Fluoridation: surfing the misinformation wave

Daniel Ryan reports from the front line of the battle against the anti-fluoridationists.

The members of Fluoride Action Network NZ and its spin-off groups are vociferous about the urgent need to remove fluoride from community water supplies. "It's a toxin," they'll tell you. But if you ask an anti-fluoridationist why no major, well-respected health organisations around the world are against fluoridation, it's a different story. The person you're speaking with will either go quiet, or start rambling about some conspiracy.

Studying the major anti-fluoridation leaders, I've found most have a tale regarding why fluoride is being added into our drinking water: most commonly, they believe it's the only way fertiliser companies can dispose of fluoride by-products. They see their story as being true, as being an accurate view of what's happening, and they believe they need to "fight the corruption" of the fertiliser companies using water as a "dumping ground" for their "toxic waste". They believe someone is "paying to cover up the corruption" and "others don't know they are being fooled". Many also see removing community water fluoridation as the first step in regaining the right to take care of their own health, in their own way.

You don't think so? In his Wellington talk, retired chemistry professor and anti-fluoridationist "World Expert" Dr Paul Connett, who recently visited New Zealand, used a medieval castle as an analogy1. "The outer perimeter is fluoridation, the inner perimeter is vaccination. Pull up the drawbridge and defend the castle. And the castle is orthodox medicine; one pill from the pharmaceutical industry for every ailment, and of course the King here is the pharmaceutical industry and their control of modern medicine." He sees them "attacking chiropractors, people that practice alternative medicine, it's all part of the same thing of protecting orthodoxy". Connett believes fluoridation is "the first battle" in bringing down the castle.

Is it possible to change the beliefs of a committed anti-fluoridationist? I'm not sure that we can. If they firmly believe the scientific community, major health organisations and the government to be corrupt or incompetent, no amount of evidence is going to change their minds2. And these leaders of the anti-fluoride groups, and their followers, continue to spread misinformation over social networks at such a massive rate that most won't be able to be effectively disproved.

However, it is possible to reach those who have yet to make up their minds, and to provide people with the skills needed to accurately assess this out-pouring of anti-fluoride misinformation - skills that need to be developed at school:

"It's essential that children gain basic science literacy skills at school - including the ability to assess the validity of websites and other sources of information, and to critically evaluate that information. This is a basic skill for anyone living in the 21st century, regardless of whether they're going on to a career in science." - Dr Alison Campbell, science educator and science communicator

And we can push back in the social media. In July 2013 I created a Facebook page called Making Sense of Fluoride (MSoF), to help people look into the science of fluoridation. The original lay group has now grown to include scientists, skeptics, teachers, health professionals, students and other individuals, all of whom advocate that this significant public health initiative is either introduced or maintained in New Zealand's communities. We are concerned by the mass of misinformation regarding fluoridation, published on the internet by those opposed to this important, effective public health intervention. We try to educate the general public about the lies, misinformation, cherry-picking and soundbites from self-anointed "experts" who can and do blame any negative health issues on community water fluoridation (CWF).

Over the top? Unfortunately not. If you read any of the anti-fluoride internet sites you will see claims that fluoride causes cancer, increases suicide rates, results in skin reactions, makes people complacent, and reduces IQ. In fact, it's even claimed that CWF reduces spiritual powers! Then they have the audacity to say that fluoride does not work for reducing caries.

This is simply incorrect. Fluoridated town supply water contains 0.7-1.0 ppm, enough to help our teeth but not so much that fluorosis is a problem. Nor has it been shown to cause other harmful health effects:

"Fluoride is a normal and natural component of calcium phosphate (apatite) minerals - including those in our bones and teeth. It strengthens the mineral and lowers its solubility. So fluoride's beneficial role in fighting tooth decay is just what we expect from the chemistry. Laboratory experiments as well as epidemiological studies confirm fluoridation of public water supplies is a very effective way of reducing tooth decay for all ages.

"Excessive intake of fluoride (usually from industrial pollution or habitual eating of fluoridated toothpaste) can have negative health effects - as is the case with many beneficial elements. However, the only confirmed negative effects from fluoridation are very mild dental fluorosis in some people. This is only cosmetic and usually only noticeable to a professional dentist.

"It is easy to cherry-pick scientific studies, as opponents of fluoridation do, to argue against the effectiveness and safety of fluoridation. But these selected studies usually refer to high fluoride intake or ignore confounding factors. A critical and intelligent consideration of all the literature supports the current scientific assessment that fluoridation of community water supplies is safe and effective in reducing tooth decay." - Dr Ken Perrott, retired research chemist

In June last year, a small but outspoken anti-fluoride group (many of whom did not even live in the city) managed to convince a Hamilton City Council (HCC) tribunal to remove fluoride from the water supply, using evidence from "experts" such as Paul Connett and Declan Waugh. The response was a strong backlash from both the public and the scientific community.

Hamilton then held a referendum on the issue of CWF, and Hastings and Whakatane also ran referenda. In all three referenda a significant majority of those who voted wanted fluoride retained or reinstated in their water supply.

However, in Hamilton this did not happen. New Health New Zealand (a creation of the New Zealand Health Trust, a political lobby group financed by the 'natural' health industry) took South Taranaki District Council to court, claiming that fluoridation is mass medication and illegal. At this point, HCC said they would wait until the court case was done before deciding their next course of action.

The court case, which cost ratepayers $200,000, ended with a great (and not unexpected) outcome for public health. The High Court ruled that fluoridation of the water supply:

• is not a medical treatment,
• does not violate the right to refuse medicine,
• is not in breach of the Bill of Rights,

and that

• the Council was thoughtful and responsible in making their decision to begin fluoridation,
• and had no obligation to consider "controversial factual issues" (anti-fluoride propaganda)

Unfortunately, New Health NZ will appeal the judgement; more costs to the taxpayer that actually could go towards paying for extra dental care.

We personally contacted the HCC members and helped to reduce some of the misinformation. I had hoped everyone on the council knew how political polling worked but alas we even had a discussion regarding statistics, regression and the margin of error. On 27 March HCC saw reason and voted nine to one in favour of reinstating the fluoride supply.

In a review document3, the National Fluoridation Information Service (NFIS) states that fluoridation is cost-effective for populations of 1000 or more people. Fluoridation costs around 50 cents per person per year. Depending on how large the city is, $1 invested in water fluoridation can save up to $38 in dental treatment4.

New Zealanders need to fight back, challenge the promoters of pseudoscience, and get fluoridation added into more cities around New Zealand.

www.fb.com/fluoridewater

Notes and References

1. www.facebook.com/fluoridewater/posts/ 663124637059217?stream_ref=10
2. This mirrors a recent study of efforts to change the minds of those opposed to vaccination.www.motherjones.com/environment/2014/02/vaccine-denial-psychology-backfire-effect
3. www.rph.org.nz/content/d49e7586-71fe-4503-97d3-1a352f266aaf.cmr
4. www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&list_uids=11474918