The NZ Ministry of Ignorance
by Paul Connett
Dear All,
I have just received a copy of a letter the NZ Minister of Health sent to Sylvia Cole, the citizen who led the successful effort to overturn the decision by Waoroa District to fluoridate their water (see IFIN 733). The letter pre-dates Sylvia's victory.
We have grown accustomed to editorials in local newspapers which simply parrot the propaganda of the pro-fluoridation zealots, but it comes as a bit of a shock to see these same falsehoods coming out of the mouth of a Minister of Health. Please read the letter from the Hon. Annette King below and my detailed reply which follows.
Quite frankly I am sick of this nonsense. These people are paid very large salaries to do their level best to protect the health of the people they serve. They are supposed to be working for the taxpayers not against them!
I hope very much that International Fluoridation Information Network (IFIN) readers share my anger on this and that you will use this as an opportunity to shake the NZ pro-fluoridation establishment to its rotten core. You can help do this by sending your very best letter to the Minister at this e-mail address Aking@ministers.govt.nz and also send a copy to me at ggvideo@northnet.org.
I plan to send all these letters to Bill Wilson the chairperson of the newly formed NZ chapter of the Fluoride Action Network (FAN-NZ), and ask him to do two things: a) send all the letters on to every news outlet in NZ for which he can find an e-mail address, b) consider selecting the very best letters and making them up into a booklet which can be used by anti-fluoridation campaigners in New Zealand.
It is time that these people were heavily embarrassed. Let us help Bill let this Minister know that citizens and scientists from all over the world are watching her and are disgusted with her irresponsibility at best, or her dishonesty, at worst.
Paul Connett (Professor)
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Copy letter from the Minister of Health 18 Feb 2003
Ms Silvia Cole
86 Campbell Street, WAIROA
Dear Ms Cole
Thank you for your letter of 6 December 2002 regarding your concerns about the fluoridation of the Wairoa water supply. I apologise for the long delay in responding.
I am not in a position to comment on the process followed by your Council on deciding to fluoridate Wairoa's water supply. However, I am pleased with this decision as I support the fluoridation of drinking water supplies.
I note your comments that sodium fluoride or hydrofluorosilicic acid 'do nothing but harm'. However, there is a large body of scientific material that shows overwhelming evidence for the effectiveness and safety of water fluoridation. For example, a New Zealand report, by the Institute of Environmental Science and Research Ltd, concluded that there was no persuasive evidence of harmful effects from optimal water fluoridation (between 0.7 and 1.0 ppm), and the evidence has strengthened the fact that there are no serious health risks associated with water fluoridation.
The only effect that has been associated with water fluoridation (apart from improved oral health status) is very mild dental fluorosis in a small number of children. Dental fluorosis is a defect of the tooth enamel caused by the ingestion of fluoride during the development of tooth enamel. Clinically, dental fluorosis is characterised by opaque white areas in the enamel. In its mild forms these opacities may be unrecognisable to other than a dental professional or have no more than cosmetic significance. The level of fluoride recommended in the New Zealand Drinking Water Standards 2000 of 0.7 to 1.0 mg/litre is specifically designed to minimise the risk of dental fluorosis.
You suggest very few countries have fluoridated water and that the number of countries is declining. On the contrary, when last reviewed, approximately 40 countries fluoridated their water supplies within the recommended levels of 0.7 to 1.0 parts per million and a further 48 countries had water supplies with natural fluoride concentrations of 0.7 ppm or higher. This includes counties in Asia, Europe (including Scandinavia), the United Kingdom, North America and Australasia. The trend in the United States has been for referenda to vote in support of water fluoridation. The state of California has made water fluoridation mandatory for communities of 100,000 or greater and there is a significant demand for fluoridated bottled water in the United States bottled water market. Elsewhere, the Israeli Knesset has voted to make water fluoridation mandatory for communities of 5,000 or more, the South African government has legislated for water fluoridation, and the United Kingdom is considering legislation.
I am aware of the views of Professor Connett and am also aware that his views are not supported by the scientific evidence available in the reputable scientific literature. Reports of independent experts, in relevant fields of medicine, epidemiology, oral health and water engineering, are unanimous that the benefits of water fluoridation outweigh the very small potential risks. There are no significant health risks associated with water fluoridation at optimal levels.
I must also caution that the websites and pseudo-scientific magazines purporting to provide information on the health risks of fluoridation contain information that is less likely to have undergone rigorous peer review than the articles in leading scientific journals. Most of the Internet articles and research that raise fears about water fluoridation lack substance or repeat previous statements already shown to be without scientific validity.
You suggest that water fluoridation provides no benefits. The role of fluoride in the prevention of dental decay is well documented in both international studies and from New Zealand data. While it is unquestionable that decay rates have fallen in unfluoridated communities, this is not to the same extent as communities with fluoridated water. A number of studies of the benefits of fluoridation to the primary and permanent teeth of children have demonstrated significant reductions in decay rates (ranging from 20 to 80 percent). Water fluoridation is effective throughout the lifespan, preventing root caries in adults and older people, so that fluoride can be seen to be of benefit to anyone with their natural teeth, not just children. A New Zealand report on Preventative Dental Strategies for Older Populations, noted that 'fluoride [is] the most important preventive measure available against decay at both the individual and population levels'.
The lifetime benefit of exposure to water fluoridation is estimated to be the prevention of a total of 2.4 to 12.0 decayed, missing or filled teeth for the average individual.
Fluoridation of water supplies remains the most effective and socially equitable means of achieving community-wide exposure to the caries-preventive effects of fluoride. Fluoridation of water supplies at levels between 0.7 and 1.0 mg/litre is safe and effective in promoting oral health. The Government will therefore continue to support the fluoridation of drinking water supplies.
Thank you for writing. I trust this information is useful.
Yours sincerely
(Signed) Hon Annette King
MINISTER OF HEALTH
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PAUL CONNETT'S REPLY TO THE NZ MINISTER OF HEALTH
March 5, 2003.
Dear Minister,
I have just read a copy of a letter (Feb 19, 2003, copy below) you sent to Mrs Sylvia Cole on the subject of water fluoridation.
Your letter goes a long way to explain why it is that New Zealand, so progressive and free-thinking in many other areas, is so backward on the issue of water fluoridation.
One of the sentences that stood out in your letter was your attack on my credibility. You wrote: "I am aware of the views of Professor Connett and am also aware that his views are not supported by the scientific evidence available in the reputable scientific literature."
This is an extraordinary statement considering that I have put nearly 7 years of "independent" research into this issue (with no axe to grind in the matter) and most of my views are based upon articles in the "reputable scientific literature". To state a few:
1) On declining tooth decay in both fluoridated and non-fluoridated areas: Leverett (1982); Diesendorf (1986); Colquhoun (1984, 1994); Gray (1987); Brunelle and Carlos (1990); Petersson & Bratthall (1996); Spencer et al (1996); de Liefde (1998) and WHO figures for 12-year olds available online.
2) On increasing rates of dental fluorosis in both fluoridated and non-fluoridated areas: Spencer (1996); Heller (1997); McDonagh (2000); and Griffin (2002).
3) On the benefits of fluoride being largely topical, not systemic: Fejerskov (1981); Carlos (1983); Featherstone (1987, 1999, 2000); Burt (1994); Locker (1999); Limeback (1999); and CDC (1999, 2001).
4) On the increase in bone (particularly hip) fractures in clinical trials using fluoride to treat patients with osteoporosis: Inkovaara (1975); Gerster (1983); Dambacher (1986); Hedlund and Gallagher (1989); Bayley (1990); Gutteridge (1990, 2002); Orcel (1990); Riggs (1990); Schnitzler (1990), and Haguenauer (2000).
5) On investigations of possible relationship between
fluoridated water and increased bone (particularly hip) fractures: Cooper
(1990, 1991); Jacobsen (1990, 1992); Keller (1991); Sowers (1991); Danielson
(1992); May and Wilson (1992); Jacobsen (1993); Suarez-Almazor (1993);
Cauley (1995); Jacqmin-Gadda (1995, 1998); Karagas (1996); Feskanich (1998);
Lehmann (1998); Kurttio (1999); Hegmann (2000); Hillier (2000); Phipps
(2000); Alarcon-Herrera (2001); and Li (2001).
6) On the levels of fluoride in human bone: Glock (1941); Smith (1953); Zipkin (1958); Jackson (1958); Parkins (1974); Kuo (1974); Charen (1979); Alhava (1980); Stein (1980); Wix (1980); Hefti (1981); Arnala (1985); Boivin (1988); Eble (1992); Sogaard (1994); and Richards (1994).
7) On the levels of fluoride causing bone weakening in animals: Chan (1973), Moskilde (1987), Turner (1992, 1993), LeFage (1995); Sogaard (1995).
8) On a possible association between fluoride and reduced fertility: Freni (1994).
9) On the accumulation of fluoride in the human pineal gland: Luke (2001).
10) On fluoride's interference with hydrogen bonding: Emsley (1981).
11) On fluoride's mutagenicity: Mohamed (1982); Tsutsui (1984); Caspary (1987); Scott (1987); Kishi (1993); Sheth (1994); Meng (1995, 1997); Wu (1995); Mihashi 1996; Joseph (2000).
12) On fluoride's facilitation of increased uptake of aluminum into the brain (and other parts of the body): Varner et al (1998); see also Allain (1996).
13) On the association between the use of silicofluorides as water fluoridating agents and the increased uptake of lead into children's blood: Masters and Coplan (1999, 2000).
14) On the ability of fluoride in the presence of a trace amount of aluminum to switch on G-proteins, which are involved in carrying messages across membranes: Strunecka and Patocka (1999, 2002).
Which of these citations do you believe are taken from non-reputable sources?
I also take exception to your very generalized attack on resource material made available on the Internet, when you say in paragraph 7, "Most of the Internet articles and research that raise fears about water fluoridation lack substance". Two of the sites with which members of my family have been involved, http://www.fluoridealert.org and http://www.SLweb.org/bibliography.html, have been scrupulous in citing scientific references for all the arguments made. Instead of dismissing all this evidence with a broad, and highly prejudiced, brush, you would do well to examine some of this scientific evidence.
While, I believe that the scientific evidence I have examined clearly illustrates that the benefits of fluoridation have been wildly exaggerated and the risks downplayed, still the strongest argument against fluoridation remains the ethical one. It is simply wrong to force medication on people who don't want it. It violates one of the cornerstones of medical ethics, the right of the patient to "informed consent" to medication. I am surprised as a Miniser of health you are insensitive to this ethical imperative.
The practice of fluoridation becomes even more preposterous when one discovers that the level of fluoride in mothers' milk is remarkably low ( 0.01 ppm, IOM, 1997). Those who believe that fluoride is needed for healthy teeth have to explain why it is that fluoride is naturally so low in the baby's first meal. Did evolution screw up on this? Also your Ministry should be pondering what it means to the new born infant to be bottle fed with formula made up with fluoridated tap water. Such a baby - and there are many - will be receiving 100 times more fluoride than nature intended. Does your Ministry advise local authorities to advise parents to use non-fluoridated water for this purpose?
Here are some of the other false or misleading claims in your letter:
Paragraph 3: If your paid consultants found "no persuasive evidence of harmful effects from optimal water fluoridation (between 0.7 and 1.0 ppm)" it is probably because they chose to:
a) ignore the impacts on people who are particularly
vulnerable to fluoride, especially those with kidney disorders;
b) ignore the plight of those who are supersensitive to fluoride;
c) ignore the total dose of fluoride that people are getting from other
sources in addition to fluoridated water and the fact that some people
drink more water than others;
d) ignore the cumulative effect of lifelong doses on the bone;
e) gloss over the fact that the New Zealand government has failed to track
the level of fluoride in the bones of their citizens at autopsy, thereby
depriving epidemiological studies of a biomarker for individual exposure;
f) ignore a possible connection between lifelong accumulation of fluoride
and the early symptoms of arthritis, which are identical to the pre-clinical
symptoms of skeletal fluorosis;
g) ignore the accumulation of fluoride on the pineal gland;
h) ignore the findings by Masters and Coplan of an association between
the use of silicofluorides as fluoridating agents and the increased uptake
of lead into children's blood (Masters and Coplan, 1999, 2000), and
i) gloss over the significance of a huge increase in dental fluorosis
(up to five times the original desired limit).
Paragraph 4: You claim that, "The only effect that has been associated with water fluoridation (apart from improved oral health status) is very mild dental fluorosis in a small number of children."
You offer no statistics to support this claim. It is a highly dubious claim considering that the late Dr. John Colguhoun was reporting a rate of 25% in Auckland in the early 1980's and some of that was in the moderate to severe range. Indeed, it was serious enough for him to take the children before the TV cameras. We also know from studies in the US (Heller et al, 1997), Australia (Spencer et al, 1996) and the UK (McDonagh et al, 2000) that in optimally fluoridated areas dental fluorosis impacts from 29.9% to 56% of children, with a worldwide average estimated at 48%, with 12.5% in the category which is not considered mild, and may require expensive treatment (McDonagh et al, 2000). It should be remembered that those who launched fluoridation thought they could hold dental fluorosis down to 10% of the children in its mildest form. Thus this goal has been a marked failure, but unfortunately you fail to recognize this.
Paragraph 5: You claim that, "when last reviewed, approximately 40 countries fluoridated their water supplies". You would be hard pressed to verify this claim. Many of the countries listed by NZ authorities have either stopped fluoridation, or only fluoridate one city. Only seven countries have a majority of their citizens drinking artificially fluoridated water: Australia; Canada; Israel; Ireland; New Zealand; Singapore and the US. Most of western Europe does not fluoridate its water, yet according to WHO figures available online their dental health is as good if not better than those countries that do. Your further claim that "a further 48 countries had water supplies with natural fluoride concentrations of 0.7 ppm or higher" is highly misleading if it is meant to imply that the average fluoride content of their water was over 0.7 ppm as opposed to some areas having a fluoride content above 0.7 ppm.
Paragraph 6: Your claim that, "Reports of independent experts, in relevant fields of medicine, epidemiology, oral health and water engineering, are unanimous that the benefits of water fluoridation outweigh the very small potential risks" ignores the fact that most of the panels that have reviewed this issue have been selected by governments which are practicing fluoridation and which usually appoint panels to prove that what they are doing is "safe and effective". Very seldom, if ever, do these panels include anyone who is opposed to fluoridation, but frequently they contain panelists who have either made a living promoting the practice or are beholden to government agencies for their research grants. A classic example of this occured recently in Ireland with the Fluoridation Forum, whose report issued in 2002 was a travesty. If New Zealand had the courage to appoint a genuinely independent panel of experts, who were beholden to no one, you would get a shock when they examined the literature with an open mind.
Paragraph 7: I have already commented on the broadbrush attack on the internet. Intelligent people know that when they read scientific material, whether it is on the internet, or in the public library, they have to judge it on the quality of the data that is mobilized. If you in fact included the sites http://www.fluoridealert.org or http://www.SLweb,org in your dismissal, I would be most anxious to hear what scientific papers cited there do not meet your "standards". Or is it simply your position that any study cited which demonstrates a problem with fluoridation is immediately classified as "rubbish"?
Paragraph 8: You claim that, "A number of studies of the benefits of fluoridation to the primary and permanent teeth of children have demonstrated significant reductions in decay rates (ranging from 20 to 80 percent)." However, such percentages are highly misleading when considering the low level of tooth decay now occurring in industrialized countries. For example, the largest survey ever conducted in the US, which examined 39,000 children in 84 communities found that the average difference for children (aged 5-17 ) in decay of the permanent teeth, for those who had lived all their lives in fluoridated as opposed to non-fluoridated communities was 18%. However, when you examine this 18% difference it actually amounted to just 0.6 of one tooth surface out of 128 tooth surfaces in a child's mouth. The absolute saving is less than 0.5% of the child's tooth surfaces. The 18% figure may sound impressive but it represents the mathematical vagaries of comparing two small numbers. The absolute difference in Australia is even less, 0.12 - 0.3 of a tooth surface , which is less than 0.25% of the tooth surfaces (Spencer et al, 1997). It is absurd to claim this as a great achievement when the result is neither clinically nor statistically significant. This is especially so when it goes hand in hand with dental fluorosis rates ranging from 30-56%! Moreover, when Betty de Liefde (1998) compared dental decay in fluoridated and non-fluoridated communities in New Zealand she recorded the fact that the difference had little clinical significance. As far as tooth decay in the elderly is concerned, you have offered no reason why the same protection could not be offered via fluoridated toothpaste.
Paragraph 9: I think your claim of a lifelong saving of 2.4 to 12 DMFT is an exaggeration and cannot be supported with the most recent research. However, since it is now generally accepted that the benefits of fluoride are topical and not systemic (CDC, 1999, 2001), it makes more sense to apply fluoride (if you want it and I don't want any) in the form of toothpaste than it does to put it in the drinking water.
Paragraph 10: When you state that, "Fluoridation of water supplies remains the most effective and socially equitable means of achieving community-wide exposure to the caries-preventive effects of fluoride" I believe you are following a belief system rather than stating a conclusion based upon defendable science. Moreover, contrary to your assertion, I do not believe this policy is socially equitable for two important reasons: a) the poor, unlike those with middle incomes, cannot afford to avoid fluoride if they chose to do so, because of the costs of reverse osmosis equipment or the purchase costs of bottled water, and b) the poor are more likely to be vulnerable to fluoride's toxic effects because they are more likely to have poor nutrition.
When citizens see just how many false claims you have made in such a short letter, they will quite understand why it is that no one from your Ministry will defend this archaic practice in open public debate. Would you have felt free, I wonder, to have said the things you have written in your letter if I had been in the room?
Citizens might also be disturbed by the arrogant way your Ministry refused to send anyone to the XXVth conference of the International Society of Fluoride Research which was held in Dunedin (a short plane ride from Wellington) a few weeks ago. An independent observer would find it difficult to imagine any excuse which permitted your Ministry to fail to take advantage of the fluoride experts who gathered there from many different countries. Especially, now that your government has announced a renewed effort to step up the promotion of fluoridation in New Zealand. One has to wonder about an education campaign, financed by the tax-payer, that steadfastly ignores one side of such a controversial issue.
If the false and misleading claims in your letter have resulted from poor information and research from your subordinates, then perhaps a few resignations are in order. If on the other hand, you have passed on these claims knowing them to be misleading, inflated or false then perhaps you should consider your own resignation. I believe the taxpayers in any country deserve a Minister of Health who puts the protection of the public health as her number one goal, not the protection of a discredited policy.
Sincerely,
Dr. Paul Connett,
Professor of Chemistry,
St. Lawrence University,
Canton, NY 13617.
315-229-5853
pconnett@stlawu.edu
