Fluoride Action Network

Patterns of fluoridation promotion

By Paul Connett, PhD | September 15, 2002

On the web page of the Fluoride Action Network you will find an interesting article from York County, Maine, titled “Kennebunk dentist leads fight for fluoridation.”

Now, I do not know Lisa Howard, and I am not suggesting that she is lying, however, it is very interesting how her comments and this article as a whole fall into a very neat pattern used by those who promote fluoridation. How often we read about a dentist who appears from out of town, who has practiced elsewhere where the water is fluoridated and the children’s teeth are great, and who is shocked to find the state of children’s teeth in the local unfluoridated town, and then offers the town the “magic bullet” of fluoridation to put things right.

In this case Lisa Howard claims to have practiced in two towns in Minnesota, one fluoridated and the other unfluoridated, and the difference in tooth decay convinced her ” beyond a shadow of a doubt that (fluoride) made a difference.” Well it may have, but should it convince anyone else? It probably will, but should it?

The answer is of course, “No”. What Lisa has produced is what scientists call “anecdotal evidence”. Anecdotal evidence like this might be used as a starting point for some scientific research to validate the observation, but as of itself it wouldn’t convince someone with a good scientific training,  and certainly not “beyond a shadow of a doubt.”

Before one could make a valid comparison between the two communities, one would need to know whether there was a difference in income levels, mineral levels in water and soil, overall quality of diets,  the quality of dental care offered, educational level of parents and so on. There are many variables that go into making good teeth.

What would be interesting for Lisa Howard, and the public she is trying to influence, would be to go to Dr. John Yiamouyiannis’s paper of 1990, in which he analyzed the tooth decay rates obtained by the National Institute of Dental Research (NIDR) in a survey of 84 different communities in the USA in 1986-87. When he lined up the communities in order of their DMFT’s (Decayed Missing and Filled Teeth) for 12-year olds, there was  no relationship with the fluoridation status of the community. If Lisa Howard had been dropped by heliocopter into any  one of these 84 communities she would not have been able to tell whether she was in a fluoridated or non-fluoridated community – according to the science that is.

Now, any pro-fluoridationist reading this piece might satisfy themselves by pointing out that Dr. Y. was a very active anti-fluoridationist, and therefore one cannot necessarily rely on his analysis – maybe he played with the numbers. There is no evidence that he did, but they might use this in an attempt to distract eyes from this important survey conducted by the NIDR. So for the doubters, it is important to add that NIDR scientists Brunelle and Carlos (1990) published their own analysis of this same database. They found very little, if any, difference in tooth decay (although they inflated the significance of their findings in their abstract!). For children (aged 5 -17 years) who had lived all their lives in a fluoridated community, compared to those who had lived their whole lives in a non-fluoridated community, there was a saving of 0.6 tooth surfaces. That is 0.6 tooth surfaces out of a total of 128 tooth surfaces in a child’s mouth. Not only is that very, very small, but the authors didn’t even show that this difference was statistically significant.  Now Lisa Howard, may have a very fine eye, and she may be a very fine dentist, but she would be hard put to recognize an average difference in tooth decay of 0.6 tooth surfaces, when comparing across communities and across the whole age range 5 to 17. In Australia, she would have had an even harder job, because there Spencer et al (1996) report an average difference in DMFS of 0.12 – 0.3 tooth surfaces, between lifelong residence in fluoridated versus non-fluoridated communities.

In the rest of the article we see two other key threads in the pattern of fluoridation promotion:

1) Denigrate the opponents of fluoridation.

“‘It’s a communist plot,’ Howard jokingly said.” This is an old tired joke, and some of us, who have studied the issue very carefully and objectively are getting rather sick of it.

2) Use statements from authority rather than solid argument.

“(T)he American Dental Association has endorsed fluoridation  and the Centers for Disease Control called it one of the ‘great public health achievements of the 20th century.'”

Should Lisa Howard, or those she is attempting to influence, actually read the statement from the CDC on which this quote is based (Mortality and Morbidity Weekly Report, Oct. 22, 1999), she, and they, will get a shock. Firstly, the evidence the CDC author(s) (unknown) use to dismiss health concerns about fluoridation is six years out of date, and secondly, they claim that the fall in tooth decay (for 12-year olds) in the US between the 1960s and the 1990s is directly relatable to the percentage of the population drinking fluoridated water, while ignoring World Health Organization (WHO) figures (available on-line) that show that these same declines, or greater, have been experienced by 12-year olds, over the same period, in most non-fluoridated industrialized countries – i.e. the vast majority of European children. In other words, the author was either incompetent or dishonest.

The problem with relying on US “authorities” in this matter is that the US Public Health Service has been avidly promoting fluoridation since they first endorsed it in 1950 (with little evidence of safety or effectiveness).  Sadly, many of their reviews of fluoridation that they have published since have been written more from the perspective of protecting that policy (and the professional reputations of those who have endorsed it) than protecting the health of US citizens. As far as the credibility of the American Dental Association is concerned, one only has to look at their other favorite toxic, the mercury used in dental amalgams, to see how dubious that is. This association has been telling the world since the mid-nineteenth century that there are no harmful effects of putting mercury amalgams in our mouths.  The ADA may be a nice economic shield for the average dentist to hide behind, with its massive economic and political lobbying power, but it can hardly be relied on to give us an objective analysis of the fluoridation issue.

Does anyone know anyone in Kennebunk, Maine? They need help fast.



Brunelle JA, Carlos JP. (1990). Recent trends in dental caries in U.S. children and the effect of water fluoridation. J. Dent. Res 69(Special edition): 723-727. http://www.fluoridealert.org/brunelle-carlos.htm

CDC report and critique at http://www.fluoridealert.org.cdc.htm

Spencer AJ, et al. (1996). Water Fluoridation in Australia. Community Dental Health. 13(Suppl 2): 27-37.

Yiamouyiannis JA. (1990). Water Fluoridation and Tooth decay: Results from the 1986-87 National Survey of U.S. Schoolchildren. Fluoride. 23: 55-67. http://www.fluoridealert.org/DMFTs.htm

WHO figures displayed graphically at http://www.fluoridealert.org/WHO-DMFT.htm