In his letter of Sept. 10, Dr. Uswak cites five websites to support the erroneous contention that fluoridation of public water supplies has improved health. Websites don’t weigh much beside primary research published in peer-reviewed, credible scientific journals. The latter have shown no substantial lowering of cavities. All of the reports Dr. Uswak cites have been found to be woefully incomplete in the materials reviewed and otherwise biased.
The 2007 report of Health Canada was a preliminary effort and a request for criticism. Yet even when critical scientific studies indicating possible harm from fluoridation were pointed out to the panel, they were not even mentioned in the final report (2009). That panel was composed of six individuals. Four were dentists engaged in promoting fluoridation. Two were in the process of writing a report in favour of fluoridation. Lacking any evidence of safety or effectiveness, the report represents an admission of possible harms and a reliance on the backward position that the harms have not been proven so fluoridation should continue (some have been proven).
The York review is often falsely cited as supporting fluoridation. But that panel of experts in epidemiological investigation found that there is no evidence sufficient to conclude that fluoridation is either safe or effective.
The benefits Dr. Uswak claims are imaginary. There is not one randomized, double-blind, control study of effectiveness published. There is no systematic toxicological study, even though studies of particular adverse conditions are known to be associated with exposure to fluoride in drinking water.
It is true that oral health has improved since the beginning of fluoridation, but countries without fluoridation have seen the same improvements as those with fluoridation. The improvement is clearly a result of other factors, probably better diet and topical treatment such as use of fluoridated toothpaste.
It is commendable that “the Canadian Association of Public Health Dentistry (CAPHD) promotes the use of scientific evidence.” But that use must be critical and smart and complete.
James S. Beck, MD, PhD
Professor Emeritus of Medical Biophysics
University of Calgary