Letterbox

Reader Disappointed With Fluoride Letters

Dear Watchers:

It was disappointing to read, in your June and July issues, more letters with egregious misrepresentations of the nature, conclusions and panel membership of the National Academy of Sciences (NAS) report on maximum permissible fluoride drinking water concentrations (“Fluoride in Drinking Water: A Scientific Review of EPA’s Standards,” National Academies Press, 2006).

1. The June letter misrepresented the entire nature of the report, as if it dealt with reparative fluoridation for prevention of dental caries. The report clearly states that it was not charged to deal with any aspect of low-level therapeutic fluoridation. It clearly stated that, therefore, it did not deal with such data. Rather, it endorsed the long-standing positions of the United States Public Health Service (USPHS) and the National Institutes of Health (NIH) that the prophylactic replacement of low levels of fluoride in selected areas which were grossly deficient in natural fluoride, and the resulting decrease in child dental caries, was “One of the great achievements of American preventive medicine.”

2. The references to Dr. Isaacson are not correct:

A. He is not a member of the National Academy of Sciences. He was a temporary member of a panel from outside the NAS studying whether the long-standing maximum permissible value of 4 parts per million (ppm) should be lowered.

B. The panel studied all the available reports, most small and suggestive, and concluded that, although even the high level of 4ppm was not associated statistically with any untoward medical effects, that in view of increased exposures to fluoride, e.g. in dentifrices, the maximum permissible upper level could be dropped to 2ppm. They also suggested that some of the suggestive studies should be broadened. Recall, please, that they were dealing with levels that average four times that which might be reached by reparative fluoridation.

C. Neither of these men based their objection to the reports conclusions re the maximum permissible levels. Rather they seem to object to the report’s reconfirming the USPHS/NIH position on dental fluoridation.

D. Both of these men have been long-standing opponents of fluoridation for dental caries. Dr. Isaacson stridently so. Their work on the panel on higher levels did not relate to nor alter their previously stated opinions about replacing the low levels missing in areas high in dental caries

3. The July letter (and the caption heading) both misstate that Dr. Limeback is a member of the USNAS.

A. He is a Canadian dentist who has been speaking against dental fluoridation since 1999. He was also a temporary member of the panel on maximim permissible levels.

B. The NAS report clearly, carefully and explicitly stated that none of the conditions stated by the writer had been found statistically to be related to chronic ingestion of fluoride at the maximum permissible levels of 4ppm. I will provide the interested reader with the relevant pages.

C. The reported fluoride levels in bottled drinking water are most commonly reported as: “zero.” This is the same absence of any fluoride as is seen in most drinking waters derived from surface sources. The bottlers, accordingly, may add low levels of fluoride to improve its healthfulness and salability. When they do this, they must print the levels achieved on the label by law. These levels are carefully controlled, and usually kept at 1ppm, or one-fourth the maximum permissible level. I have not found any bottled water in Bellingham to contain any fluoride.

The use of inaccurate statements to instill fear is widespread these days!

1. The NAS Report did not discuss reparative low-dose fluoridation except to re-endorse it.

2. Drinking water derived from surface sources, such as rain and snowmelt, is too low in natural fluoridation to provide the dental caries protection naturally enjoyed by those drinking from higher-level naturally fluoridated groundwater sources such as wells. As we move into cities, the well water, which many of us drank as children, is replaced by surface waters naturally deficient in fluoride.

3. Some areas in Texas, New Mexico, Colorado and Utah have naturally fluoridated drinking water, with concentrations up to three times the old NAS maximum permissible standards. No nests of increased diseases have been reported.

4. Dental caries are rampant in areas with low fluoride surface drinking water.

5. When areas low in natural fluoride have low dose (about 1ppm) added in strictly controlled and monitored conditions, dental decay in poor children virtually disappears.

6. Bellingham drinking waters, both at Lake Whatcom and at the tap, have been monitored by the county for decades. Both sources have always been reported as zero! (Copies of the reports will be provided if you desire.)

7. Hence, we have amongst the highest child caries rates in the state, and our water, being fluoride-deficient, should be fluoridated.

However, the voters have spoken. Nevertheless, it remains a necessity that the presentation of scientific data and conclusions should always be accurate. We thrive on truth.

Editor’s Note: The June and July letters referred to the following study. Both Robert Isaacson and Hardy Limeback were members of the committee reviewing the fluoride in drinking water standards for the National Research Council arm of the National Academy of Sciences.

The Committee on Fluoride in Drinking Water included Robert L. Isaacson, Binghamton Univ., Binghampton, NY, and Hardy Limeback, Univ. of Toronto, Ontario.

The report brief was prepared by the National Research Council based on the committee’s report. “Fluoride in Drinking Water” is available from the National Academies Press, (800) 624-6242 or http:nap.edu.

The National Research Council is the working arm of the National Academy of Sciences and the National Academy of Engineering, carrying out most of the studies done in their names.