Response FAN

Response by Michael Connett
(FAN Webmaster)
as posted July 6th, 2003 on the Yahoo Fluoride Poisoning Support Group
see also
PFPC Response, July 7, 2003

Hi,

Here's some points I'd like to make in response to PFPC's critique of my article on Basel Switzerland's decision to stop water fluoridation. (See critique at: http://64.177.90.157/pfpc/html/basel.html

The Key Issue

First of all, before I address the specific criticisms of the article, I think it's important to place the emphasis where the emphasis most needs to be placed: namely, that the fluoridation of salt, as the PFPC has thankfully highlighted, is a growing, and frequently overlooked, source of fluoride exposure.

On this note, the PFPC's article serves a *very* useful purpose, as it brings into focus a very important issue (one that, I myself, have not yet paid enough attention to).

I could therefore probably end my response here, as this (the growing exposure to fluoride from salt fluoridation) is, in the largest scheme of things, the most important piece of information to take in from PFPC's article.

My Article

However, being that PFPC also made specific criticisms of my article's accuracy, I will now provide responses to these specific criticisms.

a) 2 Reasons/3 Reasons?

As PFPC notes, the GSK - in its report - provided 3 reasons why it was recommending the end of water fluoridation. I was indeed aware of this fact when I wrote the article (I included all 3 reasons in my initial drafts). However, after reading through the 3 reasons, and after careful consideration, I came to the conclusion that reason #1 and reason #3 were interchangeable; that is, they were stating the same thing, but in different ways.

More specifically:

Reason #1 states that there's no reason for Basel to be the "lone island" in Switzerland, or continental Europe, by fluoridating its water supply. But why? Why was the GSK opposed to a "solo effort" with water fluoridation? They were opposed to a solo effort, not out of some fundamental opposition to "solo efforts", but rather because they believed that other cities in Europe were equally successful at reducing tooth decay without water fluoridation.

To me, this reasoning is the same as that expressed in reason #3, where the GSK states that it could find no studies showing Basel to have a lower tooth decay rate than in neighboring European cities.

In other words, both Reason #1 and Reason #3 are stating that the GSK believes there is no difference between tooth decay rates in Basel versus other comparable European cities.

In my article, therefore, I cut down on what I felt was unnecessary verbage, by distilling the 2 key and most distinct pieces of reasoning contained in the 3-point-list.

My confidence in focusing on these 2 reasons further increased when I directly contacted 2 members (Tobias Studer & the President, Jurg Merz) of the GSK board.

b) "Base-Fluoridation"

Being that PFPC has people in their group who can speak German, I readily concede that they are more knowledgeable about the language interpretation issues at play.

This, in fact, was one of the troubles I ran into when writing the article.

After I accessed a pdf file of the GSK report on the internet, I was eager to read it. Not knowing German, I used an online translation device which translated the article into - admittedly rather crude - english.

This is where the problem arose. And looking back, I confess that I should have exercised a bit more caution. For in the specific quote that the PFPC highlights, I mistakenly assumed that the phrase "Base-Fluoridation" was referring to fluoride exposure in general, which, as PFPC notes, it was not.

For this, I apologize.

(Note: It was due in part to the poor quality of the translation, that I went and contacted 2 members of the GSK board (Tobias Studer & the President, Jurg Merz), to learn first hand from them what their reasons were for rejecting water fluoridation.)

c) GSK's request for Studies

PFPC takes objection with my statement that the GSK called for studies comparing the tooth decay rates in Basel with the tooth decay rates in other Swiss cities.

I think, however, that the PFPC has gone a bit too far with this one. Yes, it is true that the GSK was primarily interested in comparing the effectiveness of water and salt fluoridation. However, to do so, the GSK wanted comparisons between the tooth decay rates of Basel with other comparable Swiss cities (i.e. Zurich & St. Gall). This is stated clearly in the GSK report.

Thus, while it is correct that the GSK wanted comparisons
between salt & water fluoridaton, it is also correct that they wanted comparisons of tooth decay rates between Basel and Zurich/St. Gall. (It is the comparisons between Basel & Zurich/St. Gall that would help provide an approximate sense of the efficacy of water vs. salt fluoridation.)

Thus, I think PFPC's statement that

"The GSK did not ask such thing (comparisons between Basel & Zurich/St. Gall, MC) and should never be quoted as such, really"

is a bit misleading.

d) Tooth decay rates in Switzerland

According to PFPC, "It is further untrue that most other Swiss cities have very low rates of tooth decay."

Unless Zurich is a remarkable exception (note: the World Health Organization cites Zurich tooth decay rates to represent Swiss tooth decay rates - see: http://www.whocollab.od.mah.se/euro.html ), the tooth decay rates in Switzerland are quite low in relation to what is considered a success here in the US.

For instance, according to a recent study (published in 2003), the average DMFT of 12-14 year old children in Zurich in the year 2000, was 0.9 - 1.27 respectively. See:
               http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12708326&dopt=Abs tract

To put this in perspective, the US NIDR's 1986-87 survey of tooth decay in US children, found an average of roughly 2.0 DMFT in 12 year old children. See: http://www.fluoridealert.org/DMFTs.htm

While the NIDR's data is now a bit out of date, the fact that the NIDR's findings were seen as evidence of a major public health success in reducing tooth decay, coupled with the fact that Zurich's tooth decay rates in 2000 were 50% lower, provides evidence that Switzerland's tooth decay rates are - in the western context - pretty good.

I'd be interested, however, in any data that PFPC may have which shows that it is "untrue" that Swiss cities have low rates of tooth decay. I'd also be interested in the yardstick they use to gauge whether tooth decay rates there are high or low. (The fact that tooth decay rates have increased there in the 1990s - a trend which is present in almost every western country - does not mean that decay rates are high, at least not yet.)

e) Definition of "Unfluoridated"

A point made throughout PFPC's critique is that my article, and the FAN site in general, is incorrect when it states that Basel has stopped "fluoridation", or that western Europe is 98% "unfluoridated."

I have mixed views on this point. On one hand, I think - as noted earlier - that it is important that we - FAN & all groups working on fluoride - start focusing more on salt fluoridation, and that it is good that PFPC has brought the issue to the fore.

However, on the other hand, I think it is clear both in the Basel article and on the FAN site in general, that when we speak of Basel & Europe rejecting "fluoridation" we are referring to "water fluoridation." For instance, in regards to the Basel article, it is clear from the outset that it is "water fluoridation" which is being  referred to. This is evident from the

a) title
b) first sentence
c) summation sentence of introduction

all of which specify "water fluoridation" as being the policy which has been rejected.

That said, I do think I could have provided a more critical spotlight on Basel's decision to allow salt fluoridation. While I refer to the GSK's preference for fluoridated salt over fluoridated water, I do concede that I didn't discuss this aspect in the depth that it deserves.

Thus, while I think the Basel article is going to provide a welcome headache to water fluoridation proponents in the US, England, Australia, and elsewhere, I do think I could improve the article by including a link to an article discussing the problems of salt fluoridation. On that note, perhaps if the PFPC, or someone else, is interested, they could write such an article and I could provide a link to it from the Basel article. I would just ask that the article stay focused on the problems with salt fluoridation, and not on inter-group disagreements.

In the meantime, I will begin trying to incorporate more
information onto the FAN site concerning salt fluoridation. As to the "Sources of Fluoride Exposure" page, I do concede that it is geared more towards a North American audience, and that this is problematic considering the international realities of fluoride exposure. That said, I will therefore seek to improve & remedy as soon as I can.

If anyone has any suggestions or questions on this, or anything else on the FAN website, please feel free to contact me, either by email or phone.

Sincerely,

Michael Connett
Web Manager
Fluoride Action Network
http://www.fluoridealert.org
802-859-3363