at the fluoride health effects database at: http://www.fluorideaction.net/health/
In addition it would be helpful if the NHMRC would speak out on this environment of cultivated ignorance among medicos and dentists as illustrated by The Merck Manual of Medical Information where nothing is said about fluoride's severe toxicity, where it is claimed that fluoride is required for the formation of bone and teeth (wrong, that is calcium; fluoride is toxic to bone and teeth.), where it is claimed that fluoride deficiency can lead to tooth decay (wrong, fluoride deficiency does not exist), where topical application of fluoride having some protective effect on teeth has been omitted.
If these statements about fluoride reflect in any way what you find in medical textbooks, then there is work to be done at universities and medical and dental schools. Medicos and dentists who are misinformed about fluoride's toxicity can become a danger to the public.
It is about time that the NHMRC gets real on this whole issue.
The Evidence