The first-ever independent review of the California Oral Health Needs Assessment of 1993-94, was delivered to the City of Escondido on Tuesday, February 1st. The analysis of the Needs Assessment was performed by the internationally renowned Senes Oak Ridge Inc., Center for Risk Assessment in Tennessee.

The repeated message of the 25 page review was that the results of the California study as reported by Pollick et al, (1994), and subsequent brochures, do not support its primary conclusion, namely that increased fluoridation of public water supplies and increased supplementation of fluoride in non fluoridated areas are warranted.

The City of Escondido contracted with Senes Oak Ridge to perform the review last year after the authors of the study revealed at an Escondido council meeting that they used the unpublished study to lobby Legislators’ votes for the passage of AB733, the 1995 state mandate calling for 167 cities and water districts to add fluoride to their water.

While noting it was not intended to be an exhaustive review, the reviewers concentrated on the issues that were expected to be most important: study design, sampling and data collection methods, and analysis of the results __ whether the results follow logically from the data.

Summing up the predominant criticism of the study, the reviewers explained, “In other words, the major endpoint of importance (caries prevalence) has not been analyzed with respect to some of the most important factors assumed to affect it.

“It is not correct, for example, to conclude that children in fluoridated areas have fewer cavities per child when (a) the actual individual fluoride exposures have not been evaluated, and (b) factors that might have contributed to the high caries experience of a few children, or to the low caries experience of many children, have not been fully explored.”

Escondido City Council Member Marie Waldron states, “This is a classic example of the manipulation of science to prove a case. This study in effect compares non-poor children in fluoridated communities, with protective sealants on their teeth, against poor children in Head Start programs in non fluoridated communities, with no sealants on their teeth. Who are we kidding here?

“Like a lot of other people, I don’t want to have to read through volumes of statistical analysis in an area with which I am not familiar. But, the promoters of fluoridation wouldn’t have put this obviously skewed study in front of us if they had the science they claimed to have. They told us we didn’t need to look at the science, that we should just trust them,” said Waldron.

* The study at no time attempts to quantify a deficiency in total fluoride exposure of children from all sources, either on an individual basis or on an average basis by regional fluoridation status.

* No consideration is given to variations in exposure to dietary items such as fluoride-containing sodas, fruit juices, cereals, white grape juice, teas; and fluoride pesticide residues on produce such as lettuce, tomatoes, cabbage and raisins; or even bottled water and use of fluoridated toothpaste.

* The study design clearly states that the study sample is not representative of all of California’s children; nor representative with respect to randomness or distribution across races, economic levels, geographic regions, etc.; nor collected blindly, without prior knowledge of a child’s fluoridation status.

In answer to “specific concerns” on possible political motivations behind the Needs Assessment, the reviewers suggested that these should be the concern of the funding agency or the state legislature.

The subject of these concerns included the sole-source contract being awarded to the Dental Health Foundation whose founding purpose was to promote the fluoridation of California, possible conflict of interest of an author of the Needs Assessment who was simultaneously employed by the State, and joint collaboration by the State and the Contractor, as participating members of the CA Fluoridation Task Force.

“This Oral Health Needs Assessment was an intentionally non-published, non peer-reviewed, expensive study that they expected not one of us without a background in science would want to read. So they offered summarizing bullet points and glossy brochures to our Council, and evidently to many others throughout the entire state, as proof that we should convert our precious water supply into a delivery system for special interests, forcing those who can not afford bottled water to drink industrial-waste fluoride every day of their lives.”

Not here!,” said Waldron.

Other selected past or present government clients served by Senes Oak Ridge:

Agency for Toxic Substances and Disease Registry (ATSDR)
Centers for Disease Control and Prevention (CDC)
National Academy of Sciences (NAS)
National Cancer Institute
National Oceanographic & Atmospheric Administration (NOAA)
State of Colorado
State of Idaho
State of Kentucky
State of Tennessee
U.S. Army Corps of Engineers
U.S. Department of Energy
U.S. Department of Justice
U.S. Environmental Protection Agency
U.S. National Park Service
U.S. Nuclear Regulatory Commission
World Health Organization

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