Let me share with you my own experience with the issue of fluoridation of the water supply here in Portland. I plan to vote “No,” but I’ve had quite a few conversations on the matter in the last few weeks (which is probably true for any political activist in this city today, on either side of the issue).
Early in the month the Eastside Democratic Club, which I serve as secretary, held a debate on the advisability of fluoridation. Dr. Philip Wu, a member of the board of directors of Upstream Public Health — the group which successfully lobbied the City Council to adopt fluoridation without any hearing or public process in the first place — argued in favor, with Rick North, of the executive committee of Clean Water Portland — the folks whose campaign I spent the afternoon today helping.
What was striking about the debate wasn’t the content: Wu said that fluoridation is safe and effective; North doubted it. The unusual thing was, that while Rick North cited one scientific study after another, Philip Wu repeatedly asked his audience to accept the word of experts — he cited not one scientific study while maintaining the evidence in favor of his view was “massive.”
It was embarrassing. Either Dr Wu was quite unprepared to discuss the issue, or he so underrated the audience that he was unready to trust it to understand scientific evidence.
Something similar happened at the fluoridation debate on April 10 sponsored by the Multnomah County Democratic Party. One consequence of the poor showing by the pro-fluoride people was, that when I started volunteer work this noon I was standing next to K.C. Hanson, the chair of the Multnomah Democratic Party.
My wife doesn’t agree, by the way. You see, when she was young, she had quite a few cavities (with the unfluoridated, Portland water): as a youngster of eight years of age, she had to have a root canal done. Since my two teenaged boys were toddlers, they’ve had fluoride drops and have never had a cavity. It’s very hard to change someone’s mind when they’ve had that experience. The front of our house has a No on Fluoride sign, that I put up, and three Yes on Fluoride signs posted by my wife — one for her, and two more for the boys.
My older son’s science teacher spoke to me this month (it was a highly unusual interview: he wanted to meet me, since my son was doing so well — but then he indicated he knew quite a bit about me, including my running for office twice and even the letters I’ve written to the editor of the Oregonian), and in the course of discussion I said I opposed the fluoridation of Portland’s water, for the reason I just gave, that the proponents never seem to produce any of the “massive” scientific studies showing safety or effectiveness. He assured me that I was mistaken and made me promise to go to the pro-fluoride website, Healthy Kids, Healthy Portland. I did, and found no reference to any specific scientific study of safety or effectiveness — just the assertion that there’s lots of them. Try it yourself.
Why would one question a consensus among professionals, especially health professionals? Aren’t they more knowledgeable? Perhaps not. From the New York Times op-ed page of 2 February of this year, there’s this:
The best evidence shows that half of all the clinical trials ever conducted and completed on the treatments in use today have never been published in academic journals. Trials with positive or flattering results, unsurprisingly, are about twice as likely to be published — and this is true for both academic research and industry studies . . . .
This problem has been documented for three decades, and many in the [healthcare] industry now claim it has been fixed. But every intervention has been full of loopholes, none has been competently implemented, and, lastly, with no routine public audit, flows have taken years to emerge.
The Food and Drug Administration Amendment Act of 2007 is the most widely cited fix. It required that new clinical trials conducted in the US post summaries of their results at clinical trials.gov within a year of completion, or face a fine of $10,000 per day. But in 2012, the British Medical Journal published the first open audit of the process, with found that four out of five trials covered by the legislation had ignored the reporting requirements. Amazingly, no fine has yet been levied. [emphasis added — MM]
No scientific dispute should be decided on trust, in the first place; but doesn’t that report tend to erode the trust you have in a purported consensus of professional groups? It does mine.
The controversy has not been completely without exchanges on the science — here is one, from the Lund Report. You can see that the anti-fluoridation folks, in the comments, can address the scientific results cited in circumstantial detail. The best option at the moment, surely, is to do no harm by voting No.
At least, so I thought when I canvassed Pioneer Courthouse Square today on behalf of Clean Water Portland. Many of the people I met weren’t from the United States at all; most were not from Portland (I didn’t even try people who were looking at a map). But of the ones who were, most of them were planning to vote against fluoridation. I did meet a pro-fluoridation dentist, and although he did not conceal a dismissive attitude toward the whole thing, his attitude did not put me off, since I myself have been taxed with impatience in the past.
He asked me if I knew the chemical similarities between fluorine and chlorine. I said I did (they’re both highly electronegative, next to the noble gases in the periodic table). Then, he said, why is it standard, unobjectionable practice to add chlorine, a known poison, to water in small amounts, but dangerous to add small amounts of fluorine?
(He also claimed that fluorine is the 13th most abundant terrestrial element. I told him I doubted that, but he reiterated it, with emphasis. As soon as I got home, I checked: it’s 23rd in abundance — scroll down to “Earth’s bulk elemental abundance” and open the table by clicking “show”. So at least in one point, the gentleman was mistaken, but that does not affect his argument with respect to chlorine.)
I must admit, I had no answer. Nor did the co-ordinator at Clean Water Portland have a substantive reply when I shared the thought with her upon my return to headquarters: she rolled her eyes — I guess she’d heard it before — and said that one was added to water to make it safe to drink, and the other was added to improve people’s health.
Well, that’s a distinction without a difference. Poison doesn’t care which motive moved you to add it to water. We make water safe to drink by killing living organisms, and it’s a living organism which rots our teeth. Adding small amounts of poison, in other words, can be more of a benefit than it is a danger. The reason chlorine is acceptable is because the danger of unchlorinated water is simply orders of magnitude greater than the danger, whatever it is, of unfluoridated water.
I’ll be voting No. But if the pro-flouoridation people had a presentation with persuasive evidence of safety and efficacy, I’d vote Yes.