Second Opinion: A crucial study on fluoride produces silence

By Dr. Johnny Johnson Jr., DrBicuspid.com contributing writer

June 26, 2018 -- Although the leading health and medical organizations such as the ADA, the World Health Organization, and the American Academy of Pediatrics endorse community water fluoridation, critics continue to attack this public health practice. A few years ago, opponents were pleased when the U.S. government's National Toxicology Program (NTP) proposed to conduct an animal study examining the effect of fluoride on learning and memory.

In fact, in a December 2015 release, the Fluoride Action Network predicted that NTP's study "could end fluoridation." So why have fluoride critics been conspicuously silent since the program released its study in the journal Neurotoxicity Research (February 5, 2018)?

Johnny Johnson Jr., DMD
Johnny Johnson Jr., DMD, president of the American Fluoridation Society.

The answer, in my opinion, is clear: The researchers' findings contradict the critics' assertions that fluoride negatively affects cognitive ability. The NTP study examined rats that consumed food and water with varying exposures of fluoride during their prenatal development through their adulthood. At these exposures, the researchers reported that they "observed no exposure-related differences in motor, sensory, or learning and memory performance" for any of the nine different tests they performed.

Yet here we are, four months after a major study was released, and critics are ignoring the NTP's findings. This contrasts sharply with how the public health community has responded when studies have been published about fluoride. Regardless of what those studies have revealed, I have been willing to talk to news reporters and health officials, and so have many of my colleagues.

Both before and after results of a fluoride study was published in Environmental Health Perspectives (September 19, 2017), I spoke at length with a CNN staff writer on background about the study. I wanted her to understand the impressive research that has been conducted on fluoride's effectiveness and safety. I joined others in pointing out that co-authors of the Mexican study were urging that their findings be interpreted with caution. But that didn't stop opponents from spinning the study to fit their fear-based messages.

For the past 50 years, whenever concerns have been raised about fluoride's safety -- even ones that might seem to lack legitimacy -- researchers in the public health community have responded appropriately. The NTP study is only one example.

“Any community that stops fluoridating its water is jeopardizing the health of its residents.”

Moreover, when opponents asked the Environmental Protection Agency to ban the most commonly used fluoride additive for water, the agency's experts carefully reviewed their petition before rejecting this request. Time and time again, when the scientific analysis doesn't fit their narrative, critics simply resume their "toxic" refrain.

Opponents will always say we haven't conducted enough studies about fluoride and fluoridation. Never mind that nearly 57,000 studies about fluoride are cataloged in the National Library of Medicine's database. In addition, more than 6,400 studies have been published on fluoridation specifically.

According to the Association of State and Territorial Dental Directors, opponents fail about 80% of the time when they campaign to end a local water fluoridation policy. On the one hand, that's a good percentage for those who care about healthy teeth. On the other hand, we shouldn't accept or downplay our losses. Any community that stops fluoridating its water is jeopardizing the health of its residents. Let's do more to get the word out, sharing the NTP findings and other compelling research showing that fluoride is a safe way to prevent tooth decay.

Johnny Johnson Jr., DMD, is the president of the American Fluoridation Society.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Tap water study shows higher blood lead, fewer caries in kids
U.S. children and adolescents who drank tap water had a higher prevalence of elevated blood lead levels but a much lower rate of dental caries than those...
Study: High fluoride levels may affect young kids' IQ
Does a high level of prenatal fluoride exposure affect children's cognitive function? What about their brain development after birth? A study published...
EPA denies petition by fluoride opponents
The U.S. Environmental Protection Agency (EPA) has denied a petition from the Fluoride Action Network and other groups that would have prohibited adding...
New fluoridation society provides help to fight myths
Johnny Johnson Jr., DMD, president of the newly formed American Fluoridation Society (AFS) got into the fluoridation fight when local officials in his...
Dentists, physicians create new fluoridation society
A group of dental and medical professionals has created the American Fluoridation Society (AFS), seeking to "debunk myths and clarify the evidence behind...

Copyright © 2018 DrBicuspid.com

Last Updated np 6/25/2018 3:04:56 PM

20 comments so far ...
6/26/2018 5:43:30 AM
Dr. Hardy Limeback PhD,DDS
The handful of people who formed the America Fluoridation Society troll comment sections of media outlets to try and shut down opposition to fluoridation. Dr. Johnson denies that dental fluorosis exists, and yet it has become epidemic in the US, a country that has increased fluoridation (we in Canada have decreased it drastically and almost all of Europe has stopped fluoridation schemes). Fluoridation promoters admit there is little effect on dental decay prevention (Slade, 2013, 2018, McLaren, 2016). The latest Cochrane review on fluoridation could not find a single double-blinded randomized clinical trial  on fluoridation (gold standard for therapy for human diseases) and evidence form all the fluoridation studies is weak at best. Regarding the neurotoxic effect of fluoride, after reviewing the literature, the National Toxicology Program said “Conclusions were reached based on an analysis of 32 studies. Results show low-to-moderate confidence for a pattern of findings suggestive of an effect on learning and memory based on developmental and adult exposure studies.” The NTP found a rat model system that did not respond like humans or other rats to the toxic effects of fluoride so they used that rat model.  Dr. Johnson says that there is no reply to that NTP rat study (McPherson, 2018). He's wrong. Twitter is abuzz. He and his 'American Fluoridation Society' have simply blocked me and others on Twitter. I'd be happy to write a summary for Dr Bicuspid to offer a 'sober' second opinion. Thank you. Dr. Hardy Limeback BSc PhD DDS, Professor Emeritus University of Toronto Faculty of Dentistry and past member of the 2006 US NRC Committee on Fluoridation in Drinking Water. 

6/26/2018 6:00:24 AM
Seabreezes1
About study quality & media silence 
  1. There have been 3 major high-quality human studies proving neurotoxicity on a dose-response trend line in the past few months, two were sponsored by the NIH/EPA and all three found low dose prenatal exposure to fluoride consistent with fluoridation policy results in lower IQ. These findings are consistent with dozens of other human studies. There are only a few studies that do not have these findings and they have all been criticized for flaws, like Broadbent, 2015 where at least half of the non-fluoridated subjects had taken fluoride supplements - just one of several fatal flaws. There has been next to no media coverage of these three studies finding lower IQ in people: 
    1. Morteza Bashash, Deena Thomas, Howard Hu, et al. Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6–12 Years of Age in Mexico. Environ Health Perspect. Sept 2017. Vol 125, Issue 9.  https://ehp.niehs.nih.gov/ehp655/
    2. Thomas D, Sanchez B, Peterson K, et al OP V – 2 Prenatal fluoride exposure and neurobehavior among children 1–3 years of age in Mexico. Occup Environ Med 2018;75:A10.  http://oem.bmj.com/content/75/Suppl_1/A10.1
    3. Yu X et al. Threshold effects of moderately excessive fluoride exposure on children's health: A potential association between dental fluorosis and loss of excellent intelligence. Environ Int. 2018 Jun 2;118:116-124.  https://www.ncbi.nlm.nih.gov/pubmed/29870912
  2. Similarly, there has been no media coverage on a report of the latest U.S. surveillance of dental fluorosis analysis released to the public that found over half of today's teens have some level of dental fluorosis and that 23% have brown stains (some with enamel pitting and flaking) on at least two brittle teeth. That report ends with "The continued increase in fluorosis rates in the U.S. indicates that additional measures need to be implemented to reduce its prevalence."  The 3rd study in the list above also tracked an increase in dental fluorosis on a dose response trend line, every 0.1 mg/L (ppm) increases dental fluorosis in the population by 2.24%. Both the 2000 York and 2015 Cochrane panels also expressed alarm at the high incidence of dental damage resulting from fluoridation policy. 
    1. Wiener RC, et al. Dental Fluorosis over Time: A comparison of National Health and Nutrition Examination Survey data from 2001-2002 and 2011-2012. J Dent Hyg February 2018 vol. 92 no. 1 23-29.  https://www.ncbi.nlm.nih.gov/pubmed/29500282 
  3. The 2018 NTP animal study (McPherson, 2018) used purified NaF, not the contaminated stuff added to our water, did not expose the rats to fluoride during the entire pregnancy or while nursing, only tested male pups, used a rat species that is typically not used in these types of studies, did not do a thorough testing i.e. attempt to recreate several types of tests that found neurotoxic harm, etc. etc. I could go on.... but you get the picture. NTP as part of the family of government agencies that endorse fluoridation did everything they could to avoid documenting harm. The study was a manipulated stunt and the naive opponents who pressed for it essentially 'handed OJ the glove' to allow those with vested interests in getting the study to come out the way they wanted to manipulate it.
There are significant differences in strength of any study based on whether it's a human study or animal study as well as based on study design and its resemblance to real world application. There is also apparently a great deal of media bias against any of us who try to get studies, opinions and reports unfavorable to fluoride policy published by pro-fluoride outlets. JJ founded an organization to promote fluoridation and made himself president in order to give himself a bully pulpit. Media is happy to oblige. 
 
Regardless of the NTP rat study or any other neurotoxicity study: 
 
Fluoridation policy is a medical mandate that forces contaminated product into the bodies of
convenient consumers regardless of harm caused to millions with
inflammatory, immune system, thyroid or kidney diseases.  
The narrative promoted by fluoridation policy suppresses emerging science,
silences evolving medical opinions and stifles the voices of victims. 



 
 

6/26/2018 1:31:24 PM
sedation doc
I was a fan of fluoridation of the community water supply. I thought they took bags of high grade sodium fluoride and tossed it into the water plant reservoirs.Oops! Instead they use a liquid--HexaFluorosilicic acid- a waste product from phosphate fertilizer production-cause it dissolves more easily. The problem is it is typically contaminated with heavy metals. And now, a lot of it comes from China. It would be very expensive to dispose of so it goes in our drinking water! Brilliant! Save money on disposal and get paid for it! Remember--the solution to pollution is dilution.

6/26/2018 1:57:31 PM
Steveslott
Wow, it’s very disappointing to see Dr. Hardy Limeback, once a respected dental educator and researcher, to have sunk so low into the depths of childish personal attacks, false claims, and half-truths, that are the hallmark of antifluoridationists. I expected more of him than this.

So, let’s look at his claims:

1. “Trolls” are those who intentionally post misinformation on various sites of the internet. Members of the AFS post facts supported by valid evidence to counter the mounds of misinformation constantly put forth by antifluoridationists who have no regard for truth and accuracy. “Troll” is obviously a term descriptive of antifluoridationists.

Since Dr. Limeback seems to resent the AFS constantly exposing the false claims of antifluoridationists, with the AFS challenging and holding these activists accountable at every turn, perhaps he should seek to improve the integrity of antifluoridationists rather than attacking those of us who expose their lack thereof.

2. To my knowledge, Dr. Johnson has never denied the existence of dental fluorosis, as Dr. Limeback inexplicably claims that he has. There is no reason that Dr. Johnson, a pediatric dentist, would deny dental fluorosis. As an expert in children’s dentistry he certainly understands the different levels of dental fluorosis, which level is of any concern, and which levels are not, even if Dr. Limeback seems not to do so.

3. Neither Slade, nor McLaren have “admitted” that fluoridation has “little effect on dental decay prevention” as Limeback claims they have. What these two researchers have done is to provide peer-reviewed studies published in respected scientific journals, which demonstrate an association of water fluoridation with significant reductions in dental decay in entire populations.

4. As Cochrane 2015 clearly noted, randomized controlled trials are infeasible for large, population-based public health initiatives such as water fluoridation, and will probably never be done for this reason.

From Cochrane 2015:

“However, there has been much debate around the appropriateness of GRADE when applied to public health interventions, particularly for research questions where evidence from randomised controlled trials is never going to be available due to the unfeasibility of conducting such trials. Community water fluoridation is one such area.”

—-Water fluoridation for the prevention of dental caries (Review) 30
Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

As such, quality observational studies, such as those for fluoridation, are the next best thing, are fully accepted as valid evidence, and arguably provide equal or more reliable results for population-based public health initiatives than do RCTs..

From a Cochrane 2014 paper on observational versus RCTs:

“As such, we have reached similar conclusions--there
is little evidence for significant effect estimate differences between
observational studies and RCTs, regardless of specific observational study design, heterogeneity, or inclusion of drug studies.”

—Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials (Review) 15
Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

5. It is interesting that while Dr. Limeback’s colleagues at the antifluoridation group, FAN, instigated, promoted, and pledged to closely monitor, the 2016 NTP study when it began, highly praising the integrity of the NTP in the process.......with the recent release of results of this study completely contradicting the claims of FAN, the silence from this group has been deafening and very telling as to their lack of interest in valid science which debunks their claims. Limeback now chooses to respond only to the initial literature review of the NTP, and put forth conspiracy/corruption nonsense about the 2016 study which his antifluoridation colleagues celebrated until they learned of the results.

6. “Twitter”? This is now where Limeback obtains his “scientific” information?


Steven D. Slott, DDS

6/26/2018 2:00:49 PM
Steveslott
Wow, it’s very disappointing to see Dr. Hardy Limeback, once a respected dental educator and researcher, to have sunk so low into the depths of childish personal attacks, false claims, and half-truths, that are the hallmark of antifluoridationists. I expected more of him than this.

So, let’s look at his claims:

1. “Trolls” are those who intentionally post misinformation on various sites of the internet. Members of the AFS post facts supported by valid evidence to counter the mounds of misinformation constantly put forth by antifluoridationists who have no regard for truth and accuracy. “Troll” is obviously a term descriptive of antifluoridationists.

Since Dr. Limeback seems to resent the AFS constantly exposing the false claims of antifluoridationists, with the AFS challenging and holding these activists accountable at every turn, perhaps he should seek to improve the integrity of antifluoridationists rather than attacking those of us who expose their lack thereof.

2. To my knowledge, Dr. Johnson has never denied the existence of dental fluorosis, as Dr. Limeback inexplicably claims that he has. There is no reason that Dr. Johnson, a pediatric dentist, would deny dental fluorosis. As an expert in children’s dentistry he certainly understands the different levels of dental fluorosis, which level is of any concern, and which levels are not, even if Dr. Limeback seems not to do so.

3. Neither Slade, nor McLaren have “admitted” that fluoridation has “little effect on dental decay prevention” as Limeback claims they have. What these two researchers have done is to provide peer-reviewed studies published in respected scientific journals, which demonstrate an association of water fluoridation with significant reductions in dental decay in entire populations.

4. As Cochrane 2015 clearly noted, randomized controlled trials are infeasible for large, population-based public health initiatives such as water fluoridation, and will probably never be done for this reason.

From Cochrane 2015:

“However, there has been much debate around the appropriateness of GRADE when applied to public health interventions, particularly for research questions where evidence from randomised controlled trials is never going to be available due to the unfeasibility of conducting such trials. Community water fluoridation is one such area.”

—-Water fluoridation for the prevention of dental caries (Review) 30
Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

As such, quality observational studies, such as those for fluoridation, are the next best thing, are fully accepted as valid evidence, and arguably provide equal or more reliable results for population-based public health initiatives than do RCTs..

From a Cochrane 2014 paper on observational versus RCTs:

“As such, we have reached similar conclusions--there
is little evidence for significant effect estimate differences between
observational studies and RCTs, regardless of specific observational study design, heterogeneity, or inclusion of drug studies.”

—Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials (Review) 15
Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

5. It is interesting that while Dr. Limeback’s colleagues at the antifluoridation group, FAN, instigated, promoted, and pledged to closely monitor, the 2016 NTP study when it began, highly praising the integrity of the NTP in the process.......with the recent release of results of this study completely contradicting the claims of FAN, the silence from this group has been deafening and very telling as to their lack of interest in valid science which debunks their claims. Limeback now chooses to respond only to the initial literature review of the NTP, and put forth conspiracy/corruption nonsense about the 2016 study which his antifluoridation colleagues celebrated until they learned of the results.

6. “Twitter”? This is now where Limeback obtains his “scientific” information?


Steven D. Slott, DDS