Pros - Cons Water Fluoridation

1. Pros - ConsWater Fluoridation Jason Woodforth -Feb 2013

2. Its Natural ! • Fluoride occurs naturally in the world • 13th most common element • Found in water naturally • Found in some foods, tea, fish • The fluoride come from natural rock • Natural level just “ topped up ” to optimal level .......like a car radiator is topped up ??

3. Its Natural ? • Arsenic, lead, mercury are natural • Most common chemicals -Hexafluorosilicic acid & Sodium Fluorosilicate do NOT exist in nature – they are created from the waste fluoride removed in phosphate fertiliser plants pollution control wet scrubbers (Incitec Pivot, Shanghai Mintchen Development Co – Shanghai) • Fluoride level in Brisbane tap water before fluoridation was <0.05 ppm - “ topping up”means adding more than 16 times

4. Toxicity of Fluoride compared to Lead and Arsenic Toxicity based on LD50 – Clinical Toxicology of Commercial Products 5th edition 1984 Gosselin, Smith and Hodge

5. Fluoride chemicals allowed to contain Cadmium, Lead and Arsenic NSF/ANSI Standard 60: Drinking Water Chemicals Health Effects ( NSF 60 ) the main impurities of concern for fluoride are arsenic, cadmium, copper and lead Page 54

6. Fluoride chemicals allowed to contain Cadmium, Lead and Arsenic Most common chemical used – Sodium Fluorosilicate allowed to contain.. 420 mg of Arsenic, 120 mg Cadmium, 610 mg Lead and 121,300 mg Copper for every kg fluoride chemical added. Water Fluoridation Code of Practice Qld 2010 Page 54

7. Its not a poison ! • Anyway - its the dose that makes the poison (Paracelcus) • Its only one drop in a million • Concentration is tightly controlled (it isn’t rocket science to inject fluoride into water – yet in April 2009 North Pine Dam Treatment Plant temporarily put out water with 30 ppm ) • There is no control over dose received – only thirst ( for a lifetime) • Fluoride is difficult for kidneys to excrete – can only excrete 50% at best – rest accumulates in body • The USA Public Health Service since Jan 2011 has recommended that the concentration be lowered to 0.7 ppm because of fluorosis - Most of Australia fluoridates at 1.0ppm

8. Yes – they are Schedule 6 and 7 Poisons

11. SEQ Water fluoride chemicals imported from China SEQWater ....company sources it fluoride chemical from Shanghai Mintchen Development Co Ltd based in Shanghai China does not fluoridate

12. Its good for your teethsystemically and topically Fluoridated water reduces tooth decay both systemically ( ingested ) and topically ( when it touches your teeth when drinking water Qld Health ,miscellaneous Dental Assns

13. Its good for your teeth • However ,in 1999 the CDC finally acknowledged... “the main action of fluoride is topical ” • When water fluoridation started there was no fluoridated toothpastes, fluoridated mouthwashes or fluoride dental treatments – for topical application • Now Dentists are selling toothpastes with five times as much fluoride - massive 5000 ppm for topical effect CDC = Centre For Disease Control and Prevention

14. Swallowing fluoride makes a much sense as swallowing sun-block to prevent sunburn

15. Can reduce tooth decay by 65% • “ In Townsville, water supplies have been fluoridated since 1964, resulting in 65% less tooth decay in children than those in Brisbane” • “ fluoride, which is proven to be safe and effective ” Qld Health newspaper ads Dec 2007

16. TOWNSVILLE VS BRISBANE This 1996 publication was the study that Anna Bligh based mandated fluoridation on. Study found that Townsville children aged 6 to 12 years who had consumed fluoridated water all of the lives, had on average 0.23 less decayed tooth surfaces in their permanent teeth ( out of a total of 128 tooth surfaces ) than did children from Brisbane . Data for the study was collected in 1990-1991 Teeth have either 4 surfaces ( incisors) or 5 surfaces ( molars ) 28 teeth in a child’s mouth = 128 tooth surfaces

17. Where did they get the 65%and how many teeth is 65%? This 1996 study measured tooth decay in “ tooth surfaces “ (128 tooth surfaces per mouth) There was a difference of 0.17 less decayed tooth surfaces in Townsville kids ( at age 7 ) 0.17 divided by 0.26 X 100 = 65% Taking the small difference between two very small numbers and expressing as a percentage gives a very large percentage - for a tiny fraction of a tooth less decay.

18. Australian Children's’ Dental Surveys Qld unfluoridated children measured at age 12 years old ( WHO International comparison standard) have very similar, or even less decay than 12 years old from Tasmania ( 83% fluoridated and the ACT ( 100 % fluoridated ) DMFT = 1 means an overall average of only 1 decayed tooth

19. Latest published Australian Children’s Dental Survey –2008 - pub Sept 2012 Tasmanian 6 year olds ( 83% fluoridated ) have exactly the same average amount of tooth decay as Qld 6 year olds ( <5% fluoridated in 2008 )

20. Latest published Australian Children’s Dental Survey –2008 - pub Sept 2012 Tasmanian 12 year olds ( 83% fluoridated ) have the same average amount of tooth decay as Qld 12 year olds (<5% fluoridated in 2008 ) ( no significant difference between DMFT 1.28 and DMFT 1.31 ) Northern Territory Children ( 70 % fluoridated ) have the most decay

21. Average Tooth decay in 10 year olds by Capital City 1977 and 1987 School Dental Service data ( FOI - Dr Mark Diesendorf, 1990). All cities except Brisbane fluoridated for at least 10 years by 1987

22. Child tooth decay has come down similarly in fluoridated and non- fluoridated countries (WHO data)

26. Jason M. Armfield and A. John Spencer 2004 ( Adelaide University Dental School) ‘Consumption of non-public water: implications for children’s caries experience’, Community Dentistry & Oral Epidemiology, 32: 283 A comparison of children who had always drunk fluoridated tap water to those who had always drunk tank or bottled water. “The effect of consumption of nonpublic water on permanent caries experience was not significant.” the pro-fluoridation authors claim that their result is being “taken out of context”!

27. There are no adverse effects “Fact – the only known side effect of known optimal fluoridation is a slight increase in dental fluorosis” Qld Health document 2007 Common fluoride myths

28. Fluoride and Kidney impairment • The 2004 and 2011 NHMRC Australian Drinking Water Guidelines states “People with kidney impairment have a lower margin of safety for fluoride intake. Limited data indicate that their fluoride retention may be up to three times normal ”Has the NHMRC investigated cumulative effects of fluoride on people with Kidney impairment ? No – even though this was a specific requirement of the Tender to do the 2007 NHMRC fluoride review ( known through FOI )

29. No risk assessments done 2009 Freedom of Information on Qld Health – no risk assessments were done No Environmental Impact Assessments were done either

30. Fluoridated water claimed not to cause harm but fluoride exposure is linked to..... • Lowering of IQ • Dental fluorosis • Skeletal fluorosis • Brittle bones – possible increase in fractures • Fluoride accumulating in Pineal gland • Depressed thyroid activity • Hypersensitivity:  adverse reactions • Osteosarcoma (bone cancer) in young men • Risk to the kidney impaired ( Aboriginals / Diabetics) 

31. 2004 Letter to the UK House of Lords Professor Trevor Sheldon, BSc, MSc, Sc, Med SciChair of UK govt commissioned 2000 Fluoride Review York UniversityUniversity of York 2    The review found water fluoridation to be significantly associated with high levels of dental fluorosis which was not characterised as "just a cosmetic issue".3    The review did not show water fluoridation to be safe.The quality of the research was too poor to establish with confidence whether or not there are potentially important adverse effects in addition to the high levels of fluorosis. The report recommended that more research was needed.   4  There was little evidence to show that water fluoridation has reduced social inequalities in dental health. NOTE – The NHMRC 2007 fluoride review was very largely based on the 2000 York University fluoride review – which did not find water fluoridation to be safe

34. What is dental fluorosis? “ One side effect of too much fluoride ingested in early childhood while teeth are forming is dental fluorosis; the enamel covering of teeth fails to crystallise properly, leading to defects ranging from barely discernible to severe brown stain, surface pitting and brittleness. “ Health Effects of Ingested Fluoride National Research Council (USA) 1993

35. What Dental Fluorosis looks like

36. Current prevalence of dental fluorosis In 2007 nearly 4 children in every 100 in NSW Fluoridated areas have Moderate or Severe Dental Fluorosis – compared to only 2 in a 1000 in non – fluoridated NSW areas In 2007 nearly 25 % ( one in every four children ) 11 – 12 year old children in NSW fluoridated areas had Dental Fluorosis of some degree Moderate Dental Fluorosis ( clearly visible fluorosis ) has been linked to Psychological harm by Australian researchers ( harm to self-esteem )

37. WHO – considers Fluorosis as a “ water related disease “

38. www.who.int/water_sanitation_health/diseases/fluorosis/en/#

40. Fluoride and babies “The issue isn’t the infant formula itself, but the water it’s reconstituted with” Stamm and Maas said. “For their size, babies consume a large percentage of their body weight in fluoridated water when reconstituted formula is their primary source of nutrition” William Maas, director of CDC’s Division of Oral Health and John Stamm, a spokesman for the American Dental Association Qld Health 2007

41. Fluoride and babies Breast milk contains an average of only 0.004 ppm F (unfluoridated areas) National Research Council report Fluoride in Drinking Water 2006 Water fluoridated at 1.0 ppm F used to reconstitute infant formula contains more than 150 times more fluoride than what babies would have got from breast milk

42. Fluoride and babies • Since 2006 the Centre For Disease Control and the American Dental Association have advised that parents can use water low in fluoride to reconstitute infant formula to reduce risk of dental fluorosis • In Jan 2011 the US Public Health Service lowered their “ optimal fluoride level “ down to 0.7 ppm – (lower than Australia) – because of dental fluorosis concerns • In mid 2012 the State of New Hampshire passed legislation that all water consumers be warned annually that fluoridated water poses a risk of dental fluorosis for bottle fed babies

43. Fluoride and babies “ infants of all age groups will receive fluoride that is above the NHMRC Upper Limits of safety from the combination of fluoride in fluoridated water at 1.0 mg/L and any additional fluoride that may be present in formula.” Aust N Z J Public Health. 2009 Dec;33(6):573-6.Fluoride content of powdered infant formula meets Australian Food Safety Standards.Clifford H, Olsowy H, Young M, Hegarty J, Cross M ( Queensland Health Staff )

44. Fluoride and babies “according to the intake model used in by the study that infant formula prepared with water fluoridated at 0.7 mg/L would result in mean fluoride intake for fully formula-fed infants in the first 6 months of life of 0.66 mg/day, with a 30 percent probability of exceeding the UL. At a water fluoride concentration of 1.0 mg/L, there is a near certainty of fully formula fed infants exceeding the UL (UL = NHMRC Upper Limit ) Cressey P. Dietary fluoride intake from fully formula-fed infants in New Zealand: impact of formula and water fluoride Journal Public Health Dentistry 2010

45. Fluoride and lowering of IQ 2012 Harvard Study Meta- analysis of 27 studies Mean difference - 7 IQ pts Fluoride concentrations in water mostly only 2, 3 or 4 times that of fluoridated water – dose depends on amount of water drunk LITTLE MARGIN OF SAFETY

46. Developmental Fluoride Neurotoxicity: A SystematicReview and Meta-Analysis • "The children in high fluoride areas had significantly lower IQ than those who lived in low fluoride areas," write Choi et al. • “Fluoride seems to fit in with lead, mercury, and other poisons that cause chemical brain drain,” Grandjean says. “The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us.” • Choi's team writes, "Fluoride readily crosses the placenta. Fluoride exposure to the developing brain, which is much more susceptible to injury caused by toxicants than is the mature brain, may possibly lead to damage of a permanent nature."

47. Fluoride and lowering of IQ • 36 human studies have found elevated fluoride exposure associated with reduced IQ • 16 animal studies -fluoride exposure impairs the learning and memory capacity of animals • References for these 52 studies - see www.fluoridealert.org/studies/brain01/

48. Learning Difficulties in Australia • Approximately 20 per cent of children experience learning difficulties. • ~3.5 per cent are seen as having a specific learning disability characterised by being ongoing persistent (2-3 years) and resistance to interventions • Diagnosed Learning Disabilities include: ADHD, Dyslexia, Dyscalculia, Dysgraphia and Developmental Coordination Disorder (DCD) Department of Education, WA 2013

49. Water fluoridation & Osteosarcomabone cancer Conclusions : Our exploratory analysis found an association between fluoride exposure in drinking water during childhood and the incidence of Osteosarcoma among males but not consistently among females. Further research is required to confirm or refute this observation. - this finding has not been refuted

50. Water fluoridation & Osteosarcomabone cancer “ These results suggest a link between fluoride exposure and osteosarcoma. “ South Asian Journal of Cancer Oct – Dec 2012 Volume 1 Issue 2