[1960] The Fluoridations Fallacy by R.F. Boyd Gaudin, B.Sc., A.C.G.I., A.M.I.C.E.
[1960] The Fluoridations Fallacy by R.F. Boyd Gaudin, B.Sc., A.C.G.I., A.M.I.C.E. The Fluoridation Fallacy A Commentary on Official Statements Which support the Fluoridation of Public Water Supplies by R. F. BOYD GAUDIN B.Sc, A.C.G.I., A.M.I.C.E. "Nothing is so firmly believed as that of which we know least."—Montaigne. THE G. W. DANIEL COMPANY LIMITED ASHINGDON, ROCHFORD, ESSEX, ENGLAND First published 1961 © COPYRIGHT R. F. Boyd Gaudin 1960 Acknowledgments and Recommendations Foreword PART I1. The Case for Fluoridation 2. The Ethical Aspect (i) The Ethical Blindness of Proponents (ii) Chlorine and Fluorine (iii) Water supplies "deficient" in Fluorine (iv) Fluorine is "harmless" and "beneficial" 3. Does Fluorine always reduce Dental Caries? (i) Increase in Dental Caries in areas where the water is Artificially Fluoridated (ii) Decrease in Dental Caries where unfluoridated water is used (iii) Increase in Dental Caries where naturally fluoridated water is used 4. How "Safe" is Fluoridation? . . . (i) Evidence of Acute Poisoning (ii) Evidence of Chronic Poisoning (iii) Reports of Injury to Health 5. Comments on Other Statements made by the Promoters of Fluoridation (i) Fluorine in Tooth Substance is proportional to water drunk (ii) "Fluorine appears in water in exactly the same state as does the fluorine derived from natural sources" (iii) "A recent study carried out in Russia goes so far as to claim that people in high fluoride areas live longer and enjoy better health than those in low fluoride areas" (iv) "The cost is only 4d. per head per year" (v) Fluoridation of the Public Water Supply is not Mass Medication and the liberty of the subject is in no way impaired. Fluorine is not a drug (vi) Mottled enamel due to low fluorine concentration up to 2 parts per million actually "improves" the appearance of the teeth (vii) The Pseudo-scientific Propaganda using the technique of the "big lie" PART II 6. An Examination of some Items of the North American Fluoridation Trials and an Assessment of their Reliability (i) Introduction (ii) Water Supply Analyses not stated (iii) Comparable waters become contrasting waters (iv) Delay in tooth eruption (v) Variations in the incidence of caries in a "control" city (vi) Variations in sample size (vii) Variations in method of Assessment (viii) Unreliability of the assessment of dental caries rates (ix) Contrasting Conclusions: (A) Those of Dr. Philip R. N. Sutton (B) „ Dr. Douw G. Steyn. (C) Report of the New Zealand Commission on Fluoridation with Comments (D) „ the World Health Organization Expert Committee on Fluoridation with Comments 7. A Glut makes a Quandary (i) Turn a Glut into an Asset (ii) Discreditable Methods of Promotion 8. The Growth and Signs of Decline of Fluoridation (i) The Flow and Ebb in America (ii) Rejections of Fluoridation elsewhere (iii) A New Zealand opinion on its Commission on Fluoridation (iv) The Expert Committee on Water Fluoridation of The World Health OrganizationPART III Summary and Conclusions References Appendix Bibliography . . . . . . Acknowledgments and Recommendations I would like to express my appreciation of the help and advice given by The Rt. Hon. The Lord Douglas of Barloch, k.c.m.g., and Mrs. W. M. Sykes who are respectively President and Hon. Secretary of the National Pure Water Association. I would also like to thank my neighbour, Lt.-Col. E. H. Casper, t.d., for his help and encouragement, and my wife for reading through the proofs. Permission to quote at length from the undermentioned works, given by their authors or publishers is gratefully acknowledged. They contain an exceptional amount of vital information on this subject of fluoridation, without which this essay might not have been attempted. The works are: Fluoridation: Errors and Omissions in Experimental Trials, 2nd. ed. 1960 by Philip R. N. Sutton, D.D.SC. (Mel.). (Melbourne University Press and Cambridge University Press, London). The American Fluoridation Experiment. By F. B. Exner M.D., G. L. Waldbott, M.D., and James Rorty, Editor. (The Devin-Adair Company, New York). The Problem of Dental Caries and the Fluoridation of Public Water Supplies. By Douw G. Steyn, B.SC, DR.MED.VET. (Pharmacol.), D.V.SC.(Tox.), (Voortrekkers Beperk, Voorwaarts, Johannesburg). All readers who wish to obtain further information on this subject are recommended to procure copies as works of reference. Before closing I should like to call the attention of readers, to the National Pure Water Association which was formed in March 1960, appropriately enough, at a meeting held in the Moses Room of The House of Lords. The objects are to promote the protection of water supplies from all forms of contamination and to oppose the use of Public Water Supplies for the purpose of mass medication. Readers are invited to join the Association by sending ten shillings annual subscription to the Hon. Secretary, National Pure Water Association, Thorpe End, Almondsbury, Huddersfield. Alternatively, should they require further particulars in the first place they should write and enclose one shilling to cover cost and postage. R. F. Boyd Gaudin. Farnham, Surrey. September 1961 Foreword It is understandable that many Medical Officers of Health in making out a case for fluoridation of a public water supply would rely on what would seem to be the most up-to-date and authoritative reports on the subject. It would be quite exeptional for them to have any first-hand experience in the matter. Hence to base their case on the findings of such bodies the Expert Committee on Water Fluoridation published by the World Health Organization in 1958 and those of The Commission of Inquiry (New Zealand) on the Fluoridation of Public Water Supplies published in 1957 would seem to be wise. But the fluoridation of a public water supply is unethical and morally wrong and on these grounds alone it should be repudiated. One purpose of this essay is to convince the reader that this is so. The other is to show that these reports are unreliable. They give neither conclusive proof that the fluoridation of water supplies will always give the results claimed, nor that it is without grave dangers to bodily health. This is not to say that, in some cases, fluoride administered to a child under careful medical supervision might not prove beneficial. If a child should react unfavourably in regard to its general health the doses can be stopped or modified. In such cases the doctor-patient relationship is being maintained and each patient treated as an individual. This is the very antithesis of the "hit and miss" method of the fluoridation of the public water supply. Even so, bearing in mind the hazards which this reveals, it would appear to be far wiser to teach all children strict oral hygiene, reduce the consumption of caries-producing food and, conversely, encourage the consumption of foods which have not got this unfortunate properly. PART I The Case for Fluoridation The following paragraphs set out the usual arguments used by Medical Officers of Health in favour of adding fluorine to the public water supply when, in their opinion, there is a deficiency. (i) The increase in dental caries in children is alarming and it is urgent that some way be found to reduce its incidence. (ii) There are several major causes of this increase. Too much sugar, starchy foods, soft drinks and, in general prepared foods which fail to give the teeth enough work to do. They are acid or acid forming and so the teeth are attacked. In addition there is bad oral hygiene. (iii) As it is difficult to change habits immediately some other remedy must be sought. It has been found that where the element fluorine is naturally present in the water supply in amounts of one part per million and over, there is less dental decay. The teeth are also stronger and if the fluorine content does not exceed two parts per million the appearance of the teeth is actually improved. (iv) According to one M.O.H. "all" water contains fluorine, but while this may be doubted, it is known that many do. "The amount of fluorine found in the tooth substance depends directly on the quantity present in the water drunk by the mother and child during the tooth's formation and growth" (1). (v) Fluorine is one of the trace elements necessary to induce good health; it is, in fact, a nutrient and no harm whatsoever can come to anybody drinking water containing an artificial fluoride, such as sodium fluoride, in the water, provided the total of fluorine does not exceed 1 to 1.5 parts per million. "The cost is negligible and the fluorine appears in the water in exactly the same state as does the fluorine derived from natural sources". "Dental decay is reduced in infants and children to less than half its former level . . ."(1). "A recent study carried out in Russia goes so far as to claim that people in high fluoride areas live longer and enjoy better health than those in low fluoride areas" ( (1) and Appendix (a) ). (vi) Just as chlorine is added to the water to safeguard against the spread of an epidemic, fluorine can now be a further means of safeguarding health by reducing the incidence of dental caries and secondary diseases that can be fostered by bad teeth. "The cost is only 4d. per head per year" (1). (vii) As the addition of fluorine to the public water supply is perfectly safe, no one can logically object to the proposal and consequently the liberty of the individual is in no way infringed. (viii) The foregoing information is based upon a vast amount of research and experiment carried out, chiefly, in North America. This information has been examined and reviewed by several expert bodies set up for that purpose. Two may be mentioned. The New Zealand Commission of Inquiry on the Fluoridation of Public Water Supplies whose report was published in 1957 and the World Health Organization Expert Committee on Water Fluoridation who published their report in 1958. Both these bodies commented very favourably on the work carried out and endorsed fluoridation. (ix) In spite of the findings of these authorities and others equally competent to assess the position there is, as always, "a small vocal minority" who "look for arguments that they might use against fluoridation". "In quite a short time they put together a library of pseudo-scientific propaganda which contains a substantial number of frightening statements that are, without exception, demonstrably false". "They have used the technique of the 'big lie' again and again. Unfortunately the effect of their publications on the uninstructed lay mind can have much the same effect as did the writings of Streicher on the German nation"(1). In view of the findings of the authorities mentioned, you will doubtless discount this 'big lie' propaganda and agree to the facts here presented. (x) This short statement of facts should enable the public to appreciate the great advantages arising from fluoridation of the public water supplies. It is a simple, harmless and inexpensive means of improving the public health and reducing dental caries in children by at least 50%, and it should be adopted without delay. The author of this work has tried to make a fair statement of the kind of information given by the proponents of fluoridation, and will now proceed to examine the matter in some detail. 2. The Ethical Aspect In the Foreword, the paramount importance of the ethical aspect of these proposals was mentioned, so that before the main argument for fluoridation is considered in some detail, it seems to be absolutely necessary to look into the morality of the proposition. (i) The Ethical Blindness of Proponents. Our Western Civilization is derived from Christian teaching. Our Common Law, alas often over-ridden in modern times, is derived from that source. The Christian concept makes it imperative that everybody should have freedom consistent with like freedom in others; but licence should never be tolerated. Arising out of this conception, it follows that no public authority has the right to misuse its power to interfere with the individual, provided the latter always conforms to the Christian Ethic. An individual suffering from dental caries is not a source of danger to others, so that, if he objects to drinking flouridated water, he should not be virtually compelled to do so. On the other hand, if he has smallpox or is the innocent carrier of some infectious disease, such as scarlet fever, then he must suffer that loss of freedom to safeguard the freedom of others. The principle is quite simple. No one then should have his body experimented on without his prior consent. This is completely ignored when public water supplies are fluoridated. Millions of people have been experimented on against their will. Public Authorities have ignored the basic principle enunciated at the Nuremberg Trials in 1947 when it was decreed that "the voluntary consent of the human subject is absolutely essential" before any treatment or experiments can be performed on him. In fluoridation then, you have an authoritarian concept put in practice by the very people who, as likely as not, took part in the fight for the "Free World"! (ii) Chlorine and Fluorine. ARGUMENT: The ethical blindness just discussed is illustrated when proponents argue that as chloride is put into the water supply to kill harmful bacteria which might cause an epidemic, so why not fluorine to reduce caries? Both are preventive measures. REPLY: There are two different principles involved. A public water authority is under an implied contract to purify the natural water and deliver it to the consumer, inter alia, free from harmful bacteria which might cause an epidemic. The use of sundry chemicals for this purpose, including chlorine, is necessary and ethical. They are not added or used to produce any positive or negative effect (i.e. preventive medicine) on the human organism. As such they do not constitute drugs. Fluorine, on the other hand, is not added to the water supply to purify it, but to cause an alteration, primarily the tooth structure, in the human body. In one case chemicals, chlorine being one, are used to ensure that the water is pure and safe to drink. In the other, fluorine is added to treat the human body and it is no part of its function to purify water. (iii) Water supplies "deficient" in Fluorine. ARGUMENT: Having decided that water having less than i to i \ parts per million fluorine is "deficient" in fluorine, then to add to this deficient water sufficient fluoride to bring the fluorine content up to this optimum amount is not "mass medication". REPLY: The amount of the extra fluoride added is not the point. It is the violation of a basic ethical principle that matters. To add any material whatever to the public water supply to treat the mass of the population is no other than "mass medication". To say otherwise is a sophism. (Incidentally New Zealand which has an area comparable to Great Britain and Ireland, has no water supplies serving the public containing more than 0.50 parts per million fluorine and the average of 109 supplies is less than 0.15 parts per million. Report New Zealand Commission). (iv) Fluorine is "harmless" and "beneficial". ARGUMENT: There is another argument which states that fluorine in the proportions suggested is quite harmless and everybody will certainly benefit. Fluourine is, in fact, a necessary nutrient and not a drug. How then can it be unethical to do good? REPLY: The point is not whether the drug fluorine (in this context) is harmless or not, but whether its use in this way is in accordance with established medical practice. This method must, of necessity, ignore the doctor-patient relationship which is implicit in any medical qualification and legal registration. Sir Stanton Hicks in a letter to the "Medical Journal of Australia", Vol. 2, p. 156-157, said; "I submit that the medication of a whole population variable in individual response, regardless of individual age, state of teeth, of general health, rate of consumption of water, and so on, is quite unscientific and unethical, and that the passive acceptance of the right of a government or municipal authority to implement such medication through its water supply, is to sacrifice a fundamental principle of medical practice". Sir Stanton goes on to say; "Once, however, the principle of personal responsibility is abandoned, why not iodine in the water supply in goitrous regions, or aspirin for the mass Australian headache? This is the very essence of authoritarian 'progress' . . .". Unfortunately, authoritarianism is only too well established. Iron and chalk in bread, iodine in salt and so on. Often we are quite unaware of what we are eating. William Cavendish in The Citizen, Gloucester, on 20th April 1960 in an article called "Go Steady with Those Slimming Tablets!" says: "There is strong scientific evidence that it will soon be possible to prevent much illness by administering the proper drugs in 'invisible' form, just as some towns already add fluoride to their water supplies to reduce dental decay. Is not this kind of thing very dangerous? Does it not put too much power into the hands of medical administrators in treating whole populations as if they were cattle who must drink and eat what they decree ? Water is needed by everyone. It is time we demanded pure water always and not water, doctored, to the whims of these people. CONCLUSION The inevitable conclusion, then, is that on ethical grounds alone, the fluoridation of water supplies is absolutely unjustified. 3. Does Fluorine always reduce Dental Caries ? The claim that dental decay in children and infants is reduced to less than half its former level seems very remarkable. With so many variables is this really possible? The Expert Committee of the World Health Organization in their Report published in 1958 says that "hundreds of controlled fluoridation programmes ..." are being carried out (page 20, para. 6), but it quotes only from the … truncated (76,174 more characters in archive)